Date of Conferral

10-26-2025

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Shanna Barnett

Abstract

Breast and cervical cancer screening reduces mortality; however, women with disabilities and mental health challenges experience persistent disparities in access to preventive services. The purpose of this quantitative study was to examine the relationships between self-reported serious difficulty hearing, serious difficulty seeing, and frequent mental distress with breast (mammogram) and cervical (Pap test) cancer screening use among women in the United States (mammogram model, n = 844; Pap model n = 774), using the 2023 Behavioral Risk Factor Surveillance System dataset. The social-ecological model provided the framework. Two logistic regression models were conducted, adjusting for age, race/ethnicity, education, income, marital status, and employment status. The mammogram model was statistically significant overall, x^2(23) = 304.09, p < .001, with strong classification accuracy (91.1%). Age (AOR = 0.27, 95% CI [0.21, 0.35], p < .001) and race/ethnicity (p = .018), particularly among Asian, non-Hispanic women (AOR = 7.85, 95% CI [1.48, 41.55], p = .015), were significant predictors, whereas disability and mental health indicators were not. The Pap model was also statistically significant, x^2(23) = 128.14, p < .001, with 68.6% classification accuracy. Frequent mental distress was associated with lower Pap utilization (AOR = 0.53, 95% CI [0.30, 0.93], p = .026), along with significant effects for age, education, income, and selected race/ethnicity contrasts. The implications for positive social change include informing public health strategies and clinical practice guidelines to improve access to cancer screening among women with mental health challenges and across diverse sociodemographic subgroups.

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