Breast Cancer Protective Behaviors Among Low-Income, Ethnically Diverse Women: The Role of Biopsychosocial Factors

摘要

Breast cancer incidence and mortality vary substantially by ethnic group which makes ethnicity a likely marker for understudied social, attitudinal, and behavioral risks. Ethnic-specific cultural norms and beliefs affect health-related perceptions which may influence early detection practices. In this dissertation we examined ethnic models of breast exams (breast self- examination (BSE) and clinical breast examination (CBE)) in order to identify facilitators and barriers to detection. We analyzed data on low-income, ethnically diverse women in South Florida using multivariate statistical techniques. Independent variables included: socio-demographic characteristics psychosocial factors (e.g., health beliefs, personal and religious community networks), structural barriers (e.g. unmet basic needs, worry over basic needs), and lifestyle behaviors (diet, exercise, smoking). Results revealed that predictors of breast cancer detection vary considerably by ethnic group and breast exam. Monthly BSE is associated to community networks among Latinas and to worry about basic needs among White women. Being current on CBE is associated to religious community networking among Black women and to worrying about basic needs among Latinas. Finally preventive behaviors such as exercise and smoking are associated to BSE and CBE differently across ethnic groups. This information is important for designing effective breast cancer prevention programs targeted at culturally diverse at risk populations.