223725 Mammography Adherence: Results of a Focus Group Study

Monday, November 8, 2010

Lisa Watson, MPH , National Center for Chronic Disease and Prevention and Health Promotion, Division of Cancer Prevention and Control, Comprehensive Cancer Control Branch, Atlanta, GA
Lisa Richardson, MD, MPH , National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, CSB, Centers for Disease Control and Prevention (CDC), Atlanta, GA
Michelle Revels, MA , ICF Macro Inc., Atlanta, GA
Danielle Beauchesne, MPH , ICF Macro, Atlanta, GA
Judith Lee Smith, PhD , Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Comprehensive Cancer Control Branch, Atlanta, GA
C. Brooke Steele, DO , Division of Cancer Prevention and Control, Comprehensive Cancer Control Branch, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
Amy Degroff, PhD, MPH , Nccdphp/CDC, Centers for Disease Control and Prevention (CDC), Atlanta, GA
Erin Justen, MPH , CDC Foundation, Atlanta, GA
Rachel Barron-Simpson, MPH , Centers for Disease Control and Prevention, Atlanta, GA
Ngozi N. Kamalu, MPH , Macro International, Inc., Atlanta, GA
Epidemiological reports suggest mammography adherence has declined. Given that mammography accounts for at least half of the decrease in breast cancer mortality, understanding this decline is critical. We conducted a focus group study to explore why some women discontinue routine mammographic screening. Nineteen focus groups and one dyad interview were conducted with white non-Hispanic (WNH), black non-Hispanic (BNH), Hispanic, Japanese American (JA), and Native American (NA) women who were segmented by age (43-49, 50-64, 65+), race/ethnicity and health insurance status. A conceptual framework, based on existing research, informed development of the focus group guide.Topics included previous mammography experiences, perceptions of personal breast cancer risk, barriers to mammography, and risks and benefits associated with undergoing mammography. Atlas.ti was used to facilitate data analysis. All focus groups (n=128 women) were completed in 2009 in five cities across the United States. Half of the groups were held with WNH women and the remainder with other racial/ethnic groups. Major barriers to routine mammography included 1) lack of awareness that risk increases with age; 2) doubts about the safety, accuracy, and benefits of mammograms; 3) distrust of providers and medical system; and 4) physical and emotional discomfort associated with the screening procedure and mammography technicians. For uninsured women, lack of health insurance was the primary barrier to mammography. The findings direct us to social media marketing that would allow crafting and tailoring of messages and materials to address the barriers women face through traditional channels (e.g. print media) and newer social media (e.g. Facebook, blogs).

Learning Areas:
Administer health education strategies, interventions and programs
Chronic disease management and prevention
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
By the end of the presentation, participants will be able to identify key barriers women face in seeking routine mammography and describe at least three ways in which to address those barriers.

Keywords: Breast Cancer Screening, Access to Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am the project manager for the Mammography adherence study.
Any relevant financial relationships? No

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.