On-time Mammography Screening with a Focus on Latinas with Low Income: A Proposed Cultural Model

Abstract

Background: Initial U.S.A. breast cancer screening rates have risen, but not repeat screening, especially among low-income minority populations. Latinas are particularly at-risk of underscreening. Consequently, late-detection is common, with increased risk of dying after diagnosis. Why women with low-income, particularly Latinas, who had initial mammography, were not regularly screened was examined. Patients and Methods: An expanded model was tested, incorporating the Theory of Planned Behavior (TPB), cultural factors, potential facilitators and barriers. Participants were 112 women, 72 of whom were Latinas, who had contacted an Early-Detection Program and received a mammogram 3-4 years earlier. Results: The TPB did not explain mammography rescreening behavior among Latinas. The cultural factors: high familism and low fatalism showed significant multivariate associations with recent mammogram among Latinas. A major barrier for Latinas was “distorted familism”: neglecting own health because family was first priority. Conclusion: A cultural model is proposed, which can guide interventions for improving on-time mammography among Latinas.