title: Factors associated with adherence to recommendations for screening mammography among American Indian women in Colorado.
abstract: OBJECTIVE
  To compare adherence to screening mammography recommendations of American Indian and non-Hispanic White women in the Denver, Colorado, area.
  
  
  METHODS
  This study retrospectively examined adherence patterns in 229 American Indian and 60,197 non-Hispanic White women > or = 40 years and older, with at least one screening mammogram in the Colorado Mammography Project (CMAP), from January 1, 1999, to December 31, 2003. The CMAP was a prospective study of women receiving mammograms at participating clinics around Denver.
  
  
  METHODS
  Using logistic mixed models, we defined two dependent variables as annual and biennial adherence from the intervals between screening mammograms for each woman.
  
  
  RESULTS
  Biennial adherence was substantially higher than annual adherence for both American Indian and non-Hispanic White women in our analyses. American Indian women were less likely than non-Hispanic White women to adhere to biennial recommendations in multivariate models controlling for age, family history of breast cancer, and economic status (zip code): odds ratio (OR) .4 and 95% confidence interval (CI) .2-.6. The association between American Indian race/ethnicity and annual adherence was similar, although not as strong (OR .5, 95% CI .3-.8).
  
  
  CONCLUSIONS
  American Indian women in the CMAP cohort were less likely than non-Hispanic White women to adhere to recommendations for screening mammography, both annually and biennially. Additional research is needed to explore the effect of biennial screening and other barriers among American Indian women.
authors.affiliation: Epidemiology Department, Noqsi Research, Ltd., Pine, Colorado, USA. wampler@wispertel.net
authors.forename: Nina S
authors.initials: NS
authors.lastname: Wampler
authors.forename: Laura
authors.initials: L
authors.lastname: Saba
authors.forename: Saleh M M
authors.initials: SM
authors.lastname: Rahman
authors.forename: Mark
authors.initials: M
authors.lastname: Dignan
authors.forename: Jenifer H
authors.initials: JH
authors.lastname: Voeks
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Strzelczyk
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000208:ethnology; D003120:Colorado / Q000453:epidemiology; D015986:Confounding Factors, Epidemiologic; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006287:Health Planning Guidelines; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D016015:Logistic Models; D008327:Mammography; D008403:Mass Screening; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D010349:Patient Compliance / Q000208:ethnology*; D011446:Prospective Studies; D012189:Retrospective Studies; D044465:White People / Q000706:statistics & numerical data