Moving in between mammography: screening decisions of American Indian women in Vermont.

Breast cancer is a leading cause of cancer death among American Indian women, with mammography screening rates below the national average for this population. A grounded theory study, conducted with Vermont American Indian women, explicated factors that influence mammography decision making. The authors examined mammography decision making across the breast cancer screening continuum: women with a history of consistent annual mammograms, women who were under users or nonusers of mammography, and women who were breast cancer survivors. The generated theory, Moving in Between Mammography, describes the decision-making process and factors that influenced women's participation in routine mammography screening. Specific influencing factors addressed include Connecting to Nativeness, Taking Care of Self, Financing Health Care, and (Mis)Trusting the Health Care System. Implications and directions for future research are addressed.