Women's health. Part II: Individual, environmental and economic factors affecting adherence to recommended screening practices for breast cancer.

In order for cancer mortality rates to be sufficiently reduced to meet the goals set by the National Cancer Institute, it is imperative that we broaden our understanding of the factors which affect participation in preventive health practices. Early detection and diagnosis of breast cancer are associated with participation in mammography, breast self-examination, and seeking medical care. A stratified random sample of women residing in Orleans Parish (40 to 65 years of age; annual family incomes < $40,000) were surveyed by telephone. Results of the survey were examined to determine the impact of individual, environmental, and economic factors on adherence to recommended screening practices for breast cancer. Results indicate a significant proportion of women are not adhering to recommended practices. Preventive health practices were positively related to physician recommendation of a mammogram and how the physician communicated with the patient; patient's income; belief in Powerful Others Locus of Control; and beliefs about the efficacy of early diagnosis and treatment. Fear of breast cancer was negatively related to preventive health practices. Findings highlight the utility of an ecological perspective in the development of secondary prevention strategies for breast cancer.