Determinants of screening participation of disadvantaged populations in France: a qualitative study

Abstract

Background People from deprived backgrounds and people with disability have generally limited access to health screening. This study aimed to identify the factors influencing access to recommended screenings for these disadvantaged groups, to inform development of tailored screening support. Methods Thirty semi-structured interviews were conducted with 18 participants from deprived backgrounds and 12 participants with disability. A content analysis using an analytical framework was performed. Barriers and facilitators to screening participation were categorized into four domains: individual, social, healthcare system/healthcare professional, and screening procedure. Results Most barriers and facilitators pertained to the individual or healthcare system/healthcare professional domains. In the individual domain, fear could have a negative influence on screening participation in both groups. In the social domain, social influences (i.e. having children, knowing people suffering from the disease) were reported as facilitating screening. People with disability reported to be more influenced by factors related to the healthcare domain (i.e. perceived risk; recommendation from a healthcare professional or an educator). Conclusion Our results highlight the need to better consider the environmental factors of individuals, in particular the potential influence of relatives and healthcare professionals, to improve their participation in screening.