Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Mary Jo Clark, PhD, RN, Chairperson; Kathy Shadle James, DNSc, RN; Barbara Sarter, PhD, RN


Breast health, elderly, Gerontology, Mammography, nursing


Age-related health disparities in breast cancer screening are a public health concern. From 2002 to 2006, the median age for newly diagnosed cases of breast cancer was 61 years and the median age for breast cancer mortality was 68 years of age (Surveillance Epidemiology and End Results [SEER], 2009). Mammography is the best available screening tool for breast cancer detection (Susan G. Komen Foundation, 2008). The Centers for Medicare and Medicaid Services (CMS, 2006) reported that only about half of older women who are eligible for mammograms through Medicare obtain a mammogram every two years. The literature identifies psychosocial barriers, including a lack of breast cancer knowledge and cancer fatalism, as independent predictors of mammography participation among older women. The purpose of this quasi-experimental study was to determine the effects of a breast health awareness program on older women's knowledge of and fatalistic attitudes toward breast cancer and breast cancer screening and on their participation in mammography screening. Sixty women over 65 years of age will be recruited from 4 senior nutrition programs located in underserved areas of San Diego County to participate in a breast health awareness program. Data will be collected using a demographic questionnaire, pre and postintervention revised Powe Fatalism Inventory, and a breast health knowledge questionnaire. Descriptive statistics will be used to analyze the relationship of fatalism to breast cancer knowledge and the relationships of knowledge and fatalism to mammography participation. The potential impact of the intervention will lie in earlier diagnosis of breast cancer disease in older women through improved screening participation, resulting in decreased breast cancer mortality among older women in San Diego County.

Document Type

Dissertation: Open Access



Included in

Nursing Commons