title: Screening mammography: a cross-sectional study to compare characteristics of women aged 40 and older from the deep South who are current, overdue, and never screeners.
abstract: OBJECTIVE
  We sought to identify unique barriers and facilitators to breast cancer screening participation among women aged 40 and older from Mississippi who were categorized as current, overdue, and never screeners.
  
  
  METHODS
  Cross-sectional data from a 2003 population-based survey with 987 women aged 40 and older were analyzed. Chi-square analysis and multinomial logistic regression examined how factors organized under the guidance of the Model of Health Services Utilization were associated with mammography screening status.
  
  
  RESULTS
  Nearly one in four women was overdue or had never had a mammogram. Enabling factors, including poor access to care (no annual checkups, no health insurance) and to health information, lack of social support for screening, and competing needs, were significantly associated with being both overdue and never screeners. Pertaining to factors unique to each screening group, women were more likely to be overdue when they had no usual source of health care and believed that treatment was worse than the disease. In turn, women were more likely to be never screeners when they were African American, lacked a provider recommendation for screening, and held the fatalistic view that not much could be done to prevent breast cancer.
  
  
  CONCLUSIONS
  Similar and unique factors impact utilization of mammography screening services among women. Those factors could inform efforts to increase screening rates.
authors.affiliation: Department of Psychology, and The Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, Alaska 99775-6480, USA. edlopez@alaska.edu
authors.forename: Ellen D S
authors.initials: ED
authors.lastname: Lopez
authors.forename: Amal J
authors.initials: AJ
authors.lastname: Khoury
authors.forename: Amy B
authors.initials: AB
authors.lastname: Dailey
authors.forename: Allyson G
authors.initials: AG
authors.lastname: Hall
authors.forename: Latarsha R
authors.initials: LR
authors.lastname: Chisholm
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008327:Mammography / Q000523:psychology / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D008922:Mississippi / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D010349:Patient Compliance; D012944:Social Support; D012959:Socioeconomic Factors