• Deborah Farmer, Bobbie Reddick, Ralph D'Agostino, and Sharon A Jackson.
• Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA. farmerde@wssu.edu
• Oncol Nurs Forum. 2007 Jan 1; 34 (1): 117-23.

Purpose/ObjectivesTo explore psychosocial correlates of older African American women's adherence to annual mammography screening, including cancer fatalism, dispositional optimism, social support, knowledge of breast cancer screening guidelines, perceptions of general health, and components of the Health Belief Model (HBM), and to examine factors associated with annual mammography screening.DesignCross-sectional survey.SettingCentral North Carolina.Sample198 African American women aged 50-98 years living in low-income housing.MethodsWomen attended group sessions at low-income housing complexes and completed questionnaires. Differences between women who had or did not have a mammogram in the previous year were explored using correlate variables associated with the HBM. Stepwise multivariable regression models were fit to explore factors associated with social support and significant components of the HBM.Main Research VariablesDemographics, cancer fatalism, dispositional optimism, social support, perceptions of general health, components of the HBM, and mammography in the past year.FindingsThe groups did not differ by age, education, marital status, having a friend or family member with breast cancer, ever having had a clinical breast examination, self-rated health, cancer fatalism, dispositional optimism, or feelings about the seriousness of and their susceptibility to breast cancer. The groups differed significantly on mammogram-related variables, how often women should have clinical breast examinations, benefits and barriers to mammography screening, and social support. Stepwise multivariable regression analyses showed that dispositional optimism and social support were related significantly to perception of benefits; education, dispositional optimism, and cancer fatalism were related to barriers; and dispositional optimism was related to social support.ConclusionsOlder, low-income, African American women have perceived barriers to cancer screening, educational and cancer knowledge detriments, and a lack of health-related social support that may decrease adherence to mammography screening.Implications For NursingThe next step is to develop culturally appropriate educational interventions that increase knowledge about breast cancer and screening guidelines, enhance health-related social support, and address barriers and perhaps cancer fatalism in older, low-income, African American women.

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