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

Patient Education and Counseling

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

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.