Mammography-Seeking Practices of Central Illinois Amish Women

Objective: To explore possible explanations for differences in mammography rates between Amish women in Arthur, Illinois, and other populations. Design: In this cross-sectional study, primary data were collected through a mail questionnaire focusing on breast cancer history, mammography-seeking practices, and beliefs surrounding breast health. Setting: Arthur is a small, rural community in central Illinois. Though most residents are Amish, the Arthur Amish community expands beyond the Arthur city limits into several other small, neighboring towns, including Arcola, Atwood, Humboldt, Lovington, Sullivan, and Tuscola, Illinois. Sample: Female members of the Arthur, Illinois, Amish community (N = 143), aged 40 to 70. Methods: Data were collected from this unique, socially isolated group through a mail questionnaire. Sample mammography adherence and rates of ever having a mammogram were compared with the general population and other U.S. Amish communities. Results: Logistic regression on the ever having a mammogram variable showed that compared to those who did not have knowledge of screening guidelines, Amish women with knowledge of screening guidelines had an odds ratio (OR) of 5.26 (confidence interval [CI] 1.79-15.45) for mammography screening compared to those without that knowledge. Participants who believed nutrition/diet causes breast cancer had an OR of 4.27 (CI 1.39-13.11) for mammography, and those who believed physical injury causes breast cancer had an OR of 3.86 (CI 1.24-12.04) compared to women who do not hold these beliefs. Conclusion/Implications for Nursing Practice: Pre-existing research and data from this study indicate that rates of mammography in Amish women and ideas about mammography lag far behind the rest of the U.S. population. Future research is needed to confirm these results and further explore the role of nurses in providing outreach and education to Amish women regarding the benefits of mammography and breast cancer risk.