Factors Influencing Adherence to Mammography Screening Guidelines in Appalachian Women Participating in a Mobile Mammography Program

J Community Health. 2012 Jun;37(3):632-46. doi: 10.1007/s10900-011-9494-z.


The objectives of this study were to evaluate the characteristics (demographic, access to care, health-related behavioral, self and family medical history, psychosocial) of women age 40 years and above who participated in a mobile mammography screening program conducted throughout West Virginia (WV) to determine the factors influencing their self-reported adherence to mammography screening guidelines. Data were analyzed using the Andersen Behavioral Model of Healthcare Utilization framework to determine the factors associated with adherence to mammography screening guidelines in these women. Of the 686 women included in the analysis, 46.2% reported having had a mammogram in the past 2 years. Bivariate analyses showed predisposing factors such as older age and unemployed status, visit to a obstetrician/gynecologist (OB/GYN) in the past year (an enabling factor) and need-related factors such as having a family history of breast cancer (BC), having had breast problems in the past, having had breast biopsy in the past, having had a Pap test in past 2 years, and having had all the screenings for cholesterol, blood glucose, bone mineral density and high blood pressure in past 2 years to be significant predictors of self-reported adherence to mammography guidelines. In the final model, being above 50 years (OR=2.132), being morbidly obese (OR=2.358), having BC-related events and low knowledge about mammography were significant predictors of self-reported adherence. Breast cancer related events seem to be associated with mammography screening adherence in this rural Appalachian population. Increasing adherence to mammography screening may require targeted, community-based educational interventions that precede and complement visits by the mobile mammography unit.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Ambulatory Care / statistics & numerical data*
  • Appalachian Region
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / prevention & control*
  • Cross-Sectional Studies
  • Early Detection of Cancer / statistics & numerical data*
  • Female
  • Humans
  • Mammography / statistics & numerical data*
  • Middle Aged
  • Patient Compliance / statistics & numerical data*
  • Practice Guidelines as Topic
  • Program Evaluation
  • Self Report