Effects of personal characteristics on African-American women's beliefs about breast cancer.

PURPOSE: This study measured the effect of demographic and clinical characteristics on health and cultural beliefs related to mammography. DESIGN: Cross-sectional study. SETTING: Interviews were conducted during 2003 and 2004 in a Midwestern urban area. SUBJECTS: Subjects were 344 low-income African-American women 40 years and older who had not had mammography within the previous 18 months. MEASURES: The instrument measured personal characteristics, belief and knowledge scales, and participants' mammography experience and plans. ANALYSIS: Multiple regression analysis assessed the effect of specific demographic and clinical characteristics on each of the scale values and on subjects' stages of readiness to change. RESULTS: The subjects' levels of education significantly affected six of the 12 belief and knowledge scales. Higher-educated women felt less susceptible to breast cancer, had higher self-efficacy, had less fear, had lower fatalism scores, were less likely to be present-time oriented, and were more knowledgeable about breast cancer. Older women felt they were less susceptible to breast cancer, had higher fatalism scores, were more present-time oriented, and were less knowledgeable about breast cancer. CONCLUSIONS: The findings suggest that mammography promotion programs for African-Americans should consider the education levels and ages of the target women to be most effective.

An intervention to improve communication between breast cancer survivors and their physicians.

Breast cancer survivors often use clues to convey their concerns to their oncologists. The authors conducted a randomized trial of a communication coaching intervention in which 22 female breast cancer survivors were randomized to the coaching and 22 to treatment as usual. They hypothesized that the intervention would increase breast cancer self-efficacy, improve mood, and reduce fears of recurrence. Through a series of ANCOVAs they found that the intervention led to increases in self-efficacy. Changes in self-efficacy predicted changes in anxiety, depression, and womanhood fears. This coaching intervention shows promise but requires additional studies to establish is efficacy and effectiveness.

Randomized trial of DVD, telephone, and usual care for increasing mammography adherence.

The purpose of this study was to test an intervention to increase mammography screening in women 51-75 years of age who had not received a mammogram in the last 15 months. A total of 1681 women were randomized to (1) a mailed tailored interactive DVD, (2) a computer-tailored telephone counseling, or (3) usual care. Women with income below US$75,000 who were in the interactive DVD group had significantly more mammograms than women in usual care. Women with income above US$75,000 had significantly fewer mammograms than women with income less than US$75,000 regardless of group. Further investigation is needed to understand why women with income above US$75,000 did not show the same benefit of the intervention.