“Getting a mammogram suggests thinking about the future in the absence
of symptoms,” say Matthew W. Kreuter, Ph.D., M.P.H., and colleagues
in a study published in the August issue of the American Journal of Public
Health.
Kreuter’s group interviewed 435 African American women,
age 40 to 65, recruited from 10 public health centers in St. Louis. They
had an average
education
of more than 12 years and the median household income fell into the $10,000
to $20,000 bracket. Most women in the study had a future, not present, time
orientation.
But for some women, orientation toward the present, rather than contemplating
their future health, can have important medical consequences.
African-American women are more likely to die of breast
cancer than women from other racial or ethnic groups, says Kreuter, of
the School of Public
Health at Saint Louis University. They get mammograms at about the same rate
as other
women, so their higher death rate may be due to diagnosis at later — and
more dangerous — stages of the disease. Learning why African-American
women delay mammography might lead to more effective measures to overcome
that deficit, Kreuter and colleagues suggest. Understanding the role of time
orientation
could help that process.
In this study , the importance of present-time orientation proved significant
even after the researchers adjusted for income, education and employment.
“Having a present-time orientation is probably more closely linked to
income than race,” Kreuter says, “and we believe it reflects
life circumstance more than individual disposition.”
While many of the women said they faced barriers to getting a mammogram, the
study also found that women were more likely to get a mammogram if recommended
by a health care provider.
However, unlike other research, Kreuter’s team did
not find any association between mammography and education or income, possibly
because women who visited
health clinics were more often aware of programs to pay for mammograms for
uninsured women.
The researchers also found that women who scored higher on a scale of racial
pride knew more about breast cancer and mammography. Even though this was not
a statistically significant trend, it does offer an opening for new health
education strategies, Kreuter says.
Prior research has shown the benefit of tailoring health messages to specific
audiences, he notes. So developing new messages that incorporate the results
of his current study might help more African-American women look to their future
health and thus decide to get mammograms earlier.
“Public health practitioners working to promote mammography might consider
integrating present-time orientation and racial pride into their approaches
for African-American women,” Kreuter concludes.
The National Cancer Institute provided funding for the study.
