title: Perceived barriers to mammography among underserved women in a Breast Health Center Outreach Program.
abstract: BACKGROUND
  To investigate perceived barriers to mammography among underserved women, we asked participants in the Siteman Cancer Center Mammography Outreach Registry-developed in 2006 to evaluate mobile mammography's effectiveness among the underserved-why they believed women did not get mammograms.
  
  
  METHODS
  The responses of approximately 9,000 registrants were analyzed using multivariable logistic regression. We report adjusted odds ratios (OR) and 95% confidence intervals (CI) significant at 2-tailed P values less than .05.
  
  
  RESULTS
  Fears of cost (40%), mammogram-related pain (13%), and bad news (13%) were the most commonly reported barriers. Having insurance was associated with not perceiving cost as a barrier (OR .44, 95% CI .40 to .49), but with perceiving fear of both mammogram-related pain (OR 1.39, 95% CI 1.21 to 1.60) and receiving bad news (OR 1.38, 95% CI 1.19 to 1.60) as barriers.
  
  
  CONCLUSIONS
  Despite free services, underserved women continue to report experiential and psychological obstacles to mammography, suggesting the need for more targeted education and outreach in this population.
authors.affiliation: Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA. Electronic address: fayanju@wustl.edu.
authors.forename: Oluwadamilola M
authors.initials: OM
authors.lastname: Fayanju
authors.affiliation: Joanne Knight Breast Health Center, The Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Kraenzle
authors.affiliation: Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Bettina F
authors.initials: BF
authors.lastname: Drake
authors.affiliation: Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Oka
authors.affiliation: Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Melody S
authors.initials: MS
authors.lastname: Goodman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D055088:Early Detection of Cancer / Q000191:economics / Q000379:methods / Q000523:psychology; D005260:Female; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D007348:Insurance, Health; D016015:Logistic Models; D008327:Mammography / Q000191:economics / Q000379:methods / Q000523:psychology; D008875:Middle Aged; D008923:Missouri; D008952:Mobile Health Units / Q000191:economics; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000523:psychology; D011446:Prospective Studies; D012042:Registries; D035862:Vulnerable Populations / Q000523:psychology; D055815:Young Adult
keywords: Breast cancer; Health beliefs; Health disparities; Mobile mammography; Screening