UNDERSTANDING MAMMOGRAPHY INTENTION AND UTILIZATION AMONG WOMEN IN ANINNER-CITY PUBLIC HOSPITAL CLINIC

Background. Most research on mammography utilization has been conducte d among middle-class women. There is a need for research to identify f actors affecting mammography utilization among low-income women to dev elop effective interventions for this underserved subgroup. Methods. A n expanded theory of reasoned action guided this research among low-in come inner-city women who use a public hospital. Qualitative interview s were conducted to develop a questionnaire with items relevant to thi s population. The questionnaire included 5 affect measures, 13 behavio ral beliefs, 5 sources of influence, and 6 facilitator/constraint meas ures. The survey was mailed to 584 women ages 50 to 69 identified thro ugh the hospital database, Results. After those ineligible and undeliv erable were excluded, responses were obtained from 361 women (84% adju sted response rate). Sixty-six percent had a mammogram within the prev ious year and 58% were very sure that they would get a mammogram in th e next year. Affect, attitude, subjective norm, and facilitator scores were computed. All four constructs had significant correlations (r = 0.38 to 0.41) with intention to get a mammogram in the next year and a ll had significant multiple regression weights (R = 0.54), All but thr ee items making up the model components were significantly correlated with screening intention, Conclusions. The data from applying a behavi oral model indicate that intervention efforts to increase mammography utilization among low-income women should target all four model compon ents. A clinic-based intervention could use multiple methods to delive r messages developed to target each of the model component items found to be associated with mammography intention. (C) 1997 Academic Press.