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Assessment of mammography experiences and satisfaction among American Indian/Alaska Native women

TitleAssessment of mammography experiences and satisfaction among American Indian/Alaska Native women
Publication TypeJournal Article
Year of Publication2013
AuthorsNdikum-Moffor, FM, Braiuca, S, Daley, CM, Gajewski, BJ, Engelman, KK
JournalWomens Health IssuesWomens Health Issues
Date PublishedNov-Dec
ISBN Number1878-4321 (Electronic)<br/>1049-3867 (Linking)
Accession Number24183414
KeywordsAdult, Alaska, Attitude to Health, Breast Neoplasms/ethnology/ prevention & control/psychology, Community-Based Participatory Research, Early Detection of Cancer/psychology, Female, Focus Groups, Health Behavior, Health Knowledge, Attitudes, Practice, Health Services Accessibility, Humans, Indians, North American/ psychology/statistics & numerical data, Mammography/ psychology/utilization, Mass Screening/psychology/utilization, Middle Aged, Patient Acceptance of Health Care/ psychology/statistics & numerical data, Questionnaires, Rural Population, Socioeconomic Factors, United States, United States Indian Health Service, Urban Population
AbstractBACKGROUND: American Indian/Alaska Native (AI/AN) women have lower breast cancer (BCA) screening and 5-year survival rates than non-Hispanic Whites. Understanding reasons for low screening rates is important to combatting later stage diagnoses. The purpose of this study was to assess mammography experiences and satisfaction among AI/AN women. METHODS: Nine focus groups were held with rural (N = 15) and urban (N = 38) AI/AN women 40 years and older in Kansas and Kansas City, Missouri, living both near and far from Indian Health Service (IHS) and tribal facilities, to examine experiences and satisfaction with mammography. Transcripts were coded and themes identified using a community-based participatory research approach. FINDINGS: Themes were classified under knowledge, communication, and awareness of BCA; barriers to mammography; mammogram facility size; impressions of mammogram technologist; motivations for getting a mammogram; and how to improve the mammogram experience. Participants had knowledge of prevention, but described cultural reasons for not discussing it and described better experiences in smaller facilities. Participants indicated having a mammogram technologist who was friendly, knowledgeable, respectful, competent, and explained the test was a determining factor in satisfaction. Other factors included family history, physician recommendation, and financial incentives. Barriers included transportation, cost, perceptions of prejudice, and time constraints. Participants on reservations or near IHS facilities preferred IHS over mainstream providers. Suggestions for improvement included caring technologists, better machines with less discomfort, and education. CONCLUSIONS: Interventions to enhance the professionalism, empathy, and cultural awareness of mammogram technologists; reduce barriers; and provide positive expectations and incentives could improve satisfaction and compliance with screening mammography.
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