Keeping mammography referral appointments: Motivation, health beliefs, andaccess barriers experienced by older minority women

Older women of color tend to have much lower rates of regular mammography s creening for breast cancer than younger Caucasian women; yet, they have hig her rates of mortality. This study was designed to increase mammography rat es among inner-city women aged 50 years or older. Another goal was to inves tigate differences in mammography utilization related to race/ethnicity and language after barriers associated with cost and the difficulty of making an appointment are removed. A peer delivered intervention, which consisted of interview, mammography referral, and the scheduling of a next-day appoin tment, was conducted among a convenience sample of 151 culturally and racia lly diverse older women through a primary care referral project operating w ithin an urban emergency department (ED). A brief motivational interview an d mammography referral at the One of an ED visit, including scheduling of a next-day no cost appointment, was followed by a cross-sectional telephone survey of utilization and motivating and hindering factors. Follow-up was a chieved with 96 women (66%). Fifty-eight women (60%) had a post-interventio n mammogram: of those, 69% were first time users. More than 90% planned a r epeat mammogram the following year. Of the 27 who did not receive a mammogr am, 21 (77%) requested a "second try" appointment. These findings demonstra te that an interactive intervention among older women of color has the pote ntial to dramatically increase mammography rates. (C) 2000 by the American College of Nurse-Midwives.