title: Knowledge and perceptions of breast health among free clinic patients.
abstract: BACKGROUND
  Breast cancer is a significant women's health problem in the United States. However, critical information on specific populations is still lacking. In particular, it is not well known how free clinic patients perceive breast health. The purpose of this study was to assess knowledge and perceptions of breast health among uninsured women utilizing a free clinic that serves as a safety net for the underserved.
  
  
  METHODS
  A self-administrated survey that included knowledge and perceptions of breast health was conducted for female free clinic patients aged 40 or older in fall 2012. There were 146 participants. The participants were classified into three groups for comparison; U.S. citizen English speakers, non-U.S. citizen English speakers, and Spanish speakers.
  
  
  RESULTS
  Spanish speakers had the highest average score on the knowledge of breast health, whereas the non-U.S. citizen English speakers had the lowest average score. Free clinic patients may consider breast health screening if recommended by health care providers. The non-U.S. citizen English speakers and Spanish speakers were more likely to have negative perceptions of breast health compared with the U.S. citizen English speakers.
  
  
  CONCLUSIONS
  Promoting knowledge about breast health is important for free clinics. Recommendation by a health care provider is a key to increasing attendance at health education programs and breast health screening. Non-U.S. citizens and non-English speakers would need culturally competent interventions. Free clinics have limited human and financial resources. Such characteristics of free clinics should be considered for practice implementations.
authors.affiliation: Department of Sociology, University of Utah, Salt Lake City, Utah. Electronic address: akiko.kamimura@utah.edu.
authors.forename: Akiko
authors.initials: A
authors.lastname: Kamimura
authors.affiliation: Maliheh Free Clinic, Salt Lake City, Utah.
authors.forename: Nancy
authors.initials: N
authors.lastname: Christensen
authors.affiliation: Department of Sociology, University of Utah, Salt Lake City, Utah.
authors.forename: Wenjing
authors.initials: W
authors.lastname: Mo
authors.affiliation: Maliheh Free Clinic, Salt Lake City, Utah.
authors.forename: Jeanie
authors.initials: J
authors.lastname: Ashby
authors.affiliation: Department of Health Promotion and Education, University of Utah, Salt Lake City, Utah.
authors.forename: Justine J
authors.initials: JJ
authors.lastname: Reel
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000191:economics / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D010465:Perception; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States; D044465:White People / Q000706:statistics & numerical data*; D016387:Women's Health; D055815:Young Adult