Training community health workers: factors that influence mammography use.
The purpose of this study was to assess factors that influence mammography use among volunteer community health workers (CHWs). Data trends indicate lower mammography rates among minority and low-income women. Although CHW interventions have been shown to promote mammography use among this population, training strategies and the use of a comprehensive needs assessment are lacking. Using a cross-sectional study design, data were collected via a mailed survey. The dependent variable was mammography use within the past 2 years. The independent variables were categorized according to the factors in the PRECEDE-PROCEED model. Predisposing factors included susceptibility, barriers, benefits, health motivation, self-efficacy, education, and age. Enabling factors included income, health insurance, and regular source of care. Reinforcing factors included physician recommendation to get a mammogram, social norms, and family history of breast cancer. Self-reported data from a mailed survey were obtained from a convenience sample of urban CHWS (N = 109) ages 40-73 with a mean age of 55 (SD = 9.43). The sample included 90% African American and 8% White women. Logistic regression results showed barriers to be predictive of mammography use among CHWs controlling for age, self-efficacy, health motivation, and social norms. The findings suggest CHW training focus on how to identify and address barriers to increase the likelihood of mammography use among CHWs. Future research is needed to identify cultural differences in barriers for minority CHWs.
Kratzke
Cynthia
C
Department of Health Science, New Mexico State University, P.O. Box 30001, Las Cruces, NM 88003, USA. ckratzke@nmsu.edu
Garzon
Laurel
L
Lombard
John
J
Karlowicz
Karen
K
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis; D003150:Community Health Workers / Q000193:education / Q000523:psychology*; D003430:Cross-Sectional Studies; D005192:Family Health; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007348:Insurance, Health; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D010817:Physician-Patient Relations; D012959:Socioeconomic Factors; D014838:Volunteers / Q000193:education / Q000523:psychology*
Health Educ Behav. 2003 Jun;30(3):337-59
19731500
Prev Chronic Dis. 2005 Jan;2(1):A20
15670473
Health Educ Behav. 2009 Feb;36(1):113-26
19188371
Health Promot Pract. 2006 Jul;7(3 Suppl):201S-12S
16760248
Health Educ Behav. 2001 Apr;28(2):200-16
11265829
J Nurses Staff Dev. 2003 Mar-Apr;19(2):81-7
12679659
J Community Health. 2009 Feb;34(1):47-55
18821000
Am J Public Health. 2005 Apr;95(4):596-601
15798115
Fam Community Health. 2005 Jan-Mar;28(1):28-40
15625504
Fam Community Health. 2005 Jan-Mar;28(1):41-50
15625505
Am J Public Health. 2002 Apr;92(4):646-54
11919066
Health Educ Q. 1988 Summer;15(2):175-83
3378902
Res Nurs Health. 1999 Aug;22(4):341-8
10435551
Health Educ Res. 2007 Aug;22(4):513-21
17032707
Am J Public Health. 2005 Apr;95(4):652-9
15798126
Public Health Nurs. 2003 Jul-Aug;20(4):260-70
12823786
J Health Commun. 2001 Jul-Sep;6(3):219-33
11550590