The purpose of this study was to identify factors associated with the use of mammography screening in a farm population, before and after a community-based educational intervention. The educational intervention included sending individual mailings containing information about breast cancer risk and community sources for screening, and providing information and screening at local county fairs and agricultural community fairs. The authors used multivariate analytic methods to analyze the responses, reported by 1,545 women, to discern the roles of sociodemographic, attitudinal, and knowledge variables in this population's breast cancer screening practices. Results showed that the rural participants in both the intervention and the control communities demonstrated significant changes in knowledge and attitudes about breast cancer. Mammography usage was significantly higher among women who had higher scores on the knowledge and awareness assessments. Education--rather than income, insurance coverage, or family history of breast cancer--emerged in multivariate analyses as the most significant predictor of knowledge and awareness score levels associated with greater use of mammography. Implications of this study include support for education that emphasizes the benefits of early detection of breast cancer for all women.