Mayne, L. and Earp, J.A. Journal of Rural Health, 19(1):63-70, 2003.
| Initial and repeat mammography screening: different behaviors/different predictors | ||
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Mayne, L. and Earp, J.A. Journal of Rural Health, 19(1):63-70, 2003. |
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| Despite evidence of
the efficacy of mammography in early detection of breast cancer, many women
choose not to have a mammogram. Some women who have an initial mammogram
do not return for a second one. Many others, especially minority women,
women living in rural areas, and women of lower socioeconomic status, are
not being screened according to recommended guidelines. The full benefits
of early detection are available only if women receive regular screening.
This study of 830 randomly selected women over age 50 from rural eastern
North Carolina included women who had never had a mammogram (213), those
who had one but not in the prior two years (89), and women who reported
having a mammogram in the previous two years (528). Logistic regression
was used to identify significant mammography predictor variables. The results,
while supporting the robust role that provider recommendation plays in encouraging
mammography behavior, also demonstrates that past behavior is also a strong
predictor of future screening participation. Only 13% of the women who never
had a mammogram reported getting a referral from their provider compared
to 79% of the women who had a mammogram in the previous two years. Likewise,
75% of the women who had engaged in mammography behavior in the prior two
years expressed a positive intention to be screened in the next year compared
to only 14% of those women who had never had a mammogram. Initial and repeat
mammography screenings are different behaviors influenced by different factors.
For provider counseling to be effective, the strategies employed need to
consider past behavior as well as current recommendation and incorporate
a discussion of beliefs as well as reinforcement of regular screening behavior.
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