Mammography Screening in Latino Women Living in the Northeast United States: Qualitative research findings

Background: Mammography screening rates in Latinas are lower than reported for Whites, and Latinas are more likely to be diagnosed with later staged breast cancer and to have poorer survival compared with White women. Little is known about barriers to mammography screening among Latinas living in the Northeast US. Objective: Using a mixed methods approach to identify culture-specific predictors of screening and related variables, we report on the qualitative methods used to incorporate cultural context into the quantitative component of this investigation. Methods: In preparation for a larger, community-based, prospective study of mammography screening, six focus groups were held at community health centers. Using a slideshow to guide the discussion, we identified key themes reflecting attitudes, perceptions, and barriers affecting 1) annual mammography screening; 2) adequate follow-up of abnormal results; and 3) culturally sensitive interventions. Sessions were audiotaped and transcribed verbatim; dominant themes were coded by the research team and analyzed using QDA software. Results: An average of 10 women (mean age 48.5) attended one of 6 focus groups. Most women were foreign-born, representing 8 countries of origin. Major themes identified insurance, “carelessness” [descuido], fear, and forgetfulness as barriers to routine screening, with fear and insurance concerns cited for failure to return for needed follow-up following an abnormal result. Conclusions: Multilevel, culturally sensitive interventions are needed to improve the benefits of mammography screening in Latinas. This qualitative phase of a mixed methods approach to identify culture-specific factors that impact mammography screening in Latinas represents a critical first step in ensuring that research initiatives are conducted within an appropriate cultural context.