title: Perspectives of Low-Income African-American Women Non-adherent to Mammography Screening: the Importance of Information, Behavioral Skills, and Motivation.
abstract: Although information-motivation-behavioral skills (IMB) adherence model has been successfully used in many illness domains and with other populations, it has not been used in understanding mammogram screening among low-income African-American women. Thus, a qualitative examination is needed to theoretically and collectively understand the barriers to screening, given the disparities in breast cancer mortality rates among this population. Semi-structured telephone interviews were conducted with 28 low-income uninsured and underinsured African-American women, 40 to 70 years, who had not had a mammogram within the past 12 months. Women were recruited from 21 hair and nail salons and Laundromats within the five North St. Louis city zip codes with the highest breast cancer mortality rates. Transcripts were analyzed and rooted in grounded theory. This study found that the individual relevancy of information, behavioral skills-both procedural and systematic-and motivation seemed to affect screening adherence; (the results suggest the importance of reordering traditional IMB components into the following sequential order: information, behavioral skills, and motivation (IBM)). Future analyses should include a larger, more representative sample of unscreened women, in which quantitative statistical analyses could be conducted to assist in strengthening assertions about information, behavioral skills, and motivational aspects and their relationship to screening.
authors.affiliation: Brown School of Social Work, Washington University in St. Louis, 210 Brown Hall, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130-4899, USA. awells23@wustl.edu.
authors.forename: Anjanette A
authors.initials: AA
authors.lastname: Wells
authors.affiliation: Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: En-Jung
authors.initials: EJ
authors.lastname: Shon
authors.affiliation: Brown School of Social Work, Washington University in St. Louis, 210 Brown Hall, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130-4899, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: McGowan
authors.affiliation: Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
authors.forename: Aimee
authors.initials: A
authors.lastname: James
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D001943:Breast Neoplasms / Q000517:prevention & control; D005260:Female; D066296:Grounded Theory; D015438:Health Behavior / Q000208:ethnology; D006801:Humans; D008327:Mammography / Q000523:psychology; D008875:Middle Aged; D009042:Motivation; D011203:Poverty; D036301:Qualitative Research; D013689:Telephone; D014481:United States
keywords: African-American; Information-Motivation-Behavioral skills (IMB) model; Low-income; Mammography screening; Qualitative methodologies