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Breast cancer is the leading cause of cancer mortality in African-American women. Studies have reported that African-American women with breast cancer are more likely to be diagnosed at a later stage of the disease and have a higher mortality rate than White women. Despite this, African-American women are less likely than White women to avail themselves of the benefits of screening mammography. This is most often attributed to lack of education, lack of access, and low socioeconomic status. However, it has been repeatedly shown that when socioeconomic, educational, and logistic barriers are minimized, African-Americans continue to underutilize these screening procedures. In this study, breast cancer screening behaviors and the factors that influence those behaviors are measured by means of a survey questionnaire distributed to members of a defined population of African-American and White women with comparable levels of education, health care access, and socioeconomic status. This report describes the background, objectives, and procedures of this study, and details the work carried out in Year 01, including selection of the sample, pilot testing, finalizing materials and procedures, creation of the project database, hiring of personnel. and preliminary mailings.
This qualitative study addressed the research question, what are the perspectives and experiences related to breast cancer and breast cancer screening of African American women residing in rural eastern North Carolina? A literature review indicated little research related to the perceptions and experiences of rural African American women about breast cancer and breast cancer screening. In a previously conducted unpublished larger study (Burke, Barrett, & Cherry, 2009), the perspectives of women from rural North Carolina about breast cancer and breast cancer screening were collected by means of focus group interviews. The researcher in the present study conducted a qualitative analysis of data from a sub-set of focus group interviews that involved African American women. A qualitative approach in this study afforded an opportunity to gain insight into African American women's experiences and views regarding breast cancer and breast cancer screening. The researcher analyzed transcripts from three focus group interviews that involved 17 African American women residing in rural eastern North Carolina. Five themes that emerged from the data were: knowledge and beliefs about breast cancer, influences on breast cancer screening behaviors, personal experience with screening, emotional reactions to discussing breast cancer and breast cancer screening, and promoting breast cancer screening. Key findings related to these emergent themes included a self-perceived low level of knowledge about breast cancer, cultural views about various causes of breast cancer, perspectives about mammograms, perceived barriers to breast cancer screening, the influence of faith on breast cancer and breast cancer screening, personal experiences with breast cancer screening, fear as a commonly shared reaction to breast cancer and breast cancer screening, and best practices for promoting breast cancer awareness and education. The researcher identified a need for future research on the topic of minority health in rural populations, specifically around breast cancer screenings and preventive health. An analysis of a sub-set of qualitative data provided by African American women and a comparison of findings with the research literature led the researcher to recommend that tailored health education be provided African American women on the topic of breast cancer and breast cancer screening.
Breast cancer is the leading cause of cancer mortality in African-American women. Studies have reported that African-American women with breast cancer are more likely to be diagnosed at a later stage of the disease and have a higher mortality rate than white women. Despite this, African-American women are less likely than White women to avail themselves of the benefits of screening mammography. This is most often attributed to lack of education, lack of access, and low socioeconomic status. However, it has been repeatedly shown that when socioeconomic, educational, and logistic barriers are minimized, African-Americans continue to underutilize these screening procedures. In this study, breast cancer screening behaviors and the factors that influence those behaviors were measured by means of a survey questionnaire distributed to members of a defined population of African-American and White women with potentially comparable levels of education, health care access, and socioeconomic status. This report describes the background, objectives, and procedures of this study, and details the work carried out in Year 02, including data collection and analysis. A total of 782 usable surveys were returned from female public school teachers in Philadelphia aged 40 and older. White respondents were more likely than African-Americans to be married or cohabiting, and had significantly higher annual household incomes; they were also more likely to have been adherent to mammography guidelines over the previous five years and to say that they would definitely get a mammogram in the next 24 months. African-Americans, by contrast, were more likely than Whites to have practiced regular breast self-examination. When demographic and health- related factors were controlled for, however, no significant effect of race on mammography adherence or intentions was found.
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Breast cancer screening programs offer the greatest promise for early detection but rates of participation in free screening programs have been disappointing for challenged populations. The purpose of the current study is to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women hold toward breast cancer and breast cancer screening. During Year 01, the intermediary systematically attempted to contact 685 potentially eligible women from a - population data base from the Breast and Cervical Health Program in Washington state. Of these, 318 women had non-functioning phone contact numbers. Another 175 women were successfully contacted by the study intermediary, 91 of whom were screened out as ineligible and 26 of whom refused participation. A total of 64 eligible women agreed to be contacted by a study interviewer, 9 of whom declined or were determined to be ineligible by the interviewer. Thirty-one (31) women were enrolled and completed the case intensive interview and an additional 24 eligible women agreed to be contacted by a study team interviewer and are pending enrollment. Quality monitoring has been instituted for data generation and transcription. Initial inductive coding has yielded findings not previously documented in the research literature.
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.