Equity in breast density notification in Australia: A focus group study exploring the impact and needs amongst culturally and linguistically diverse (CALD) women

Brooke Nickel; Claire Hudson; Jennifer Isautier; Kirsten McCaffery; Allan Ben Smith; Paula Legerton; Tong Li; Shu Wang; Nehmat Houssami

doi:10.1016/j.pec.2024.108628

Equity in breast density notification in Australia: A focus group study exploring the impact and needs amongst culturally and linguistically diverse (CALD) women

Patient Educ Couns. 2024 Dec 19:133:108628. doi: 10.1016/j.pec.2024.108628. Online ahead of print.

Authors

Brooke Nickel¹, Claire Hudson², Jennifer Isautier³, Kirsten McCaffery⁴, Allan Ben Smith⁵, Paula Legerton⁶, Tong Li⁷, Shu Wang⁸, Nehmat Houssami⁹

Affiliations

¹ Wiser Healthcare, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia. Electronic address: [email protected].
² Wiser Healthcare, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia. Electronic address: [email protected].
³ Wiser Healthcare, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia. Electronic address: [email protected].
⁴ Wiser Healthcare, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia. Electronic address: [email protected].
⁵ The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia. Electronic address: [email protected].
⁶ Cancer Screening Unit, Queensland Health, Brisbane, Queensland, Australia. Electronic address: [email protected].
⁷ The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia. Electronic address: [email protected].
⁸ Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia. Electronic address: [email protected].
⁹ Wiser Healthcare, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia. Electronic address: [email protected].

PMID: 39724690
DOI: 10.1016/j.pec.2024.108628

Abstract

Objectives: Previous research suggests a one-size-fits-all approach to breast density notification may disadvantage culturally and linguistically diverse (CALD) women. This study aimed to qualitatively explore CALD women's understanding and views of breast density, attitudes towards health services access, acceptability of notification and preferences for breast density communication ahead of population-based notification in Australia.

Methods: Online focus groups were conducted with CALD women of breast screening age (40-74 years) who spoke one of the five languages with the lowest English proficiency in Australia (Korean, Mandarin, Cantonese, Vietnamese and Arabic). Focus group sessions were in-language and incorporated an evidence-based presentation interspersed with group discussions which were audio-recorded, transcribed and analysed thematically.

Results: Thematic analysis revealed four themes indicating participants had overall strong desires to be informed of breast density, despite some associated worry. CALD women may also face significant barriers to understanding and accessing breast density information and seeking supplemental screening.

Conclusions: Although CALD women have a strong desire to be notified of their breast density, increased anxiety and confusion may exacerbate health inequalities and barriers women from these communities already face.

Practice implications: This study highlights the need for careful consideration of breast density and supplemental screening communications for CALD women.

Keywords: Breast cancer screening; Breast density; Culturally and linguistically diverse; Qualitative; Supplemental screening.