Journal of Cancer Education

, Volume 32, Issue 2, pp 328–334 | Cite as

Perspectives of Low-Income African-American Women Non-adherent to Mammography Screening: the Importance of Information, Behavioral Skills, and Motivation

  • Anjanette A. Wells
  • En-Jung Shon
  • Kelly McGowan
  • Aimee James


Although information-motivation-behavioral skills (IMB) adherence model has been successfully used in many illness domains and with other populations, it has not been used in understanding mammogram screening among low-income African-American women. Thus, a qualitative examination is needed to theoretically and collectively understand the barriers to screening, given the disparities in breast cancer mortality rates among this population. Semi-structured telephone interviews were conducted with 28 low-income uninsured and underinsured African-American women, 40 to 70 years, who had not had a mammogram within the past 12 months. Women were recruited from 21 hair and nail salons and Laundromats within the five North St. Louis city zip codes with the highest breast cancer mortality rates. Transcripts were analyzed and rooted in grounded theory. This study found that the individual relevancy of information, behavioral skills—both procedural and systematic—and motivation seemed to affect screening adherence; (the results suggest the importance of reordering traditional IMB components into the following sequential order: information, behavioral skills, and motivation (IBM)). Future analyses should include a larger, more representative sample of unscreened women, in which quantitative statistical analyses could be conducted to assist in strengthening assertions about information, behavioral skills, and motivational aspects and their relationship to screening.


Mammography screening African-American Low-income Information-Motivation-Behavioral skills (IMB) model Qualitative methodologies 


Compliance with Ethical Standards

Each woman was provided informed consent and given a $25 incentive for participation. This study protocol was approved by the Institutional Review Board at Washington University in St. Louis.


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Copyright information

© American Association for Cancer Education 2015

Authors and Affiliations

  • Anjanette A. Wells
    • 1
  • En-Jung Shon
    • 2
  • Kelly McGowan
    • 1
  • Aimee James
    • 3
  1. 1.Brown School of Social WorkWashington University in St. LouisSt. LouisUSA
  2. 2.Jack, Joseph and Morton Mandel School of Applied Social SciencesCase Western Reserve UniversityClevelandUSA
  3. 3.Department of SurgeryWashington University in St. Louis School of MedicineSt. LouisUSA

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