Essay Sample on Screening Mammography: Reducing Mortality Among African American Women Aged 40+

Introduction

Studies have shown that screening mammography has the capability of decreasing breast cancer and the mortality of cervical cancer among women aged 40 years or older. However, despite many health programs' implementation to ensure at least all African American women aged 40 years and older adhere themselves for a free screening, most women under that age group remain unscreened. Mortality among that age group can only be reduced by following all screening guidelines that have already been implemented and the screening to be conducted regularly (Weston et al., 2018). Although the data shows an increase in mammography over the last decade, many African American women aging 40 years and older have not yet presented themselves for mammography over the last 12 months.

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Based on recent studies, telehealth visits tend to be the best approach that should be implemented while promoting mammography compared to the usual reminder letter. That is because it improves patient engagement with remote monitoring. The decreasing rate of the African American women presenting themselves for mammography has resulted in the implementation of value-based reimbursement approaches that would increase the number of women engaging themselves in self-care. Telehealth visits tend to be more beneficial than the usual reminder letter since it helps expand access to care while helping the health care system reach patients. Statistics show that most women suffering from either breast or cervical cancer that require mammography are from the rural areas hence telehealth visits playing a significant role in reaching rural areas and expanding its services to areas that are not under the normal care delivery systems.

In most of the prospective observational studies that were previously conducted, they show that most African American women aged 40 years and older who had initially been advised by their respective doctors to obtain mammography. The whole process was considered to be inconvenient due to the failure of obtaining the test. Other studies have cited other significant reasons that may have failed to attend screening mammography were adherence barriers (Champion et al., 2020). Many researchers have suggested that increasing the convenience of screening mammography, which can be done through the telehealth visits rather than the usual reminder letter, can play a great role in increasing the number of African American women aged 40 years and older. Therefore, the paper will discuss how the telehealth visit helps address barriers causing a decrease in the mammography adherence rate of the African American women aged 40 years and older that received a mammogram in the past 12 months compared to the usual reminder letter.

Methods

In order to find the best peer-reviewed articles for the paper, it was important for the articles to be measured through well-defined criteria that reflect the specific needs addressed. One of the key methods that were used in the selection of the articles was the scientific rigor. That included identifying the purpose of the research conducted by each article, their application of design and methodology, how the data has been analyzed, its results, and eventually, the conclusion. The marking of all tables and figures was also considered during the articles' selection to ensure they were appropriate for the data required in the research study.

Another significant method that was considered in selecting the articles was their editorial quality, which plays a great role in providing a clue about each journal's quality. Considering whether there are poor grammar cases, the presence of punctuation errors, and many misspellings is a clear indication of an article with poor editorial quality. While analyzing the editorial quality, it was as well important to read through their titles and abstracts, which were used to reveal the article's editorial quality. Coming across any title or abstract required to be read twice was considered a warning sign of not using such articles.

Considering the articles' ethics was another criterion used in choosing the articles for the research study. An article selected for the research study had to include the internal review board approval, the possibility of any conflicts of interest, and many other ethical considerations. The journals selected to the user in the research study had to include the information as to ethics on the journal website and how the respective authors were expected to address such issues. The journal reputation was another consideration which included the publisher of the respective journal, their aim, and mission statement. Most importantly, the sponsoring society towards the publication of each article resulted in strong credence towards using such articles in the case study since they proved to be quality journals. The journals that failed to such criteria were never included in the research study.

Literature Synthesis, Part A

The article “An RCT to increase breast and colorectal cancer screening” by Champion, V. L., et al. (2020) aims to provide the necessary interventions that can help increase the simultaneous care for women suffering breast and colon cancer, which includes screening mammography. The authors use a quantitative research method to collect data that was analyzed in 2018. The women who received mammography through the telehealth seemed to be much different from those who received screening through the usual care. The conclusion of the study supports the PICOT of the research paper by emphasizing the importance of women obtaining screenings and an increase in receipt of both tests.

The article, “Patient navigation to improve cancer screening in underserved populations: reported experiences, opportunities, and challenges” by Neal, C. D., et al. (2018), explores some of the possible causes of barriers to navigating the programs implemented to deal with breast cancer screening. The authors use quantitative research method to identify how the African American women experience challenges in accessing screening mammography. The article supports the PICOT by indicating that implementing the telehealth program can help overcome some of the most significant barriers to care.

The article, “Role of Breast Imaging Radiologists as Advocates for Screening Mammography” by Omofoye, T. S., & Parikh, J. R. (2020) advocates for screening mammography. It supports the idea that screening mammography has the capability of reducing mortality from cancer. The authors develop a template which they use while promoting screening among the breast imaging team. The research findings satisfy the mandate for radiologists to implement increased value to health care through screening mammography. It supports the PICOT by emphasizing the implementation of the guidelines to be followed, such as telehealth, which can significantly reduce such mortalities.

The article, “The use of cancer-specific patient-centered technologies among underserved populations in the United States: systematic review” by Tarver & Haggstrom (2019), aims at offering description over the use of cancer-specific patient-centered technologies among some of the underserved populations, especially the African American women. The method used in the study is the computer-based search, which was based on various academic databases. The study's conclusion supports the PICOT of the research paper. It indicates the use of patient-centered technology such as telehealth can help improve the underserved population's care.

The article "Improving cancer screening for underserved women through an FNP student-led clinic” by Weston, C. et al. (2018) aimed to increase access to screening mammography for underserved women, especially African American women. The research study used qualitative surveys while providing collaborative clinical experiences for most cancer patients. The paper's conclusion indicates that most of its participants suffering from either breast or cervical cancer preferred screening mammography. The research study is connected to the PICOT by emphasizing innovative approaches to improve screening for low-income women.

Literature Synthesis, Part B

A limitation in Weston's article is that it has constraints on the research design, affecting the findings. Nevertheless, all the authors fail to discuss their articles' limitations since it may undermine their research value. However, most of them are evident within their research studies like Tarver's and Haggstrom's article, where there is sampling bias. There exist a common controversy among all articles since they present a matter of prolonged public debate. The issue addressed by the article contradicts the public opinion, where the general public assumes that all populations have had equal access to screening mammography. The article share similarity of presenting an opinion that contradicts that of the general public. Unlike the public, which tends to assume that all access care methods are effectively the same, the articles tend to favor the telehealth that the usual reminder letter while accessing mammography. A notable difference exists between Tarver's and Weston's articles, where Tarver emphasizes better technologies among some of the underserved populations. In contrast, Weston's article focuses on improving the already existing cancer screening mechanisms.

Areas of Further Study

One of the most notable evidence from all articles is that there is a particular group of people in the US that continues to be discriminated against while accessing screening mammography, which is African American women. What is unknown is whether telehealth visits have been effectively implemented in all areas. What requires further study is how effective the telehealth visits have impacted the rate at which African American women are being screened for breast cancer.

References

Champion, V. L., Christy, S. M., Rakowski, W., Lairson, D. R., Monahan, P. O., Gathirua-Mwangi, W. G., ... & Rawl, S. M. (2020). An RCT to Increase Breast and Colorectal Cancer Screening. American journal of preventive medicine, 59(2), e69-e78. https://www.sciencedirect.com/science/article/pii/S0749379720301495

Neal, C. D., Weaver, D. T., Raphel, T. J., Lietz, A. P., Flores, E. J., Percac-Lima, S., ... & Pandharipande, P. V. (2018). Patient navigation to improve cancer screening in underserved populations: reported experiences, opportunities, and challenges. Journal of the American College of Radiology, 15(11), 1565-1572. https://www.sciencedirect.com/science/article/pii/S1546144018303193

Omofoye, T. S., & Parikh, J. R. (2020). Role of Breast Imaging Radiologists as Advocates for Screening Mammography. Journal of Breast Imaging, 2(3), 259-263. https://academic.oup.com/jbi/article-abstract/2/3/259/5818531

Tarver, W. L., & Haggstrom, D. A. (2019). The use of cancer-specific patient-centered technologies among underserved populations in the United States: a systematic review. Journal of medical Internet research, 21(4), e10256. https://www.jmir.org/2019/4/e10256

Weston, C., Page, R., Jones-Schubart, K., & Akinlotan, M. (2018). Improving cancer screening for underserved women through an FNP student-led clinic. The Journal for Nurse Practitioners, 14(5), e101-e104. https://www.sciencedirect.com/science/article/pii/S1555415518300813