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This study examined barriers and incentives to mammography screening among African American and Caucasian women in the Mississippi Delta. This study sought to identify the most salient barriers and incentives to mammography screening; determine if those barriers and incentives differed by race; and determine if barriers and incentives influenced mammography screening behavior. A cross-sectional survey design was used. The Breast Cancer Screening Measure was administered to 175 African American and Caucasian participants at eight different churches in Leflore County, and at the Mississippi State Capitol in Jackson, Mississippi. The survey measured barriers and incentives to mammography screening as well as breast cancer screening behavior. The study found that fear of breast cancer, perceived benefits of mammograms, and health motivation were the most salient barriers and incentives. It was also determined that African American women were more fearful of breast cancer and more motivated to care for their health when compared to Caucasian women. Finally, there were no differences in screening behavior by race; however, women who were more fearful of breast cancer were likelier to be overdue for a mammogram, and women who were motivated to care for their health more likely to be current. This study's findings have important implications related to the continued need to address psychological barriers to breast cancer screening among "high-risk" women in the Mississippi Delta. Ultimately, the findings may be instrumental in helping future practitioners address fear of breast cancer as a barrier to mammography screening among African American and Caucasian women in rural areas.
Background. Regular mammography screening has been shown to be the most effective means of detecting breast cancer and reducing mortality. Yet, screening rates for African-American women have consistently been lower than their white counterparts. The purpose of this study is to determine physician patterns for mammogram referral after using a reminder system, to assess the number of women who received a mammogram after receiving a referral, and to identify the barriers to mammography after receiving a referral among predominately African-American women seen in an urban primary care setting.
Descriptive statistics were used to analyze demographic data, and independent t-test were used to compare the two groups in their perceived barriers. Results revealed that both groups perceived barriers to breast cancer, there were more similarities than differences. However, African American women were significantly more likely to indicate that having a mammogram would make them worry about breast cancer (p= 0.39). Although previous research has shown differences African American and Caucasian women, this study did not support those results. The two groups of women were similar in age, education, and marital status and all were active in their churches. Perhaps these similarities led to the lack of differences in perceived barriers scores between the two groups. This finding lends support to the idea that socioeconomic status more than race leads to disparities in breast screening.
Black women of low-socioeconomic status (SES) demonstrate a higher incidence of breast cancer mortality associated with late-stage diagnosis than White women. Breast cancer screening, including mammography, breast self-examination, and clinical breast examination, remains the most effective route to early detection. Studies indicate poor adherence to breast cancer screening regimens among low-income minority women. An overall objective of the study is the construction of a theoretical model that can explain screening practices in low-SES black women. This will be accomplished in two separate waves. In the first wave, facilitators and barriers to breast cancer-screening participation among low-SES women of African-American and Caribbean descent will be determined through qualitative interview. This approach allows a voice for the concerns and experiences guiding these women in their screening choices. The current study incorporates an approach-avoidance theoretical framework that considers preventive screening behaviors to be both desirable and aversive. Based on the factors provided by respondents on the first wave of the study, a culturally sensitive Q-Sort instrument will be designed that will allow participants to rank order these factors as facilitators or barriers to screening, and therefore, provide a powerful approach to testing the theoretical paradigm. Finally innovative modeling techniques will be applied to determine the strength of emergent models to explain breast health care practices among low-SES Black women, either as idiopathic to the general population or specific to African-American or Caribbean cultural groups.
130 AND 136 African-American Women with and without a family history, respectively, were given educational brochures that framed messages about mammography as gains (i.e., how a woman benefits by getting mammograms), losses (i.e., the costs of not getting mammograms), or as neither (control), to assess their effects on intentions to get mammograms and screening. At three and seven month post-intervention follow-ups, message framing did not affect intentions or mammography screening. The majority of women in both groups were on schedule (e.g.,> 68%). Nor did the educational brochures affect knowledge of breast cancer risk factors, perceptions of risk, or concerns about getting breast cancer. Though well-received, the lack of significant findings is likely due to failure of the gain, loss, and control brochures to be viewed as intended. Women with a family history consistently expressed higher perceptions of risk and breast cancer concerns than women without a family history. Moreover, both groups expressed equally favorable attitudes towards mammography screening. Overall, knowledge of breast cancer risk factors was poor and did not improve. These results suggest that continued efforts are needed to create persuasively framed messages as well as education materials targeting African-American women with and without a family history of breast cancer.
Breast cancer is the most diagnosed cancer among women in the United States and is a leading cause of death for Black women in the state of Wisconsin. A complicated history in the country has created complex factors contributing to both population and individual health outcomes. Accessing timely mammography screening has long been seen as the primary way to reduce morbidity and mortality for breast cancer. However, if, how, and when Black women can access mammography screening is multifaceted.For many years, Black women had lower diagnosis rates and higher incidence of mortality than their white counterparts. Targeted health promotion and programming has been a tool to help ameliorate the disparity and assist Black women to access timely mammography. Interventions are most effective when they're culturally and contextually specific to the local populations. To best understand each local context, Black women's voices should be included as a primary source that directs interventions locally. Using primary study data from a community based participatory research study done locally in six counties, the goal of this qualitative secondary analysis was to expand context-specific and sociocultural understanding of breast cancer screening and knowledge of Black women in Wisconsin and northern Illinois. Using the social cognitive theory as a theoretical framework, and a blended coding scheme I analyzed six focus group transcripts which resulted in two major themes: breast cancer screening capacity, and barriers and facilitators to breast cancer screening. The analysis results support culturally and contextually specific interventions for Black women with targeted areas of intervention. Further research at each county level would elucidate county specific needs.