title: 'It's easier said than done': perspectives on mammography from women with intellectual disabilities.
abstract: OBJECTIVE
  Women with intellectual disabilities (or mental retardation) are living longer, receiving primary care in the community, and have equal rates of breast cancer compared with women in the general population, but they have lower rates of mammography. Although several public campaigns have successfully raised the mammography rate for racial and ethnic minority women, they have not penetrated the community of women with intellectual disabilities. No research to date has explored potential barriers to mammography for these women by involving the women themselves as participants.
  
  
  METHODS
  We undertook a qualitative study to explore the perceptions and understanding of mammography for women with intellectual disabilities and some of the potential reasons they would or would not have the test. Twenty-seven intellectually disabled women were recruited through a variety of community groups and interviewed using a semistructured interview guide. Data were analyzed using qualitative techniques from grounded theory.
  
  
  RESULTS
  Participants in this study described being poorly prepared for mammography: they did not understand its purpose and were not prepared for the logistics of the experience. The latter was more upsetting to participants and contributed to their negative perceptions of mammography. Participants reported feeling unprepared and singled out for being unprepared, despite their desire to have at least 1 mammogram, as do other women their age.
  
  
  CONCLUSIONS
  Women with intellectual disabilities perceive mammography differently than do women who do not have intellectual disabilities, and their perception is informed by inadequate knowledge, anxiety, and inadequate preparation. These themes should be considered when planning cancer prevention interventions with this population and when counseling individual women in the clinical setting.
authors.affiliation: Department of Family Medicine, Boston University School of Medicine, Massachusetts 02118, USA. Joanne.Wilkinson@bmc.org
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Wilkinson
authors.forename: Cristina E
authors.initials: CE
authors.lastname: Deis
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Bowen
authors.forename: Barbara G
authors.initials: BG
authors.lastname: Bokhour
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000523:psychology; D006233:Persons with Disabilities; D055088:Early Detection of Cancer; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology*; D007406:Interview, Psychological; D008327:Mammography / Q000523:psychology*; D008875:Middle Aged; D009042:Motivation; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D036301:Qualitative Research; D016387:Women's Health