title: Neighborhood Predictors of Mammography Barriers Among US-Based Latinas.
abstract: Little is known about how neighborhood factors are associated with Latinas' barriers to cancer screening, including mammography. To address this gap, we examined barriers to mammography by neighborhood racial/ethnic composition and socioeconomic status among a federally qualified health center (FQHC)-based sample of non-adherent Latinas in Western Washington State.
  
  
  
  Baseline data were drawn from a larger intervention study (n = 536 Latinas). Women indicated why they had not obtained a mammogram in the past 2 years (no reason, knowledge, psychocultural, economic). American Community Survey (2007-2011) data were used to calculate four neighborhood measures that were categorized in tertiles (T): socioeconomic-based concentration, socioeconomic-based segregation, Latino-based concentration, and Latino-based segregation.
  
  
  
  The proportion of women reporting knowledge-, psychocultural-, and economic-based reasons for not obtaining mammograms in the past 2 years was, respectively, 0.35, 0.19, and 0.31. Approximately 14 % indicated no particular reason. Relative to women residing in areas with greater Latino-based segregation, women in areas with less Latino-based segregation were less likely to report knowledge-based and economic-based reasons for not obtaining a mammogram (p ≤ 0.05). Relative to women residing in areas with greater concentration of Latinos, women in areas with the lowest concentrations were less likely to report knowledge-based reasons for not obtaining a mammogram (p ≤ 0.05).
  
  
  
  Our findings provide important information about the role of neighborhood characteristics and mammography use among Latinas obtaining care from FQHCs. Future research might examine the mediating role of neighborhood characteristics in the efficacy of mammography screening interventions.
authors.affiliation: Community Health Sciences, University of Illinois-Chicago, Chicago, IL, USA. Ymolin2@uic.edu.|Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. Ymolin2@uic.edu.
authors.forename: Yamile
authors.initials: Y
authors.lastname: Molina
authors.affiliation: Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.|Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA.
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Plascak
authors.affiliation: Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.|Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA.
authors.forename: Donald L
authors.initials: DL
authors.lastname: Patrick
authors.affiliation: Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Sonia
authors.initials: S
authors.lastname: Bishop
authors.affiliation: Kaiser Permanente Research Center for Health Research, Portland, OR, USA.
authors.forename: Gloria D
authors.initials: GD
authors.lastname: Coronado
authors.affiliation: Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.|Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
authors.forename: Shirley A A
authors.initials: SA
authors.lastname: Beresford
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003151:Community Health Centers; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D054625:Healthcare Disparities / Q000208:ethnology* / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012923:Social Class; D014481:United States; D014861:Washington
keywords: Barriers; Breast cancer; Latinas; Mammography use; Neighborhood