Context: Cervical cancer is preventable and curable, yet Hispanic populations in certain areas of the country have higher mortality rates from invasive cervical cancer than non-Hispanic white women. Objective: Our study aims to identify contextual and environmental features at the county level that are acting as barriers or facilitators of cervical cancer long-term survival in Hispanic women. Study Design: This is a mixed methods exploratory study utilizing fRAP (focused Rapid Assessment Process) methodology to uncover modifiable differences in cervical cancer survivorship contributing to mortality differences. We investigate multi-level community, medical and policy contextual elements within a county through both quantitative GIS mapping of ZCTA level data linked to fieldwork and key informant interviews. This poster highlights the qualitative Phase II of our methods, including participant observation in three Texas counties. Setting or Dataset: Phase II of fRAP includes qualitative data collected by the lead author during fieldwork from three Texas counties. Counties chosen for inclusion in the study due to differences in mortality rates between Hispanic and non-Hispanic white women were identified during Phase I GIS mapping of the study. They include Bexar, Dallas and Tarrant, all of which hold a unique disparity profile based on mortality rates. Population studied: Participants for key informant interviews identified during fieldwork visits to each county and stratified by level of interest: community, medical systems, policy, e.g. a community resource executive director, a practicing gynecologic oncologist and a county-level payment plan manager. Outcome Measures: Qualitative transcripts analyzed for themes across levels within a county, and across counties based on level. Results: Research to date has uncovered modifiable environmental and contextual differences within each of the three Texas counties contributing to how Hispanic cervical cancer survivors experience care. Outcomes to be Reported: Cross comparison of themes within a county across multiple levels and across counties within levels will allow us to identify environmental and contextual features unique to each of the three counties that contribute to their particular cervical cancer disparity profile seen on mapping. Next stages of fRAP include evaluation of modifiable features found for possible policy change targets to address disparities in care.
Published In/Presented At
Kieber-Emmons, A. M. Miller, W. Jaen, C. (2019, November 17). Environmental and Contextual Differences Affecting Cervical Cancer Survivorship in Hispanic Women in Three Texas Counties. Poster Presented at: (NAPCRG) North American Primary Care Research Group, Toronto, Canada.
Department of Family Medicine, Department of Family Medicine Faculty
Available for download on Wednesday, November 17, 2021