Learning Objective #1: Identify cultural disparities as possible barriers to regular mammography screening

Learning Objective #2: Recognize the need for increasing mammography screening rates by investigating barriers associated with screening as perceived by diverse ethnicities

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Since mammography remains the gold standard for breast cancer screening, one Healthy People 2010 objective is to increase the proportion of women aged 40 and older who have received a mammogram. Historically, samples predominately of white women have crowded the research with few studies focusing on a diverse sample that would include the barriers and benefits perceived by Hispanic, African-American, and women of other cultures. Research questions: What is the correlation between decisional balance, the relationship between the barriers and benefits of mammography, and screening mammography utilization for women age 40 and over? How will characteristics of a diverse sample relate to screening mammography utilization? What, if any, additional barriers to mammography will be identified by participants representing diverse ethnicities? Study description: Using a questionnaire, 91 urban women were sampled. The questionnaire was based upon the Transtheoretical Model (TTM) proposed by Prochaska and DiClemente (1982) testing the attitudes of women towards mammography. The women were categorized according to stages of adoption, a key element of the TTM that indicates mammography utilization. Results: Data analysis revealed four factors, instead of the two factors hypothesized by the TTM, suggesting the barriers for an ethnically diverse sample may be different than for a predominately sample of white women. Having some form of health insurance was significantly associated with the action/maintenance stage of adoption. Also, for the minority sample, “impractical” was a barrier to mammography screening. Other findings consistent with the literature were cost, pain, and provider rudeness as barriers identified through qualitative analysis. Conclusion: Research needs to continue to explore the benefits and barriers as perceived by various cultures to increase mammography utilization. Health care providers need to recognize and assess for barriers, with an awareness of cultural disparities, while continuing to recommend yearly mammograms for women over 40.