Baseline predictors of initiation vs. maintenance of regular mammography use among rural women.
BACKGROUND
Predictors of regular mammography screening over many years have not often been examined prospectively. We used data from baseline (1993-1994), first (1996-1997), and second follow-up (2000) interviews with 336 White and 314 African-American rural women in the North Carolina Breast Cancer Screening Program to evaluate baseline factors predictive of regular mammography use over 7 years.


METHODS
We defined regular mammography use as a recent mammogram (past 2 years) at all three interviews. Using binomial and logistic regression models adjusted for age, we examined factors associated with initiation (for women without prior regular use) and maintenance (for women with prior regular use) of mammography.


RESULTS
Younger age and White race were predictive of initiation of regular mammography use. Physician recommendation was the strongest predictor of both initiation and maintenance of regular mammography use. Positive mammography attitudes and fewer personal barriers were strongly associated with initiation but not with maintenance.


CONCLUSIONS
Increased contact with providers and greater support for screening mammograms by providers could have an important impact on rural women initiating and maintaining regular mammography screening. Special efforts are needed to prompt rural African-American women and those over age 65 to initiate screening, since once they start they are likely to continue.
Rauscher
Garth H
GH
Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 1603 West Taylor Street, 816 SPHPI (M/C 923), Chicago, IL 60612, USA. garthr@uic.edu
Hawley
Sarah Tropman
ST
Earp
Jo Anne L
JA
D000328:Adult; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000517:prevention & control; D015331:Cohort Studies; D016001:Confidence Intervals; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006266:Health Education / Q000458:organization & administration*; D006801:Humans; D015994:Incidence; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D016017:Odds Ratio; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012424:Rural Population; D013997:Time Factors; D014481:United States