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. 2014 Sep;208(3):425-34.
doi: 10.1016/j.amjsurg.2014.03.005. Epub 2014 May 4.

Perceived barriers to mammography among underserved women in a Breast Health Center Outreach Program

Oluwadamilola M Fayanju  1 , Susan Kraenzle  2 , Bettina F Drake  3 , Masayoshi Oka  3 , Melody S Goodman  3
Affiliations

Perceived barriers to mammography among underserved women in a Breast Health Center Outreach Program

Oluwadamilola M Fayanju et al. Am J Surg. 2014 Sep.

Abstract

Background: To investigate perceived barriers to mammography among underserved women, we asked participants in the Siteman Cancer Center Mammography Outreach Registry-developed in 2006 to evaluate mobile mammography's effectiveness among the underserved-why they believed women did not get mammograms.

Methods: The responses of approximately 9,000 registrants were analyzed using multivariable logistic regression. We report adjusted odds ratios (OR) and 95% confidence intervals (CI) significant at 2-tailed P values less than .05.

Results: Fears of cost (40%), mammogram-related pain (13%), and bad news (13%) were the most commonly reported barriers. Having insurance was associated with not perceiving cost as a barrier (OR .44, 95% CI .40 to .49), but with perceiving fear of both mammogram-related pain (OR 1.39, 95% CI 1.21 to 1.60) and receiving bad news (OR 1.38, 95% CI 1.19 to 1.60) as barriers.

Conclusion: Despite free services, underserved women continue to report experiential and psychological obstacles to mammography, suggesting the need for more targeted education and outreach in this population.

Keywords: Breast cancer; Health beliefs; Health disparities; Mobile mammography; Screening.

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Figures

Figure 1
Figure 1. Health Belief Model Components and Linkages
The major constructs of the Health Behavior Model are perceived susceptibility, severity, benefits, barriers, and self-efficacy (middle column). Modifying factors (left column) affect these perceptions, as do cues to action (right column). The combination of beliefs and cues to action leads to behavior. Perceived barriers (red text) have been demonstrated to be the single most powerful predictor of health behavior.,,
Figure 2
Figure 2
Geographic distribution of fear of cost (top), fear of mammogram-related pain (middle), and fear of receiving bad news (bottom) as perceived barriers to mammography
See this image and copyright information in PMC

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