| Sumario: | Aim: In-person patient–provider communication positively influences adherence to breast cancer screenings. This systematic review aims to examine the role of healthcare providers and family caregivers in the breast cancer screening and treatment decision process; identify communication barriers experienced by female patients at risk or diagnosed with breast cancer when speaking with a provider; and discuss effective implementation strategies to improve screening and treatment adherence rates for breast cancer. Methods: The Arksey and O'Malley York framework methodology was used to guide this systematic review. The Joanna Briggs Institute (JBI) recommendations for the extraction, analysis, and presentation of results in systematic reviews were also referenced. Results: The most frequently cited barriers (n = 16) fell into the "communication challenges" category, followed by "cultural, religious, and language issues" (n = 13), "social determinants of health" (n = 12), "insufficient provider training" (n = 5), "misconceptions and negative assumptions about providers" (n = 5), "prejudice and discrimination towards patients" (n=5), "age of patient" (n = 4), "mistrust between patients and providers" (n = 3), "fear and lack of knowledge about mammography" (n = 3), "gender differences" (n = 2), "cost and lack of insurance challenges" (n = 2), and "time constraints" (n = 1) (Table 2). Eight Expert Recommendations for Implementing Change (ERIC) domains were represented. The most frequently reported ERIC strategy was "intervene with patients/consumers to enhance uptake and adherence" (#53), appearing 28 times across all 12 studies (100%). Conclusion: Efforts to reduce financial barriers, improve health literacy, and increase access to social support services will be crucial in addressing the broader social determinants of health that affect breast cancer screening rates in underserved populations.
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