health and cancer screening. One frequently ignored aspect of the mammography experience is communication between women and radiologic technologists (Moyer et al., 2001). As noted by Moyer and colleagues, some racial and ethnic minority women (e.g., African-Americans) are less likely to understand the benefits of mammography, more likely to view cancer as fatal, and more likely to be more anxious about getting mammograms. Thus, communication and the opportunity to improve communication and increase the probability of subsequent adherence may be especially important for diverse populations.
The process of intervention development needs to take into account women’s life experiences and social contexts, which may not be reflected in their race/ethnicity, age, or other broad categorization.
Health behavior change is influenced at multiple levels, including at the individual, interpersonal, institutional, community, and policy levels. Health communications targeting individual or interpersonal factors alone are likely to be insufficient in the absence of environmental interventions, such as those that enhance coverage or increase access. Interventions to reduce access barriers to mammography are important if remaining disparities in screening use are to be reduced.
The mammography literature shows that, overall, women are more similar than different. However, although the predictors of mammography may be the same for diverse populations, their levels and intensity may vary. It is critical that interventions be built on a strong theoretical foundation using data accumulated from well-designed qualitative and quantitative studies to provide understanding of the variables that affect mammography for diverse populations. Health communications will be most effective when they are relevant, appropriate, and appealing to the specific audience targeted by the communication. Evaluations should include and report measures of fidelity and quality of intervention delivery.