Open Access Study protocol

An assessment of American Indian women's mammography experiences

Kimberly K Engelman12*, Christine M Daley123, Byron J Gajewski24, Florence Ndikum-Moffor1, Babalola Faseru123, Stacy Braiuca13, Stephanie Joseph13, Edward F Ellerbeck125 and K Allen Greiner1236

Author Affiliations

1 Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, USA

2 University of Kansas Cancer Center, Kansas City, KS, USA

3 Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS, USA

4 Department of Biostatistics & Informatics, University of Kansas Medical Center Kansas City, KS, USA

5 Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA

6 Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, USA

For all author emails, please log on.

BMC Women's Health 2010, 10:34  doi:10.1186/1472-6874-10-34

Published: 15 December 2010



Mortality from breast cancer has increased among American Indian/Alaskan Native (AI/AN) women. Despite this alarming reality, AI/AN women have some of the lowest breast cancer screening rates. Only 37% of eligible AI/AN women report a mammogram within the last year and 52% report a mammogram within the last two years compared to 57% and 72% for White women. The experiences and satisfaction surrounding mammography for AI/AN women likely are different from that of women of other racial/ethnic groups, due to cultural differences and limited access to Indian Health Service sponsored mammography units. The overall goals of this study are to identify and understand the mammography experiences and experiential elements that relate to satisfaction or dissatisfaction with mammography services in an AI/AN population and to develop a culturally-tailored AI/AN mammography satisfaction survey.

Methods and Design

The three project aims that will be used to guide this work are: 1) To compare the mammography experiences and satisfaction with mammography services of Native American/Alaska Native women with that of Non-Hispanic White, Hispanic, and Black women, 2) To develop and validate the psychometric properties of an American Indian Mammography Survey, and 3) To assess variation among AI/AN women's assessments of their mammography experiences and mammography service satisfaction. Evaluations of racial/ethnic differences in mammography patient satisfaction have received little study, particularly among AI/AN women. As such, qualitative study is uniquely suited for an initial examination of their experiences because it will allow for a rich and in-depth identification and exploration of satisfaction elements.


This formative research is an essential step in the development of a validated and culturally tailored AI/AN mammography satisfaction assessment. Results from this project will provide a springboard from which a maximally effective breast cancer screening program to benefit AI/AN population will be developed and tested in an effort to alter the current breast cancer-related morbidity and mortality trajectory among AI/AN women.