Online Program

Breast cancer fatalism and its role in the prediction of past mammography experience among American Indian women in Oklahoma

Monday, November 4, 2013 : 12:50 p.m. - 1:10 p.m.

Eleni Tolma, MPH, PhD, Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK
Julie Stoner, PhD, Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK
JI Li, MS, Biostatistics & Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK
Kimberly Engelman, Ph.D, Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS
Background: Literature suggests that breast cancer fatalism (BCF) is an important factor in screening mammography. However, most research on BCF among American Indian (AI) women has been qualitative. This study examined quantitatively the association between BCF, access to mammography screening, breast cancer family history, mammography related knowledge, strength of cultural affiliation, frequency of clinical breast examination (CBE), and cognitions (i.e. attitude, social norms, self-efficacy, perceived susceptibility, social modeling and perceived behavioral control) with past mammography experience over the last 2 years. Methods: Data were collected from 255 (mean age=51 years, SD 7.64) AI women randomly selected from a rural Oklahoma medical clinic. BCF was measured with 5 items (Powe Fatalism model, Cronbach Alpha: 0. 74). Multivariate logistic regression was used to identify factors associated with self-reported past mammography. Results: Of the participants, 65% reported a screening mammogram within the last 2 years. Based on the multivariate model, women with a higher total BCF score by 1 point had a 9% lower odds of having a past mammogram than those with a lower BCF score (OR=0.91, 95% CI: 0.84-0.98, P=0.03). Women who were less likely to be influenced by their physicians, more culturally affiliated, perceived more barriers, had no breast cancer family history and one or no annual CBE had lower odds of past mammography (P<0.01 for each). Conclusion: Fatalism is important to consider in promoting screening mammography adherence among AI women. In addition, other modifiable factors to consider include physician recommendation, addressing barriers to mammography and promoting an annual CBE.

Learning Areas:

Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the relationship between breast cancer fatalism and other socio-demographic characteristics. Assess whether breast cancer fatalism is an important factor for adherence to mammography screening among American Indian women. Discuss what other factors besides breast cancer fatalism predict adherence to mammography screening among American Indian women.

Keyword(s): Breast Cancer, Native Americans

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator of this study since 2005 and I have received several grants examining the topic of mammography screening among Native American women in Oklahoma.
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.