title: An assessment of American Indian women's mammography experiences.
abstract: BACKGROUND
  Mortality from breast cancer has increased among American Indian/Alaskan Native (AI/AN) women. Despite this alarming reality, AI/AN women have some of the lowest breast cancer screening rates. Only 37% of eligible AI/AN women report a mammogram within the last year and 52% report a mammogram within the last two years compared to 57% and 72% for White women. The experiences and satisfaction surrounding mammography for AI/AN women likely are different from that of women of other racial/ethnic groups, due to cultural differences and limited access to Indian Health Service sponsored mammography units. The overall goals of this study are to identify and understand the mammography experiences and experiential elements that relate to satisfaction or dissatisfaction with mammography services in an AI/AN population and to develop a culturally-tailored AI/AN mammography satisfaction survey.
  
  
  METHODS
  The three project aims that will be used to guide this work are: 1) To compare the mammography experiences and satisfaction with mammography services of Native American/Alaska Native women with that of Non-Hispanic White, Hispanic, and Black women, 2) To develop and validate the psychometric properties of an American Indian Mammography Survey, and 3) To assess variation among AI/AN women's assessments of their mammography experiences and mammography service satisfaction. Evaluations of racial/ethnic differences in mammography patient satisfaction have received little study, particularly among AI/AN women. As such, qualitative study is uniquely suited for an initial examination of their experiences because it will allow for a rich and in-depth identification and exploration of satisfaction elements.
  
  
  CONCLUSIONS
  This formative research is an essential step in the development of a validated and culturally tailored AI/AN mammography satisfaction assessment. Results from this project will provide a springboard from which a maximally effective breast cancer screening program to benefit AI/AN population will be developed and tested in an effort to alter the current breast cancer-related morbidity and mortality trajectory among AI/AN women.
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, USA. kengelma@kumc.edu
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: Engelman
authors.forename: Christine M
authors.initials: CM
authors.lastname: Daley
authors.forename: Byron J
authors.initials: BJ
authors.lastname: Gajewski
authors.forename: Florence
authors.initials: F
authors.lastname: Ndikum-Moffor
authors.forename: Babalola
authors.initials: B
authors.lastname: Faseru
authors.forename: Stacy
authors.initials: S
authors.lastname: Braiuca
authors.forename: Stephanie
authors.initials: S
authors.lastname: Joseph
authors.forename: Edward F
authors.initials: EF
authors.lastname: Ellerbeck
authors.forename: K Allen
authors.initials: KA
authors.lastname: Greiner
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology*; D002985:Clinical Protocols; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006306:Health Surveys; D006801:Humans; D007198:Indians, North American; D008327:Mammography / Q000523:psychology*; D008403:Mass Screening; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000523:psychology; D017060:Patient Satisfaction / Q000208:ethnology*; D011795:Surveys and Questionnaires; D014481:United States