title: Relationships of barriers and facilitators to breast self-examination, mammography, and clinical breast examination in a worksite population.
abstract: The American Cancer Society recommends a regimen for breast cancer screening that includes mammograms, clinical breast examination, and breast self-examination. Compliance with breast cancer screening guidelines has been linked to a number of barriers and facilitators. These barriers and facilitators seem to lie within the cognitive framework and generalized beliefs of women, and in the situational contexts in which they lead their lives. A comprehensive study was designed to investigate variables related to breast cancer screening behaviors (breast self-examination, mammography, and clinical breast examination) of working women > or = 35 years of age at their worksite environments. A factor analysis identified similar sets of composite variables related to each of the screening modalities, and a discriminant analysis was performed for each screening technique to identify those variables that were most significant in predicting compliance with screening guidelines. The variables discomfort, perceived efficacy, and desire for control over health were significant for all three screening behaviors. Perceived importance was identified as a fourth variable for mammography and clinical breast examination, and lack of knowledge was a fourth variable for breast self-examination. Effective breast cancer screening programs involve all three screening techniques. In the design of education and intervention programs at worksites, it is critical to emphasize the commonalities of the variables that emerged in this study as important for each screening technique. Health-care professionals who implement such intervention programs need to explore and bring into the open these common barriers and facilitators to maximize working women's compliance with breast screening guidelines.
authors.affiliation: Department of Family Medicine, Michigan State University, East Lansing 48824-1317.
authors.forename: M E
authors.initials: ME
authors.lastname: Kurtz
authors.forename: B
authors.initials: B
authors.lastname: Given
authors.forename: C W
authors.initials: CW
authors.lastname: Given
authors.forename: J C
authors.initials: JC
authors.lastname: Kurtz
mesh_terms: D000328:Adult; D001940:Breast; D001943:Breast Neoplasms / Q000517:prevention & control*; D016504:Breast Self-Examination / Q000523:psychology*; D015400:Clinical Nursing Research; D016002:Discriminant Analysis; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008327:Mammography / Q000523:psychology*; D008875:Middle Aged; D010173:Palpation; D010349:Patient Compliance; D017132:Workplace