Satisfaction with health care and cancer screening practices among women in a largely rural region of West Texas

Background. Satisfaction with medical care has been shown to influence patient behavior, but its effect on the use of preventive services is largely unstudied. This study examined whether women's satisfaction with the accessibility and quality of care was associated with the odds of receiving an annual clinical breast examination, conducting a monthly self-breast examination, or receiving an annual Pap smear. Methods. A telephone survey was conducted among 675 women in West Texas, an area with a relatively high proportion of rural residents and Hispanics. Multiple logistic regression analyses were performed to model the odds of each screening practice. Results. Women who rated the overall quality of their health care as excellent had a higher odds of receiving an annual clinical breast examination, conducting a monthly self-breast examination, and receiving an annual Pap smear. No rural/urban differences were revealed, but Hispanic women had a lower odds of conducting a self-breast examination than non-Hispanic Whites. Conclusions. Rural residence and Hispanic ethnicity were largely unassociated with cancer screening practices. Rather than directing outreach programs toward these subgroups, efforts to increase cancer screening among women may need to focus more on improving the quality of primary health care. (C) 2003 American Health Foundation and Elsevier Science (USA). All rights reserved.