In this study, breast cancer knowledge, beliefs and practices in low income black women were examined. First, focus groups were held with a total of 33 participants. Information gathered from the focus groups was used to develop a telephone survey which was partially based on the Health Belief Model (HBM) and administered to 92 subjects. Utilization rates of mammography and breast self-examination (BSE) were quite high; 66.3% of survey participants reported having at least one mammogram and 72.5% performed BSE. Because low-cost mammograms were available to the survey participants, these results suggest that women in this target population will utilize accessible and affordable mammograms. Several knowledge deficiencies that need to be addressed were also identified. Most of the health beliefs were not significantly associated with mammography or BSE utilization. Because the HBM has never been extensively tested on this population, its appropriateness as a behavior model for low-income women is examined. Implications for future research and interventions are discussed.

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iethylstilbestrol (DES), a synthetic estrogen, was prescribed to pregnant women as early as 1938. Based on limited clinical observations and speculation about its biochemical mechanisms, prescription of DES was adopted by physicians in many areas of the country under the erroneous expectation that it would prevent miscarriage and produce a healthier pregnancy (Guisti, Iwamoto, & Hatch, 1995; Wingard, Cohn, Helmrich, & Edelstein, 1996). Although no beneficial effect was observed in a large clinical trial reported in 1953 (Dieckmann, Davis, Rynkiewicz, & Pottinger, 1953), DES during pregnancy continued to be prescribed. The first report documenting the association between in utero exposure and the development of clear cell adenocarcinoma (CCA) in women 14 to 22 years old was published in 1970 (Herbst & Scully, 1970). CCA (a rare cancer of the vagina and cervix) had previously been seen only in elderly women. With additional reports of clear cell cancer in young women exposed in utero (Greenwald, Barlow, Nasca, & Burnett, 1971), the use of DES with pregnant women was contraindicated in