Retrospective Analysis of a Breast Health Program on Routine Annual Mammography in Low-income, Uninsured Women

Abstract

Problem. Detection of breast cancer in women of low socioeconomic status, lacking health insurance, can be improved by increasing annual mammography rates, yet little is known about their screening behavior.

Purpose. A retrospective subject-controlled study of an ongoing Breast Health Program, at a not-for-profit, non-government assisted, volunteer clinic, was undertaken to examine mammography usage and discovery variables.

Design and methods. English and Spanish speaking women 40 years old and over who viewed in a 7-minute breast health DVD and were offered free mammography were eligible for the study (N = 223). The Health Belief Model (HBM) (Becker, 1974) provided the study framework that utilized radiology billing records for mammography completion and a dual-language self-administered survey. Data retrieval was from March 2004 to July 2009, with DVD viewing beginning in December 2006. Recruitment occurred between July 2009 and September 2009.

Results. Results revealed that 214 (96%) women had a mammography after viewing the DVD. Of the 120 subjects that had time to complete an annual mammography, 28 (23%) completed it in the 12th month, 48 (40%) completed it within 15 months, and 91 (75%) completed even if late. Only 37 subjects had time to complete a third mammography and of those only 8 completed a fourth. Significant findings found: (1) a greater proportion of women who received a reminder postcard participated in their annual mammography in the 12th month, χ 2(1) = 3.98, p = .046; (2) perceptions of breast cancer susceptibility scores were significantly lower (M = 6.89, SD = 3.18), in those who completed their annual mammography in the 12th month, t(118) = 2.03, p = .045; (3) a greater proportion of women who were knowledgeable about screening recommendations completed annual mammography, even if late, χ2(1) = 4.736, p = .030 and; (4) Hispanic women completed at a significantly higher rate (n = 69; 81.2%) even if late, χ2(2) = 6.450, p = .04.

Implications. Longitudinal studies utilizing radiology billing records for mammography completion present real findings of mammography usage. This study’s findings enhance the understanding of low-income, working uninsured women and identify new variables not found in comparative research findings.