The importance of age as a context for understanding African-American women's mammography screening behavior

Introduction: Although several studies have explored reasons for lower mammography screening rates among African-American women generally, none has addressed the effect of age as a context for interpreting these reasons. This study examines the association of predisposing, reinforcing, and enabling factors with recent screening mammography behavior for different age groups of African-American women. Methods: Data are from stratified random sample household surveys of women in two Florida communities (n = 648). Bivariate, log linear, and multivariate logistic regression analyses were performed separately for three different age groups: 40-49, 50-64, and greater than or equal to 65. Results: Age was found to be a key context for distinguishing factors associated with having a recent mammogram: Knowledge of screening guidelines and exposure to information about breast screening on radio or television were the most important factors that distinguished the youngest group. Having health insurance and level of education were important factors for the middle group, The most noteworthy differences were found for the oldest group for whom physician recommendation for a mammogram and confidence in being able to get a mammogram were the only significant factors associated with having a recent mammogram. Conclusions: This study confirms the need to tailor breast screening initiatives to specific age groups of African-American women.