{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T04:41:04Z","timestamp":1782535264693,"version":"3.54.5"},"reference-count":44,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2011,8,19]],"date-time":"2011-08-19T00:00:00Z","timestamp":1313712000000},"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":["Health Educ Behav"],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:p>Understanding factors that promote or prevent adherence to recommended health behaviors is essential for developing effective health programs, particularly among lower income populations who carry a disproportionate burden of disease. We conducted in-depth qualitative interviews ( n = 64) with low-income Black and Latina women who shared the experience of requiring diagnostic follow-up after having a screening mammography with abnormal findings. We found that in addition to holding negative and fatalistic cancer-related beliefs, the social context of these women was largely defined by multiple challenges and major life stressors, factors that may interfere with their ability to attain health. Factors commonly mentioned included competing health issues, economic hardship, demanding caretaking responsibilities and relationships, insurance-related challenges, distrust of health care providers, and inflexible work policies. Black women also reported discrimination and medical mistrust, whereas Latinas experienced difficulties associated with immigration and social isolation. These results suggest that effective health interventions not only address change among individuals but must also change health care systems and social policies in order to reduce health disparities.<\/jats:p>","DOI":"10.1177\/1090198110382502","type":"journal-article","created":{"date-parts":[[2011,8,22]],"date-time":"2011-08-22T17:22:40Z","timestamp":1314033760000},"page":"471-481","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":73,"title":["An Investigation Into the Social Context of Low-Income, Urban Black and Latina Women"],"prefix":"10.1177","volume":"38","author":[{"given":"Rachel C.","family":"Shelton","sequence":"first","affiliation":[{"name":"Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University and Mount Sinai School of Medicine, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta E.","family":"Goldman","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Warren Alpert Medical School at Brown University, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen M.","family":"Emmons","sequence":"additional","affiliation":[{"name":"Department of Society, Human Development and Health, Harvard School of Public Health and Dana-Farber Cancer Institute, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glorian","family":"Sorensen","sequence":"additional","affiliation":[{"name":"Department of Society, Human Development and Health, Harvard School of Public Health and Dana-Farber Cancer Institute, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer D.","family":"Allen","sequence":"additional","affiliation":[{"name":"Harvard Medical School and Dana-Farber Cancer Institute, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2011,8,19]]},"reference":[{"key":"bibr1-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2008.03.024"},{"key":"bibr2-1090198110382502","volume-title":"Cancer facts & figures 2008","author":"American Cancer Society","year":"2008"},{"key":"bibr3-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1188\/06.ONF.E62-E70"},{"key":"bibr4-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2003.20532.x"},{"key":"bibr5-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20506"},{"issue":"2","key":"bibr6-1090198110382502","first-page":"359","volume":"109","author":"Battaglia T. A.","year":"2006","journal-title":"Cancer"},{"key":"bibr7-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.05.4734"},{"key":"bibr8-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1093\/phr\/118.4.358"},{"issue":"473","key":"bibr9-1090198110382502","first-page":"967","volume":"51","author":"Burgess C.","year":"2001","journal-title":"British Journal of General Practice"},{"key":"bibr10-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-3737.2000.01208.x"},{"key":"bibr11-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.6.583"},{"key":"bibr12-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.21.2458"},{"key":"bibr13-1090198110382502","volume-title":"Doing qualitative research","author":"Crabtree F.","year":"1999","edition":"2"},{"key":"bibr14-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(99)00105-1"},{"key":"bibr15-1090198110382502","volume-title":"Feeding the family: The social organization of caring as gendered work","author":"DeVault M. L.","year":"1991"},{"key":"bibr16-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(02)00058-8"},{"key":"bibr17-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21214"},{"key":"bibr18-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2006.08.001"},{"key":"bibr19-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780195083316.003.0011"},{"key":"bibr20-1090198110382502","first-page":"2","volume":"10","author":"Enn C.","year":"1997","journal-title":"Family Economics and Nutrition Review"},{"key":"bibr21-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-007-9228-9"},{"key":"bibr22-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1111\/j.1547-5069.2006.00110.x"},{"key":"bibr23-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(18)30664-0"},{"key":"bibr24-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1177\/1090198103254393"},{"key":"bibr25-1090198110382502","first-page":"81","volume-title":"Promoting health: Intervention strategies from social and behavioral research","author":"House J. S.","year":"2000"},{"key":"bibr26-1090198110382502","volume-title":"The unequal burden of cancer","author":"Institute of Medicine","year":"1999"},{"key":"bibr27-1090198110382502","volume-title":"Unequal treatment: Confronting racial and ethnic disparities in health care","author":"Institute of Medicine","year":"2003"},{"key":"bibr28-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1093\/her\/16.2.121"},{"key":"bibr29-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1001\/jama.279.21.1703"},{"key":"bibr30-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1177\/1077558700057001S07"},{"key":"bibr31-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(93)90202-F"},{"key":"bibr32-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1177\/109019818801500401"},{"key":"bibr33-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1037\/0278-6133.23.6.582"},{"key":"bibr34-1090198110382502","volume-title":"NVivo qualitative data analysis program","author":"QSR International Pty Ltd","year":"2000"},{"key":"bibr35-1090198110382502","volume-title":"Qualitative research methods: A health focus","author":"Rice P. L.","year":"1999"},{"key":"bibr36-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1177\/0898264308321023"},{"key":"bibr37-1090198110382502","first-page":"462","volume-title":"Health behavior and health education: Theory, research, and practice","author":"Sallis J. F.","year":"2002","edition":"3"},{"key":"bibr38-1090198110382502","first-page":"563","volume":"92","author":"Shavers V. L.","year":"2000","journal-title":"Journal of National Medical Association"},{"key":"bibr39-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-7435(03)00111-7"},{"key":"bibr40-1090198110382502","volume-title":"Physical activity and health: A report of the surgeon general","author":"U.S. Department of Health and Human Services","year":"1996"},{"key":"bibr41-1090198110382502","volume-title":"Healthy People 2010: Understanding and improving health and objectives for health","author":"U.S. Department of Health and Human Services","year":"2000","edition":"2"},{"key":"bibr42-1090198110382502","volume-title":"Healthy People 2010: Understanding and improving health","author":"U.S. Department of Health and Human Services","year":"2001"},{"key":"bibr43-1090198110382502","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.92.4.588"},{"key":"bibr44-1090198110382502","doi-asserted-by":"publisher","DOI":"10.1097\/01.PHH.0000338382.36695.42"}],"container-title":["Health Education &amp; Behavior"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1090198110382502","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1090198110382502","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1090198110382502","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:33:51Z","timestamp":1777448031000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1090198110382502"}},"subtitle":["Implications for Adherence to Recommended Health Behaviors"],"short-title":[],"issued":{"date-parts":[[2011,8,19]]},"references-count":44,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2011,10]]}},"alternative-id":["10.1177\/1090198110382502"],"URL":"https:\/\/doi.org\/10.1177\/1090198110382502","relation":{},"ISSN":["1090-1981","1552-6127"],"issn-type":[{"value":"1090-1981","type":"print"},{"value":"1552-6127","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,8,19]]}}}