Identifying Barriers and Decision Making for Breast Cancer Screening Among Black Caribbean Women by Using Clustering and Cart Methods - Abstract
Breast cancer is the most common form of cancer among women worldwide. Mammography is the only viable and effective, most used method for breast cancer screening, with recommendations being updated based on newly acquired knowledge. It is well-documented that Black women have higher incidence rates of breast cancer and are more likely to be diagnosed with late stage of the disease and worse health outcomes. Black Caribbean women especially have even more late-stage diagnoses and higher mortality rates. The purpose of this study is to identify barriers to breast cancer screening and the decision-making patterns in health-seeking behaviors among Black Caribbean women living in South Florida and using the identified needs to recommend possible solutions to address their needs. Using secondary data from a cross-sectional survey, descriptive analyses were performed, followed by Dendrograms for identifying cluster of barriers and Classification and Regression Trees for exploring the women’s decision-making process for screening. Five clusters were identified amongst the 124 self-identified Black Caribbean women: Healthcare and Cultural Beliefs, Barriers, Healthcare Seeking, Age, and Geographical Location. The Classification and Regression Trees recognized decision making in healthcare seeking practice indicating physician’s recommendations, and age as the main influencers for screening adherence. There is a need to increase awareness and knowledge about breast cancer screenings and overall female reproductive health and develop an appropriate, culturally sensitive screening programs to address these needs.