Factors That Influence Mammography Use Among Older American Indian and Alaska Native Women

Abstract

American Indian and Alaska Native (AIAN) women have relatively high breast-cancer mortality rates despite the availability of free or low-cost screening. Purpose This qualitative study explored issues that influence the participation of older AIAN women in mammography screening through tribally directed National Breast and Cervical Cancer Early Detection Programs (NBCCEDP). Methods We interviewed staff (n=12) representing five tribal NBCCEDP and conducted four focus groups with AIAN women ages 50 to 80 years (n = 33). Results Our analysis identified four main areas of factors that predispose, enable, or reinforce decisions around mammography: financial issues and personal investments, program characteristics including direct services and education, access issues such as transportation, and comfort zone topics that include cultural or community-wide norms regarding cancer prevention. Conclusion This study has implications for nurse education and training on delivering effective mammography services and preventive cancer outreach and education programs in AIAN communities.

Breast cancer literacy and health beliefs related to breast cancer screening among American Indian women

“…Among AIs, a study on perceived barriers to breast cancer screening were identified in a study of 255 AI women in Oklahoma, which found that barriers (i.e., long wait-times and complex referral processes) predicted the receipt of mammography in the past two years (Tolma, Stoner, Li, Kim, &Engelman, 2014). Perceived vulnerability to breast cancer, access to quality health care, affordable screenings, and the cultural appropriateness of health care providers were all factors that affected older AI women’s mammography use (James, Gold, St John-BlackBird, & Brown Trinidad, 2015). …”

Adapting a Cancer Literacy Measure for Use Among Navajo Women

“…Research among non-Navajo women highlights similar communication problems including silence, avoidance, or mutual protection around cancer (Kenen, Arden-Jones, & Eeles, 2004;Zhang & Siminoff, 2003). Other barriers to cancer communication in families include fear, distress, and the perceived stigma of cancer (Burhansstipanov, Dignan, Wound, Tenney, & Vigil, 2000;Guadagnolo et al, 2009;Hodge et al, 2000;James, Gold, St John-BlackBird, & Brown Trinidad, 2015;Kenen et al, 2004;Zhang & Siminoff, 2003). Thus, efforts toward cancer prevention and control have been compromised primarily due a lack of collectivistic approaches (i.e., including the family or community) and an inability to communicate cancer information accurately and meaningfully to those who need it.…”

A Systematic Review of Barriers and Facilitators to Mammography in American Indian/Alaska Native Women

“…Experience and satisfaction with breast cancer screening was discussed by Ndikum-Moffor, Braiuca, Daley, Gajewski, & Engelman (2013) following their nine focus groups of AI/ AN women. Seven themes emerged including three that were similar to findings from Daley, Kraemer-Diaz, et al (2012) and James et al (2015). The themes identified were knowledge, communication and awareness, barriers, and motivation.…”

“…Perceptions and experiences with breast cancer screening were described by 33 AI/AN women who participated in four focus groups and by 12 staff who were interviewed over the phone (James et al, 2015). The researchers used the PRECEDE-PROCEED framework when identifying two sets of semistructured interview questions to be used, one for the women and one for the staff.…”