Sociocultural context of mammography screening use

Purpose/Objectives: To examine variations in cultural and health beliefs about mammography screening among a socioeconomically diverse sample of African American and Caucasian women and to identify which set of beliefs predicted mammography screening adherence. Design: Descriptive, retrospective, cross-sectional study. Setting: Community-based organizations and public housing. Sample: 111 African American women and 64 Caucasian women, aged 40 years or older, with no history of breast cancer. Methods: Telephone and in-person structured interviews were conducted. Items used previously validated scales based on the Cultural Assessment Model for Health and the Health Belief Model. Main Research Variables: Race or ethnicity, education, income, personal space, health temporal orientation, personal control, fatalism, susceptibility, benefits, barriers, self-efficacy, and mammography screening adherence. Findings: African American women were more fatalistic about breast cancer and perceived fewer benefits to screening. Mammography screening-adherent women were more future oriented, believed that they had less control over finding health problems early, had fewer barriers to screening, and experienced more physical spatial discomfort during the screening procedure than nonadherent women. Conclusions: Several of the cultural beliefs were not significantly different by race or ethnicity. However, cultural and health beliefs were significant predictors of mammography screening. Implications for Nursing: Theoretically based cultural beliefs are important to consider for behavioral interventions to increase mammography screening in African American and Caucasian women.