Mammography screening for low income women

The existence of a significant fraction of women who fail to comply with mammography guidelines has led to a substantial body of literature on women\u27s decisions about mammography. Although relatively large in quantity, this literature is relatively limited in theoretical depth. Much of this work is atheoretical or based on value expectancy theory. The focus on value-expectancy theory has led many researchers to neglect the relationship between social networks/social supports and adherence to mammography guidelines. The relative oversight is a critical shortfall because there is reason to believe that social context is a determinant of health behaviors. In addition to being limited theoretically, much of the research on the correlates of mammography has been conducted on white, middle class women who are enrolled in health maintenance organizations. The behavior of uninsured and low-income women remains understudied. This dissertation seeks to address these gaps in the literature. Using data from a series of focus groups, a large scale questionnaire administered to two distinct populations, and a series of in-depth follow-up interviews, I examine the relationship between social influences and mammography guidelines for a population of middle-aged, low-income women. Analysis of the focus groups and in-depth interviews suggests that women\u27s conversations about mammography serve multiple purposes. They allow for the maintenance of a pro-mammography social norm, but also enable women to express concerns about mammography and anxiety over seeking care given financial constraints. Finally, conversation may influence the type of concerns women experience by influencing feelings of belonging and/or depression. Analysis of survey data suggest that social influences have a significant influence on plans to get a mammogram. Specifically, perceived social norms directly predict women\u27s intentions to get a mammogram. Further, emotional support and behavioral social norms influence intent to get a mammogram indirectly via positive and negative beliefs about the procedure