Barriers and facilitators to preventive cancer screening in Limited English Proficient (LEP) patients: Physicians’ perspectives

Authors

  • Kelly H. Bruce University of Wisconsin School of Medicine and Public Health
  • Rebecca J. Schwei University of Wisconsin School of Medicine and Public Health
  • Linda S. Park School of Social Work, University of Wisconsin-Madison
  • Elizabeth A. Jacobs University of Wisconsin School of Medicine and Public Health

DOI:

https://doi.org/10.1558/cam.v11i3.24051

Keywords:

limited English proficient, cancer screening, disparities, qualitative research

Abstract

Background: Limited English Proficient (LEP) patients receive fewer recommended preventive screenings than English-speaking patients. Studies have explored patients’ perceptions of the factors that contribute to this disparity, but little research has focused on physicians’ perceptions. The objective of this paper is to describe physicians’ perceptions of the barriers and facilitators to preventive cancer screening in LEP patients, based on semi-structured interviews with eight primary care physicians from Wisconsin, systematically coded to illuminate important themes. It was found that a variety of barriers specifically hinder LEP patients’ receipt of cancer screening, including poor language proficiency, lack of transportation, unfamiliarity with the concept of prevention, complex scheduling systems, poor interpretation, and limited physician time to discuss preventive care. While physicians identified many factors that facilitate preventive screening in general, they mentioned few that are perceived as specific to LEP patients. We found that primary care physicians attribute the low rates of preventive cancer screening among LEP populations to a variety of patient, provider, interpreter, and system factors, most of which go beyond simple language barriers. Interventions designed to reduce these barriers and enhance the impact of identified facilitators should be multifactorial and designed to engage primary care physicians.

Author Biographies

  • Kelly H. Bruce, University of Wisconsin School of Medicine and Public Health
    Kelly H. Bruce received her BA in Biological Chemistry from Grinnell College in Grinnell, Iowa. She is currently a medical student at the university of Wisconsin School of Medicine and Public Health. Her research interests include health disparities and global health.
  • Rebecca J. Schwei, University of Wisconsin School of Medicine and Public Health
    Rebecca J. Schwei received her MPH in Global Health from Emory University and is currently a Research Specialist at the University of Wisconsin. Her research interests include health disparities, provision of linguistically appropriate health care, and the social determinants of health.
  • Linda S. Park, School of Social Work, University of Wisconsin-Madison
    Linda S. Park received her Ph.D. in Human Development and Family Studies from the University of Wisconsin-Madison. Her research interest include cultural gerontology, health disparities, health literacy, and policy. She is currently an associate lecturer in the School of Social Work and involved in research with the Department of Medicine in the School of Medicine and Public Health at the University of Wisconsin-Madison.
  • Elizabeth A. Jacobs, University of Wisconsin School of Medicine and Public Health
    Elizabeth A Jacobs attended medical school at the University of California at San Francisco. She is currently Associate Professor at the University of Wisconsin School of Medicine and Public Health. Her research interests include access to, and cultural specificity of, medical care delivered to minority patients, the impact of interpreter service interventions on the cost and quality of healthcare, and health literacy and numeracy.

Published

2014-04-27

Issue

Section

Articles

How to Cite

Bruce, K. H., Schwei, R. J., Park, L. S., & Jacobs, E. A. (2014). Barriers and facilitators to preventive cancer screening in Limited English Proficient (LEP) patients: Physicians’ perspectives. Communication and Medicine, 11(3), 235–247. https://doi.org/10.1558/cam.v11i3.24051

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