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Patient and Clinical Site Factors Associated With Rescreening Behavior Among Older Multiethnic, Low-Income Women

Correspondence: Address correspondence to Patrick Fox, PhD, Institute for Health & Aging, University of California, San Francisco, Laurel Heights Campus, San Francisco, CA 94143-0646. E-mail: pf1965{at}itsa.ucsf.edu

Purpose: Our goal was to identify factors predictive of mammography rescreening within 18 months of baseline screening in multiethnic, low-income older women. Design and Methods: We interviewed a cross-sectional survey of staff of 102 randomly selected clinics that provided screening and diagnostic services. We also surveyed a random sample of 391 older women served by these clinics to retrospectively assess their experiences of the screening process. Results: We found that 59% of the sample returned for a repeat mammogram. Education level and the belief it is important to get an annual mammogram were significant patient-level predictors of rescreening. Offering pap smears and using hands-on demonstrations with breast models were significant clinic-level variables predictive of rescreening. Of note, among the variables that did not prove significant in the final model were those reflecting ethnicity and income. Implications: Individual and health-care-delivery-system factors play important roles in the obtaining of regular mammograms by low-income women. These findings highlight the importance of both factors in improving rescreening rates among older women.

Key Words: Mammograms • Older women • Breast-cancer screening

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