title: Racial/ethnic disparities in annual mammogram compliance among households in Little Haiti, Miami-Dade County, Florida: An observational study.
abstract: BACKGROUND
  Breast cancer is the most commonly diagnosed cancer and the 2nd leading cause of cancer-related deaths among women in the U.S. Although routine screening via mammogram has been shown to increase survival through early detection and treatment of breast cancer, only 3 out of 5 women age ≥40 are compliant with annual mammogram within the U.S. and the state of Florida. A breadth of literature exists on racial/ethnic disparities in compliance with mammogram; however, few such studies include data on individual Black subgroups, such as Haitians. This study assessed the association between race/ethnicity and annual mammogram compliance among randomly selected households residing in the largely Haitian community of Little Haiti, Miami-Dade County (MDC), Florida.
  
  
  METHODS
  This study used cross-sectional, health data from a random-sample, population-based survey conducted within households residing in Little Haiti between November 2011 and December 2012 (n = 951). Mammogram compliance was defined as completion of mammogram by all female household members within the 12 months prior to the survey. The association between mammogram compliance and race/ethnicity was assessed using binary logistic regression models. Potential confounders were identified as factors that were conservatively associated with both compliance and race/ethnicity (P ≤ 0.20). Analyses were restricted to households containing at least 1 female member age ≥40 (n = 697).
  
  
  RESULTS
  Overall compliance with annual mammogram was 62%. Race/ethnicity was significantly associated with mammogram compliance (P = 0.030). Compliance was highest among non-Hispanic Black (NHB) households (75%), followed by Hispanic (62%), Haitian (59%), and non-Hispanic White (NHW) households (51%). After controlling for educational level, marital status, employment status, the presence of young children within the household, health insurance status, and regular doctor visits, a borderline significant disparity in mammogram compliance was observed between Haitian and NHB households (adjusted odds ratio = 1.63, P = 0.11). No other racial/ethnic disparities were observed.
  
  
  CONCLUSIONS
  Compliance with annual mammogram was low among the surveyed households in Little Haiti. Haitian households underutilized screening by means of annual mammogram compared with NHB households, although this disparity was not significant. Compliance rates could be enhanced by conducting individualized, mammogram screening-based studies to identify the reasons behind low rate of compliance among households in this underserved, minority population.
authors.affiliation: Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine Department of Epidemiology, Robert Stempel College of Public Health and Social Work Department of Human and Molecular Genetics, Florida International University, Miami, Florida, USA College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia.
authors.forename: Meredith Leigh
authors.initials: ML
authors.lastname: Wilcox
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Acuña
authors.forename: Melissa
authors.initials: M
authors.lastname: Ward-Peterson
authors.forename: Abdullah
authors.initials: A
authors.lastname: Alzayed
authors.forename: Mushref
authors.initials: M
authors.lastname: Alghamdi
authors.forename: Sami
authors.initials: S
authors.lastname: Aldaham
mesh_terms: D001741:Black or African American; D001943:Breast Neoplasms / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D005431:Florida; D006205:Haiti / Q000208:ethnology; D006630:Hispanic or Latino; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000208:ethnology / Q000706:statistics & numerical data*; D044465:White People