Baseline predictors of initiation vs. maintenance of regular mammography use among rural women

Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 1603 West Taylor Street, 816 SPHPI (M/C 923), Chicago, IL 60612, USA.
Preventive Medicine (Impact Factor: 3.09). 07/2005; 40(6):822-30. DOI: 10.1016/j.ypmed.2004.09.029
Source: PubMed


Predictors of regular mammography screening over many years have not often been examined prospectively. We used data from baseline (1993-1994), first (1996-1997), and second follow-up (2000) interviews with 336 White and 314 African-American rural women in the North Carolina Breast Cancer Screening Program to evaluate baseline factors predictive of regular mammography use over 7 years.
We defined regular mammography use as a recent mammogram (past 2 years) at all three interviews. Using binomial and logistic regression models adjusted for age, we examined factors associated with initiation (for women without prior regular use) and maintenance (for women with prior regular use) of mammography.
Younger age and White race were predictive of initiation of regular mammography use. Physician recommendation was the strongest predictor of both initiation and maintenance of regular mammography use. Positive mammography attitudes and fewer personal barriers were strongly associated with initiation but not with maintenance.
Increased contact with providers and greater support for screening mammograms by providers could have an important impact on rural women initiating and maintaining regular mammography screening. Special efforts are needed to prompt rural African-American women and those over age 65 to initiate screening, since once they start they are likely to continue.

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Available from: Garth H Rauscher,
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    • "An unanticipated and disturbing theme in the literature was the fact that many reported that they were not told by their healthcare provider that they needed to obtain screening, or were not told of the benefits and risks. In a longitudinal study involving 650 women, 42% of the women said that they did not receive a recommendation or referral from their provider for mammography , even though provider recommendation is one of the strongest predictors of initiation and maintenance of regular mammography, in a study by Rauscher et al. (2005). Women who were already obtaining routine screening before the study continued to do so throughout the 7-year study, although not all of them had received a recommendation from their provider during that time. "
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