Are Health-care Relationships Important for Mammography Adherence in Latinas?

Abstract

Background Latinas are the fastest growing racial ethnic group in the United States and have an incidence of breast cancer that is rising three times faster than that of non-Latino white women, yet their mammography use is lower than that of non-Latino women. Objectives We explored factors that predict satisfaction with health-care relationships and examined the effect of satisfaction with health-care relationships on mammography adherence in Latinas. Design and Setting We conducted a cross-sectional survey of 166 Latinas who were ≥40 years old. Women were recruited from Latino-serving clinics and a Latino health radio program. Measurements Mammography adherence was based on self-reported receipt of a mammogram within the past 2 years. The main independent variable was overall satisfaction with one’s health-care relationship. Other variables included: self report of patient-provider communication, level of trust in providers, primary language, country of origin, discrimination experiences, and perceptions of racism. Results Forty-three percent of women reported very high satisfaction in their health-care relationships. Women with high trust in providers and those who did not experience discrimination were more satisfied with their health-care relationships compared to women with lower trust and who experienced discrimination (p < .01). Satisfaction with the health-care relationship was, in turn, significantly associated with mammography adherence (OR: 3.34, 95% CI: 1.47–7.58), controlling for other factors. Conclusions Understanding the factors that impact Latinas’ mammography adherence may inform intervention strategies. Efforts to improve Latina’s satisfaction with physicians by building trust may lead to increased use of necessary mammography.