Factors Associated with Breast Cancer Screening Adherence among Church-Going African American Women

Pooja Agrawal, Tzuan A. Chen, Lorna H. McNeill, Chiara Acquati, Shahnjayla K. Connors, Vijay Nitturi, Angelica S. Robinson, Isabel Martinez Leal and Lorraine R. Reitzel
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Pooja Agrawal: Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX 77204, USA
Tzuan A. Chen: Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX 77204, USA
Lorna H. McNeill: MD Anderson Cancer Center, Department of Health Disparities Research, Houston, TX 77230, USA
Chiara Acquati: MD Anderson Cancer Center, Department of Health Disparities Research, Houston, TX 77230, USA
Shahnjayla K. Connors: Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX 77204, USA
Vijay Nitturi: Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX 77204, USA
Angelica S. Robinson: Department of Radiology, University of Texas Medical Branch, Galveston, TX 77555, USA
Isabel Martinez Leal: Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX 77204, USA
Lorraine R. Reitzel: Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX 77204, USA

IJERPH, 2021, vol. 18, issue 16, 1-16

Abstract: Relative to White women, African American/Black women are at an increased risk of breast cancer mortality. Early detection of breast cancer through mammography screening can mitigate mortality risks; however, screening rates are not ideal. Consequently, there is a need to better understand factors associated with adherence to breast cancer screening guidelines to inform interventions to increase mammography use, particularly for groups at elevated mortality risk. This study used the Andersen Behavioral Model of Health Services Use to examine factors associated with adherence to National Comprehensive Cancer Network breast cancer screening guidelines amongst 919 African American, church-going women from Houston, Texas. Logistic regression analyses measured associations between breast cancer screening adherence over the preceding 12 months (adherent or non-adherent) and predisposing (i.e., age, education, and partner status), enabling (i.e., health insurance status, annual household income, employment status, patient-provider communication, and social support), and need (i.e., personal diagnosis of cancer, family history of cancer, and risk perception) factors, separately and conjointly. Older age (predisposing: OR = 1.015 (1.007–1.023)), having health insurance and ideal patient–provider communication (enabling: OR = 2.388 (1.597–3.570) and OR = 1.485 (1.080–2.041)), and having a personal diagnosis of cancer (need: OR = 2.244 (1.058–4.758)) were each associated with greater odds of screening adherence. Only having health insurance and ideal patient-provider communication remained significantly associated with screening adherence in a conjoint model; cancer survivorship did not moderate associations between predisposing/enabling factors and screening adherence. Overall, results suggest that interventions which are designed to improve mammography screening rates amongst African American women might focus on broadening health insurance coverage and working to improve patient–provider communication. Implications for multi-level intervention approaches, including the role of churches in their dissemination, are proposed.

Keywords: breast cancer screening; mammogram; cancer health equity; African American women; cancer survivorship; Andersen behavioral model; predisposing factors; enabling factors; need factors (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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