title: Healthcare Factors for Obtaining a Mammogram in Latinas With a Variable Mammography History.
abstract: To understand the relationship between mammography history and current thoughts about obtaining a mammogram among Latinas and examine the mediation effects of several healthcare factors. .
  
  
  
  Cross-sectional survey. .
  
  
  
  Federally qualified health centers (Sea Mar Community Health Centers) in western Washington. .
  
  
  
  641 Latinas nonadherent and adherent with screening mammography. .
  
  
  
  Baseline survey data from Latinas with a mammography history of never, not recent (more than two years), or recent (less than two years) were analyzed. Preacher and Hayes methods were used to estimate the mediation effect of healthcare factors. .
  
  
  
  The survey assessed mammography history, sociodemographic and healthcare factors, and current thoughts about obtaining a mammogram. .
  
  
  
  Latinas' thoughts about obtaining a mammogram were associated with mammography history. Having had a clinical breast examination mediated 70% of differences between Latinas with a never and recent mammography history. Receipt of a provider recommendation mediated 54% of differences between Latinas with and without a recent mammography history. .
  
  
  
  These findings emphasize the importance of the patient-provider relationship during a clinic visit and help inform how nurses may be incorporated into subsequent screening mammography interventions tailored to Latinas. .
  
  
  
  As providers, health educators, and researchers, nurses have critical roles in encouraging adherence to screening mammography guidelines among Latinas.
authors.affiliation: University of Washington.
authors.forename: John R
authors.initials: JR
authors.lastname: Scheel
authors.affiliation: University of Illinois.
authors.forename: Yamile
authors.initials: Y
authors.lastname: Molina
authors.affiliation: Kaiser Permanente Center for Health Research.
authors.forename: Gloria
authors.initials: G
authors.lastname: Coronado
authors.affiliation: Fred Hutchinson Cancer Research Center.
authors.forename: Sonia
authors.initials: S
authors.lastname: Bishop
authors.affiliation: Sea Mar Community Health Centers.
authors.forename: Sarah
authors.initials: S
authors.lastname: Doty
authors.affiliation: Sea Mar Community Health Centers.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Jimenez
authors.affiliation: Fred Hutchinson Cancer Research Center.
authors.forename: Beti
authors.initials: B
authors.lastname: Thompson
authors.affiliation: Massachusetts General Hospital.
authors.forename: Constance D
authors.initials: CD
authors.lastname: Lehman
authors.affiliation: University of Washington.
authors.forename: Shirley A A
authors.initials: SA
authors.lastname: Beresford
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology*; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014861:Washington / Q000208:ethnology
keywords: Latinas; adherence ; healthcare factors; mediation effect; screening mammography history