Individual and Co-Occurring Social Needs, and Breast and Cervical Cancer Screening Among Patients in Texas Federally Qualified Health Centers

Sep 23, 2026

Uploaded by Mabel

Study evaluates how individual and cumulative health-related social needs (HRSNs) influence completion of breast and cervical cancer screening among female patients receiving care at Federally Qualified Health Centers in Texas. Women who were overdue received screening-test completion tracking within 90 days after SMS text-message reminders. Adjusted logistic regression models assessed associations for individual and combined HRSNs, and results show food insecurity as a key predictor for breast screening completion and reduced odds for cervical screening. Combined HRSNs further lower completion likelihood.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Introduction

Background and burden of breast and cervical cancer

Screening recommendations and consequences of missed screening

Texas screening gaps and social determinants

Methods

Results

Conclusions

Individual and Co-Occurring Social Needs, and Breast and Cervical Cancer Screening Among Patients in Texas Federally Qualified Health Centers Journal of Primary Care & Community Health Volume 17: 1–10 © The Author(s) 2026 Article reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions) [DOI: 10.1177/21501319261448952](DOI: 10.1177/21501319261448952) [journals.sagepub.com/home/jpc](journals.sagepub.com/home/jpc) Omolola E. Adepoju, PhD, MPH1,2, Tonghui Xu, PhD1, Gonzalo Ramirez-Pulido1, Tracy Angelocci, MD3, Credo DjeDje, BS2 , Chanique Ecby, BS4, Renita Madu, PA-C, PhD5, and LeChauncy Woodard, MD, MPH6 Abstract Introduction: While prior research has examined individual health-related social needs (HRSNs) in relation to preventive care, few studies have investigated how cumulative social needs affect cancer screening behaviors. This study examines how individual and combined HRSNs affect breast and cervical cancer screening completion. Methods: Participants included 1,964 female patients overdue for breast or cervical cancer screening, receiving care at Federally Qualified Health Centers. The dependent variable was the completion of the appropriate screening test within 90 days of SMS text message reminders. Adjusted logistic regression models assessed associations between individual and combined HRSNs and screening completion. Results: Food insecurity (aOR = 0.54) was the only significant predictor of breast cancer screening completion and was also associated with reduced odds of cervical cancer screening. Housing insecurity (aOR = 0.79), living at or below 100%FPL (aOR = 0.82), and having family history of cancer (aOR = 0.62) were associated with lower odds of cervical cancer screening, while completing an annual wellness visit in the previous year was associated with higher odds of cervical cancer screening (aOR = 1.25) . In the combined models, each additional HRSN reduced likelihood of completing breast (OR=0.72) and cervical cancer screening (OR=0.77). Conclusions: Addressing HRSN is essential for improving screening completion in safety-net populations. Interventions targeting food insecurity and housing instability can support access to preventive cancer care. Keywords cancer screening, health related social needs (HRSN), underserved, text-message reminders, preventive care Received: 18 January 2026; Revised: 26 March 2026; Accepted: 20 April 2026 1Humana Integrated Health Systems Sciences Institute, University of Houston, Houston, TX, USA 2Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX, USA 3Lone Star Circle of Care, Georgetown, TX, USA 4Gessner College of Nursing, University of Houston, Houston, TX, USA 5Houston Health Department, Houston, TX, USA 6Baylor College of Medicine, Houston, TX, USA Corresponding author: Omolola E. Adepoju, PhD, MPH, Humana Integrated Health Systems Sciences Institute, University of Houston, 5055 Medical Circle, Houston, TX 77204-6064, USA. Email: [oadepoju@uh.edu](oadepoju@uh.edu) Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ([https://us.sagepub.com/en-us/nam/open-access-at-sage](https://us.sagepub.com/en-us/nam/open-access-at-sage)). Introduction Cancer is the second leading cause of death in the United States,1 and the number of new cancer cases is projected to reach 1.96 million by 2030.2 Among females, breast and cervical cancer remain especially consequential, accounting for 316,950 new cases and 42,170 deaths (breast cancer) and 13,360 new cases and 4320 deaths (cervical cancer) in 2025 only,

FAQs

What is the study’s primary research question about HRSNs and cancer screening?

The study examines how individual and combined health-related social needs affect completion of breast and cervical cancer screening.

How were participants and screening completion measured?

Participants were 1,964 female patients overdue for breast or cervical cancer screening at Federally Qualified Health Centers. Screening completion was assessed within 90 days of SMS text-message reminders.

Which HRSNs were associated with screening completion outcomes?

Food insecurity predicted breast cancer screening completion and was also linked to lower odds of cervical cancer screening. Housing insecurity and living at or below 100% FPL were associated with reduced odds of cervical screening, and each additional HRSN decreased the likelihood of completing both screenings.

Sep 23, 2026

Uploaded by Mabel