How does preference for a female physician influence health behaviors among African American women?

Significance: Disparities persist for U.S. minority women in breast cancer screening and outcomes. Female provider gender is associated with mammography utilization, but factors related to preferring female providers, and effects of unmet preferences on underscreened populations remain unexplored.

Methods and Objective: Using surveys of 576 African American women age 45-93 in East Baltimore, Maryland, we investigated five influences on gender preference: perceived gender discrimination, related coping strategies, satisfaction with care, preferred role in care, and breast cancer prevention attitudes.

Results: Female provider preference was more common than having a female provider (53% versus 36%). In the adjusted model, female provider preference was more common among women reporting gender discrimination (OR=1.56, 95% CI=1.06-2.31) and those taking less active roles in their healthcare and cancer prevention. Women having female providers but no female gender preference were most likely to report recent screening (OR=1.79, 95% CI=0.93-3.48). Women with unmet female provider preference had less intention for future screening (OR=0.64, 95% CI=0.42-0.97).

Conclusions: Findings suggest provider gender may be a “double-edged sword.” Results confirm that the widely observed “female provider” effect is associated with improved screening rates, specifically among minority low resource women. However, findings also suggest provider gender preference may arise from past disadvantage, and is associated with attitudes less conducive to health maintenance. Interventions to promote screening should recognize potential barriers among women with provider gender preference.