Background: Recent reports suggest that much of the difference in breast cancer survival between African-Americans and whites could be reduced through greater access to and use of screening by African-American women. Few community-based studies have addressed screening-related issues among low-income African-American women.
Methods: A simple random sample of households was drawn; a total of 585 women of age 40 or older were interviewed in their homes (response rate = 75%). Women were grouped into four stages of adoption of screening: participated regularly, participated nonregularly, heard of but never participated in screening, or never heard of it. Bivariate analyses were used to describe relations between screening (mammography, clinical breast examination, and breast self-examination) and mediating variables.
Results: Ninety percent of the women were not getting regular mammography screening, 36% had heard of but had never had mammography, and 33% had never heard of mammography. Strong associations were noted with predisposing, enabling, and reinforcing factors inhibiting screening at each stage of adoption.
Conclusions: For women who had heard of, but who were not getting, regular screening, recommendations were made for improving screening procedures in primary care practices. For women who had never heard of screening, coordinated community and primary care interventions were recommended for moving them toward regular screening.