Determining crucial correlates of breast self-examination in older women with low incomes

To investigate the frequency and proficiency of breast self-examination (BSE) in older women with low incomes and to identify predictors of BSE to facilitate more effective clinical encounters and improved educational programs.

Correlational, nonexperimental survey.

Urban tertiary-care center.

204 women (ages 40-86) self-referred or recruited from the community for free breast cancer screening. Criteria for inclusion were age 40 or older, a household income of less than two-and-one-half times the poverty level, and uninsured or underinsured status.

The Mamon and Zapka Breast Self-Examination Survey was modified for use with this population. Telephone surveys were conducted during the period between the initial contact and screening.

102 independent variables were correlated with frequency and proficiency. Part correlations were calculated to determine unique contributions. Variables with significant part correlations were entered into regression equations.

The mean frequency and proficiency scores were 2.9 out of 4 and 3.4 out of 19, respectively. Four variables explained 40% of the variance in frequency, and eight explained 66% of the variance in proficiency. Frequency and proficiency were significantly related.

10 variables were found to predict BSE behavior in this population: confidence, confidence level, awareness of mammography, provider influence, desire for reconstruction, knowledge of parity risk factor, education, having been taught the correct time of month to perform BSE, adequate time devoted to BSE, and exposure to BSE messages from a clinician.

The study identifies variables to include in clinical encounters and educational programs designed to promote BSE. Of importance is considering the characteristics and specific needs of the recipients of educational and interventional programs.