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Breast cancer knowledge and barriers to mammography in a low-income managed care population

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Abstract

Background. Low-income women experience multiple barriers to screening mammography. This study explored cancer knowledge as a point of intervention to reduce overall barriers. Methods. A survey of breast cancer knowledge and barriers was obtained from 173 low-income female residents of Middle Tennessee, ≥40 years, enrolled in the state managed care organization and nonadherent to mammography. Multiple regression models examined the effect of breast cancer knowledge on mammography screening barriers. Results. Comprehensive breast cancer knowledge, not mere screening awareness, was the strongest contributor towards lower barrier scores. Conclusions. Strategies to overcome mammography barriers should include comprehensive breast cancer education.

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References

  1. American Cancer Society. Cancer Facts and Figures 2007. Atlanta: American Cancer Society; 2007.

    Google Scholar 

  2. O'Malley CD, Le GM, Glaser SL, et al. Socioeconomic status and breast carcinoma survival in four racial/ethnic groups: a population-based study. Cancer. 2003;97:1303–1311.

    Article  PubMed  Google Scholar 

  3. Yabroff KR, Gordis L. Does stage at diagnosis influence the observed relationship between socioeconomic status and breast cancer incidence, case-fatality, and mortality? Soc Sci Med. 2003;57:2265–2279.

    Article  PubMed  Google Scholar 

  4. Bouchardy C, Verkooijen HM, Fioretta G. Social class is an important and independent prognostic factor of breast cancer mortality. Int J Cancer. 2006;119:1145–1151.

    Article  CAS  PubMed  Google Scholar 

  5. Strzelcyk J, Dignan MB. Disparities in adherence to recommended follow up on screening mammography: interaction of socio-demographic factors. Ethn Dis. 2002;12:77–86.

    Google Scholar 

  6. Schootman M, Jeffe DB, Reschke AH, et al. Disparities related to socioeconomic status and access to medical care remain in the United State among women who never had a mammogram. Cancer Causes Control. 2003;14:419–425.

    Article  PubMed  Google Scholar 

  7. Crump SR, Mayberry RM, Taylor BD, et al. Factors related to noncompliance with screening mammogram appointments among low income African-American women. J Natl Med Assoc. 2000;92:237–246.

    CAS  PubMed  Google Scholar 

  8. Rawl SM, Champion VL, Menon U, et al. Impact of age and race on mammography practices. Health Care Women Int. 2000;21:583–597.

    Article  CAS  PubMed  Google Scholar 

  9. Powe BD. Cancer fatalism among elderly Caucasians and African Americans. Oncol Nurs Forum. 1995;22:1355–1359.

    CAS  PubMed  Google Scholar 

  10. Sox CM, Swartz K, Burstin HR, et al. Insurance or regular physician: which is the most powerful predictor of health care? Am J Public Health. 1998;88:364–370.

    Article  CAS  PubMed  Google Scholar 

  11. Finney Rutten LJ, Nelson DE, Meissner HI. Examination of population-wide trends in barriers to cancer screening from a diffusion of innovation perspective (1987–2000). Prev Med. 2004;38:258–268.

    Article  PubMed  Google Scholar 

  12. DeVoe JE, Fryer GE, Phillips R, et al. Receipt of preventive care among adults: insurance status and usual source of care. Am J Public Health. 2003;93:786–791.

    Article  PubMed  Google Scholar 

  13. Roetzhaim RG, Pal N, Tennant C, et al. Effects of health insurance and race on early detection of cancer. J Natl Cancer Inst. 1999;91:1409–1415.

    Article  Google Scholar 

  14. National Breast and Cervical Cancer Early Detection Program. National Center for Chronic Disease Prevention and Health Promotion. Atlanta: Centers for Disease Control and Prevention. Cancer Prevention and Control 2004–2005 Fact Sheet: The: National Breast and Cervical Cancer Early Detection Program: Saving lives through screening. Available at http://www.cdc.gov/cancer/nbccedp/ about2004.htm. Accessed February 28, 2008.

  15. Fiscella K, Franks P, Doescher MP, et al. Disparities in health care by race, ethnicity, and language among the insured: findings from a national sample. Med Care. 2002;409:52–59.

    Article  Google Scholar 

  16. Rogers EM. Diffusion of Innovations. 5th ed. New York: Free Press; 1995.

    Google Scholar 

  17. Ahmed NU, Fort JG, Elzey JD, et al. Empowering factors in repeat mammography: insights from the stories of underserved women. J Ambul Care Manage. 2004;27:348–355.

    PubMed  Google Scholar 

  18. Carney PA, Harwood BG, Greene MA, et al. Impact of a telephone counseling intervention on transitions in stage of change and adherence to interval mammography screening (United States). Cancer Causes Control. 2005;16:799–807.

    Article  PubMed  Google Scholar 

  19. Russell KM, Monahan P, Wagle A, et al. Differences in health and cultural beliefs by stage of mammography screening adoption in African American women. Cancer. 2007;109(2 Suppl):386–395.

    Article  PubMed  Google Scholar 

  20. Rutter DR, Steadman L, Quine L. An implementation intentions intervention to increase uptake of mammography. Ann Behav Med. 2006;32:127–134.

    Article  CAS  PubMed  Google Scholar 

  21. Achat H, Close G, Taylow R. Who has regular mammograms? Effects of knowledge, beliefs, socioeconomic status, and health-related factors. Prev Med. 2005;41:312–320.

    Article  PubMed  Google Scholar 

  22. Pearlman DN, Clark MA, Rakowski W, Ehrich B. Screening for breast and cervical cancers: the importance of knowledge and perceived cancer survivability. Women Health. 1999;28:93–112.

    Article  CAS  PubMed  Google Scholar 

  23. Paskett E, Tatum C, Rushing J, et al. Randomized trial of an intervention to improve mammography utilization among a triracial rural population of women. J Natl Cancer Inst. 2006;98:1226–1237.

    Article  PubMed  Google Scholar 

  24. Thompson H, Valdimarsdottir H, Winkel G, Jandorf L, Redd W. The Group-Based Medical Mistrust Scale: psychometric properties and association with breast cancer screening. Prev Med. 2004;38: 209–218.

    Article  PubMed  Google Scholar 

  25. Schillinger D, Barton LR, Karter AJ, et al. Does literacy mediate the relationship between education and health outcomes? A study of a low-income population with diabetes. Public Health Rep. 2006;121: 245–254.

    PubMed  Google Scholar 

  26. de Nooijer J, Lechner L, Cander M, et al. Short- and long-term effects of tailored information versus general information on determinants and intentions related to early detection of cancer. Prev Med. 2004;38:694–703.

    Article  PubMed  Google Scholar 

  27. Danigelis NL, Worden JK, Flynn BS, et al. Increasing mammography screening among low-income African American women with limited access to health information. Prev Med. 2005;40:880–887.

    Article  PubMed  Google Scholar 

  28. Kaiser Family Foundation Kaiser commission of Medicaid and the uninsured. October, 2007. The Uninsured. A Primer. Key facts about Americans without health insurance. Publication number: 7451-03.

  29. Screening for Breast Cancer, Topic Page. November 2003. U.S. Preventive Services Task Force. Agency for Healthcare Research and Quality, Rockville, MD. Available at http://www.ahrq.gov/clinic/uspstf/ uspsbrca.htm. Accessed February 28, 2008.

  30. Nelson DE, Powell-Griner E, Town M, et al. A comparison of national estimates from the National Health Interview Survey and the Behavioral Risk Factor Surveillance System. Am J Public Health. 2003;93:1335–1341.

    Article  PubMed  Google Scholar 

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Correspondence to Nasar U. Ahmed PhD.

Additional information

Supported by grant from the U.S. Army Medical Research and Materiel Command Fund No. DAMD 17-96-l-627.

This article is dedicated to the late Dr. Robert Hardy who led the development and initial implementation of the project.

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Ahmed, N.U., Fort, J.G., Fair, A.M. et al. Breast cancer knowledge and barriers to mammography in a low-income managed care population. J Canc Educ 24, 261–266 (2009). https://doi.org/10.1080/08858190902973077

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