Mammography Screening Behavior among Black Women in the United States

Breast cancer is the second leading cause of cancer death among women in America. The prevalence of breast cancer is higher in White women than Black women; however, death rates are higher among Black women than White women due to late detection and treatment. This quantitative study used the multi-theory model to examine factors affecting mammography screening among Black American women. Data were collected using Qualtrics. An independent t-test was used to compare mammography screening behavior among Black women who had mammograms with those who had not. Multiple linear regression was used to predict the initiation and sustenance of mammography screening behavior among Black women. The results showed Black American women had lower mammography screening rates, with 45.5% of participants reporting having a mammogram within the past year before taking the survey. Participatory dialogue (β = 0.308, p < 0.001), behavioral confidence (β = 0.198, p < 0.05), and changes in the physical environment (β = 0.335, p < 0.001) were significant predictors of initiation of mammography screening behavior and were responsible for 51.1% of the variance in decisions to initiate screening. Emotional transformation (β = 0.438, p < 0.001) and changes in the social environment (β = 0.303, p < 0.001) were significant predictors of sustaining mammography screening and responsible for 60.5% of the variance in terms of the decision to undergo yearly mammography exams. An implication for positive social change of this study is the ability to create evidence-based (theory-based) mammography screening promotion interventions for Black women. The multi-theory model of health behavior change is a robust model that can help in this regard.