“Don’t Know” and Accuracy of Breast Cancer Risk Perceptions Among Appalachian Women Attending a Mobile Mammography Program: Implications for Educational Interventions and Patient Empowerment

Abstract

Risk perceptions are motivating factors for engaging in preventive health behaviors. Yet, almost one third of women attending a mobile mammography program targeted to rural and medically underserved Appalachian women respond “don’t know” to their perceived 5-year risk of breast cancer. This study used cross-sectional data from women aged ≥40 years participating in Bonnie’s Bus Mammography Screening and Preventive Care Survey from 2009 to 2011 to identify factors associated with “don’t know” responses and accuracy of perceived risk according to constructs of the health belief model and sociodemographic characteristics. Women who responded “don’t know” were more likely to be less educated, of lower income, insured by Medicaid, and less knowledgeable about breast cancer. Conversely, women who accurately perceived their risk were more likely to be of higher education, more knowledgeable about breast cancer, and have a family history of breast cancer. However, women with a high objective 5-year risk of breast cancer and older age at childbirth or were nulliparous were less likely to accurately perceive their risk. These findings suggest that women who indicate “don’t know” responses and hold inaccurate risk perceptions are a population vulnerable to health disparities and may benefit from educational interventions focused on improving breast cancer knowledge and perceptions to empower them to take an active role in their preventive health and make informed decisions based on their individual level of risk.

Level and conditioning of knowledge about breast cancer displayed by women in perimenopausal age

“…Numerous studies mention the influence of education [19]. Apart from education, other significant factors which increase knowledge about breast cancer include: age, marital status, level of income, type of insurance, and having a family member suffering from a tumour disease [11,20]. These relationships have not been observed among the Polish population [21].…”

Mobile Mammography Participation Among Medically Underserved Women: A Systematic Review

“…All 10 studies indicated that women who used mobile mammography clinics were from underserved groups. Most studies reported that users of mobile mammography identified as African American (48%–62%) or Hispanic (4%–11%) ( 13 , 14 , 16 , 17 , 19 ), had incomes below $25,000 ( 13 , 15 , 18 , 21 ), and/or were uninsured ( 14 – 16 , 18 – 20 ). One study documented use of mobile mammography by American Indians residing in the Northern Plains ( 20 ).…”

“…Two studies found that only 12% to 34% of mobile mammography users had had a screening mammogram in the past year ( 14 , 18 ). Four studies found that 40% to 48% of mobile mammography users adhered to 2-year screening guidelines ( 15 , 18 , 20 , 21 ). Another study documented that only 29% of mobile mammography users had completed a screening mammogram within the past 5 years ( 16 ).…”

“…Perceived risk. Two studies reported on mobile mammography users’ perceived 5-year risk of developing cancer ( 15 , 18 ). They were more likely than fixed site users to perceive a lower 5-year risk of developing breast cancer ( 15 ).…”

RAD-AID Asha Jyoti Mammogram Quality Assessment in India: Optimizing Mobile Radiology

“…Although there are wellestablished criteria for acceptable mammographic positioning and quality from the ACR and FDA [1][2][3][4][5] and numerous mobile mammography programs in the United States and abroad [6][7][8][9][10][11][12][13][14][15], to the best of our knowledge there is no published study regarding the effectiveness of technologist training programs abroad on mobile mammographic image quality.…”