RELATIONSHIPS OF BARRIERS AND FACILITATORS TO BREAST SELF-EXAMINATION, MAMMOGRAPHY, AND CLINICAL BREAST EXAMINATION IN A WORKSITE POPULATION

The American Cancer Society recommends a regimen for breast cancer scr eening that includes mammograms, clinical breast examination, and brea st self-examination. Compliance with breast cancer screening guideline s has been linked to a number of barriers and facilitators. These barr iers and facilitators seem to lie within the cognitive framework and g eneralized beliefs of women, and in the situational contexts in which they lead their lives. A comprehensive study was designed to investiga te variables related to breast cancer screening behaviors (breast self -examination, mammography, and clinical breast examination) of working women greater-than-or-equal-to 35 years of age at their worksite envi ronments. A factor analysis identified similar sets of composite varia bles related to each of the screening modalities, and a discriminant a nalysis was performed for each screening technique to identify those v ariables that were most significant in predicting compliance with scre ening guidelines. The variables discomfort, perceived efficacy, and de sire for control over health were significant for all three screening behaviors. Perceived importance was identified as a fourth variable fo r mammography and clinical breast examination, and lack of knowledge w as a fourth variable for breast self-examination. Effective breast can cer screening programs involve all three screening techniques. In the design of education and intervention programs at worksites, it is crit ical to emphasize the commonalities of the variables that emerged in t his study as important for each screening technique. Health-care profe ssionals who implement such intervention programs need to explore and bring into the open these common barriers and facilitators to maximize working women's compliance with breast screening guidelines.