A Pilot Analysis of Patient Portal Use and Breast Cancer Screening Among Black Patients in a Large Academic Health System

AJPM focus Pub Date : 2025-02-01 Epub Date: 2024-11-22 DOI:10.1016/j.focus.2024.100305
Leah M. Marcotte MD, MS , Sara Khor PhD, MASc , Edwin S. Wong PhD , Nkem Akinsoto MSc , E. Sally Lee PhD , Susan Onstad BA , Rachel B. Issaka MD, MAS
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Abstract

Introduction

Patient portals may facilitate breast cancer screening and could be an important factor to address inequities; however, this association is not well characterized. The authors sought to examine this association in a large academic health system to inform interventions to address breast cancer screening inequities.

Methods

The authors conducted a cross-sectional study among Black patients in a large academic health system using logistic regression to examine the association between breast cancer screening and portal use, adjusting for multilevel covariates and interactions. The authors estimated average marginal effects to examine the additive probability of breast cancer screening completion given portal use in the prior 12 months.

Results

In the unadjusted model, portal use was associated with an estimated mean 24.8 percentage points (95% CI=20.7, 29.0) increased likelihood of completing breast cancer screening. In the adjusted model, portal use was associated with an estimated mean 16.2 percentage points (95% CI=11.2, 21.3) increased likelihood for completing breast cancer screening.

Conclusions

Improving portal access and use among racialized groups who face both portal and breast cancer screening inequities could be one strategy to address inequities. These pilot data will inform subsequent community-engaged research to better understand this association and develop and test a portal intervention to facilitate breast cancer screening access among Black patients eligible for screening.

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一个大型学术卫生系统中黑人患者门户使用和乳腺癌筛查的试点分析。
导读:患者门户网站可以促进乳腺癌筛查,并可能成为解决不平等问题的重要因素;然而,这种联系并没有很好地描述。作者试图在一个大型学术卫生系统中检查这种关联,为解决乳腺癌筛查不公平的干预措施提供信息。方法:作者在一个大型学术卫生系统中的黑人患者中进行了一项横断面研究,使用逻辑回归来检查乳腺癌筛查与门户使用之间的关系,调整了多水平协变量和相互作用。作者估计了平均边际效应,以检查在过去12个月内使用门静脉的乳腺癌筛查完成的加性概率。结果:在未经调整的模型中,门户网站的使用与完成乳腺癌筛查的可能性增加的估计平均24.8个百分点(95% CI=20.7, 29.0)相关。在调整后的模型中,门户网站的使用与完成乳腺癌筛查的可能性增加的估计平均16.2个百分点(95% CI=11.2, 21.3)相关。结论:在面对门户网站和乳腺癌筛查不公平的种族化群体中,改善门户网站的获取和使用可能是解决不公平问题的一种策略。这些试点数据将为随后的社区参与研究提供信息,以更好地了解这种关联,并开发和测试门户干预措施,以促进符合筛查条件的黑人患者进行乳腺癌筛查。
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来源期刊
AJPM focus
AJPM focus Health, Public Health and Health Policy
CiteScore
0.50
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