title: Inner-city African American women who failed to receive cancer screening following a culturally-appropriate intervention: the role of health insurance.
abstract: Culturally-appropriate health promotion programs are thought to be more effective among minority groups than those designed for the population at large. We investigated factors associated with failure to obtain cervical and breast cancer screening among inner-city African American women who received a culturally-appropriate educational intervention. Women who completed the intervention, but did not obtain a Pap smear, a clinical breast examination, and/or a mammogram at follow-up were compared with those who did obtain these tests. Women with private health insurance were more likely to be screened following the intervention than those covered by Medicaid or Medicare or those who were not insured (P < 0.001). Post-intervention screening was not associated with age, education, income, employment, or marital status. The effectiveness of a culturally-appropriate intervention is likely to be reduced if women's ability to respond is limited by inadequate insurance coverage.
authors.affiliation: Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA 30310, USA.
authors.forename: John F C
authors.initials: JF
authors.lastname: Sung
authors.forename: Ernest
authors.initials: E
authors.lastname: Alema-Mensah
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Blumenthal
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D001943:Breast Neoplasms / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006297:Health Services Accessibility / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D065006:Papanicolaou Test; D010353:Patient Education as Topic; D014505:Urban Population / Q000706:statistics & numerical data; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000523:psychology; D014626:Vaginal Smears / Q000706:statistics & numerical data*