Skip to main content

Advertisement

SpringerLink
Log in

Are Health-care Relationships Important for Mammography Adherence in Latinas?

  • Original Article
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

Background

Latinas are the fastest growing racial ethnic group in the United States and have an incidence of breast cancer that is rising three times faster than that of non-Latino white women, yet their mammography use is lower than that of non-Latino women.

Objectives

We explored factors that predict satisfaction with health-care relationships and examined the effect of satisfaction with health-care relationships on mammography adherence in Latinas.

Design and Setting

We conducted a cross-sectional survey of 166 Latinas who were ≥40 years old. Women were recruited from Latino-serving clinics and a Latino health radio program.

Measurements

Mammography adherence was based on self-reported receipt of a mammogram within the past 2 years. The main independent variable was overall satisfaction with one’s health-care relationship. Other variables included: self report of patient-provider communication, level of trust in providers, primary language, country of origin, discrimination experiences, and perceptions of racism.

Results

Forty-three percent of women reported very high satisfaction in their health-care relationships. Women with high trust in providers and those who did not experience discrimination were more satisfied with their health-care relationships compared to women with lower trust and who experienced discrimination (p < .01). Satisfaction with the health-care relationship was, in turn, significantly associated with mammography adherence (OR: 3.34, 95% CI: 1.47–7.58), controlling for other factors.

Conclusions

Understanding the factors that impact Latinas’ mammography adherence may inform intervention strategies. Efforts to improve Latina’s satisfaction with physicians by building trust may lead to increased use of necessary mammography.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Schettino MR, Hernández-Valero MA, Moguel R, Hajek RA, Jones LA. Assessing breast cancer knowledge, beliefs, and misconceptions among Latinas in Houston, Texas. J Cancer Educ. 2006;21(1 Suppl):S42–46. Spring.

    Article  PubMed  Google Scholar 

  2. American Cancer Society: Cancer Facts and Figures for Hispanic/Latinos 2003–2005. Available at: http://www.cancer.org/downloads/STT/CAFF2003HispPWSecured.pdf. Last accessed July 15, 2008.

  3. American Cancer Society: Cancer Facts and Figures for Hispanic/Latinos 2006–2008. Available at http://www.cancer.org/downloads/STT/CAFF2006HispPWSecured.pdf. Last accessed July 15, 2008.

  4. Fernandez M, Tortotero-Luna G, Gold RS. Mammography and Pap test screening among low income foreign born Hispanic women in USA. Cad Saude Publica. 1998;14(Suppl. 3):133–47.

    PubMed  Google Scholar 

  5. Wu ZH, Black SA, Markides KS. Prevalence and associated factors of cancer screening: why are so many older Mexican American women never screened. Prev Med. 2001;33(4):268–73. Oct.

    Article  PubMed  CAS  Google Scholar 

  6. Gorin SS, Heck JE. Cancer screening among Latino subgroups in the United States. Prev Med. 2005;40(5):515–26. May.

    Article  PubMed  Google Scholar 

  7. Fernandez ME, Palmer RC, Leong-Wu CA. Repeat mammography screening among low income and minority women; a qualitative study. Cancer Control. 2005;12(Suppl 2):77–83. Nov.

    PubMed  Google Scholar 

  8. Darnell JS, Chang CH, Calhoun EA. Knowledge about breast cancer and participation in faith-based breast cancer program and other predictors of mammography screening among African-American women and Latinas. Health Promot Pract. 2006;7(3 Suppl):201S–12S. Jul, Epub 2006 Jun 7.

    Article  PubMed  Google Scholar 

  9. Warren AG, Londono GE, Wessel LA, Warren RD. Breaking down barriers to breast and cervical cancer screening: a university -based prevention program for Latinas. J Health Care Poor Underserved. 2006;17(3):512–21. Aug.

    Article  PubMed  Google Scholar 

  10. Mahnken JD, Freeman DH, DiNuzzo AR, Freeman JL. Mammography use among older Mexican-American women: correcting for over-reports of breast cancer screening. Women Health. 2007;45(3):53–64.

    Article  PubMed  Google Scholar 

  11. Zambrana RE, Breen N, Fox SA, Gutierrez-Mohamed ML. Use of cancer screening practices by Hispanic women: analyses by subgroup. Prev Med. 1999;29(6 Pt 1):466–77. Dec.

    Article  PubMed  CAS  Google Scholar 

  12. Qureshi M, Thacker HL, Litaker DG, Kippes C. Differences in breast cancer screening rates: an issue of ethnicity or socioeconomics? J. Womens Health Gend Based Med. 2000;9(9):1025–31. Nov.

    Article  CAS  Google Scholar 

  13. Rodriguez MA, Ward LM, Perez-Stable EJ. Breast and cervical cancer screening: impact of health insurance status, ethnicity, and nativity of Latinas. Ann Fam Med. 2005;3(3):235–241. May-Jun.

    Article  PubMed  Google Scholar 

  14. Borrayo EA, Guarnaccia CA. Differences in Mexican-born and U.S.-born women of Mexican descent regarding factors related to breast cancer screening behaviors. Health Care for Women International21:599–613.

  15. Welsh AL, Sauaua A, Jacobellis J, Min SJ, Byers T. The effect of two church-based interventions on breast cancer screening rates among Medicaid-insured Latinas. Prev Chronic Dis. 2005;2(4):A07. Oct, Epub 2005 Sep 15.

    PubMed  Google Scholar 

  16. DeLaet DE, Shea S, Carrasquillo O. Receipt of preventive services among privately insured minorities in managed care versus fee-for-service insurance plans. J Gen Intern Med. 2002;17(6):451–57. Jun.

    Article  PubMed  Google Scholar 

  17. Garbers S, Jessop DJ, Foti H, Uribelarrea M, Chiasson MA. Barriers to breast cancer screening for low-income Mexican and Dominican women in New York City. J Urban Health. 2003;80(1):81–91. Mar.

    PubMed  Google Scholar 

  18. Goel MS, Wee CC, McCarthy EP, Davis RB, Ngo-Metzger Q, Phillips RS. Racial and ethnic disparities in cancer screening: the importance of foreign birth as a barrier to care. J Gen Intern Med. 2003;18(12):1028–35. Dec.

    Article  PubMed  Google Scholar 

  19. Van Houtven CH, Voils CI, Oddone EZ, et al. Perceived discrimination and reported delay of pharmacy prescriptions and medical tests. J Gen Intern Med. 2005;20(7):578–583. Jul.

    Article  PubMed  Google Scholar 

  20. Trivedi AN, Ayanian JZ. Perceived discrimination and use of preventive health services. J Gen Intern Med. 2006;21(6):553–8. Jun.

    Article  PubMed  Google Scholar 

  21. Chen FM, Fryer GE, Phillips RL, Wilson E, Pathman DE. Patients’ beliefs about racism, preferences for physician race, and satisfaction with care. Ann Fam Med. 2005;3(2):138–43. Mar-Apr.

    Article  PubMed  Google Scholar 

  22. Nápoles-Springer AM, Santoyo J, Houston K, Pérez-Stable EJ, Stewart AL. Patients’ perceptions of cultural factors affecting the quality of their medical encounters. Health Expect. 2005;8(1):4–17. Mar.

    Article  PubMed  Google Scholar 

  23. Kreling BA, Cañar J, Catipon E, et al. Latin American Cancer Research Coalition. Community primary care/academic partnership model for cancer control. Cancer. 2006;107(8 Suppl):2015–22. Oct 15.

    Article  PubMed  Google Scholar 

  24. Angel RJ, Angel JL, Markides KS. Stability and change in health insurance among older Mexican Americans: longitudinal evidence from the Hispanic established populations for epidemiologic study of the elderly. Am J Public Health. 2002;92(8):1264–71. Aug.

    Article  PubMed  Google Scholar 

  25. Morales LS, Reise SP, Hays RD. Evaluating the equivalence of health care ratings by whites and Hispanics. Med Care. 2000;38(5):517–27. May.

    Article  PubMed  CAS  Google Scholar 

  26. Zambrana RE. A research agenda on issues affecting poor and minority women: a model for understanding their health needs. Women Health. 1987;12(3–4):137–60.

    PubMed  CAS  Google Scholar 

  27. Ashton CM, Haidet P, Paterniti DA, et al. Racial and ethnic disparities in the use of health services: bias, preferences, or poor communication. J Gen Intern Med. 2003;18(2):146–52. Feb.

    Article  PubMed  Google Scholar 

  28. Tucker CM, Herman KC, Pedersen TR, Higley B, Montrichard M, Ivery P. Cultural sensitivity in physician-patient relationships: perspectives of an ethnically diverse sample of low-income primary care patients. Med Care. 2003;41(7):859–70. Jul.

    Article  PubMed  Google Scholar 

  29. Collins KS, Tenney K, Hughes DL. Quality Health Care for African-Americans: findings from the commonwealth fund 2001 health care quality study. New York, NY: The Commonwealth Fund; 2002.

    Google Scholar 

  30. Marshall G. A comparative study of re-attenders and non-re-attenders for second triennial National Breast Screening Programme appointments. J Public Health Med. 1994;16(1):79–86. Mar.

    PubMed  CAS  Google Scholar 

  31. Miller AM, Champion VL. Mammography in women > or = 50 years of age. Predisposing and enabling characteristics. Cancer Nurs. 1993;16(4):260–269. Aug.

    Google Scholar 

  32. Orton M, Fitzpatrick R, Fuller A, Mant D, Mlynek C, Thorogood M. Factors affecting women’s response to an invitation to attend for a second breast cancer screening examination. Br J Gen Pract. 1991;41(349):320—2. Aug.

    PubMed  CAS  Google Scholar 

  33. Peipins LA, Shapiro JA, Bobo JK, Berkowitz Z. Impact of women’s experiences during mammography on adherence to rescreening (United States). Cancer Causes Control. 2006;17(4):439—47. May.

    Article  PubMed  Google Scholar 

  34. Somkin CP, McPhee SJ, Nguyen T, et al. The effect of access and satisfaction on regular mammogram and Papanicolaou test screening in a multiethnic population. Med Care. 2004;42(9):914—26. Sep.

    Article  PubMed  Google Scholar 

  35. Crow R, Gage H, Hampson S, et al. The measurement of satisfaction with healthcare: implications for practice from a systematic review of the literature. Health Technol Assess. 2002;6(32):1—244.

    PubMed  CAS  Google Scholar 

  36. Gritz ER, Bastani R. Cancer prevention-behavior changes: the short and the long of it. Prev Med. 1993;22(5):676–88. Sep.

    Article  PubMed  CAS  Google Scholar 

  37. O’Malley AS, Sheppard VB, Schwartz M, Mandelblatt J. The role of trust in use of preventive services among low-income African-American women. Prev Med. 2004;38(6):777–85. Jun.

    Article  PubMed  Google Scholar 

  38. Otero-Sabogal R, Owens D, Canchola J, Golding JM, Tabnak F, Fox P. Mammography rescreening among women of diverse ethnicities: patient, provider, and health care system factors. J Health Care Poor Underserved. 2004;15(3):390–412. Aug.

    Article  PubMed  Google Scholar 

  39. Sheppard VB, Zambrana RE, O’Malley AS. Providing health care to low-income women: a matter of trust. Fam Pract. 2004;21(5):484–91. Oct.

    Article  PubMed  Google Scholar 

  40. Sheppard VB, Figueiredo M, Cañar J, et al. Latina a Latina(SM): developing a breast cancer decision support intervention. Psychooncology. 2007 Jul 13; [Epub ahead of print].

  41. Diaz V. Cultural factors in preventive care: Latinos. Prim Care. 2002;29(3):503–17. Sep, viii.

    PubMed  Google Scholar 

  42. Lauderdale DS, Wen M, Jacobs EA, Kandula NR. Immigrant perceptions of discrimination in health care: the California Health Interview Survey 2003. Med Care. 2006;44(10):914–20. Oct.

    Article  PubMed  Google Scholar 

  43. Peragallo NP, Fox PG, Alba ML. Breast care among Latino immigrant women in the U.S. Health Care Women Int. 1998;19(2):165–72. Mar-Apr.

    Article  PubMed  CAS  Google Scholar 

  44. O’Malley AS, Beaton E, Yabroff KR, Abramson R, Mandelblatt J. Patient and provider barriers to colorectal cancer screening in the primary care safety-net. Prev Med. 2004;39(1):56–63. Jul.

    Article  PubMed  CAS  Google Scholar 

  45. Sheppard VB, Cox LS, Kanamori MJ, et al. Latin American Cancer Research Coalition. Brief report: if you build it, they will come: methods for recruiting Latinos into cancer research. J Gen Intern Med. 2005;20(5):444–7. May.

    Article  PubMed  Google Scholar 

  46. O’Malley CD, Le GM, Glaser SL, Shema SJ, West DW. Socioeconomic status and breast carcinoma survival in four racial/ethnic groups: a population-based study. Cancer. 2003;97(5):1303–11. Mar 1.

    Article  PubMed  Google Scholar 

  47. DC Office of Latino Affairs, Latinos in the District of Columbia: Demographics *, Internet - http://ola.dc.gov/ola/cwp/view,a,3,q,568739,olaNav,%7C32535%7C,.asp — Accessed on April 9, 2008.

  48. Bastani R, Marcus AC, Hollatz-Brown A. Screening mammography rates and barriers to use: a Los Angeles County survey. Prev Med. 1991;20(3):350–363. May.

    Article  PubMed  CAS  Google Scholar 

  49. Bastani R, Marcus AC, Maxwell AE, Das IP, Yan KX. Evaluation of an intervention to increase mammography screening in Los Angeles. Prev Med. 1994;23(1):83–90. Jan.

    Article  PubMed  CAS  Google Scholar 

  50. Dimatteo MR, Hays RD, Gritz ER, Bastani R, Crane L, Elashoff R. Patient adherence to cancer control regimens: Scale development and initial validation. Psych Assess. 1993;5(1):102–12.

    Article  Google Scholar 

  51. Bastani R, Maxwell AE, Bradford C, Das IP, Yan KX. Tailored risk notification for women with a family history of breast cancer. Prev Med. 1999;29(5):355–64. Nov.

    Article  PubMed  CAS  Google Scholar 

  52. O’Malley AS, Gonzalez RM, Sheppard VB, Huerta E, Mandelblatt J. Primary care cancer control interventions including Latinos: a review. Am J Prev Med. 2003;25(3):264–71. Oct.

    Article  PubMed  Google Scholar 

  53. Mandelblatt JS, Gold K, O’Malley AS, et al. Breast and cervix cancer screening among multiethnic women: role of age, health, and source of care. Prev Med. 1999;28(4):418–25. Apr.

    Article  PubMed  CAS  Google Scholar 

  54. O’Malley AS, Forrest CB. Beyond the examination room: primary care performance and the patient-physician relationship for low-income women. J Gen Intern Med. 2002;17(1):66—74. Jan.

    Article  PubMed  Google Scholar 

  55. Mojica CM, Bastani R, Ponce NA, Boscardin WJ. Latinas with abnormal breast findings: patient predictors of timely diagnostic resolution. J Womens Health (Larchmt). 2007;16(10):1468–77. Dec.

    Google Scholar 

  56. Graves KD, Huerta E, Cullen J, et al. Perceived risk of breast cancer among Latinas attending community clinics: risk comprehension and relationship with mammography adherence. Cancer Causes Control. 2008 Aug 15.

  57. Bird ST, Bogart LM. Perceived race-based and socioeconomic status (SES)-based discrimination in interactions with health care providers. Ethn Dis. 2001;11(3):554–63. Autumn.

    PubMed  CAS  Google Scholar 

  58. LaVeist TA, Nickerson KJ, Boulware LE, Powe NR. The Medical Mistrust Index: A Measure of Mistrust of the Medical Care System 2001.

  59. SAS Institute, Cary, NC, USA, 2002–2003.

  60. Bazargan M, Bazargan SH, Calderón JL, Husaini BA, Baker RS. Mammography screening and breast self-examination among minority women in public housing projects: the impact of physician recommendation. Cell Mol Biol (Noisy-le-grand). 2003;49(8):1213–8. Dec.

    CAS  Google Scholar 

  61. Jibaja ML, Kingery P, Neff NE, Smith Q, Bowman J, Holcomb JD. Tailored, interactive soap operas for breast cancer education of high-risk Hispanic women. J Cancer Educ. 2000;15(4):237–42. Winter.

    PubMed  CAS  Google Scholar 

  62. O’Malley AS, Kerner J, Johnson AE, Mandelblatt J. Acculturation and breast cancer screening among Hispanic women in New York City. Am J Public Health. 1999;89(2):219–27. Feb.

    Article  PubMed  CAS  Google Scholar 

  63. Breen N, A Cronin K, Meissner HI, et al. Reported drop in mammography: is this cause for concern. Cancer. 2007;Jun 15;109(12):2405–9.

    Article  PubMed  Google Scholar 

  64. Agency for Healthcare Research and Quality. 2007 National Healthcare Disparities Report. Rockville, MD: U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality; February 2008. AHRQ Pub. No. 08-0041.

  65. Aldridge ML, Daniels JL, Jukic AM. Mammograms and healthcare access among US Hispanic and non-Hispanic women 40 years and older. Fam Community Health. 2006;29(2):80–8. Apr-Jun.

    PubMed  Google Scholar 

  66. Saha S, Komaromy M, Koepsell TD, Bindman AB. Patient-physician racial concordance and the perceived quality and use of health care. Arch Intern Med. 1999;159(9):997–1004. May 10.

    Article  PubMed  CAS  Google Scholar 

  67. Gorin SS, Ashford AR, Lantigua R, Desai M, Troxel A, Gemson D. Implementing academic detailing for breast cancer screening in underserved communities. Implement Sci. 2007;2:43. Dec 17.

    Article  PubMed  Google Scholar 

  68. Flores G. Culture and the patient-physician relationship: achieving cultural competency in health care. J Pediatr. 2000;136(1):14–23. Jan.

    Article  PubMed  CAS  Google Scholar 

  69. Moy B, Park ER, Feibelmann S, Chiang S, Weissman JS. Barriers to repeat mammography: cultural perspectives of African-American, Asian, and Hispanic women. Psychooncology. 2006;15(7):623–34. Jul.

    Article  PubMed  Google Scholar 

  70. Saha S, Arbelaez JJ, Cooper LA. Patient-physician relationships and racial disparities in the quality of health care. Am J Public Health. 2003;93(10):1713–9. Oct.

    Article  PubMed  Google Scholar 

  71. Derose KP, Baker DW. Limited English proficiency and Latinos’ use of physician services. Med Care Res Rev. 2000;57(1):76–91. Mar.

    PubMed  CAS  Google Scholar 

  72. Levy-Storms L, Bastani R, Reuben DB. Predictors of varying levels of nonadherence to mammography screening in older women. J Am Geriatr Soc. 2004;52(5):768–773. May.

    Article  PubMed  Google Scholar 

  73. Gany FM, Herrera AP, Avallone M, Changrani J. Attitudes, knowledge, and health-seeking behaviors of five immigrant minority communities in the prevention and screening of cancer: a focus group approach. Ethn Health. 2006;11(1):19–39. Feb.

    Article  PubMed  Google Scholar 

  74. Erwin DO, Johnson VA, Trevino M, Duke K, Feliciano L, Jandorf L. A comparison of African American and Latina social networks as indicators for culturally tailoring a breast and cervical cancer education intervention. Cancer. 2007;109(2 Suppl):368–77. Jan 15.

    Article  PubMed  Google Scholar 

  75. Thompson HS, Valdimarsdottir HB, Winkel G, Jandorf L, Redd W. The Group-Based Medical Mistrust Scale: psychometric properties and association with breast cancer screening. Prev Med. 2004;38(2):209–18. Feb.

    Article  PubMed  Google Scholar 

  76. O’Malley AS, Forrest CB, Mandelblatt J. Adherence of low-income women to cancer screening recommendations. J Gen Intern Med. 2002;17(2):144–54. Feb.

    Article  PubMed  Google Scholar 

  77. Yarbroff KS, Mandelblatt JS. Interventions targeted toward patients to increase mammography use. Cancer Epidemiol Biomarkers Prev. 1999;8(9):749–57. Sep.

    Google Scholar 

  78. Williams SA, Swanson MS. The effect of reading ability and response formats on patients’ abilities to respond to a patient satisfaction scale. J Contin Educ Nurs. 2001;32:60–67.

    PubMed  CAS  Google Scholar 

  79. Terán L, Baezconde-Garbanati L, Márquez M, Castellanos E, Belkić K. On-time mammography screening with a focus on Latinas with low income: a proposed cultural model. Anticancer Res. 2007;27(6C):4325–38. Nov-Dec.

    PubMed  Google Scholar 

  80. Luquis RR, Villanueva Cruz IJ. Knowledge, attitudes, and perceptions about breast cancer and breast cancer screening among Hispanic women residing in South Central Pennsylvania. J Community Health. 2006;31(1):25–42. Feb.

    Article  PubMed  Google Scholar 

  81. Wells KJ, Roetzheim RG. Health disparities in receipt of screening mammography in Latinas: a critical review of recent literature. Cancer Control. 2007;14(4):369–79. Oct.

    PubMed  Google Scholar 

  82. Madlensky L, Vierkant RA, Vachon CM, et al. Preventive health behaviors and familial breast cancer. Cancer Epidemiol Biomarkers Prev. 2005;14(10):2340–5. Oct.

    Article  PubMed  Google Scholar 

  83. Koval AE, Riganti AA, Foley KL. CAPRELA (Cancer Prevention for Latinas): findings of a pilot study in Winston-Salem, Forsyth County. N C Med J. 2006;67(1):9–15. Jan-Feb.

    PubMed  Google Scholar 

Download references

Acknowledgements

The authors are grateful to all of the women who took time to participate in the study.

Members of the Latin American Cancer Research Coalition who participated in this study included: Janet Cañar, MD, at Spanish Catholic Center, Jyl Pomeroy at Arlington Free Clinic, John Kavanaugh at La Clinica Del Pueblo, and Yosselyn Rodriguez at Washington Cancer institute/Medstar Research Institute.

We acknowledge Michelle Goodman, MA, and Mariano Kanamori for research support and Maria Lopez, Ph.D., for review of the manuscript.

Supported, in part, by ACS grants MRSGT-06-132-01-CPPB (VBS) and MRSGT-05-104-01-CPPB (JW), National Cancer Institute grants UO1 CA86114 (EH, JM), U01-CA114593 (EH, JM), and KO5 CA96940 (JM)

Conflict of Interest Statement

None disclosed.

Author information

Authors and Affiliations

  1. Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA

    Vanessa B. Sheppard PhD, Judy Wang PhD, Bin Yi, Toni Michelle Harrison & Jeanne S. Mandelblatt MD, MPH

  2. Genentech, Inc., San Francisco, CA, USA

    Shibao Feng PhD

  3. Washington Cancer Institute, Washington Hospital Center and Medstar Research institute, Washington, DC, USA

    Elmer E. Huerta MD, MPH

Authors
  1. Vanessa B. Sheppard PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Judy Wang PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bin Yi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Toni Michelle Harrison
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shibao Feng PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Elmer E. Huerta MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jeanne S. Mandelblatt MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

For the Latin American Cancer Research Coalition

Corresponding author

Correspondence to Vanessa B. Sheppard PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sheppard, V.B., Wang, J., Yi, B. et al. Are Health-care Relationships Important for Mammography Adherence in Latinas?. J GEN INTERN MED 23, 2024–2030 (2008). https://doi.org/10.1007/s11606-008-0815-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11606-008-0815-6

KEY WORDS

Search

Navigation