title: American Indian community leader and provider views of needs and barriers to mammography.
abstract: Breast cancer incidence is rising and mortality is disproportionately high among American Indians and Alaska Natives, yet screening rates remain low. Using community-based participatory research, we conducted interviews with community leaders (n = 13) and providers from the Indian Health Service, tribal clinics, and urban safety-net clinics (n = 17). Participants in both groups identified similar needs, including culturally-appropriate mammography education, use of Native elders as patient navigators, and an emphasis on preventive care. Pertinent barriers included culturally-specific issues (e.g., historic mistrust and gender roles), cost, transportation, and fear of mammography and potential results. The results reflect the struggles of promoting mammography across diverse populations.
authors.affiliation: Department of Preventive Medicine & Public Health, University of Kansas Medical Center, Kansas City, KS 66160, USA. cdaley@kumc.edu
authors.forename: Christine M
authors.initials: CM
authors.lastname: Daley
authors.forename: Melissa
authors.initials: M
authors.lastname: Filippi
authors.forename: Aimee S
authors.initials: AS
authors.lastname: James
authors.forename: Maria
authors.initials: M
authors.lastname: Weir
authors.forename: Stacy
authors.initials: S
authors.lastname: Braiuca
authors.forename: Baljit
authors.initials: B
authors.lastname: Kaur
authors.forename: Won S
authors.initials: WS
authors.lastname: Choi
authors.forename: K Allen
authors.initials: KA
authors.lastname: Greiner
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001943:Breast Neoplasms / Q000208:ethnology; D055812:Community-Based Participatory Research; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006282:Health Personnel / Q000523:psychology*; D006297:Health Services Accessibility; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D007615:Kansas; D007857:Leadership; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D008923:Missouri; D020380:Needs Assessment; D036301:Qualitative Research; D014481:United States / Q000453:epidemiology; D016549:United States Indian Health Service