Intrapersonal barriers inhibiting mammography utilization for African American women on the southside of Chicago

Background: In Chicago, Black women are 40% more likely to die from breast cancer than their White counterparts.  While inequitable distribution of quality health care is a significant driver of the disparity; intrapersonal barriers also negatively impact mammography utilization.  Research has documented that Black women in Chicago have the lowest screening rates in the country and hold cultural beliefs about breast cancer that perpetuated delayed follow-up for suspicious breast symptoms. Understanding these barriers can inform the development of targeted interventions to reduce breast cancer mortality for black women in Chicago.

Methods: A qualitative study was conducted with Black women participating in a community navigation program who did not complete their screening mammogram to identify specific barriers inhibiting screening utilization.  Twenty-two women participated in two focus groups lasting approximately 1 hour.  A script was used to question participants about their reasons for missing appointments and perceptions of community healthcare services.  Each focus group was recorded and transcribed.

 Results: Participants shared views on breast health, mammograms, availability of healthcare services, and fears surrounding breast cancer.  Mistrust of the healthcare system emerged as the major barrier to utilization of preventative services.   Specifically participants lacked confidence in the quality of healthcare services in their community and previously had negative experiences at these neighborhood facilities. 

 Conclusion: Navigation interventions have been successful in addressing health system barriers; however, more tailored support is needed to address intrapersonal barriers to preventive screening utilization for black women in Chicago including cultural competency training for medical facilities.