Back to Annual Meeting

Back to Annual Meeting

Abstract #149223

Melanie R. Wasserman, PhD¹, Steven Meersman, PhD², Melissa A. Clark, PhD³, William Rakowski, PhD³, and Karen L. Schneider, MPH⁴. (1) Taubman Center for Public Policy, Brown University, Box 1977, Providence, RI 02912, 401-863-9036, melanie_wasserman@brown.edju, (2) Surveillance Research Program , Office of the Associate Director, Division of Cancer Control and Population Sciences, National Cancer Institute, 6116 Executive Blvd, Suite 504, Bethesda, MD 20892-8316, Bethesda, MD 20892-8315, (3) Center for Gerontology and Health Care Research, Brown University, Box G-H1, Providence, RI 02912, (4) Department of Community Health, Brown University, 121 South Main Street, Providence, RI 02912

This study assessed the relationship between distance to FDA-certified mammography facilities and recent mammography utilization in a sample of middle-aged and older women from the Rhode Island Cancer Screening Project for Women. Study participants were aged 40-75 (N=568) and were currently unmarried (previously married or never-married). ARC/GIS was used to calculate distance between participants' homes and the nearest mammography facility. Distance was categorized in tertiles (Tertile 1=0-1 miles; Tertile 2=1-2 miles; Tertile 3=2-10 miles) to facilitate interpretation of results. Models were computed in three stages: (1) distance variables only; (2) adding individual-level control variables; and (3) adding neighborhood-level control variables. Logistic regression models were computed for recent mammography (past 2 years) against distance to the nearest facility. Greater distance from a facility was positively associated with recent mammography in all three models, though it achieved statistical significance only in Model 1 (Tertile 2 OR=1.76, 95% CI=1.00-3.09; Tertile 3 OR=2.37, 95% CI=1.29-4.33). In Models 2 and 3, older age, an index of screening avoidance behaviors, and an index of structural barriers to screening were negatively associated with recent mammography (p<0.05). Results suggest that in small, densely populated areas such as Rhode Island, greater distance may not represent a barrier to mammography, and barriers to mammography may be greatest for women living closest to facilities. Thus, outreach may be most needed in the immediate vicinity of mammography facilities.

Learning Objectives:

• Describe two competing theories about the effect of distance on access to care for older women.
• Explain how distance measures generated by ARC/GIS can be used to assess the effect of distance on access to care.
• Discuss the implications of this study for interventions to increase utilization of mammograms among middle-aged and older unmarried women.

Keywords: Breast Cancer Screening, Access

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.