Mammography Screening Behavior Research Articles

Health literacy and mammography screening behaviors among women living in a rural area of Turkey.

Breast cancer is the most common cause of cancer-related deaths. and early diagnosis could reduce breast cancer deaths. Therefore, health literacy is one of the most important determinants of participation in cancer screening for early diagnosis. This study aimed to determine the relationship between women's mammography screening behaviors and health literacy levels. The cross-sectional study included 312 women aged 40-69 years living in a rural area. Data were collected through face-to-face interviews using a personal information form and the Turkish Health Literacy Scale (THLS-32). Of the women, 28.5% had mammography in the last 2 years. Of concern was the low health literacy levels. In addition, there were significant differences in the THLS-32 subgroup scores, including the THLS-32 total score, among the mammography screening groups. Health literacy levels of women were related to mammography screening rates. For this reason, effective intervention studies aiming to increase society's health literacy levels may contribute to an increase in breast cancer screenings.

Mammography screening beliefs and barriers through the lens of Black women during the COVID-19 pandemic.

Mammography is an effective screening tool that leads to decreased breast cancer mortality, yet minority women continue to experience barriers. The coronavirus disease 2019 (COVID-19) pandemic has been proven to have negatively affected minority communities, yet its effect on mammography screening habits in Black women is uncertain. The purpose of this study was to evaluate breast cancer mammography screening habits and barriers for Black women in two northeast communities amid the COVID-19 pandemic. The study participants were Black women aged 40years or older who were recruited from community outreach initiatives. Study coordinators conducted telephone surveys to determine mammography screening behaviors, perceptions, and psychosocial factors. Two hundred seventy-seven surveys were completed. Two hundred fifty-six patients who reported ever having a mammogram became the study population of interest. One hundred seventy-four of these patients (68%) reported having a mammogram within the past year (nondelayed), and 82 (32%) had a mammogram more than a year ago (delayed). Only thirty-one of the delayed participants (37.8%) had private insurance. There was a significant difference in the mean score for mammography screening perceived barriers for nondelayed participants (mean=9.9, standard deviation [SD]=3.6) versus delayed participants (mean=11.2, SD=4.3, p=.03). There was also a significant difference in the mean score when they were asked, "How likely is it that 'other health problems would keep you from having a mammogram'?" (p=.002). Barriers to mammography screening for Black women during the COVID-19 era include insurance, competing health issues, and perceptions of screening. Community outreach efforts should concentrate on building trust and collaborating with organizations to improve screening despite the COVID-19 pandemic.

Breast Cancer Knowledge and Mammography Use Among Asian American Women Aged 40 and Older: Using the Transtheoretical Model Approach.

Mammography screening rates remain low among Asian American women (AAW). The aims of our study were to: (a) assess breast cancer knowledge and mammography screening behaviors, and (b) identify the factors related to the transtheoretical model (TTM) stages of change in relation to mammography utilization among AAW aged 40 and older. Using a cross-sectional design, a convenience sample of 714 AAW completed a structured questionnaire in 2021. Participants demonstrated a moderate level of knowledge regarding breast cancer and mammography. Only 34.2% of the participants reported obtaining regular mammograms. The ordinal logistic regression indicated that age, birthplace, health perception, breast biopsy history, breast cancer knowledge, self-efficacy, and perceived barriers were correlated with TTM stages of change. Our results highlight the need for implementing effective interventions aimed at increasing knowledge and screening rates for breast cancer among AAW. Additional TTM studies with AAW are needed to determine the relationships among TTM constructs and develop theory-based programs to improve adherence to screening guidelines. Future research using a mixed-method design may provide opportunities to explore complex phenomena associated with breast cancer screening behaviors. Finally, further assessments of the Breast Cancer Knowledge Scale's psychometric properties are necessary to improve this instrument.

A multi-theory model based analysis of correlates for initiating and sustaining mammography screening behavior among Hispanic American women in the United States

Background: Despite the known advantages of mammography, screening rates among Hispanic American women are lower compared to other ethnic groups. Therefore, this cross-sectional study aimed to explore correlates of mammography screening behavior among a sample of Hispanic women aged 45-54 years living in the United States using the multi-theory model (MTM). Methods: A 50-item web-based survey consisting of psychometrically valid tools based on MTM theoretical framework was administered through non-random sampling procedures using Qualtrics. Univariate, bivariate, and multivariate statistics were used to analyze the data. Results: Out of 370 participants, nearly 49% (n=189) reported not having a mammogram in the past two years. The mean age of the sample was 48.8±2.8 years. A greater proportion of participants who have had a mammogram reported having health insurance compared to those who have not had a mammogram (93.1% vs. 75.7%, P <0.001). Results of hierarchical regression suggest that all MTM constructs, including participatory dialogue, behavioral confidence, and changes in the physical environment explained 33.4% of variance in initiating mammography behavior among those who have not had a mammogram. Similarly, practice for change, emotional transformation, and changes in the social environment explained 53% of the variance in sustenance of the behavior change. Conclusion: Along with the MTM subscales, this study points to the important correlates such as health insurance and messaging by healthcare providers to promote the mammography seeking behavior among Hispanic women.

Abstract PO-043: Perceived everyday discrimination, socioeconomic status, and mammography screening behavior

Abstract Black women (BW) experience age-adjusted breast cancer mortality rates that are 40-70% higher than White women. Although BW are more likely to report having had a mammogram compared to other racial/ethnic minority groups, differences in mammography utilization exist among women with lower socioeconomic status (SES). Moreover, perceived everyday discrimination (PED) has been shown to have an inverse relationship on health screening behavior among BW. However, mammography screening behaviors of BW with low SES, who also report higher levels of PED, is not well known. This study aims to explore the relationship between perceived discrimination, SES (income, education, health insurance), and mammography screening behavior. Methods: Participants completed a 40-item survey and were recruited between 2020-2021 through a community-based participatory research initiative—Bench to Community. Logistic regression was used to test the associations of mammography utilization with PED—short version of Everyday Discrimination Scale, SES, and race/ethnicity. Results: Most participants (n=159) identified as BW (55%)—African American, African, and Caribbean, followed by White (34%), and other groups (9.3%). Twenty-five percent had some high school (HS) or a HS diploma, 25% had some college education with 15% reporting an income below $25,000. Many respondents had health insurance (96%), and 74% reported having had a mammogram. Discrimination alone significantly impacted whether an individual had a mammogram, such that those who reported higher levels of PED were 38% less likely to have a mammogram, χ2(12) = 36.924, p&amp;lt;.001. Additionally, while education significantly contributed to the model, income demonstrated a trending influence overall, with less than $25,000 income reaching significance (B=-3.331, SE=1.210, Wald = 7.576, p=.006). As race and insurance did not significantly contribute to the overall model, subsequent model fitting excluded these variables. In a model that included only discrimination, education, and income, all three predictors significantly contributed to the model χ2(9)= 33.571, p&amp;lt;.001. Discrimination (B= -.536, SE=.178, Wald = 9.106, p=.003), education overall (B=-1.177, SE=.604, Wald = 3.797, p=.051), and income (B=-2.674, SE=.956, Wald = 7.815, p=.005) were significant predictors. More specifically, those with some college education or less were 3.245 times less likely to have a mammogram. In this final model, those who reported making less than $25,000 household income were .069 times less likely to have a mammogram. Lastly, race alone was significantly (p=.006) predictive of mammogram screening behavior. Discussion/Conclusion: PED, education, and income were associated with mammography screening behavior. The excess mortality faced by BW, is a probable reflection of their position within our hierarchal society. Addressing these social determinants of health factors may improve our understanding of ways discrimination leaves BW vulnerable to disparate health outcomes, including breast cancer. Citation Format: Jessica Vinegar, Marissa Ericson, Kommah McDowell, Tonya Fairley, Rick Kittles, Lindsey Treviño, Dede Teteh. Perceived everyday discrimination, socioeconomic status, and mammography screening behavior [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-043.

Abstract PO-218: Body mass index, age at diagnosis, and mammography screening behaviors in women diagnosed with breast cancer in Puerto Rico

Abstract The breast cancer mortality rate in Puerto Rican women is higher when compared to Hispanic women in the United States, despite having similar incidence. While disparities are well documented between Non-Hispanic Blacks and Non-Hispanic Whites, Hispanic populations have not been explored as thoroughly. Previous studies have identified high Body Mass Index (BMI) as a risk factor in postmenopausal breast cancer. Breast cancer incidence tends to increase with age, but younger age of diagnosis may be related to more aggressive disease. Studies have demonstrated that mammogram and continuous breast cancer screening can reduce mortality through early detection. Our study focuses on characterizing BMI, age at diagnosis, and screening information in Puerto Rican women obtained from a patient survey administered by the Puerto Rico BioBank (PRBB). These factors may contribute to the observed disparity in breast cancer mortality in these patients. Data abstracted from the PRBB self-reported questionnaire identified 260 females who had been diagnosed with breast cancer between the ages of 25 and 86. The questionnaire includes demographic, family history, lifestyle, and cancer-related questions. BMI was calculated from the self-reported height and weight values, then classified according to the Center for Disease Control (CDC) categories: underweight (&amp;lt;18.5), healthy (18.5-24.9), overweight (25.0-29.9), and obese (≥30.0). Age at diagnosis and frequency of patients who reported getting annual mammograms were both recorded. Descriptive statistics were performed. According to the CDC categories of BMI, 106 respondents (41.2%) were obese, 88 (34.2%) were overweight, 58 (22.6%) were of a healthy weight, and 5 (1.9%) were underweight. This indicates that approximately 77% of the respondents had a BMI outside of the healthy range. The average BMI of 28.8 and median BMI of 28.4 both fall within the overweight category, and the population standard deviation was 5.9. The mean age at diagnosis among our cohort was 56.78 years. The percentage of women who reported having a mammogram annually was 81%. Our data suggests that Puerto Rican women have a high rate of screening using mammograms and have a high BMI. This study suggests that the distribution in age in Puerto Rican women are in-line with national averages. Further examination of breast cancer among Puerto Rican women is needed to establish consistent risk factors and mitigate any health disparities confirmed among this population of breast cancer patients. Citation Format: Abigail E. Lantz, William D. Cress, Allison Bahr, Edna Gordián, Jaileene Perez-Morales, Idhaliz Flores, María Rojas. Body mass index, age at diagnosis, and mammography screening behaviors in women diagnosed with breast cancer in Puerto Rico [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-218.

Tendency to Breast Cancer Screening Among Rural Women in Southern Iran: A Structural Equation Modeling (SEM) Analysis of Theory of Planned Behavior.

Background:Early detection of breast cancer is a crucial factor in surviving the disease. This study aimed to investigate the mammography screening based on the theory of planned behavior (TPB) among rural women in Fasa and Shiraz cities, Iran.Methods:This study is a cross-sectional study performed on 800 female clients referring to rural health centers in Fasa and Shiraz cities in southern Iran in early 2021. The authors decided to send and distribute the electronic questionnaire form through the WhatsApp application in collaboration with the health staff of rural health centers for the people covered by these centers. Data gathering tools were a questionnaire on demographic characteristics, a questionnaire based on constructs of TPB, and behavior of mammography screening. Using the structural equation model (SEM), the TPB constructs and demographic variables were entered into the model. Data analysis was executed employing SPSS software version 26 and Amos version 24 (IBM Co., Ann Arbor, MI, USA). Analyzing the data was carried out using the 1-way analysis of variance (ANOVA), logistic regression, and structural equation analysis. During data analysis, various model indicators such as the goodness of fit, including comparative fit index (CFI), goodness-of-fit index (GFI), root mean square error of approximation (RMSEA), and chi-square index/df were evaluated. The significance level in all tests was considered 0.05.Results:The knowledge, attitude, and perceived behavioral control were the predictors of intention and behavior of mammography screening among the women. Among demographic variables, age, literacy, being menopausal, cancer in family, city, and ethnicity contribute more to the variance variation in TPB constructs. In this study, 7.2% of Persians, 8% of Qashqai Turks, and 4.5% of Arabs are contemplating going to mammography screening. In total, 6.8% (54 people) of all individuals intended to go mammography screening, and 5.4% (43 people) had a history of mammography screening. Goodness-of-fit indices (χ2 = 18.45, df = 10, n = 800, χ2/df = 1.845, RMSEA = 0.032, GFI = 0.90, non-normed fit index (NNFI) = 0.91) of conceptual model of this study indicate the suitability of the model.Conclusions:The results of the study indicated that the constructs of the TPB can predict mammography screening behaviors in rural women. It has also demonstrated that mammographic behavior can be improved in rural women using education based on the TPB model, emphasizing critical psychological factors of creating or changing behavior.

Mammography Screening Disparities in Asian American Women: Findings From the California Health Interview Survey 2015–2016

To identify mammography screening prevalence and predictors in Asian American women, focusing on the potential disparities in race and its influence on screening behaviors. A secondary analysis utilized the California Health Interview Survey (CHIS) 2015-2016. California, U.S. Cisgender women who were non-Hispanic (NH) White, Chinese, Filipino, Vietnamese, Japanese, Korean, or "other Asian", aged 40 or above (unweighted N=13 451). Socioeconomics, chronic health conditions, and preventive care utilization were mesuared as potential risk factors, where up-to-date mammography screening as the outcome variable. Multivariable adjusted logistic regressions were generalized to identify the up-to-date mammography screening behaviors in relation to potential factors, stratified by race and ethnicity. The prevalence for up-to-date mammography screening in NH-White and Asian American women were 68.06% and 65.97%, respectively. In NH-White women, receiving an up-to-date mammogram was associated with age, birthplace, smoking status, diabetes, hypertension, health insurance coverage, and a preventive care visit in the past 12months, whereas only age and a preventive care visit were significant predictors in Asian women. The findings indicate that utilization disparities exist in mammogram in relation to socioeconomics, chronic health conditions, preventive care utilization, when comparing between race and ethnicity. Asian American women with borderline hypertension and no preventive care visits may require more public health outreach and cancer education.

HEALTH BELIEFS ON THE BEHAVIORAL ADOPTION OF MAMMOGRAPHY SCREENING MODERATED BY KNOWLEDGE AND MARITAL STATUS: A PATH ANALYTIC MODEL

Despite the effectiveness of mammography for early breast cancer detection, its’ utilization among Malaysian women remains low. Health beliefs are closely related to health screening behavior. Hence, it is important that health beliefs are employed when exploring mammography screening behavior. Thus, the study utilized HBM constructs in predicting the variance in adoptive behavior of mammography. A multi-stage, stratified random sampling method was utilized to select the polyclinics in Kuantan, Pahang. Using sample size calculation at 5% type 1 error, p &lt; 0.05 and absolute error at 2%, 520 Malaysian women aged 35 to 70 years were randomly selected. Sets of copyrighted, validated questionnaire were used to obtain the data. Structural equation modeling using Mplus was used to test the model. All health beliefs were found to significantly influence the behavioral adoption of mammography screening. Socio-demographic factors (married women) were found to moderate significantly the relationship between perceived susceptibility and behavioral adoption of mammography. Further, knowledge and married women were found to significantly affect self-efficacy. Additionally, perceived severity, motivator factors and perceived benefits were found to significantly influence self-efficacy and that self-efficacy significantly influences the behavioral adoption of mammography screening. However, a negative correlation was found between perceived severity and perceived barriers on the behavioral adoption of mammography. The model can be used as an interventional tool in designing promotional and educational programs to encourage women to adopt mammography screening.

Demographic variables affecting participation in mammography screening: a cross-sectional study

Breast cancer is one of the most common cancers among women. There are three commonly used diagnostic methods in this cancer type, in which the survival rate can be quite high with early diagnosis. Compared to breast self-examination and clinical examination, mammography stands out as a more accurate diagnostic method. Although there are health policies regarding mammography screening in many countries, mammography screening behavior has not reached the desired level worldwide. In this study, we tried to reveal the demographic factors affecting the frequency of women getting mammograms in Turkey. The frequency of mammography screening was estimated with a generalized logit model using the microdata of TURKSTAT Turkey Health Survey. As a result of the model, it was observed that mammography screening differentiated in different age and income groups. It was determined that the disease status increased the frequency of mammography screening, however, marital status and employment status did not have a significant effect.

Healthy lifestyle behaviors and the periodicity of mammography screening in Brazilian women

Introduction:Certain behaviors have been associated with health promotion, including mammography screening, in women worldwide.Objective:The objective of this study was to determine whether there is an association between the periodicity of mammography screening and healthy lifestyle behaviors in Brazilian women employed at a public university in Bahia, Brazil.Methods:A total of 635 women of 50–69 years of age at the time of the interview, from the Brazilian Longitudinal Study of Adult Health cohort who were resident in Bahia, participated in the study. Data were collected using a multidimensional questionnaire that included questions on participants’ sociodemographic characteristics and health-related behaviors (smoking, alcohol consumption, leisure-time physical activity and diet) and another questionnaire that dealt with risk factors and breast cancer screening. Measures of association were calculated using simple and multivariate logistic regression.Results:The practice of physical activity, not smoking, moderate alcohol consumption and a healthy diet were the health behaviors most adopted by the women who had last had a mammogram ⩽2 years previously (which is in line with the interval recommended by the Brazilian Ministry of Health). A statistically significant association was found between a lapse of ⩾3 years since last undergoing mammography screening and excessive alcohol consumption, while a borderline association was found between the same screening interval and leisure-time physical inactivity.Conclusion:There was an association between lifestyle risk behaviors and a longer time interval between mammography screenings. The present results contribute to the debate on the use of mammography, lifestyle behaviors and health promotion among women.

The Relationship between Risk Levels of Breast Cancer and Use of Early Diagnosis and Screening Services in Healthcare Workers in Turkey.

Background:This study aimed to determine the factors affecting early diagnosis and screening behaviors of healthcare workers concerning breast cancer and the breast cancer risk levels using the risk identification model and to evaluate the relationship between breast cancer risk levels and early diagnosis and screening behaviors.Methods:Overall, 466 healthcare workers from Balikesir Province, Turkey participated in this cross-sectional study. Data were collected thanks to a questionnaire prepared by the researchers. Cuzick-Tyrer model was utilized to determine breast cancer risk levels.Results:78.1% of the healthcare workers regularly perform breast self-examination (BSE), 11.6% had clinical breast examination (CBE), 7.7% had breast ultrasound scan and 4.5% had mammography. BSE behavior increased, as education level got higher. Mammography screening behavior increased in those aged 40 yr and older and those with breast or ovarian cancer history in their family. There was not any relationship between breast cancer risk levels and early diagnosis and screening behaviors.Conclusion:Early diagnosis and screening behaviors of healthcare workers were low concerning breast cancer. Age, education level and family history are the most prominent factors affecting early diagnosis and screening behaviors of healthcare workers. Informing healthcare workers on breast cancer risk factors and screening can make positive contributions to them and the public through them.

Comparison of mammography behaviors, health beliefs, and fear levels of women with and without familial breast cancer history*

ABSTRACT This comparative descriptive study compared mammography behaviors, health beliefs, and fear levels of Turkish women aged 40–69 years, who had or did not have a familial breast cancer history (FBCH). The sample included first-degree female relatives (n = 350) of 220 female patients who had received breast cancer treatment at Akdeniz University Hospital and first-degree female relatives of women who did not have a FBCH (n = 300) who had applied to a Family Health Center (FHC) in Antalya. Data were collected between October 2015 and March 2016. The percentage of women who regularly had a mammography was 38% in women with a FBCH and 15.3% in women without a FBCH. Women with a FBCH had higher susceptibility, seriousness, health motivation, mammography self-efficacy perception, and fear of breast cancer, and lower perception of mammography barriers than women without a FBCH. The frequency of having mammography in women with and without a FBCH increased with increased susceptibility perception and was higher in women with a FBCH than in women without a FBCH. Additionally, being single increased mammography screening behavior in those with FBCH. Trainings on screenings should emphasize risks of breast cancer and mammography barriers of the married ones should be reduced.

H-BwoaSvm: A Hybrid Model for Classification and Feature Selection of Mammography Screening Behavior Data

Breast cancer is one of the most common cancer in the world. Early detection of cancers cause significantly reduce in morbidity rate and treatment costs. Mammography is a known effective diagnosis method of breast cancer. A way for mammography screening behavior identification is women's awareness evaluation for participating in mammography screening programs. Todays, intelligence systems could identify main factors on specific incident. These could help to the experts in the wide range of areas specially health scopes such as prevention, diagnosis and treatment. In this paper we use a hybrid model called H-BwoaSvm which BWOA is used for detecting effective factors on mammography screening behavior and SVM for classification. Our model is applied on a data set which collected from a segmental analytical descriptive study on 2256 women. Proposed model is operated on data set with 82.27 and 98.89 percent accuracy and select effective features on mammography screening behavior.

Breast Cancer Risk Perception and Mammography Screening Behavior of Women in Northeast Brazil

Background: Previous studies suggest that education and income affect Brazilian women's breast cancer prevention behavior. The present study focused on the impact of perceived and estimated risk on mammography screening (MS) behavior.Materials and Methods: Information regarding socioeconomic variables and risk perception was obtained from 396 healthy women aged 40–79 years. Perceived comparative risk was measured on a seven-point Likert scale. A Breast Cancer Risk Assessment Tool of 5-year risk to develop breast cancer was used to determine objective risk. Estimated comparative risk was determined as categories of perceived risk relative to the objective risk. Regression analysis was applied to determine odds ratios (ORs) and confidence intervals (95% CIs) of variables.Results: Asked about the potential of MS to lower risk of death because of breast cancer, 215 (54.29%) responded that it does not lower risk. Women with low perceived comparative risk had a twofold (OR = 0.493; 95% CI: 0.24–1.00) decreased chance to participate in MS annually, compared with women with high-perceived comparative risk (p = 0.020). Women without family history had a 7.6-fold (OR = 0.132; 95% CI: 0.07–0.25) decreased chance of having a high-perceived comparative risk (p = 0.000). If compared with underestimation, the overestimation and accurate estimation of comparative risk tended to be associated with a decreased chance of MS attendance (p = 0.017). Regression modeling indicated that low educational level, no occupation, and no family history decreased the chance of women having MS (p = 0.040; p = 0.010; p = 0.022).Conclusions: Risk perception depended on family history. Present data did not indicate that overestimation, or accurate estimation of comparative risk, increased chance of MS attendance. Educational level, occupation status, and family history, instead, determined MS performance.

Effects of different reminder strategies on first-time mammography screening among women in Taiwan

BackgroundThe study’s purpose was to examine the effectiveness of different reminder strategies on first-time free mammography screening among middle-aged women in Taiwan.MethodsA quasi-experimental design with random assignment was adopted to divide the participants into three Reminder Strategies groups (mail reminder, telephone reminder, and combined mail and telephone reminders) and one control group. This study recruited 240 eligible middle-aged women, and 205 of them completed the study. Upon the completion of data collection, mail reminders were provided to women of the first group; telephone reminders were provided to the second group; mail followed by telephone reminders were provided to the third group, and the usual postcards were provided to the control group 1 month after the interventions. Two follow-up assessments were conducted 1 and 3 months after the intervention to collect mammography-screening behaviors from all groups.ResultsThe findings showed that, compared to the control group, more participants in the intervention groups underwent mammography screening after receiving reminder interventions. Telephone contact as reminder was found to have the most significant influence among the interventions (OR = 5.0556; 95% CI = 2.0422–13.5722).ConclusionsGovernment and healthcare providers are recommended to consider adopting the telephone reminder strategy to encourage women to undergo their first-time mammography screening.

Comparison of self-reported adherence to cervical and breast cancer screening guidelines in relation to the researcher’s profession.

Introduction: Self-reporting is a major and, in many cases, the only feasible method to use in cancer screening research. However, its validity has been questioned and numerous studies indicate that women over-report their participation in preventive Pap-test and mammography screenings. Aim: The objective of this study was to determine whether individuals report in the same way their Pap-test and mammography screening behaviors when the interviews are conducted by researchers of different professions, in this case a social worker and a general practitioner. Methods: Two studies assessing adherence to cervical and breast cancer screening guidelines were conducted during late 2006 - early 2007 in the same 114 women in Crete, Greece. Kappa coefficient was used to measure the agreement of participants’ answers to the same questions between the two interviewers. Results: Only 32 out of 90 (35,5%) of the women replied that ‘have had at least one’ gynecological exam respectively in both studies (Kappa=0.189, p&lt;0.001). Agreement was also weak (Kappa=0.386 and 0.235) for self-reported mammography and Pap smear tests in the last 6 years, respectively. There were no significant differences in major demographic characteristics between women who provided, or not, the same answers in both interviewers, apart from the self-reported health status (p=0.032). Conclusions: Women overestimated their self-reported adherence to cancer screening guidelines when the interviewer was a doctor once their responses were matched to those given to a social worker. The professional identities of the researchers that perform the data collection should be made explicit to make comparison across studies more accurate.

Effects of Model-Based Interventions on Breast Cancer Screening Behavior of Women: a Systematic Review

Background:Breast cancer is a great concern for women’s health; early detection can play a key role in reducing associated morbidity and mortality. The objective of this study was to systematically assess the effectiveness of model-based interventions for breast cancer screening behavior of women.Methods:We searched Scopus, PubMed, Web of Science, Science Direct, Cochrane library and Google scholar search engines for systematic reviews, clinical trials, pre- and post-test or quasi-experimental studies (with limits to publication dates from 2000-2017), Keywords were: breast cancer, screening, systematic review, trials, and health model. In this review, qualitative analysis was used to assess the heterogeneity of data.Results:Thirty six articles with 17,770 female participants were included in this review. The Health belief model was used in twenty three articles as the basis for intervention. Two articles used both the Health belief model and the Health Promotion Model, 5 articles used Health belief model and The Trans theoretical Model, 2 used Hthe ealth belief model and Theory planned behavior, 2 used the Health belief model and the Trans theoretical Model, 2 used the Trans theoretical Model, 1 used social cognitive theory, and 1 used Systematic Comprehensive Health Education and Promotion Model. The results showed that model-based educational interventions are more effective for BSE and CBE and mammography screening behavior of women compare to no model based intervention. The Health belief model was the most popular model for promoting breast cancer screening behavior.Conclusions:Educational model-based interventions promote self-care and create a foundation for improving breast cancer screening behavior of women and increase policy makers’ awareness and efforts towards its enhancement breast cancer screening behavior.

Understanding mammography behavior among the west of Iranian women: stage of change model testing

Breast cancer is the second leading cause of death in industrial countries and the third one in developing countries. The aim of this study was determined the stages of change of mammography screening behavior among women. This cross-sectional study was conducted on 400 women aged 30 to 60 years old referred to health centers in Kermanshah County, the west of Iran, during 2016, who were randomly selected to participate in the study. Data collected by standard questioner and were analyzed by SPSS version 21. The mean age of respondents was 39.61 years [SD: 8.28]. Our findings indicated, nearly 59 % (236/400), 27.3 % (109/400), 2.5 % (10/400), 9.3 % (37/400), and 1.8 % (7/400) of the respondents reported that pre-contemplation, contemplation, preparation, action, and maintenance, respectively. Our results showed most of the women were in pre-contemplation and contemplation stages regarding doing mammography. These results can be highly useful to the researchers in designing effective interventional plans for achieving the intended objectives.

Abstract A33: Promoting screening mammography in an American Indian community in Oklahoma: The Native Women's Health Project

Abstract Background: The stagnant breast cancer mortality rates and the increased number of younger American Indian (AI) women who are being diagnosed with breast cancer indicate that breast cancer remains an important public health issue among the AI community. This 4-year study is a continuation of two preliminary studies at a rural tribal clinic in Oklahoma. In the first study, we developed a culturally-sensitive survey of mammography screening practices and beliefs, entitled Women's Health Survey (WHS), based on the Theory of Planned Behavior. In the second study, we identified the salient mammography screening beliefs held by AI women. The results led to the development of a Logic Model of mammography screening behavior, involving both clinical and community components, which guided intervention development. In the current study, we implemented the intervention and evaluated its efficacy via Community-based Participatory Research. Methods: A Community Steering Committee (CSC) was formed. The priority population consisted of AI women without a history of breast cancer who lived in the target region between the ages of 52-74 years, and who have not had a screening mammogram within the last 2 years. The study had four aims: 1) Conduct a needs and resource assessment of the priority population, 2) Utilize the needs and resource assessment data to develop a community-driven intervention program, 3) Pilot-test and refine the intervention, and 4) Evaluate the intervention using a one-group pre- and post-evaluation design and mixed research methodology. A modified version of the WHS was used as the evaluation tool. Results: The results of the formative research (Aim 1) indicated that: a) AI women lack knowledge of mammograms, b) Fatalistic attitudes toward breast cancer exist among AI women, c) Many AI women prefer a holistic approach to their health, d) Physicians influence women's screening mammography decisions, and e) Social modeling is an important motivating factor. Using a prioritization process through the CSC and data triangulation, we concluded that the intervention would center on the concepts of social modeling, physician recommendation, breast cancer fatalism, and lack of knowledge about mammography screening. The Logic Model was finalized, educational intervention materials were developed, and alliances were built with regional grassroots initiatives (Aim 2). The intervention included four main strategies: a) Structured communication between medical practitioner and patient about screening mammography; b) Receipt of a breast cancer brochure and subsequent follow-up letter from the medical provider; c) Participation in a breast cancer discussion group at a community setting by using the Freire (raising consciousness) approach; and d) Receipt of a congratulatory bracelet upon receipt of a mammogram. Based on the evaluation results (Aim 4), the intervention is feasible despite its complexity; however, process evaluation revealed a shallow implementation of the clinic component. Almost half of the research participants (N=21) received a future mammogram, indicating moderate program success. Focus group research (N=4) showed that the participants became more conscious of their health and more vocal in discussing breast cancer with their friends and family. Moreover, sustainable environmental changes were introduced at the tribal clinic including a bulletin board poster on mammography and a screening mammography algorithm located in the exam rooms. Conclusions: Designing, implementing and evaluating a theory-based culturally-sensitive multi-component intervention on mammography screening within a Native American community is an exciting, yet challenging process. Replications of the current study with a bigger sample size and a controlled, comparative evaluation design are needed to further establish the efficacy of the intervention. Citation Format: Eleni L. Tolma, Kimberly Engelman, Cara Thomas, Stephanie Joseph, Julie Stoner, Ji Li, Norma Neely. Promoting screening mammography in an American Indian community in Oklahoma: The Native Women's Health Project. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A33.