Barriers to breast and cervical cancer screening in underserved women of the District of Columbia.

PURPOSE/OBJECTIVES: To identify barriers to breast and cervical cancer screening services from the perspective of medically underserved women of the District of Columbia (DC) that may influence intentions to perform breast and cervical cancer screening behaviors; to determine any relationship between attitudes and influence of significant others on intended behaviors; and to identify a relationship between the site where services are provided and the underserved women's intentions to engage in screening behaviors.

DESIGN: Cross-sectional, correlational.

SETTING: Breast and cervical cancer screening clinics in DC.

SAMPLE: 339 medically underserved, adult women.

METHODS: Face-to-face investigator-conducted interviews.

MAIN RESEARCH VARIABLES: Demographic and contextual variables as well as attitudes and influence of significant others. Intention to have a mammogram or Pap test or perform breast self-examination (BSE) monthly.

FINDINGS: Intention to have a mammogram was positively related to influence of significant others and negatively related to uncaring healthcare professionals. Intention to have a Pap test had a positive relationship with one's attitude toward the test and with the influence of significant others. Intention to perform BSE was positively related to attitude toward and previous performance of BSE and influence of significant others. No significant relationships were observed between intention to perform screening behaviors and demographic variables.

CONCLUSIONS: Factors that influence women's attitudes toward screening and intention to perform these behaviors include previous screening behaviors, influence of significant others, and relationships with healthcare professionals.

IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses are well-positioned to develop and test intervention strategies designed to increase access to and compliance with recommended screening guidelines among the medically underserved. Findings from this study potentially could guide development and evaluation of such strategies that are sensitive to this special population.