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Research Projects
Cancer Anxiety, Information Processing,
and Promotional Message Form in
African American Utilization of Mammography
Grant Summary
Specific Aims
The goal of this study is to examine knowledge, attitudes, and beliefs that may serve as barriers to breast cancer screening in African American women as a foundation for designing more effective messages to address this population. The five year survival rate for African American women is approximately 43%, compared with 90% for whites (El-Tamer, Homel, & Wait, 1999; Komen Breast Cancer Foundation, 1999; Lipkus, Iden, Terrenoire, & Feaganes, 1999; National Cancer Institute, 1996; American Cancer Society, 2000). Much of this discrepancy may be due to the fact that African American women have a significantly lower utilization rate of breast cancer screening than other groups.
Factors affecting mammography utilization
Researchers have examined a wide variety of factors that may serve as barriers to breast cancer screening in African American women. Psychological responses such as fear, fatalism, and cancer anxieties have been identified as personal factors that inhibit Blacks from participating in cancer health promotion behaviors (Cardwell & Collier, 1981; Long, 1993). Other research in the area of breast cancer specifically identifies lack of knowledge about breast cancer and breast cancer screening, distrust in the health care system and providers, and cost of care as major barriers to screening and regular mammography (Daniegelis et al., 1995; Long, 1993; Phillips & Wilbur, 1995). Beliefs in the efficacy of disease prevention behaviors, perceived threats and feelings of personal susceptibility and methods of cancer information communication have also been cited as factors that influence health promotion behaviors among Blacks (Denniston, 1981).
Religious beliefs have been identified as a potential indicator/predictor of health behavior among African American women. Hughes et al. (1996) attribute differences in breast cancer risk perceptions and avoidance to the influence of cultural factors such as the importance of interpersonal relationships, spirituality, and time orientation. These researchers found that, even after the breast cancer diagnosis of a first-degree relative, African American women tend to base their perceptions of risk on factors other than heredity. Clarke-Tasker (1993) found that some African Americans believe that illness may be due to their failure to live according to God’s will. Distrust of the health care system must also be considered as a serious barrier to breast cancer screening (Burnett, Steakley, & Tefft, 1995). Finally, we examined general anxiety about breast cancer. Prior research conducted by Evaxx (1981) showed that blacks were found to be pessimistic about the prognosis of cancer, reporting that “getting cancer is a death sentence for most people” (Evaxx, 1981, p. 213).
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