{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:45:59Z","timestamp":1777916759149,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Most U.S. states require written notification of breast density after mammograms, yet effects of notifications on knowledge are mixed. Little is known about potential misunderstandings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We used a sequential mixed-methods study design to assess women's knowledge about breast density, after receiving a notification. We conducted a telephone survey among a racially\/ethnically and health-literacy level diverse sample (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u2009754) and qualitative interviews with 61 survey respondents.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In survey results, 58% of women correctly indicated that breast density is not related to touch, with higher accuracy among non-Hispanic White women and those with greater health literacy. Next, 87% of women recognized that breast density is identified visually\n                      <jats:italic toggle=\"yes\">via<\/jats:italic>\n                      mammogram, with no significant differences in responses by race\/ethnicity or health literacy. Most (81%) women recognized that a relationship exists between breast tissue types and density; Non-Hispanic White women were less likely to respond correctly. Only 47% of women correctly indicated that having dense breasts increases one's risk of breast cancer; women with low health literacy were more often correct. Qualitative results revealed additional dimensions of understanding: Some women incorrectly reported that density could be felt, or dense breasts were lumpier, thicker, or more compacted; others identified \u201cdense\u201d tissue as fatty. Interpretations of risk included that breast density was an early form of breast cancer.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We found areas of consistent knowledge and identified misperceptions surrounding breast density across race\/ethnicity and health literacy levels. Further education to address disparities and correct misunderstandings is essential to promote better knowledge, to foster informed decisions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jwh.2021.0343","type":"journal-article","created":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T11:44:39Z","timestamp":1646135079000},"page":"983-990","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Women's Understandings and Misunderstandings of Breast Density and Related Concepts: A Mixed Methods Study"],"prefix":"10.1177","volume":"31","author":[{"given":"Nancy R.","family":"Kressin","sequence":"first","affiliation":[{"name":"Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jolie B.","family":"Wormwood","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of New Hampshire, Durham, New Hampshire, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy A.","family":"Battaglia","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariel D.","family":"Maschke","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priscilla J.","family":"Slanetz","sequence":"additional","affiliation":[{"name":"Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Pankowska","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine M.","family":"Gunn","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA."},{"name":"Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts, USA."},{"name":"The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,7,12]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-8-201110180-00005"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-156-9-201205010-00006"},{"key":"e_1_3_5_4_2","unstructured":"DenseBreast-Info.org. DenseBreast-Info.org. 2021. Available at https:\/\/densebreast-info.org Accessed June22 2021."},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-05708-2"},{"key":"e_1_3_5_6_2","unstructured":"U.S. Food and Drug Administration. Mammography Quality Standards Act. 2019. Available at https:\/\/www.federalregister.gov\/documents\/2019\/03\/28\/2019-05803\/mammography-quality-standards-act Accessed July27 2020."},{"key":"e_1_3_5_7_2","doi-asserted-by":"crossref","unstructured":"Becker M. The health belief model and personal health behavior. Thorofare: CB Slack 1974.","DOI":"10.1177\/109019817400200407"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.2307\/3348967"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2018.01.017"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-018-4709-y"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-019-05578-3"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2020.11.012"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.57.0325"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2296-7-21"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.NNR.0000313482.33917.7d"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2019.11.003"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-06213-2"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/23814683211033249"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djab016"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-019-05590-7"},{"key":"e_1_3_5_21_2","first-page":"43","article-title":"Breast density legislation. Implications for patients and primary care providers","volume":"97","author":"Rhodes D","year":"2014","unstructured":"Rhodes D, , Conners A. Breast density legislation. Implications for patients and primary care providers. Minnesota Med, 2014; 97:43\u201348.","journal-title":"Minnesota Med"},{"key":"e_1_3_5_22_2","unstructured":"Equity FOoMHaH. FDA Office of Minority Health and Health Equity 2021. Available at https:\/\/www.fda.gov\/about-fda\/office-commissioner\/office-minority-health-and-health-equity Accessed June22 2021."}],"container-title":["Journal of Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/jwh.2021.0343","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jwh.2021.0343","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jwh.2021.0343","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:55:55Z","timestamp":1777658155000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/jwh.2021.0343"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":21,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1089\/jwh.2021.0343"],"URL":"https:\/\/doi.org\/10.1089\/jwh.2021.0343","relation":{},"ISSN":["1540-9996","1931-843X"],"issn-type":[{"value":"1540-9996","type":"print"},{"value":"1931-843X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7]]}}}