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Interventions to Reduce Healthcare Disparities in Cancer Screening Among Minority Adults: a Systematic Review

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Abstract

Background

Racial minority populations face an increased burden relative to cancer interventions. Compared with Caucasians, the cancer screening rate is substantially lower among African American, Asian American, Latinx American, and American Indian/Alaska Native populations. Barriers such as low health literacy, lack of health insurance, and miscommunication between patients and providers have been identified as important factors that result in low screening rates among minority adults. This study was designed to identify interventions targeting racial minority adults 40 years of age or older that were effective in increasing cancer screening uptake rates.

Methods

A systematic review of articles published in and after January 2009 was conducted using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Twenty-six published studies of cancer screening intervention tested with minority adults were identified through the searches of CINAHL, Global Health, PsycINFO, PubMed, and Scopus databases.

Results

Thirteen (50%) of the studies utilized lay community health workers to increase cancer awareness and knowledge and to encourage screening. These methods took place over the telephone, at community education sessions, or within the context of personalized patient navigation support. The intervention programs utilized culturally relevant materials as well as spoken and written information in the targeted population’s native language. Various intervention designs resulted in statistically significant increases in cancer screening adherence. However, we found no intervention that consistently elevated cancer screening rates across all racial/ethnic minority adults.

Conclusions

The finding suggests that highly segmented interventions are needed in order to improve cancer screening among various racial/ethnic minority adults.

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Authors and Affiliations

  1. Department of Public Health, Des Moines University, 3200 Grand Avenue, Des Moines, IA, 50312, USA

    Darren Liu

  2. College of Osteopathic Medicine, Des Moines University, Des Moines, IA, USA

    Hayley Schuchard

  3. Department of Health Care Administration and Policy, University of Nevada Las Vegas, Las Vegas, NV, USA

    Betty Burston

  4. Department of Sociology, Anthropology, and Health Administration and Policy, University of Maryland, Baltimore County, Baltimore, MD, USA

    Takashi Yamashita

  5. Department of Behavioral & Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    Steven Albert

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DL and SA had the idea for the article; DL, HS, BB, and TY performed the literature search and data analysis. The first draft of the manuscript was written by DL and HS. DL and BB critically revised the work. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Liu, D., Schuchard, H., Burston, B. et al. Interventions to Reduce Healthcare Disparities in Cancer Screening Among Minority Adults: a Systematic Review. J. Racial and Ethnic Health Disparities 8, 107–126 (2021). https://doi.org/10.1007/s40615-020-00763-1

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