KNOWLEDGE, PERCEPTIONS, AND MAMMOGRAPHY STAGE OF ADOPTION AMONG OLDERURBAN WOMEN

Introduction: Mammography is under-used among older minority women. Id entifying differences in their attitudes and beliefs by stage of mammo graphy adoption will guide interventions for these under-studied and u nder-served women. Methods: A total of 253 older urban women were inte rviewed, assessing breast cancer knowledge, perceived mammography bene fits and barriers, stage of mammography adoption, personal experience with breast cancer, physical and cognitive functioning, smoking status , source and frequency of regular medical care, and demographics. Anal yses compared scale scores and individual items by stage of mammograph y adoption. Multivariate analysis used linear and logistic regression with stepwise model selection. Results: Sample mean age was 72.5 years ; 88% were African American. About half (52%) had had a mammogram with in the past 2 years (i.e., action stage of mammography adoption). Of t he rest, 16% were thinking about having a mammogram in the next 6 mont hs (contemplators) and 32% were not thinking about having a mammogram within 6 months (precontemplators). Knowledge and benefit scores were lowest for precontemplators. Overall barrier scores were highest for p recontemplators (P < .001), but contemplators were most likely to worr y about finding a lump (P < .05). Lower perceived barriers, provider r ecommendation, regular medical care somewhere other than a private phy sician's office, and age <75 years were independently associated with more favorable mammography stage (R-2 = .47). Conclusion: Mammography interventions for older urban women should combine provider recommenda tions with barrier-reducing interventions. Knowledge is associated wit h mammography contemplation, but barriers may affect whether contempla tion leads to action. Precontemplators may need explanation of the rat ionale for screening; contemplators may need intervention to assuage f ears.