A critical review of theory in breast cancer screening promotion across cultures

• Published in: Annual review of public health Vol. 29; p. 351
• Main Authors: Pasick, Rena J, Burke, Nancy J
• Format: Journal Article
• Language: English
• Published: United States 01.01.2008
• Subjects: Breast Neoplasms - diagnosis; Breast Neoplasms - ethnology; Breast Neoplasms - prevention & control; Cultural Competency; Female; Health Knowledge, Attitudes, Practice; Health Promotion - methods; Health Promotion - standards; Health Services Accessibility; Health Status Disparities; Healthcare Disparities; Humans; Mammography; Mass Screening - methods; Qualitative Research; Socioeconomic Factors
• ISSN: 0163-7525
• DOI: 10.1146/annurev.publhealth.29.020907.143420

This article reviews the contribution and potential of widely used health behavior theories in research designed to understand and redress the disproportionate burden of breast cancer borne by diverse race/ethnic, immigrant, and low-income groups associated with unequal use of mammography. We review the strengths and limitations of widely used theories and the extent to which theory contributes to the understanding of screening disparities and informs effective intervention. The dominant focus of most theories on individual cognition is critically assessed as the abstraction of behavior from its social context. Proposed alternatives emphasize multilevel ecological approaches and the use of anthropologic theory and methods for more culturally grounded understandings of screening behavior. Common and alternative treatments of fatalism exemplify this approach, and descriptive and intervention research exemplars further highlight the integration of screening behavior and sociocultural context.