Breast cancer screening in older African-American women: qualitative research findings.

PURPOSE: The purpose of this study was to gain a better understanding of the cultural meanings that shape the breast cancer screening behavior of older African-American women.
DESIGN: Qualitative research methods elicited social and cultural themes related to breast cancer screening.
SETTING: Focus group interviews were conducted in the natural settings (churches, etc.) of older African-American women.
SUBJECTS: Interviews were conducted with 132 members from 14 social networks of older African-American women. MEASURES: A focus group guide asked about 1) perceived risk of breast cancer, 2) behavioral intentions about breast cancer screening, 3) health seeking behavior, and 4) social support.
RESULTS: For older African-American women: other health concerns are of more concern than breast cancer; age is generally not recognized as a risk factor for breast cancer; fear of finding breast cancer and its social consequences are salient barriers to mammography; they tend to rely on breast self-exam rather than mammography to detect a breast problem; cost may be more an issue of competing priorities than cost per se; the tradition is to go to doctors for a problem, not prevention; and women in their own social networks are important sources of social support for health concerns.
CONCLUSIONS: These data offer explanations for mammography screening in older African-American women and emphasize the strength of naturally existing sources of social support for designing interventions to increase breast cancer screening.