Obstacles to the Primary and Secondary Prevention of Breast Cancer In African-American Women

摘要

Study objectives were to describe the barriers to primary and secondary prevention of breast cancer in African American women, to develop tools to measure these barriers, and to describe prevalence in a community sample. This final report describes all four phases of our research. After a comprehensive review of the literature, we developed a structured interview, interviewed 155 African American women, and developed a systematic and detailed coding system to successfully describe the barriers to reducing fat intake, increasing consumption of fruits and vegetables, doing breast self-examination, and getting a mammogram. These results were used to develop 4 questionnaires that were demonstrated to be reliable and valid in a sample of 117 African American women. The questionnaires were then used to survey the occurrence of the barriers to behavior change in a community sample of older white and black women in Nashville, TN. While many women in the community described themselves as already compliant with cancer prevention guidelines, a substantial subgroup reported varying degrees of difficulty with both psychological and environmental barriers to behavior changes. Few differences were found between African American and Caucasian women with members of each ethnic group falling into the five stages of change.