title: Breast health education for working women in Appalachia: insights from focus group research.
abstract: BACKGROUND
  This study seeks to understand rural working women, their knowledge of health systems, and how breast health issues fit into their lives. A key aim of this study was to identify regionally and culturally specific factors that influence how these women approach breast health and to identify ways that more positive breast health behaviors can be achieved.
  
  
  METHODS
  Five focus groups (N = 42) were conducted among women at sites where the Breast Health Outreach Program (BHOP) had been conducted. Focus groups were composed of 7 to 10 women who were in about the same age cohort.
  
  
  RESULTS
  Women provided multiple insights about their attitudes and behaviors related to breast heath concerns. Analysis of the data revealed that many of the comments clustered around two types of "systems" in these women's lives: the professional health care system and personal community systems. The BHOP provides a bridge between these two systems and seems to facilitate positive actions. Workplace health professionals also provide a bridge between professional and personal systems.
  
  
  CONCLUSIONS
  Women exhibited the general distrust of the medical system that the literature indicates is often associated with Appalachian culture. However, this study found that distrust can be overcome with education programs that meet women where they live and work. Such programs are most likely to be successful when the materials and methods are sensitive to Appalachian culture and when medical services are brought into the community.
authors.affiliation: College of Communication and Information, University of Tennessee, Knoxville, 37996, USA. sjmcmill@utk.edu
authors.forename: Sally J
authors.initials: SJ
authors.lastname: McMillan
authors.forename: Eric
authors.initials: E
authors.lastname: Haley
authors.forename: Paige
authors.initials: P
authors.lastname: Zollman-Huggler
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Johnson Avery
authors.forename: Melissa G
authors.initials: MG
authors.lastname: Winchenbach
authors.forename: John L
authors.initials: JL
authors.lastname: Bell
mesh_terms: D001061:Appalachian Region; D001940:Breast / Q000502:physiology*; D001941:Breast Diseases / Q000175:diagnosis / Q000517:prevention & control*; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D016730:Program Development; D036301:Qualitative Research; D016387:Women's Health