title: Barriers to repeat mammography: cultural perspectives of African-American, Asian, and Hispanic women.
abstract: Women of minority races and ethnicities have lower mammography return rates compared to Caucasians. To better understand barriers to mammography, we conducted six focus groups with 49 women of minority races and ethnicities (19 Asian, 16 African-American, and 14 Hispanic) recruited from outpatient medical clinics in Boston. Eligible women had at least one prior mammogram and no personal history of cancer. Discussions were recorded and transcribed, and thematic content analyses were performed. African-Americans and Hispanics felt that lack of insurance was not a barrier to mammography as they were aware of free programs. Some African-Americans avoided mammograms because they were fatalistic and believed that a breast cancer diagnosis would inevitably lead to death. African-Americans agreed that social issues, such as drug and domestic abuse, made obtaining preventive health care less important. Asian participants agreed that mammogram return rates were poor because appointments took time away from work. Asian and Hispanic women identified discourteous behavior by hospital staff as a barrier. Cultural barriers to repeat mammography appear to vary among different racial groups. Interventions to improve screening among minority populations may be more successful if they address group-specific concerns.
authors.affiliation: Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, USA. bmoy@partners.org
authors.forename: Beverly
authors.initials: B
authors.lastname: Moy
authors.forename: Elyse R
authors.initials: ER
authors.lastname: Park
authors.forename: Sandra
authors.initials: S
authors.lastname: Feibelmann
authors.forename: Sylvia
authors.initials: S
authors.lastname: Chiang
authors.forename: Joel S
authors.initials: JS
authors.lastname: Weissman
mesh_terms: D000328:Adult; D001071:Appointments and Schedules; D001213:Asian / Q000523:psychology*; D001293:Attitude to Death; D044383:Black People / Q000523:psychology*; D003431:Cross-Cultural Comparison; D003469:Culture; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008327:Mammography / Q000523:psychology*; D008404:Massachusetts; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011287:Prejudice; D011369:Professional-Patient Relations; D012945:Social Values; D013179:Spouse Abuse / Q000523:psychology; D019966:Substance-Related Disorders / Q000523:psychology; D044465:White People / Q000523:psychology*; D001741:Black or African American