Investigation of the Facilitative and Inhibitory Variables Impacting Breast Health Care Practices in Low Socioeconomic Status Black Women of African- American and Caribbean Descent.

摘要

Black women of low-socioeconomic status (SES) demonstrate a higher incidence of breast cancer mortality associated with late-stage diagnosis than White women. Breast cancer screening, including mammography, breast self- examination, and clinical breast examination, remains the most effective route to early detection. Studies indicate poor adherence to breast cancer screening regimens among low-income minority women. An overall objective of the study is the construction of a theoretical model that can explain screening practices in low-SES black women. This will be accomplished in two separate waves. In the first wave, facilitators and barriers to breast cancer-screening participation among low-SES women of African-American and Caribbean descent will be determined through qualitative interview. This approach allows a voice for the concerns and experiences guiding these women in their screening choices. The current study incorporates an approach-avoidance theoretical framework that considers preventive screening behaviors to be both desirable and aversive. Based on the factors provided by respondents on the first wave of the study, a culturally sensitive Q-Sort instrument will be designed that will allow participants to rank order these factors as facilitators or barriers to screening, and therefore, provide a powerful approach to testing the theoretical paradigm. Finally innovative modeling techniques will be applied to determine the strength of emergent models to explain breast health care practices among low-SES Black women, either as idiopathic to the general population or specific to African- American or Caribbean cultural groups.