Breast Cancer Screening Among Dominican Latinas

Abstract

With the marked increase of the Latino population in the United States during the past 20 years, there has been growing interest in the social, cultural, and structural factors that may impede breast cancer screening among Latino women, especially among those subgroups that have been understudied. Acculturation and fatalism are central cultural constructs in these growing fields of research. However, there is great debate on the extent to which acculturation and fatalism affect breast cancer screening among Latinas relative to other social or structural factors or logistical barriers. Moreover, little theoretical work specifies or tests pathways between social, structural, and cultural determinants of screening. This study tests a theoretical model of social and structural (socioeconomic status and access to health care) and cultural factors (acculturation and fatalism) as correlates of mammography screening among Dominican Latinas, a group that has been understudied. The study expands prior work by examining other factors identified as potential impediments to mammography screening, specifically psychosocial (e.g., embarrassment, pain) and logistical (e.g., not knowing how to get a mammogram, cost) barriers. Interview-administered surveys were conducted with 318 Latinas from the Dominican Republic aged 40 years or older. Fatalistic beliefs were not associated with mammogram screening. Greater acculturation assessed as language use was associated with decreased screening. The strongest predictor of decreased screening was perceived barriers. Results highlight the importance of assessing various self-reported psychosocial and logistical barriers to screening. Possible avenues for screening interventions include intensifying public health campaigns and use of personalized messages to address barriers to screening. Results add to a limited body of research on Dominicans, who constitute the fifth largest Latino group in the United States.

Older Women’s Perspectives Driving Mammography Screening Use and Overuse: a Narrative Review of Mixed-Methods Studies

“…For instance, one cross-sectional study found that Korean-American women ≥ 65 years perceive breast cancer to be more serious compared to Korean-American women ≤ 65 years [48•] and a cross-sectional study of women ≥ 65 years from racially and ethnically diverse backgrounds found that women who are more worried about breast cancer were more likely to undergo screening [45]. In contrast, older Hopi women who feared a breast cancer diagnosis were less likely to undergo mammography screening [42] while a study among Dominican Latinas found no association between mammography behavior and the belief that there is not much one can do to keep from getting cancer or that cancer was a death sentence [40].…”

Mastectomized women’s perception of breast cancer early detection

“…The authors point out that women living in rural areas of the United States receive mammography screening only when they have health insurance. Abraído-Lanza et al [ 20 ] studied Latino women living in the United States and found that cultural and logistical barriers lower breast cancer screening participation rates and suggested intensifying public health campaigns targeted at this public.…”

Latina young adults' use of health care during initial months in the United States

“…Previous studies on social and cultural determinants of health care use among Latina immigrants in the US have primarily focused on older, US-born Latinas or Latina immigrants residing in the US for many years (Abraído-Lanza, Martins, Shelton, & Flórez, 2015; Asamoa et al, 2004; Fuentes-Afflick & Hessol, 2009; Garcés, Scarinci, & Harrison, 2006). Understanding potential determinants of health care soon after immigration to the US among young women may foster an evidence base for early interventions targeting health disparities affecting Latina young adults as well as similar immigrant populations internationally.…”