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. 2014;11(3):235-247.
doi: 10.1558/cam.v11i3.24051.

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

Kelly H Bruce  1 , Rebecca J Schwei  2 , Linda S Park  3 , Elizabeth A Jacobs  4
Affiliations

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

Kelly H Bruce et al. Commun Med. 2014.

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.

Objective: To describe physicians' perceptions of the barriers and facilitators to preventive cancer screening in LEP patients.

Design: Qualitative interview study using a semi-structured interview guide.

Participants: Eight primary care physicians from Wisconsin.

Approach: Each interview was systematically coded to illuminate important themes.

Key results: 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.

Conclusion: 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.

Keywords: Limited English proficiency; cancer screening; disparities; qualitative research.

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Figures

Figure 1
Figure 1. Barriers and facilitators to preventive cancer screening
Starred, bolded items represent factors that physicians discussed specifically in regard to LEP patients. Normal text represents factors that physicians discussed as factors for all patients, regardless of their LEP status.
See this image and copyright information in PMC

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