title: Beliefs regarding mammography screening among women visiting the emergency department for nonurgent care.
abstract: BACKGROUND
  One in 8 US women will develop invasive breast cancer in their lifetime. Despite evidence that mammography is an effective method of early detection, certain vulnerable groups, such as those using the emergency department as a medical home, do not adhere to mammography screening guidelines, and suffer disparate mortality from breast cancer. The purpose of this study was to investigate differences in beliefs regarding mammography screening among women attending the emergency department for nonurgent care and ultimately to develop interventions that promote mammography for this vulnerable population.
  
  
  METHODS
  We explored the relationship between stage of readiness to adopt mammography behavior and barriers, benefits, and perceived susceptibility by administering scales for risk, benefits, and barriers to a sample of 110 women who had presented to the emergency department of a public hospital for nonurgent complaints or were seated in the ED waiting room. We also collected sociodemographic information and stage of readiness.
  
  
  RESULTS
  Mammography adherence was about 60%. Most women who were not compliant with current guidelines were contemplators. Those who were not contemplating being screened were significantly less likely to perceive themselves to be at risk of getting breast cancer. Women who had more barriers to mammography perceived less benefit from having a mammogram. African American women perceived less benefit from having a mammogram.
  
  
  CONCLUSIONS
  Mammography promotion is appropriately placed in the ED waiting room given the suboptimal rate at which this population is being screened. Beliefs regarding mammography differ for women in various stages of mammography adoption and for minority women. Understanding these differences will allow intervention in this setting to be tailored to the population. ED nurses are an important and sometimes sole point of health care contact for patients who routinely visit the emergency department. As such, they have a valuable opportunity to provide cancer screening promotion messages. It is critical that nurses in this setting understand the complexities of delivering this information and the need to do so.
authors.affiliation: Lexington, KY. Electronic address: jhscot2@uky.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hatcher-Keller
authors.affiliation: Lexington, KY.
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Rayens
authors.affiliation: Lexington, KY.
authors.forename: Mark
authors.initials: M
authors.lastname: Dignan
authors.affiliation: Lexington, KY.
authors.forename: Nancy
authors.initials: N
authors.lastname: Schoenberg
authors.affiliation: Lexington, KY.
authors.forename: Penne
authors.initials: P
authors.lastname: Allison
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000517:prevention & control*; D015331:Cohort Studies; D003469:Culture; D055088:Early Detection of Cancer / Q000523:psychology*; D004636:Emergency Service, Hospital; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008327:Mammography / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D020380:Needs Assessment; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D005791:Patient Care / Q000379:methods; D057240:Patient Preference; D012189:Retrospective Studies; D018570:Risk Assessment; D012959:Socioeconomic Factors; D014481:United States
keywords: Cancer control; Mammography; Nonurgent care; Stages of change