title: The role of physicians in mammography referral for older Caribbean women in Canada.
abstract: BACKGROUND
  Despite the fact that the proportion of immigrant and minority women who consult a general practitioner about their health is similar to that of their Canadian-born counterparts, studies suggest that they are less likely to be screened for breast cancer. This study examines physician characteristics associated with mammography referral and perceived barriers to mammography among family physicians serving the Caribbean community of Toronto.
  
  
  METHODS
  The study consisted of a mail-back family physician survey.
  
  
  RESULTS
  Among the 64 physicians who responded to the survey, over half reported that they were "very likely" to refer women for mammography during a regular preventive check-up. Among physician variables, only the amount of time spent on patient education was significantly associated with the likelihood of referral. Regarding perceived barriers, for male physicians, patient refusal and intervention causing patient discomfort were significantly associated with referral. For female physicians, only forgetting to provide service was identified as a significant barrier to referral.
  
  
  CONCLUSIONS
  An increased emphasis on patient education may help to increase screening referral among all physicians. Gender differences in perceived barriers to referral suggest that the gender of the physician is of major importance to the Caribbean community.
authors.affiliation: The Centre for Research in Women's Health, Department of Public Health Sciences, University of Toronto, Ontario, Canada.
authors.forename: I
authors.initials: I
authors.lastname: Hyman
authors.forename: M
authors.initials: M
authors.lastname: Singh
authors.forename: F
authors.initials: F
authors.lastname: Ahmad
authors.forename: L
authors.initials: L
authors.lastname: Austin
authors.forename: M
authors.initials: M
authors.lastname: Meana
authors.forename: U
authors.initials: U
authors.lastname: George
authors.forename: L M
authors.initials: LM
authors.lastname: Wells
authors.forename: D
authors.initials: D
authors.lastname: Stewart
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel / Q000208:ethnology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000208:ethnology / Q000517:prevention & control; D017691:Caribbean Region / Q000208:ethnology; D005260:Female; D005783:Gender Identity; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D009864:Ontario; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D010353:Patient Education as Topic; D010819:Physician's Role; D010821:Physicians, Family / Q000145:classification / Q000523:psychology*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D016387:Women's Health