Abstract
African American women (AAW) have a higher breast cancer mortality rate and a lower survival rate than any other racial or ethnic group. Research has demonstrated that limited access to care reduces mammography screening for AAW. Despite barriers, some AAW do access mammography and engage in breast cancer screening behaviors. The salutogenic theory of health focuses on factors that support well-being and increase positive health behaviors. Given this perspective, salutogenesis offers a novel framework to understand personal factors that allow some AAW to surmount barriers and to engage in health behaviors. Sense of coherence (SOC) is central to salutogenesis. Individuals with greater SOC view life as more manageable and take advantage of available resources.
A two-group cross sectional design was used to address the following aims: 1) evaluate the contribution of SOC to breast cancer screening (BCS) motivation and behaviors in AAW, 2) determine whether social support and/or spirituality modifies the effect of SOC on BCS motivation and behaviors, 3) determine if health perception mediates the effect of SOC on BCS motivation and behaviors, and 4) determine whether there are differences in SOC, spirituality, and social support of AAW who take advantage of the IBCCP (free mammogram) program compared to AAW who do not. This study enrolled 134 women with 53 in the IBCCP group and 81 in the non-IBCCP group. Logistic and multiple regression were used to analyze findings.
Findings revealed that SOC was significantly related to health perception, social support, spirituality, and motivation. Spirituality and education significantly predicted BCS motivation. Barriers were associated with decreased odds of women practicing BSE. Regression models containing covariates and predictor variables as complete units predicted specific BCS behaviors. IBCCP participants' had greater SOC, motivation and compliance with BCS guidelines than non-IBCCP participants; these differences trended toward significance.
These findings demonstrate the importance of free mammography programs and the contribution of spirituality to BCS in AAW. Future studies exploring the impact of components of SOC and barriers on BCS behaviors in AAW are warranted. Such results can inform future studies designed to reduce the large disparity in breast cancer mortality in AAW.
Sigma Membership
Alpha Beta
Type
Dissertation
Format Type
Text-based Document
Study Design/Type
Cross-Sectional
Research Approach
Quantitative Research
Keywords:
Sense of Coherence, Cancer Screenings, African American Women
Advisors
Janusek, Linda||Hogan, Nancy S.||Jacobson, Gloria
Degree
PhD
Degree Grantor
Loyola University Chicago
Degree Year
2011
Recommended Citation
Conway-Phillips, Regina, "A salutogenic framework to understand disparity in breast cancer screening behavior in African American women" (2023). Dissertations. 625.
https://www.sigmarepository.org/dissertations/625
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Review Type
None: Degree-based Submission
Acquisition
Proxy-submission
Date of Issue
2023-01-31
Full Text of Presentation
wf_yes
Description
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3454917; ProQuest document ID: 871222182. The author still retains copyright.