title: Breast cancer screening beliefs and behaviors among American Indian women in Kansas and Missouri: a qualitative inquiry.
abstract: American Indian women have rising incidence and disproportionate mortality rates due to breast cancer. Using a community-based participatory research approach, we conducted ten focus groups with American Indian women in Kansas and Missouri to understand their barriers to mammography and identify ways to intervene to improve screening rates. Focus groups were stratified by screening status, including women who were up to date with current screening mammography recommendations (mammogram within the last 2 years, N = 7 groups, 66 participants) and women who were not (N = 3 groups, 18 participants). While many similarities were identified across strata, some differences emerged, particularly descriptions of prior negative experiences with the health care system among women who were not up to date with screening recommendations. Primary areas identified by participants for intervention included culturally appropriate educational materials and interventions directed specifically at improving American Indian women's trust in Western medicine and alleviating feelings of discrimination.
authors.affiliation: Department of Family Medicine, Center for American Indian Community Health, University of Kansas Medical Center, MS 1030, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA. cdaley@kumc.edu
authors.forename: Christine Makosky
authors.initials: CM
authors.lastname: Daley
authors.forename: Anne
authors.initials: A
authors.lastname: Kraemer-Diaz
authors.forename: Aimee S
authors.initials: AS
authors.lastname: James
authors.forename: Darryl
authors.initials: D
authors.lastname: Monteau
authors.forename: Stephanie
authors.initials: S
authors.lastname: Joseph
authors.forename: Joseph
authors.initials: J
authors.lastname: Pacheco
authors.forename: Julia White
authors.initials: JW
authors.lastname: Bull
authors.forename: Angel
authors.initials: A
authors.lastname: Cully
authors.forename: Won S
authors.initials: WS
authors.lastname: Choi
authors.forename: K Allen
authors.initials: KA
authors.lastname: Greiner
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D055812:Community-Based Participatory Research; D055088:Early Detection of Cancer / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007198:Indians, North American / Q000523:psychology* / Q000706:statistics & numerical data; D007615:Kansas; D008327:Mammography; D008875:Middle Aged; D054525:Minority Health / Q000208:ethnology / Q000706:statistics & numerical data*; D008923:Missouri; D036301:Qualitative Research; D013637:Tape Recording; D014481:United States; D016387:Women's Health