Mammography use has increased over the past 20 years, yet more than 30% of women remain inadequately screened. Structural barriers can deter individuals from screening, however, cognitive, emotional, and communication barriers may also prevent mammography use. This study sought to identify the impact of number and type of barriers on mammography screening status, and to examine whether number and type of barriers are different for never-screened and off-schedule women. A total of 182 women aged 40 years or older completed a computer kiosk facilitated survey as part of a larger patient navigator intervention. Logistic regression analysis indicated that breast cancer knowledge predicted whether a woman had ever had a mammogram (odds ratio [OR] = 1.04, 95% confidence interval [CI] = 1.02-1.06, p = .0003), while the number of emotional, structural, and communication barriers predicted whether a woman was on-schedule for mammograms (OR = 0.79, 95% CI = 0.65-0.95, p = .0127). The results suggest that to increase the use of mammography at recommended regular intervals, interventions should be tailored toward current screening status.
AchatH.CloseG.TaylorR. (2005). Who has regular mammograms? Effects of knowledge, beliefs, socioeconomic status, and health-related factors. Preventive Medicine, 41, 312-320.
BanduraA. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.
4.
ChewL. D.BradleyK. A.BoykoE. J. (2004). Brief questions to identify patients with inadequate health literacy. Family Medicine, 36, 588-594.
5.
ChewL. D.GriffinJ.PartinM.NoorbaloochiS.GrillJ.SnyderA.. . . VanRynM. (2008). Validation of screening questions for limited health literacy in a large VA outpatient population. Journal of General Internal Medicine, 23, 561-566.
6.
ClarkM. A.BonacoreL.WrightS. J.ArmstrongG.RakowskiW. (2003). The cancer screening project for women: Experiences of women who partner with women and women who partner with men. Women & Health, 38(2), 19-33.
7.
ClarkM. A.RogersM. L.ArmstrongG. F.RakowskiW.BowenD. J.HughesT.McGarryK. A. (2009). Comprehensive cancer screening among unmarried women aged 40–75 years: Results from the cancer screening project for women. Journal of Women’s Health, 18, 451-459.
8.
DietrichA. J.O’ConnorG. T.KellerA.CarneyP. A.LevyD.WhaleyF. S. (1992). Cancer: Improving early detection and prevention. A community practice randomised trial. British Medical Journal, 304, 687-691.
9.
GoelM. S.GraciaG.BakerD. W. (2011). Development and pilot testing of a culturally sensitive multimedia program to improve breast cancer screening in Latina women. Patient Education and Counseling, 84, 128-131.
10.
HalabiS.SkinnerC. S.SamsaG. P.StrigoT. S.CrawfordY. S.RimerB. K. (2000). Factors associated with repeat mammography screening. Journal of Family Practice, 49, 1104-1112.
11.
KreuterM. W.AlcarazK. I.PfeifferD.ChristopherK. (2008). Using dissemination research to identify optimal community settings for tailored breast cancer information kiosks. Journal of Public Health Management and Practice, 14, 160-169.
12.
KreuterM. W.BlackW. J.FriendL. B.BookerA. C.KlumpP.BobraS.HoltC. L. (2006). Use of computer kiosks for breast cancer education in five community settings. Health Education & Behavior, 33, 625-642.
13.
MandelblattJ. S.YabroffK. R. (1999). Effectiveness of interventions designed to increase mammography use: A meta-analysis of provider-targeted strategies. Cancer Epidemiology, Biomarkers & Prevention, 8, 759-767.
14.
MayneL.EarpJ. (2003). Initial and repeat mammography screening: Different behaviors/different predictors. Journal of Rural Health, 19, 63-71.
Otero-SabogalR.OwensD.CancholaJ.GoldingJ. M.TabnakF.FoxP. (2004). Mammography rescreening among women of diverse ethnicities: Patient, provider, and health care system factors. Journal of Health Care for the Poor and Underserved, 15, 390-412.
17.
PasickR. J.BurkeN. J. (2008). A critical review of theory in breast cancer screening promotion across cultures. Annual Review of Public Health, 29, 351-368.
18.
PeekM. E.HanJ. H. (2004). Disparities in screening mammography. Journal of General Internal Medicine, 19, 184-194.
19.
PolitiM. C.ClarkM. A.RogersM. L.McGarryK.SciamannaC. N. (2008). Patient–provider communication and cancer screening among unmarried women. Patient Education and Counseling, 73, 251-255.
20.
SchuelerK. M.ChuP. W.Smith-BindmanR. (2008). Factors associated with mammography utilization: A systematic quantitative review of the literature. Journal of Women’s Health, 17, 1477-1498.
21.
TaplinS. H.IchikawaL.YoodM. U.ManosM. M.GeigerA. M.WeinmannS.. . . BarlowW. E. (2004). Reason for late-stage breast cancer: Absence of screening or detection, or breakdown in follow-up?Journal of the National Cancer Institute, 96, 1518-1527.
22.
U.S. Cancer Statistics Working Group. (2012). United States cancer statistics: 1999–2009 incidence and mortality web-based report. Retrieved from http://www.cdc.gov/uscs
23.
U.S. Preventive Services Task Force. (2009). Screening for breast cancer: U.S. Preventive services task force recommendation statement. Annals of Internal Medicine, 151, 716-726, W-236.
24.
WallaceL. S.RogersE. S.RoskosS. E.HolidayD. B.WeissB. D. (2006). Brief report: Screening items to identify patients with limited health literacy skills. Journal of General Internal Medicine, 21, 874-877.
25.
WebsterP.AustokerJ. (2007). Does the English breast screening programme’s information leaflet improve women’s knowledge about mammography screening? A before and after questionnaire survey. Journal of Public Health, 29, 173-177.
26.
YasmeenS.XingG.MorrisC.ChlebowskiR. T.RomanoP. S. (2011). Comorbidities and mammography use interact to explain racial/ethnic disparities in breast cancer stage at diagnosis. Cancer, 117, 3252-3261.
27.
YoungR.SeversonR. (2005). Breast cancer screening barriers and mammography completion in older minority women. Breast Cancer Research and Treatment, 89, 111-118.
