TY - JOUR
T1 - Measuring sustained mammography use by urban African-American women
AU - Greene, Amanda L.
AU - Torio, Celeste M.
AU - Klassen, Ann C.
N1 - Funding Information:
This work was supported in part by awards to Dr. Klassen from the National Cancer Institute (investigator-initiated grant R01 CA66065) and the AVON Foundation (AVON Foundation Gift to the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins).
PY - 2005/8
Y1 - 2005/8
N2 - Although the numbers of African-American women who are 'ever' screened for breast cancer has increased, sustaining regular screening over a lifetime remains a problem. Face-to-face interviews about breast cancer screening were conducted with 576 African-American women from an east coast city. The well-screened index measuring adherence to breast cancer screening guidelines was developed and tested. This index incorporated a woman's past and present use of mammography plus her future intent to be screened. Respondents were dichotomized into well-screened and not well-screened groups. Social and psychological factors associated with sustained screening as measured by this index were then explored. In bivariate analyses, education, health insurance, usual source of care, chronicity and preference for provider ethnicity and gender were significantly different for the two groups. In the multivariate model, women who were well-screened were significantly more likely to report recent physician contact, Pap smear, dental visit, history of breast problems, and beliefs that screening should be done annually and that early detection improves outcomes. Women reporting poor health were less likely to be well-screened. The well-screened index can potentially be used for assessment by clinicians and for program evaluation; however further validation studies need to be conducted. Despite limited resources, the majority of these urban African-American women are building lifetime patterns of regular breast cancer screening. Focused efforts are needed to achieve sustained screening patterns in the 25% who are not regularly screened.
AB - Although the numbers of African-American women who are 'ever' screened for breast cancer has increased, sustaining regular screening over a lifetime remains a problem. Face-to-face interviews about breast cancer screening were conducted with 576 African-American women from an east coast city. The well-screened index measuring adherence to breast cancer screening guidelines was developed and tested. This index incorporated a woman's past and present use of mammography plus her future intent to be screened. Respondents were dichotomized into well-screened and not well-screened groups. Social and psychological factors associated with sustained screening as measured by this index were then explored. In bivariate analyses, education, health insurance, usual source of care, chronicity and preference for provider ethnicity and gender were significantly different for the two groups. In the multivariate model, women who were well-screened were significantly more likely to report recent physician contact, Pap smear, dental visit, history of breast problems, and beliefs that screening should be done annually and that early detection improves outcomes. Women reporting poor health were less likely to be well-screened. The well-screened index can potentially be used for assessment by clinicians and for program evaluation; however further validation studies need to be conducted. Despite limited resources, the majority of these urban African-American women are building lifetime patterns of regular breast cancer screening. Focused efforts are needed to achieve sustained screening patterns in the 25% who are not regularly screened.
KW - African-American women
KW - Breast cancer screening
KW - Mammography
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U2 - 10.1007/s10900-005-3703-6
DO - 10.1007/s10900-005-3703-6
M3 - Review article
C2 - 15989207
AN - SCOPUS:19944387284
SN - 0094-5145
VL - 30
SP - 235
EP - 251
JO - Journal of Community Health
JF - Journal of Community Health
IS - 4
ER -