Date of Award


Document Type


Degree Name

Doctor of Nursing Practice (DNP)




Dr. Patricia Keane

First Committee Member

Dr. Eva Fried

Second Committee Member

Dr. Julianne Krebs


Screening mammography, Rural health, Rural health barriers, Barriers to mammography, Rural women

Subject Categories

Medicine and Health Sciences


Rural residents at all income levels are significantly less likely than urban residents to participate in cancer screenings. Furthermore, rural women face common significant barriers to mammography, including: knowledge deficit, lack of primary care provider, no health insurance, fear, decreased access, transportation issues and financial constraints. The purpose of this project is to investigate factors influencing participation in screening mammography among rural women in Adams and Highland counties. Both of these Southern Ohio counties have lower than average rates of screening mammography. For this project, a non-experimental, cross-sectional design was utilized. Data was collected using a survey, based on the revised Champions Health Belief Model Scale. One hundred women voluntarily signed consent and participated in the survey, ninety of the women met the inclusion criteria. Quantitative data analysis was performed, as well as qualitative inquiry on the open-ended questions. A two proportions test found with statistical significance that women who have a primary care provider are more likely to participate in screening mammography than women without a primary care provider. It was also found that the majority of rural women surveyed, unless there is a positive family history of breast cancer, do not view themselves as susceptible to breast cancer. The qualitative data provided valuable insight regarding the attitude of rural women towards participation in screening mammography. “Time constraints” was the most common reason given for not having a mammogram in the past 12 months. A “reminder card” is what the participants believed made it easy for them to get a mammogram regularly. Consistent with the literature, the findings reiterate the importance of the role of the primary care provider in health promotion among rural women.



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