Original article Perceptions of the Screening Mammography Experience by Hispanic and Non-Hispanic White Women Kimberly K. Engelman, PhD a,b, * , Amy M. Cizik, MPH c,d , Edward F. Ellerbeck, MD, MPH a,b,e , Veronica F. Rempusheski, RN, PhD, FAAN f a Department of Preventive Medicine and Public Health, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas b University of Kansas Cancer Center, Kansas City, Kansas c Department of Orthopaedics and Sports Medicine, School of Medicine, University of Washington, Seattle, Washington d Pharmaceutical Outcomes Research and Policy Program, Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, Washington e Department of Internal Medicine, School of Medicine, University of Kansas, Kansas City, Kansas f School of Nursing, University of Delaware, Newark, Delaware Article history: Received 10 February 2011; Received in revised form 23 April 2012; Accepted 24 April 2012 abstract Purpose: To uncover perceptive differences in mammography experiences (from scheduling the mammography appointment to receipt and reporting of mammography results) between women from two different racial/ethnic groups. Methods: Focus groups (n ¼ 9) were conducted with Hispanic, and non-Hispanic White women (n ¼ 88) who were aged 40 years or older and had a mammogram within the preceding 36 months. We used a qualitative ethnographic approach with content analysis to identify key categories present in the transcripts and domain analysis to discover domains of meaning. A matrix was designed to determine which domains differed by racial/ethnic group. The primary mammography-related topics of focus group discussion included 1) the scheduling process, 2) the day of the mammogram, 3) receipt of results, and 4) recommendations to improve the mammography process. Main Findings: Six domains uniquely described issues women of the differing racial/ethnic groups experience and perceive as important. Hispanic women highlighted embarrassment surrounding the examination and fear of negative news about their mammography results. Non-Hispanic White women focused on instructions given before or during the examination as a critical process feature. Conclusions: Perceptions of the mammography experience vary by race/ethnicity. Mammography experiences might be improved through enhanced sensitivity of healthcare personnel to cultural differences in perceptions of mammogram testing. Future research to investigate the extent to which the domains of meanings uncovered in this study influence a women’s decision to return for routine mammograms would be of great value. Copyright Ó 2012 by the Jacobs Institute of Women’s Health. Published by Elsevier Inc. Background Minority populations suffer disproportionately from breast cancer. A poignant example of this can be found in breast cancer incidence and death rates. African-American women are more likely than White and other minority women (e.g., Asian Amer- ican, African American, and Hispanic/Latina) to die from breast cancer (American Cancer Society, 2007). Although Hispanic women are less likely to be diagnosed with breast cancer than non-Hispanic White women, they are more likely to receive later stage diagnoses (American Cancer Society, 2003). A critical factor in this morbidity and mortality from breast cancer may be disparities in breast cancer prevention and early diagnosis of malignancies. Whereas 68.4% of non-Hispanic White women over the age of 40 have had a mammogram in the past 2 years, only 58.8% of Hispanic women report having had a mammogram (National Center for Health Statistics, 2007). Previous research has uncovered a variety of reasons why women of different races or ethnicities either are or are not compliant with routine mammography screening practices. Such barriers include socioeconomic-related issues, including lack of insurance, income, or education (Otero-Sabogal et al., 2004; Supported by American Cancer Society Research Scholars Grant No. CCE- 103763 awarded to Kimberly Engelman. * Correspondence to: Kimberly K. Engelman, PhD, University of Kansas Medical Center, School of Medicine, Department of Preventive Medicine and Public Health, MSN 1056, Kansas City, KS, 66160. Phone: (913) 588-7246; fax: (913) 588-2780. E-mail address: kengelma@kumc.edu (K.K. Engelman). www.whijournal.com 1049-3867/$ - see front matter Copyright Ó 2012 by the Jacobs Institute of Women’s Health. Published by Elsevier Inc. doi:10.1016/j.whi.2012.04.006 Women's Health Issues 22-4 (2012) e395–e401