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APHA Scientific Session and Event Listing

Recorded presentation

Sophie Ziegler, MD, MPH, University of Florida, PO Box 100195, Gainesville, FL 32610, 352-273-6079, sophie.ziegler@meduniwien.ac.at and Amal Khoury, PhD, College of Public Health & Health Professions, University of Florida, PO Box 100195, Gainesville, FL 32610.

Background: Breast cancer screening facilitates early detection and promotes survival. Screening is underutilized by subgroups of women, including women in the rural south. The identification of factors that promote screening is critical for addressing disparities in cancer mortality.

Objective: To identify the association between primary care provider characteristics (specialty, gender) and Health Belief Model constructs and adherence to mammography screening guidelines.

Methods: A cross-sectional telephone survey of a representative sample of 1,050 women 40+ years was conducted in Mississippi in 2003. We excluded 225 women who did not have a regular source of care and/or reported a previous breast cancer diagnosis (n= 825).

Results: Among women with a usual source of care, 81% reported a mammogram in the past 2 years. Women whose primary care provider was an obstetrician/gynaecologist were twice as likely as women whose provider was a family physician to report a mammogram in the past 2 years. Physician gender was not associated with mammography rates. In addition to physician specialty, health insurance, physician's recommendation, social support, and perceived barriers to screening were key predictors of mammography utilization. Sociodemographic characteristics (race/ethnicity, education, income) were associated with screening at the bivariate but not at the multivariate level.

Conclusions: Provider specialty was associated with mammography rates even when “physician's recommendation” was controlled for. Further research is needed to investigate how and why specialty impacts screening rates. Access to care is critical for promoting early detection. Community-based programs should address perceived barriers to screening and encourage social support.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Appreciate the role of breast cancer screening in the early detection of the disease;
• Understand constructs of the Health Belief Model in relationship to breast cancer screening.
• Articulate the association between characteristics of primary care providers, HBM constructs, and screening rates.

Keywords: Breast Cancer Screening, Primary Care

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation