Patricia I. Documét, MD, DrPH¹, Janet Adams, PhD¹, Lou Ann Weil, MPH², Christie L. Hudson, MPA³, Cheri J. Petrovich, BA¹, and Bonnie Delozier, BSEd². (1) Applied Research Department, Family Health Council, Inc., 960 Penn Avenue, Suite 600, Pittsburgh, PA 15222, (412) 288-2130, documetp@yahoo.com, (2) Family Health Council, 960 Penn Ave., Suite 600, Pittsburgh, PA 15222, (3) Learning Research and Development Center, University of Pittsburgh, 3939 O'Hara St., Room 81, Pittsburgh, PA 15260

Minority and rural women are less likely have Pap smears and mammograms and more likely to have breast and cervical cancer detected at a later stage than the general population. This descriptive study aimed at identifying environmental factors affecting this disparity in early detection as it applied to African American, Latino, rural Appalachian and Amish women. Thirty-one focus groups with community women were held in eight western Pennsylvania counties. Data were analyzed using NUD*IST, with results from the first wave of focus groups (N=20) guiding discussions for the second (N=11). Women identified the main barriers to screening as: 1) Appalachian: distance, transportation, cost, provider availability, mistrust in the health system, and lack of information and support networks; 2) African American: cost, providers' reluctance to accept public insurance, disrespectful treatment by providers, lack of time due to too many life demands, distrust of providers, and lack of support networks within the community; Latinas: lack of health insurance, cost, lack of information about cancer and the health system, embarrassment, machismo, fear of deportation, language incompatibility, and limited support networks; and 4) Amish: lack of cancer screening tradition and cultural distance from the health system. All groups were affected by misconceptions about cancer and cancer screening tests. Factors that affected women’s utilization of cancer screening in all groups were related to demographics, health care access, cultural environment, and support networks. However, each factor exerted influence in a distinct manner in each group. These findings have direct implications for health promotion programs.

Learning Objectives:

• Identify a method for obtaining relevant information from minority ethnic groups in a culturally appropriate way.
• List at least two dimensions of the social and cultural environment that affect cancer screening for rural Appalachian, African American, Latino, and Amish women in Pennsylvania.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.