Deconstructing the Monolith: Differences in Attitudes About Mammography Among Low-Income African American Women

The purpose of this study was to explore how health beliefs may vary within a minority group. In this mixed-method study, 63 low-income African American women engaged in six focus groups discussing beliefs that inhibited or facilitated mammography. Differences in cognitive complexity, self-efficacy, and attributions of causality occurred across neighborhoods despite the geographic proximity and demographic similarity. The attitude change that occurred during the discussion suggested ways to construct effective health interventions. The data suggest (a) that women were similarly knowledgeable about mammography and cancer, (b) knowledge did not correspond with attitudes, (c) attitudes must be addressed before knowledge can be utilized, (d) attitudes are developed and maintained within neighborhood social networks and that stories maintain these attitudes, (e) increasing the discussion among peers should lead to greater attitude change and discussion leads to increased thought, and (f) motivation and follow through are connected to women's roles within their communities.