Table 1.

Themes from Focus Groups on Barriers to Mammography Appointment Adherence Related to Barriers from the Literature and Key Informant Interviews.

Overarching Theme	Supporting Quote	Supporting Quote
Barriers from the Research Literature	Similar Themes and Quotations from the Focus Groups	Similar Themes from the Key Informant Interviews
Fear of Outcome	Traumatizing fear of bad news “I just automatically think…it is cancer.” “I am thinking the worst… death is close.”	“She won’t get it done, maybe out of fear, rather not know because of worry. The worry after the diagnosis.”
Competing Demands	We always put others before ourselves “African American women take care of everyone else before ourselves.” “If young black African American women get bad news, it is devastating.”	“When you think of work, kids, you say, ‘Why inconvenience myself?” “There is a lot of extenuating circumstances in the community. She may casually say sign me up, but child care, job, time of day, and where the location is all play a part.”
Logistics including lack of insurance, cost and transportation	It all goes back to finances “A lot [of women] won’t think about it unless it’s free.” “…can’t afford to go to the doctor, because [the doctor will] slap a big bill on you.”	“Lack of transportation.” “Some say they don’t have time, running around, just don’t show up. Lack of time, so they don’t re-schedule.”
Fear of partner abandonment	Feel less than a woman “What man will accept me like this?” because “you have to worry if the boyfriend/significant other will like you.” “What kind of man would like me the way I look without breasts?” “What kind of man would like me the way I look without breasts?”	Not mentioned
Education	Nobody talks about it Referring to education: “it’s just not enough.” “My doctor told me, “If it don’t bother you, don’t bother it (referring to the breast).”	“Educate, encourage and empower women to see that it’s not a death sentence.” “Lack of knowledge “it’s not in my family.” People that I talk to on the street are under the influence that breast cancer is heredity.”
Fear of Pain	Painful smashing of the breast “The squeezing is very hard. Just smashing the breast to get behind [the machine] is painful.” “The second time I went back, she used a spatula, and another technician was with her, I was devastated to go back there…”	“Last mammogram she was too rough to me…just pounded my breast!” “I went one year, when it was painful too, and I told the doctor I wouldn’t go back to that center.”
Faith	It won’t touch me “I am not going to claim it;” “I rebuke it in the name of Jesus! Don’t speak or claim it.”	“Some can be cultural. Not going to get my body, ***touch it.” “Churches are a biggie, for African American women the church is everything.”