Defense Date


Graduation Date



Immediate Access

Submission Type


Degree Name





School of Nursing

Committee Chair

Joan Lockhart

Committee Member

Karen Paraska

Committee Member

Aysegul Timur


Breast, Cancer, Low-income, Mammography, Uninsured, Women


Problem: Detection of breast cancer in women of low socioeconomic status, lacking health insurance, can be improved by increasing annual mammography rates, yet little is known about their screening behavior.

Purpose: A retrospective subject-controlled study of an ongoing Breast Health Program, at a not-for-profit, non-government assisted, volunteer clinic, was undertaken to examine mammography usage and discovery variables.

Design and Methods: English and Spanish speaking women 40 years old and over who viewed in a 7-minute breast health DVD and were offered free mammography were eligible for the study (N= 223). The Health Belief Model (HBM) (Becker, 1974) provided the study framework that utilized radiology billing records for mammography completion and a dual-language self-administered survey. Data retrieval was from March 2004 to July 2009, with DVD viewing beginning in December 2006. Recruitment occurred between July 2009 and September 2009.

Results: Results revealed that 214 (96%) women had a mammography after viewing the DVD. Of the 120 subjects that had time to complete an annual mammography, 28 (23%) completed it in the 12th month, 48 (40%) completed it within 15 months, and 91 (75%) completed even if late. Only 37 subjects had time to complete a third mammography and of those only 8 completed a fourth. Significant findings found: (1) a greater proportion of women who received a reminder postcard participated in their annual mammography in the 12th month, Χ2(1) = 3.98, p = .046; (2) perceptions of breast cancer susceptibility scores were significantly lower (M = 6.89, SD = 3.18), in those who completed their annual mammography in the 12th month, t(118) = 2.03, p = .045; (3) a greater proportion of women who were knowledgeable about screening recommendations completed annual mammography, even if late, Χ2(1) = 4.736, p = .030 and; (4) Hispanic women completed at a significantly higher rate (n= 69; 81.2%) even if late, Χ2(2) = 6.450, p = .04.

Implications: Longitudinal studies utilizing radiology billing records for mammography completion present real findings of mammography usage. This study's findings enhance the understanding of low-income, working uninsured women and identify new variables not found in comparative research findings.