Associations among predisposing, enabling factors and mammography screening in Chinese immigrants

Problem/Objective: Despite the proven survival benefits associated with breast cancer screening, utilization of the mammography continues to be suboptimal in some ethnic minority populations, particularly Chinese women immigrants who report considerable barriers to screening. The incidence rate of breast cancer for this population continues to rise. Predictors of predisposing and enabling factors and barriers to mammography screening behaviors were examined amongst Chinese immigrants. Methods: Women (n= 474) were recruited from Chinese community centers. The study, guided by Health Belief Model and Behavioral Model of Health Service Utilization, tested two hypotheses. Hypothesis 1: predisposing factors (perceived barriers, risks, severity, benefits, self-efficacy and demographic variables) and enabling factors (health insurance, income and regular physician availability) predict Mammography screening. Hypothesis 2: Personal factors (trust in physicians and satisfaction with access to health care) predict mammography screening. Results: A multivariate logistic regression model indicated that being of greater age, having had a general check-up, check-up frequency, having health insurance, and greater English speaking ability were the most significant predictors for mammogram screening. Conclusion: Health-seeking norms most strongly predicted mammography screening. Being of older age, having a longer length of time living and working in the US particularly in companies that provide insurance uniquely contributed to the prediction of screening behavior. Higher levels of English proficiency indicate a greater adoption of more prevalent health-seeking beliefs in the US. Culturally appropriate interventions will be recommended to address predisposing and enabling factors and access barriers that can significantly contribute to increasing breast cancer screening in Chinese women.