Examining breast health behavior among African American caregivers

Background and Purpose: This study examines factors that promote or hinder African American female caregivers in obtaining breast cancer preventative screenings, including mammograms, clinical examinations, and breast self-examinations. Breast cancer is the most frequently occurring type of cancer for women in the United States. Although African American women have a lower incidence of breast cancer compared to White women, they have a higher mortality rate. Several commonly cited factors contributing to this breast health disparity include less access to breast health screenings, lack of health insurance, and lack of information/understanding about breast cancer among African American women. Although physical and emotional burden associated with caregiving has been studied extensively, the effects on breast health behavior among female caregivers have not been examined. Since negative consequences such as financial challenges are particularly pronounced among African American female caregivers, it is likely that breast health behavior will be impacted by the strain of caregiving.

Method: Data was analyzed from the Black Rural and Urban Caregivers Mental Health and Functioning Study, a cross-sectional study of 521 African American female caregivers from mid-western urban and rural communities age 65 years and older. Separate logistic regression models were conducted for mammograms, clinical examinations, and self-examinations to assess the relative influence of variables on caregivers' breast health behavior.

Results: Care recipients' cancer diagnosis (OR=0.45), having a regular doctor checkup (OR=13.07), and living in rural areas (OR=0.57) significantly predict caregivers' mammography attainment. Having more than a high school degree (OR=2.08) and a regular doctor checkup (OR=27.21) are significantly associated with greater likelihood of receiving a clinical examination. Perceived strain (OR=1.04), social support (OR=0.55), and living in rural areas (OR=1.77) significantly predict performing self-examination.

Conclusions and Implications: This study offers baseline knowledge on African American female caregivers' breast health behavior. Results imply that increasing accessibility of regular doctor checkups will contribute to raising the completion rates of mammograms and clinical examinations. Targeting African American caregivers who do not receive a regular doctor checkup and informing them of the importance of receiving a breast cancer screening is crucial. Findings also indicate that rural caregivers are less likely to obtain a mammogram and more likely to depend on a self-examination. Having resources available, encouraging caregivers to get a mammogram and clinical examination, and directing public education toward caregivers are important points of intervention.