title: Keeping mammography referral appointments: motivation, health beliefs, and access barriers experienced by older minority women.
abstract: Older women of color tend to have much lower rates of regular mammography screening for breast cancer than younger Caucasian women; yet, they have higher rates of mortality. This study was designed to increase mammography rates among inner-city women aged 50 years or older. Another goal was to investigate differences in mammography utilization related to race/ethnicity and language after barriers associated with cost and the difficulty of making an appointment are removed. A peer delivered intervention, which consisted of interview, mammography referral, and the scheduling of a next-day appointment, was conducted among a convenience sample of 151 culturally and racially diverse older women through a primary care referral project operating within an urban emergency department (ED). A brief motivational interview and mammography referral at the time of an ED visit, including scheduling of a next-day no cost appointment, was followed by a cross-sectional telephone survey of utilization and motivating and hindering factors. Follow-up was achieved with 96 women (66%). Fifty-eight women (60%) had a post-intervention mammogram; of those, 69% were first time users. More than 90% planned a repeat mammogram the following year. Of the 27 who did not receive a mammogram, 21 (77%) requested a "second try" appointment. These findings demonstrate that an interactive intervention among older women of color has the potential to dramatically increase mammography rates.
authors.affiliation: Department of Maternal and Child Health, Boston University School of Public Health, MA 02118, USA.
authors.forename: J
authors.initials: J
authors.lastname: Bernstein
authors.forename: P
authors.initials: P
authors.lastname: Mutschler
authors.forename: E
authors.initials: E
authors.lastname: Bernstein
mesh_terms: D001741:Black or African American; D000368:Aged; D001213:Asian; D001294:Attitude to Health / Q000208:ethnology; D001900:Boston; D001943:Breast Neoplasms / Q000208:ethnology* / Q000517:prevention & control*; D005260:Female; D006301:Health Services Needs and Demand; D006299:Health Services for the Aged; D006630:Hispanic or Latino; D006801:Humans; D008327:Mammography / Q000523:psychology; D008875:Middle Aged; D008913:Minority Groups; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D012017:Referral and Consultation; D016387:Women's Health