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Is Perceived Susceptibility for Breast Cancer Less Predictive of Mammogram Use among Blacks and Hispanics than Whites?
APHA 138th Annual Meeting (2010)
  • Heather Orom, University at Buffalo
  • Marc T. Kiviniemi, University at Buffalo
  • Willie Underwood III
  • Levi Ross

Background: Intervention efforts should be tailored to be meaningful within the context of people's beliefs, values and social contexts.

Significance: Increasingly, researchers are inquiring into the cross-cultural relevance of constructs long considered central to health behavior theory. Some suggest that perceived susceptibility may lack cultural resonance for some groups, including Blacks and Hispanics; however, there have been few empirical tests of this hypothesis.

Purpose: We examined the relative importance of perceived susceptibility to breast cancer (BCa) for predicting ever mammogram use among Blacks, Hispanics, and Whites. Methods: We employed data from female respondents, aged 40 and over (ns >=2046), to HINTS 2003, a nationally representative survey of adults in the U.S. Analyses were conducted using weighted data and controlling for demographic characteristics and access to care.

Results: For the sample as a whole, perceived susceptibility to BCa (absolute risk, comparative risk, worry) predicted having had a mammogram (ORs =1.27, 1.44, 1.45); however, there was an interaction between race/ethnicity (Hispanic vs. White) and susceptibility such that the associations between susceptibility and screening only held for Whites. Interaction terms were significant for absolute risk and worry (interaction ORs = 0.64, 0.47). Interaction effects for Blacks vs. Whites followed the same pattern but were not statistically significant.

Conclusion: System-level barriers and lack of cultural resonance may explain the lack of association between perceived susceptibility and mammogram use for Hispanics. Stratifying by race/ethnicity when identifying determinants of health behavior provides useful information for focusing culturally tailored health promotion programs on constructs of maximum relevance.

Learning Areas: Diversity and culture; Planning of health education strategies, interventions, and programs; Social and behavioral sciences.

Learning Objectives: Describe racial/ethnic variations in the relationship between perceived susceptibility and mammogram use. Discuss reasons why health behavior theory may be relatively less predictive for racial/ethnic minorities and other disadvantaged groups. Discuss how stratifying by race/ethnicity in analyses of determinants of health behavior can inform intervention.

  • Breast Cancer,
  • Screening
Publication Date
November, 2010
Citation Information
Heather Orom, Marc T. Kiviniemi, Willie Underwood III and Levi Ross. "Is Perceived Susceptibility for Breast Cancer Less Predictive of Mammogram Use among Blacks and Hispanics than Whites?" APHA 138th Annual Meeting (2010)
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