A motivational message, external barriers, and mammography utilization

Based on a theory of behavior, the interaction of a motivational message an d external barriers on mammography utilization was tested. Participants (N = 101) had not had mammograms annually, and were identified from an urban c linic serving a disproportionally high percentage of indigent clients. Fift y-five percent were Caucasian; 45% were African-American. In an experimenta l design, half of the sample received a telephone discussion about rational e feelings and beliefs regarding mammograms and half did not receive this c ontact Four months later, nurses assessed women's recent mammography utiliz ation and external barriers (e.g., affordability and accessibility). A logi stic regression revealed an interaction between the intervention and barrie rs on postintervention mammography utilization (odds ratio: 2.12; p < 0.05) . As proposed, the intervention was associated with a 64% rate of mammograp hy utilization among women without barriers, but only a 26% rate among wome n,with barriers. Not only should clinicians offer motivational messages abo ut mammography, but also administrators should address external barriers to maximize mammography among socioeconomically disadvantaged groups.