Skip to main content

Advertisement

SpringerLink
Log in

Health Care Access and Breast Cancer Screening Among Latinas Along the California–Mexican Border

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

Latinas are more likely to exhibit late stage breast cancers at the time of diagnosis and have lower survival rates compared to white women. A contributing factor may be that Latinas have lower rates of mammography screening. This study was guided by the Behavioral Model of Health Services Use to examine factors associated with mammography screening utilization among middle-aged Latinas. An academic–community health center partnership collected data from community-based sample of 208 Latinas 40 years and older in the San Diego County who completed measures assessing psychosocial factors, health care access, and recent mammography screening. Results showed that 84.6 % had ever had a mammogram and 76.2 % of women had received a mammogram in the past 2 years. Characteristics associated with mammography screening adherence included a lower acculturation (OR 3.663) a recent physician visit in the past year (OR 6.304), and a greater confidence in filling out medical forms (OR 1.743), adjusting for covariates. Results demonstrate that an annual physical examination was the strongest predictor of recent breast cancer screening. Findings suggest that in this community, improving access to care among English-speaking Latinas and addressing health literacy issues are essential for promoting breast cancer screening utilization.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. Context-specific variables are specifically related to the population, the disease, or the utilization behavior under investigation.

References

  1. National Cancer Institute. Breast Cancer Prevention (PDQ®). 2007 (cited 2012 December 7). http://www.cancer.gov/cancertopics/pdq/prevention/breast/Patient/.

  2. Elmore JG, et al. Screening for breast cancer. JAMA. 2005;293(10):1245–56.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Wells KJ, Roetzheim RG. Health disparities in receipt of screening mammography in Latinas: a critical review of recent literature. Cancer Control. 2007;14(4):369–79.

    PubMed  Google Scholar 

  4. California Cancer Registry. Public use data set: California cancer incidence and mortality rates plus interactive maps 2008 (cited 2008 August 1). http://www.ccrcal.org/dataquery.html.

  5. Zambrana RE, et al. Use of cancer screening practices by Hispanic women: analyses by subgroup. Prev Med. 1999;29(6 Pt 1):466–77.

    Article  CAS  PubMed  Google Scholar 

  6. Frazier EL, Jiles RB, Mayberry R. Use of screening mammography and clinical breast examinations among black, Hispanic, and white women. Prev Med. 1996;25(2):118–25.

    Article  CAS  PubMed  Google Scholar 

  7. Hubbell FA, et al. Differing beliefs about breast cancer among Latinas and Anglo women. West J Med. 1996;164(5):405–9.

    CAS  PubMed Central  PubMed  Google Scholar 

  8. Andersen RM. A behavioral model of families’ use of health services, Research Series No. 25. Center for Health Administration Studies, University of Chicago. 1968 (cited 2012 August 1). http://www.chas.uchicago.edu/documents/Publications/RS/RS25.PDF.

  9. Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995;36(1):1–10.

    Article  CAS  PubMed  Google Scholar 

  10. Andersen R, et al. Access of vulnerable groups to antiretroviral therapy among persons in care for HIV disease in the United States. HCSUS Consortium. HIV Cost and Services Utilization Study. Health Serv Res. 2000;35(2):389–416.

    CAS  PubMed Central  PubMed  Google Scholar 

  11. Gelberg L, Andersen RM, Leake BD. The Behavioral Model for Vulnerable Populations: application to medical care use and outcomes for homeless people. Health Serv Res. 2000;34(6):1273–302.

    CAS  PubMed Central  PubMed  Google Scholar 

  12. Miller DC, et al. Racial disparities in access to care for men in a public assistance program for prostate cancer. J Community Health. 2008;33(5):318–35.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Stein JA, Andersen R, Gelberg L. Applying the Gelberg–Andersen behavioral model for vulnerable populations to health services utilization in homeless women. J Health Psychol. 2007;12(5):791–804.

    Article  PubMed  Google Scholar 

  14. Swanson KA, Andersen R, Gelberg L. Patient satisfaction for homeless women. J Womens Health (Larchmt). 2003;12(7):675–86.

    Article  Google Scholar 

  15. Andersen RM, Giachello AL, Aday LA. Access of Hispanics to health care and cuts in services: a state-of-the-art overview. Public Health Rep. 1986;101(3):238–52.

    CAS  PubMed Central  PubMed  Google Scholar 

  16. Estrada AL, Trevino FM, Ray LA. Health care utilization barriers among Mexican Americans: evidence from HHANES 1982-84. Am J Public Health. 1990;80(Suppl):27–31.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Fernandez LE, Morales A. Language and use of cancer screening services among border and non-border Hispanic Texas women. Ethn Health. 2007;12(3):245–63.

    Article  PubMed  Google Scholar 

  18. Gorin SS, Heck JE. Cancer screening among Latino subgroups in the United States. Prev Med. 2005;40(5):515–26.

    Article  PubMed  Google Scholar 

  19. Pasick RJ, Burke NJ. A critical review of theory in breast cancer screening promotion across cultures. Annu Rev Public Health. 2008;29:351–68.

    Article  PubMed  Google Scholar 

  20. Abraido-Lanza AF, Chao MT, Gammon MD. Breast and cervical cancer screening among Latinas and non-Latina whites. Am J Public Health. 2004;94(8):1393–8.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Aparicio-Ting F, Ramirez AG. Breast and cervical cancer knowledge, attitudes, and screening practices of Hispanic women diagnosed with cancer. J Cancer Educ. 2003;18(4):230–6.

    Article  PubMed  Google Scholar 

  22. Cohen M. Breast cancer early detection, health beliefs, and cancer worries in randomly selected women with and without a family history of breast cancer. Psychooncology. 2006;15(10):873–83.

    Article  PubMed  Google Scholar 

  23. McCaul KD, et al. What is the relationship between breast cancer risk and mammography screening? A meta-analytic review. Health Psychol. 1996;15(6):423–9.

    Article  CAS  PubMed  Google Scholar 

  24. McCaul KD, Tulloch HE. Cancer screening decisions. J Natl Cancer Inst Monogr. 1999;25:52–8.

    Article  PubMed  Google Scholar 

  25. Andersen R, Newman JF. Societal and individual determinants of medical care utilization in the United States. Milbank Mem Fund Q Health Soc. 1973;51(1):95–124.

    Article  CAS  PubMed  Google Scholar 

  26. Carrasquillo O, Pati S. The role of health insurance on Pap smear and mammography utilization by immigrants living in the United States. Prev Med. 2004;39(5):943–50.

    Article  PubMed  Google Scholar 

  27. Fox P, et al. Patient and clinical site factors associated with rescreening behavior among older multiethnic, low-income women. Gerontologist. 2004;44(1):76–84.

    Article  PubMed  Google Scholar 

  28. Jones AR, Caplan LS, Davis MK. Racial/ethnic differences in the self-reported use of screening mammography. J Community Health. 2003;28(5):303–16.

    Article  PubMed  Google Scholar 

  29. Qureshi M, et al. Differences in breast cancer screening rates: an issue of ethnicity or socioeconomics? J Womens Health Gend Based Med. 2000;9(9):1025–31.

    Article  CAS  PubMed  Google Scholar 

  30. Reyes-Ortiz CA, et al. The impact of education and literacy levels on cancer screening among older Latin American and Caribbean adults. Cancer Control. 2007;14(4):388–95.

    PubMed  Google Scholar 

  31. Sambamoorthi U, McAlpine DD. Racial, ethnic, socioeconomic, and access disparities in the use of preventive services among women. Prev Med. 2003;37(5):475–84.

    Article  PubMed  Google Scholar 

  32. Goel MS, et al. Racial and ethnic disparities in cancer screening: the importance of foreign birth as a barrier to care. J Gen Intern Med. 2003;18(12):1028–35.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Hubbell FA, et al. From ethnography to intervention: developing a breast cancer control program for Latinas. J Natl Cancer Inst Monogr. 1995;18:109–15.

    PubMed  Google Scholar 

  34. O’Malley AS, et al. Acculturation and breast cancer screening among Hispanic women in New York City. Am J Public Health. 1999;89(2):219–27.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Otero-Sabogal R, et al. Access and attitudinal factors related to breast and cervical cancer rescreening: why are Latinas still underscreened? Health Educ Behav. 2003;30(3):337–59.

    Article  PubMed  Google Scholar 

  36. Rodriguez MA, Ward LM, Perez-Stable EJ. Breast and cervical cancer screening: impact of health insurance status, ethnicity, and nativity of Latinas. Ann Fam Med. 2005;3(3):235–41.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Suarez L. Pap smear and mammogram screening in Mexican-American women: the effects of acculturation. Am J Public Health. 1994;84(5):742–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  38. Valdez A, et al. Correlates of breast cancer screening among low-income, low-education Latinas. Prev Med. 2001;33(5):495–502.

    Article  CAS  PubMed  Google Scholar 

  39. Davis TC, et al. Knowledge and attitude on screening mammography among low-literate, low-income women. Cancer. 1996;78(9):1912–20.

    Article  CAS  PubMed  Google Scholar 

  40. Donelle L, Arocha JF, Hoffman-Goetz L. Health literacy and numeracy: key factors in cancer risk comprehension. Chronic Dis Can. 2008;29(1):1–8.

    CAS  PubMed  Google Scholar 

  41. Barroso J, et al. Comparison between African–American and white women in their beliefs about breast cancer and their health locus of control. Cancer Nurs. 2000;23(4):268–76.

    Article  CAS  PubMed  Google Scholar 

  42. Borrayo EA, Guarnaccia CA. Differences in Mexican-born and U.S.-born women of Mexican descent regarding factors related to breast cancer screening behaviors. Health Care Women Int. 2000;21(7):599–613.

    Article  CAS  PubMed  Google Scholar 

  43. Niederdeppe J, Levy AG. Fatalistic beliefs about cancer prevention and three prevention behaviors. Cancer Epidemiol Biomarkers Prev. 2007;16(5):998–1003.

    Article  PubMed  Google Scholar 

  44. Chavez LR, et al. The influence of fatalism on self-reported use of Papanicolaou smears. Am J Prev Med. 1997;13(6):418–24.

    CAS  PubMed  Google Scholar 

  45. Florez KR, et al. Fatalism or destiny? A qualitative study and interpretative framework on dominican women’s breast cancer beliefs. J Immigr Minor Health. 2009;11(4):291–301.

    Article  PubMed Central  PubMed  Google Scholar 

  46. Salazar MK. Hispanic women’s beliefs about breast cancer and mammography. Cancer Nurs. 1996;19(6):437–46.

    Article  CAS  PubMed  Google Scholar 

  47. Schettino MR, et al. Assessing breast cancer knowledge, beliefs, and misconceptions among Latinas in Houston, Texas. J Cancer Educ. 2006;21(1 Suppl):S42–6.

    Article  PubMed  Google Scholar 

  48. Audrain J, et al. Awareness of heightened breast cancer risk among first-degree relatives of recently diagnosed breast cancer patients. The High Risk Breast Cancer Consortium. Cancer Epidemiol Biomarkers Prev. 1995;4(5):561–5.

    CAS  PubMed  Google Scholar 

  49. Hubbell FA, et al. The influence of knowledge and attitudes about breast cancer on mammography use among Latinas and Anglo women. J Gen Intern Med. 1997;12(8):505–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  50. Perez-Stable EJ, et al. Misconceptions about cancer among Latinos and Anglos. JAMA. 1992;268(22):3219–23.

    Article  CAS  PubMed  Google Scholar 

  51. Storch EA, et al. The duke religion index: a psychometric investigation. Pastoral Psychol. 2004;53(2):175–82.

    Article  Google Scholar 

  52. Magana A, Clark NM. Examining a paradox: does religiosity contribute to positive birth outcomes in Mexican American populations? Health Educ Q. 1995;22(1):96–109.

    Article  CAS  PubMed  Google Scholar 

  53. Arredondo EM, et al. Is church attendance associated with Latinas’ health practices and self-reported health? Am J Health Behav. 2005;29(6):502–11.

    Article  PubMed  Google Scholar 

  54. De Alba I, et al. Impact of U.S. citizenship status on cancer screening among immigrant women. J Gen Intern Med. 2005;20(3):290–6.

    Article  PubMed Central  PubMed  Google Scholar 

  55. Ramirez AG, et al. Hispanic women’s breast and cervical cancer knowledge, attitudes, and screening behaviors. Am J Health Promot. 2000;14(5):292–300.

    Article  CAS  PubMed  Google Scholar 

  56. Hiatt RA, et al. Community-based cancer screening for underserved women: design and baseline findings from the Breast and Cervical Cancer Intervention Study. Prev Med. 2001;33(3):190–203.

    Article  CAS  PubMed  Google Scholar 

  57. Selvin E, Brett KM. Breast and cervical cancer screening: sociodemographic predictors among White, Black, and Hispanic women. Am J Public Health. 2003;93(4):618–23.

    Article  PubMed Central  PubMed  Google Scholar 

  58. Dominick KL, et al. Relationship of health-related quality of life to health care utilization and mortality among older adults. Aging Clin Exp Res. 2002;14(6):499–508.

    Article  PubMed  Google Scholar 

  59. Zahran HS, et al. Health-related quality of life surveillance—United States, 1993–2002. MMWR Surveill Summ. 2005;54(4):1–35.

    PubMed  Google Scholar 

  60. Gonzalez P, et al. Determinants of breast, cervical and colorectal cancer screening adherence in Mexican-American women. J Community Health. 2012;37(2):421–33.

    Article  PubMed Central  PubMed  Google Scholar 

  61. Andersen MR, et al. Breast cancer worry and mammography use by women with and without a family history in a population-based sample. Cancer Epidemiol Biomarkers Prev. 2003;12(4):314–20.

    CAS  PubMed  Google Scholar 

  62. Hay JL, Buckley TR, Ostroff JS. The role of cancer worry in cancer screening: a theoretical and empirical review of the literature. Psychooncology. 2005;14(7):517–34.

    Article  PubMed  Google Scholar 

  63. Austin LT, et al. Breast and cervical cancer screening in Hispanic women: a literature review using the health belief model. Womens Health Issues. 2002;12(3):122–8.

    Article  PubMed  Google Scholar 

  64. Garbers S, et al. Barriers to breast cancer screening for low-income Mexican and Dominican women in New York City. J Urban Health. 2003;80(1):81–91.

    PubMed Central  PubMed  Google Scholar 

  65. Diefenbach MA, Miller SM, Daly MB. Specific worry about breast cancer predicts mammography use in women at risk for breast and ovarian cancer. Health Psychol. 1999;18(5):532–6.

    Article  CAS  PubMed  Google Scholar 

  66. McCaul KD, et al. A descriptive study of breast cancer worry. J Behav Med. 1998;21(6):565–79.

    Article  CAS  PubMed  Google Scholar 

  67. McCaul KD, Schroeder DM, Reid PA. Breast cancer worry and screening: some prospective data. Health Psychol. 1996;15(6):430–3.

    Article  CAS  PubMed  Google Scholar 

  68. Schwartz MD, Taylor KL, Willard KS. Prospective association between distress and mammography utilization among women with a family history of breast cancer. J Behav Med. 2003;26(2):105–17.

    Article  PubMed  Google Scholar 

  69. Sadler GR, et al. Recruitment of hard-to-reach population subgroups via adaptations of the snowball sampling strategy. Nurs Health Sci. 2010;12(3):369–74.

    Article  PubMed Central  PubMed  Google Scholar 

  70. Centers for Disease Control and Prevention. 2007 Behavioral Risk Factor Surveillance System Questionnaire. 2007 (cited 2012 May 15). http://www.cdc.gov/brfss/questionnaires/pdf-ques/2007brfss.pdf.

  71. Agency for Healthcare Research and Quality (AHRQ). Appendix F: screening for breast cancer, guide to clinical preventive services, 2012, Clinical Summary of 2002 U.S. Preventive Services Task Force Recommendation. 2012 (cited 2013 July 15). http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/appendix-f.html.

  72. Norris AE, Ford K, Bova CA. Psychometrics of a brief acculturation scale for Hispanics in a probability sample of urban Hispanic adolescents and young adults. Hispanic J Behav Sci. 1996;18(1):29–38.

    Article  Google Scholar 

  73. Chew LD, Bradley KA, Boyko EJ. Brief questions to identify patients with inadequate health literacy. Fam Med. 2004;36(8):588–94.

    PubMed  Google Scholar 

  74. Powe BD. Fatalism among elderly African Americans. Effects on colorectal cancer screening. Cancer Nurs. 1995;18(5):385–92.

    Article  CAS  PubMed  Google Scholar 

  75. Powe BD. Cancer fatalism among elderly Caucasians and African Americans. Oncol Nurs Forum. 1995;22(9):1355–9.

    CAS  PubMed  Google Scholar 

  76. Lopez-McKee G, et al. Spanish translation and cultural adaptation of the Powe Fatalism inventory. J Nurs Scholarsh. 2007;39(1):68–70.

    Article  PubMed  Google Scholar 

  77. Andresen EM, et al. Retest reliability of surveillance questions on health related quality of life. J Epidemiol Community Health. 2003;57(5):339–43.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  78. Gramling R, et al. The cancer worry chart: a single-item screening measure of worry about developing breast cancer. Psychooncology. 2007;16(6):593–7.

    Article  PubMed  Google Scholar 

  79. Tabachnick B, Fidell L. Using multivariate statistics. 4th ed. Boston: Allyn & Bacon; 2001.

    Google Scholar 

  80. Afifi A, Clark VA, May S. Computer-aided multivariate analysis. 4th ed. Boca Raton, FL: Chapman & Hall/CRC; 2004.

    Google Scholar 

  81. Nunnally JC, Bernstein IH. Psychometric theory. 3rd ed. New York: McGraw-Hill; 1994.

    Google Scholar 

  82. Malcarne VL, Fernandez S, Flores L. Factorial validity of the multidimensional health locus of control scales for three American ethnic groups. J Health Psychol. 2005;10(5):657–67.

    Article  PubMed  Google Scholar 

  83. Hosmer DW, Lemeshow S. Applied logistic regression. 2nd ed. New York: Wiley; 2000.

    Book  Google Scholar 

  84. Kleinbaum DG, et al. Applied regression analysis and multivariable methods. 4th ed. Pacific Grove, CA: Duxbury Press; 2007.

    Google Scholar 

  85. Long JS. Regression models for categorical and limited dependent variables. Thousand Oaks, CA: Sage; 1997.

    Google Scholar 

  86. Menard S. Applied logistic regression analysis. Quantitative applications in the social sciences: a Sage University paper. Thousand Oaks: Sage; 2002.

    Google Scholar 

  87. Guerra CE, Krumholz M, Shea JA. Literacy and knowledge, attitudes and behavior about mammography in Latinas. J Health Care Poor Underserved. 2005;16(1):152–66.

    Article  PubMed  Google Scholar 

  88. Breen N, Rao SR, Meissner HI. Immigration, health care access, and recent cancer tests among Mexican-Americans in California. J Immigr Minor Health. 2010;12(4):433–44.

    Article  PubMed  Google Scholar 

  89. True S, et al. In conclusion: the promise of comprehensive cancer control. Cancer Causes Control. 2005;16(Suppl 1):79–88.

    Article  PubMed  Google Scholar 

  90. Lucas JW. Theory-testing, generalization, and the problem of external validity. Sociol Theory. 2003;21(3):236–53.

    Article  Google Scholar 

  91. Legler J, et al. The effectiveness of interventions to promote mammography among women with historically lower rates of screening. Cancer Epidemiol Biomarkers Prev. 2002;11:59–71.

    PubMed  Google Scholar 

  92. Sohl SJ, Moyer A. Tailored interventions to promote mammography screening: a meta-analytic review. Prev Med. 2007;45(4):252–61.

    Article  PubMed Central  PubMed  Google Scholar 

  93. Metsch LR, et al. The role of the physician as an information source on mammography. Cancer Pract. 1998;6(4):229–36.

    Article  CAS  PubMed  Google Scholar 

  94. Burger JM. The foot-in-the-door compliance procedure: a multiple-process analysis and review. Pers Soc Psychol Rev. 1999;3(4):303–25.

    Article  CAS  PubMed  Google Scholar 

  95. Pascual A, Gueguen N. Foot-in-the-door and door-in-the-face: a comparative meta-analytic study. Psychol Rep. 2005;96(1):122–8.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research was supported by a California Breast Cancer Research Program/Community Research Collaborative Pilot Award to Sadler and Riley.

Author information

Authors and Affiliations

  1. Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, 9245 Sky Park Court, Suite 110, San Diego, CA, 92123, USA

    Sheila F. Castañeda & Manpreet K. Mumman

  2. SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA

    Vanessa L. Malcarne

  3. Department of Psychology, Michigan State University, East Lansing, MI, USA

    Pennie G. Foster-Fishman & William S. Davidson

  4. Vista Community Clinic, Vista, CA, USA

    Natasha Riley

  5. Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA, USA

    Georgia R. Sadler

Authors
  1. Sheila F. Castañeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vanessa L. Malcarne
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pennie G. Foster-Fishman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. William S. Davidson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Manpreet K. Mumman
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Natasha Riley
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Georgia R. Sadler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sheila F. Castañeda.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Castañeda, S.F., Malcarne, V.L., Foster-Fishman, P.G. et al. Health Care Access and Breast Cancer Screening Among Latinas Along the California–Mexican Border. J Immigrant Minority Health 16, 670–681 (2014). https://doi.org/10.1007/s10903-013-9938-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-013-9938-x

Keywords

Search

Navigation