Screening Mammography: A Cross-Sectional Study to Compare Characteristics of Women Aged 40 and Older From the Deep South Who Are Current, Overdue, and Never Screeners
Received 30 November 2008; received in revised form 25 July 2009; accepted 27 July 2009.
Purpose
We sought to identify unique barriers and facilitators to breast cancer screening participation among women aged 40 and older from Mississippi who were categorized as current, overdue, and never screeners.
Methods
Cross-sectional data from a 2003 population-based survey with 987 women aged 40 and older were analyzed. Chi-square analysis and multinomial logistic regression examined how factors organized under the guidance of the Model of Health Services Utilization were associated with mammography screening status.
Results
Nearly one in four women was overdue or had never had a mammogram. Enabling factors, including poor access to care (no annual checkups, no health insurance) and to health information, lack of social support for screening, and competing needs, were significantly associated with being both overdue and never screeners. Pertaining to factors unique to each screening group, women were more likely to be overdue when they had no usual source of health care and believed that treatment was worse than the disease. In turn, women were more likely to be never screeners when they were African American, lacked a provider recommendation for screening, and held the fatalistic view that not much could be done to prevent breast cancer.
Conclusion
Similar and unique factors impact utilization of mammography screening services among women. Those factors could inform efforts to increase screening rates.
aDepartment of Psychology, and The Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, Alaska
bDepartment of Health Services Administration, East Tennessee State University, Johnson City, Tennessee
cDepartment of Epidemiology and Biostatistics, University of Florida, Gainesville, Florida
dDepartment of Health Services Research, Management, and Policy, University of Florida, Gainesville, Florida
Correspondence to: Ellen D. S. Lopez, MPH, PhD, Department of Psychology, University of Alaska Fairbanks, PO 756480, Fairbanks, AK 99775-6480; Phone: (907) 474-7318; Fax: (907) 474-5781.
Funded by a grant from the Susan G. Komen Breast Cancer Foundation.
ABSTRACT