Abstract
American Indian women have rising incidence and disproportionate mortality rates due to breast cancer. Using a community-based participatory research approach, we conducted ten focus groups with American Indian women in Kansas and Missouri to understand their barriers to mammography and identify ways to intervene to improve screening rates. Focus groups were stratified by screening status, including women who were up to date with current screening mammography recommendations (mammogram within the last 2 years, N = 7 groups, 66 participants) and women who were not (N = 3 groups, 18 participants). While many similarities were identified across strata, some differences emerged, particularly descriptions of prior negative experiences with the health care system among women who were not up to date with screening recommendations. Primary areas identified by participants for intervention included culturally appropriate educational materials and interventions directed specifically at improving American Indian women’s trust in Western medicine and alleviating feelings of discrimination.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Cancer Society (2010) Breast cancer facts and figures 2009–2010. American Cancer Society, Inc., Atlanta
Stewart SL, King JB, Thompson TD, Friedman C, Wingo PA (2004) Cancer mortality surveillance—United States, 1990–2000. MMWR Surveill Summ 53(3):1–108
Horner MJ, Ries LAG, Krapcho M et al (2009) SEER Cancer statistics review, 1975-2006. National Cancer Institute, Bethesda
Smith-Bindman R, Miglioretti DL, Lurie N et al (2006) Does utilization of screening mammography explain racial and ethnic differences in breast cancer? Ann Intern Med 144(8):541–553
Wingo PA, King J, Swan J (2008) Breast cancer incidence among American Indian and Alaska Native women: US, 1999–2004. Cancer 113(S5):1191–1202
US Department of Health and Human Services, Office of Disease Prevention and Health Promotion, Healthy People 2020, Washington, DC
National Center for Health Statistics, Centers for Disease Control and Prevention. “DATA 2010.” https://wonder.cdc.gov/DATA2010
American Cancer Society (2007) Cancer facts and figures 2007. American Cancer Society, Inc., Atlanta
US Preventive Services Task Force (2009) Screening for breast cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med 151(10):716–726
Susan G. Komen for the Cure (2010) Breast cancer screening recommendations for women of average risk
Crawley LM, Ahn DK, Winkleby MA (2008) Perceived medical discrimination and cancer screening behaviors of racial and ethnic minority adults. Cancer Epidemiol Biomarkers Prev 17(8):1937–1944
Paskett ED, Tatum C, Rushing J et al (2004) Racial differences in knowledge, attitudes, and cancer screening practices among a triracial rural population. Cancer 101(11):2650–2659
Ogunwole S (2006) We the people: American Indians and Alaska Natives in the United States. Census 2000 Special Reports (CENSR-28). US Census Bureau, Washington
Espey DK, Wu XC, Swan J et al (2007) Annual report to the nation on the status of cancer, 1975-2004, featuring cancer in American Indians and Alaska Natives. Cancer 110(10):2119–2152
Daley CM, Prue R, Briscoe J, James AS, & Greiner KA (2007) Community leader and provider views of breast and colorectal cancer screening needs and barriers for Native people in the Heartland. Spirit of Eagles 7th National Changing Patterns of Cancer in Native communities: the power of partnerships. Minneapolis
Daley CM, James AS, Ulrey E, Joseph S, Talawyma A, Choi WS, Greiner KA, Coe MK (2010) Using focus groups in community-based participatory research: challenges and resolutions. Qual Health Res 20(5S), ePub 2010; Feb 12
Daley, CM, Joseph, S, Monetau, D, Cully, A, Kraemer-Diaz, A (2010) Barriers to Mammography among Native Women in Kansas and Missouri. Spirit of Eagles 8th National Changing Patterns of Cancer in Native communities. Seattle
Kraemer A, Daley CM (2010) Views of American Indian women age 40 and older about breast cancer screening. Annual Meeting of the Society for Applied Anthropology, Merida
Burhansstipanov L, Dignan MB, Schumacher A, Krebs LU, Alfonsi G, Apodaca CC (2010) Breast cancer screening navigator programs within three settings that assist underserved women. J Cancer Educ 25(2):247–252
Donelan K, Mailhot JR, Dutwin D, Barnickle K, Oo SA, Hobreker K, Percac-Lima S, Chabner BA (2010) Patient perspectives of clinical care and patient navigation in follow-up of abnormal mammography. J Gen Intern Med 26(2):116–122
Schlueter DF, Thompson WW, Mason TA, Rayton M, Arriola KJ (2010) A qualitative evaluation of the Avon Foundation community education and outreach initiative patient navigation program. J Cancer Educ 25(4):571–576
Engelman KK, Daley CM, Gajewski BJ, Ndikum-Moffor F, Faseru B, Braiuca S, Joseph S, Ellerbeck EF, Greiner KA (2010) An assessment of American Indian women’s mammography experiences. BMC Womens Health 10:34
Engelman KK, Cupertino AP, Daley CM, Long T, Cully A, Mayo MS, Ellerbeck EF, Geana MV, Greiner KA (2011) Engaging diverse underserved communities to bridge the mammography divide. BMC Public Health 11:47
Acknowledgments
Funding for this study was provided by Susan G. Komen for the Cure (POP0600430). The authors wish to thank the tribes and community organizations who provided recruitment help and locations to conduct focus groups.
Conflict of Interest
The authors declare that they have not conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Daley, C.M., Kraemer-Diaz, A., James, A.S. et al. Breast Cancer Screening Beliefs and Behaviors Among American Indian Women in Kansas and Missouri: a Qualitative Inquiry. J Canc Educ 27 (Suppl 1), 32–40 (2012). https://doi.org/10.1007/s13187-012-0334-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13187-012-0334-3