A changing dialogue within health communication in New Zealand: a case study of the Waikato screening mammography programme
Brunton, M. A. (2000). A changing dialogue within health communication in New Zealand: a case study of the Waikato screening mammography programme (Thesis, Doctor of Philosophy (PhD)). The University of Waikato, Hamilton, New Zealand. Retrieved from https://hdl.handle.net/10289/14500
Permanent Research Commons link: https://hdl.handle.net/10289/14500
As part of changes in the health sector in New Zealand over the past decade, government has provided a number of community-based health interventions. The purpose of such interventions is to provide information and resources that will empower “well” individuals to participate in proactively managing their health, thereby contributing towards both cost and mortality savings. In 1991, government introduced population-based screening mammography pilot programmes into two communities: one in Otago and Southland, the other in the greater Waikato region. As a community-based health intervention, the breast screening programme communicates with eligible women to encourage them to participate in screening mammograms every two years. The purpose is early detection and treatment of malignant tumours. However, to achieve mortality and cost savings the programme must attain a 70% participation rate of eligible women. The purpose of this research was to examine the ways in which the breast screening programme in the greater Waikato region communicates with women to encourage them both to participate in the programme and also return regularly. In turn, the ways in which a random sample of women responded to that communication were also examined. To investigate the process, a triangulated approach to data collection and analysis was undertaken. First, a questionnaire survey was sent to a random sample of 1,085 women, stratified by age and ethnicity; 611 (58%) usable responses were returned. Following initial analysis of the questionnaire data, five focus groups were held with 41 women, and 3 individual interviews undertaken to further explore the outcomes from the questionnaire. Nineteen interviews were also held with staff in the breast screening programme to identify the influences on the ways in which they communicate with eligible women who undergo the process of mammography. The resulting data were analysed and interpreted using a combined quantitative and qualitative approach. Fisher’s exact tests in 2x2 tables and chi-squared tests for independence in contingency tables were used to establish general trends in the data. Qualitative analysis was undertaken using interpretive thematic analysis (Owen, 1984) with a critical turn and reference to Ricoeur (1981). The findings from this research emphasise the importance of effective communication in the process of screening mammography, to encourage both initial and ongoing participation. There were a number of discrepancies identified between the perception of staff and participants about the communication processes from the breast screening programme. The use of a random sample stratified by ethnicity further identified a number of statistically significant differences among ethnic groups in their responses to communication from the programme. The analysis identifies the divergent communication that women receive from staff in the breast screening programme. The importance of communication in enhancing both the invitation and physical process for women participating in the population-based breast screening programme is highlighted in this research. Although the programme is provided as a community intervention there appears to be little consultation with participants. Accordingly, the diverse cultural needs of ethnic minority groups are not always recognised in the programme’s practice. A willingness to both recognise and incorporate the varied needs of women undergoing screening mammography would serve to not only enhance the process for participants but also assist the programme to attain the desired 70% participation rate of the eligible population.
The University of Waikato
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