Study Significance. In the past two decades, the United States government has invested enormous resources to increase mammography screening rates, with a focus on targeting low- income, uninsured/underinsured women. While the program is considered successful, statistics show that this subgroup of the general population remains underserved. Through a qualitative investigation, the reasons why low-income or uninsured/underinsured women do not receive routine mammograms despite the availability of free services can be identified. With this knowledge, the NBCCEDP can conduct better-informed outreach to this marginalized population. As research shows, routine mammography screening leads to earlier detection of breast cancer and subsequently better treatment outcomes. Improving mammography use among low-income uninsured/underinsured women will thus avert avoidable breast cancer deaths. In this study, women who have breast cancer diagnoses and are enrolled in the Georgia Women’s Health Medicaid Program are interviewed about their prior mammography use. This will provide a particularly useful perspective on breast cancer screening behavioral patterns as these were both low-income and uninsured or underinsured at the time of their diagnosis, but also were obviously at high-risk of developing breast cancer.
Study Significance. Trichiasis is thought to have widespread consequences on individuals, families and communities. However, the evidence supporting this statement is scant. The little available evidence, largely anecdotal, suggests that at the individual level, trichiasis causes negative physical and psychological effects, such as pain, photophobia and social isolation (Xxxx, Xxxxx, & Xxxxxxxx, 2012). At the family level, trichiasis patients may be unable to provide financially or perform household tasks to care for their families. Moreover, they may require care from their children, who then may miss the opportunity to attend school or use resources caring for their ill parents that would normally support the growth and development of their own children (International Coalition for Trachoma Control, 2011). At the societal level, lost productivity keeps a community in poverty (Xxxxx, Xxxxxx, & Xxxxxxxx, 2003), and women in particular may lose status, both as individuals and as a class if they are no longer be able to care for their children properly or perform other tasks for which they are responsible (Xxxxxxx, Xxxxx, & Xxxxx, 1997; The Xxxxxx Center, 2009). Despite these far-reaching effects, much of the published literature on trachoma has focused on its prevalence and risk factors, as well as programmatic evaluations of the SAFE strategy. The three published studies available on quality of life (one evaluating overall quality of life and the two others evaluating physical functioning) indicate that trichiasis significantly affects physical and psychological health, particularly for women (Xxxxxxxx, Xxxxxx, & Xxxxxx, 2006; Xxxxx et al., 2011; Xxxxx et al., 2001). However, these studies were conducted using quantitative quality of life instruments that were not designed specifically for those with trichiasis. While these instruments claim validity, they may not capture issues important to this population. In addition, there is a lack of published literature in which trichiasis patients themselves describe the effects of trichiasis on their lives. Finally, as described above by Xxxxxx and Xxxxx (2009), standardized measures of disease burden do not take into account trichiasis in the absence of blindness or visual impairment; however, there have been few published studies substantiating the call to include trichiasis itself as a morbidity resulting from trachoma.
