ArticlePublic health reports (Washington, D.C. : 1974)2026
Predictors of Breast Cancer Screening Variability Among National Breast and Cervical Cancer Early Detection Program Awardees: Provider Shortages and Nurse Practitioner Autonomy.
Article in Public health reports (Washington, D.C. : 1974), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThe percentage of eligible women screened for breast cancer varies among National Breast and Cervical Cancer Early Detection Program (NBCCEDP) awardees. We assessed the effect of awardee- and state-level factors on the percentage of eligible women screened for breast cancer among NBCCEDP awardees. We focused on primary care-health professional shortage areas (PC-HPSAs) and nurse practitioner scope of practice.
methodsFirst, we calculated the study outcome, defined as the percentage of eligible women screened among NBCCEDP state awardees during July 2022-June 2024. Next, we gathered data on awardee- and state-level predictors from multiple sources and estimated 2 general linear multilevel models. Models differed only by the inclusion of an interaction term between PC-HPSA and nurse practitioner autonomy. Finally, we calculated marginal and partial
resultsThe average percentage of eligible women screened for breast cancer among awardees was 9.6% (range, 0.5%-78.0%). Awardees in states with (1) full nurse practitioner autonomy or (2) a larger percentage of their population living in PC-HPSAs screened larger percentages of eligible women as compared with awardees in states without full autonomy or with smaller PC-HPSA populations. Awardees in states with full nurse practitioner autonomy and larger PC-HPSA populations screened even higher percentages of eligible women (β = 0.46;
conclusionsNBCCEDP awardees can encourage their clinical partners to reach women in PC-HPSAs and encourage strategic partnerships with nurse practitioners to address differences in screening.
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