Understanding mammography intention and utilization among women in an inner city public hospital clinic

Prev Med. Nov-Dec 1997;26(6):817-24. doi: 10.1006/pmed.1997.0215.


Background: Most research on mammography utilization has been conducted among middle-class women. There is a need for research to identify factors affecting mammography utilization among low-income women to develop effective interventions for this underserved subgroup.

Methods: An expanded theory of reasoned action guided this research among low-income inner-city women who use a public hospital. Qualitative interviews were conducted to develop a questionnaire with items relevant to this population. The questionnaire included 5 affect measures, 13 behavioral beliefs, 5 sources of influence, and 6 facilitator/constraint measures. The survey was mailed to 584 women ages 50 to 69 identified through the hospital database.

Results: After those ineligible and undeliverable were excluded, responses rates were obtained from 361 women (84% adjusted response rate). Sixty-six percent had a mammogram within the previous year and 58% were very sure that they would get a mammogram in the next year. Affect, attitude, subjective norm, and facilitator scores were computed. All four constructs had significant correlations (r = 0.38 to 0.41) with intention to get a mammogram in the next year and all had significant multiple regression weights (R = 0.54). All but three items making up the model components were significantly correlated with screening intention.

Conclusions: The data from applying a behavioral model indicate that intervention efforts to increase mammography utilization among low-income women should target all four model components. A clinic-based intervention could use multiple methods to deliver messages developed to target each of the model component items found to be associated with mammography intention.

Publication types

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

MeSH terms

  • Aged
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Hospitals, Public*
  • Hospitals, Urban*
  • Humans
  • Mammography / statistics & numerical data*
  • Middle Aged
  • Motivation*
  • Outpatient Clinics, Hospital*
  • Poverty
  • Regression Analysis
  • Surveys and Questionnaires
  • Women / psychology*