Predictors of regular mammography use among American Indian women in Oklahoma: a cross-sectional study

BMC Women's Health

Research Article

Julie A Stoner¹  Ji Li¹  Eleni L Tolma²  Kimberly K Engelman³  Yoonsang Kim⁴ 

[1] Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA;Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, P.O. Box 26901, CHB Rm. 473, 73126, Oklahoma City, OK, USA;Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS, USA;Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA;

关键词: Breast cancer;    Native American;    American Indian;    Theory of planned behavior;    Mammography;    Quantitative research;   

DOI  :  10.1186/1472-6874-14-101

 received in 2013-12-20, accepted in 2014-08-18,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThere are significant disparities in breast cancer screening and survivorship between American Indian (AI) and non-Hispanic white women. This study aimed to identify the salient beliefs AI women from Oklahoma have on regular mammography screening, and to determine which beliefs and health- related practices are associated with past mammography screening behavior.MethodsThis study used an integrated model of the Theory of Planned Behavior as the guiding theoretical framework. Data were collected from 255 (mean age = 51 years, SD 7.64 years) AI women randomly selected from a rural Oklahoma medical clinic (response rate: 79%). Multivariate logistic regression was used to identify factors associated with self-reported past mammography within the last two years while controlling for demographic variables. Associations were summarized using odds ratios (OR), the ratio of the odds of past mammography per a 1-unit increase in continuous independent factor scales (subjective physician norm, cultural affiliation, fatalism, knowledge of mammography screening guidelines, and perceived behavior control barriers) or between groups defined by categorical variables, and 95% confidence intervals (CI).ResultsOf the participants, 65% (n = 167) reported a screening mammogram within the last two years. After adjustment for age and educational status, women with a higher total subjective-norm physician score (OR = 1.15, 95% CI: 1.06-1.24), a higher knowledge of mammography screening guidelines (OR = 1.52, 95% CI: 1.00-2.31), a family history of breast cancer (OR = 9.97, 95% CI: 3.05-32.62), or reporting an annual versus none or a single physician breast examination (OR = 5.57, 95% CI: 1.79-17.37) had a higher odds of past mammography. On the other hand, women who were more culturally affiliated (OR = 0.42, 95% CI: 0.24-0.74), perceived more barriers (OR = 0.86, 0.78-0.94), or had higher fatalistic attitudes toward breast cancer (OR = 0.90, 95% CI: 0.82-0.99) had lower odds of past mammography.ConclusionIn the development of culturally-appropriate interventions promoting mammography among AI communities, emphasis could be put on the following: a) promoting clinic-related practices (e.g. physician recommendation, physician breast examination); b) promoting community-related practices (e.g. knowledge about mammography while eliminating fatalistic attitudes); and c) reducing environmental barriers.

【 授权许可】

CC BY   
© Tolma et al.; licensee BioMed Central Ltd. 2014