Mapping women's journeys to breast cancer screening: A participatory action research study

Objective: To document the experiences of women targeted by national breast cancer mammography screening policies to identify systematic improvement opportunities. Materials and Methods: This action research study was conducted between March 5, 2018 ve May 19, 2020. Women aged 40-69 and living in Istanbul were recruited using a snowball method. The women completed a Health Belief Model survey and participated in focus groups to explore their thoughts and experiences regarding mammographies. A self-selected subgroup of women volunteered to have mammography observations. Results: Although 48 women (57%) said they had had at least one mammogram in their lives, 26 women (%31) reported that they had received a mammogram within the last two years and 32 women (%38) reported that they had never had one. The compliance rate for this group of women is similar to the national rate of 30-40%. Health Belief Model survey results are comparable to other larger studies conducted in Istanbul. 12 focus groups and 10 mammography observations were conducted. Major themes revealed high self-confidence to obtain a mammography, but considerable barriers with regard to fears, self-neglect, cultural and religious beliefs, confidence that mammographies are beneficial in finding breast cancer, and general surgeon exam pre-requisites. Conclusion: Opportunities for improvement include removal of clinical pre-requisites, standardizing privacy measures, providing education at screening and improving reporting durations. Keywords: mammography, cancer screening, breast cancer, action research, patient journey mapping