Table. Results of Studies Examining Medically Underserved Women’s Participation in Mobile Mammography, United States, January 2010–March 2018.

Study Location	Underserved Group Targeted and Sample Size	Research Design	Screening Guideline and Recency of Screening	Adherence Rate	Study Purpose	Major Findings
Studies That Compared Mobile Sites With Fixed Sites
Chen et al, 2016 (12)
Santa Clara County, California: mobile mammography operated by nonprofit community health centers; fixed unit operated by county hospital	Uninsured or underinsured Latina, Asian, or African American women (n = 11). Non-Hispanic white women not included.	Mixed methods: focus groups and a demographic survey	Not reported	Not reported	Examine women’s perceptions of mobile mammography and fixed mammography	Women’s perceptions of mobile mammography: • Concerned about quality of images • Felt technologists were less meticulous at mobile sites than at fixed sites • Experienced better communication at mobile site (eg, notification of long wait times, telephone call reminders)
Fayanju et al, 2014 (13)
St. Louis and southeastern Missouri: mobile mammography operated by university hospital; fixed unit operated by academic medical center	Low-income African American and Hispanic women; non-Hispanic white women also included (n = 9,082).	Cross-sectional survey: 6-item questionnaire about women’s mammography experience	Not reported	Not reported	Investigate perceived barriers to use of screening mammograms	Three most commonly perceived barriers to screening mammography were • Fear of cost • Fear of mammogram-associated pain • Fear of getting bad news
						Fear of mammogram-related pain was more likely to be reported among • Women screened on van (OR, 1.63) than among women at fixed clinic sites • Black (OR, 1.32) and Hispanic (OR, 1.05) women than among non-Hispanic white women; and • Uninsured women than among insured women (OR, 1.39)
						Black (OR, 2.46) and Hispanic (OR, 2.98) women were also more likely to report fear of receiving bad news than were non-Hispanic white women.
Stanley et al, 2017 (14)
Charleston, South Carolina, and surrounding areas: mobile mammography unit operated by university hospital; fixed unit operated by academic medical center	Hispanic and African American women; non-Hispanic white and “other” racial/ethnic women also included (n = 1,433 at mobile site; n = 1,434 at fixed site).	Retrospective review of electronic medical records	Past 1 year	Mobile, 34.5%; fixed, 56.9%	Evaluate characteristics of women who use mobile vs fixed mammography	• Mobile site had a higher recall rate than fixed site (16% vs 13%) • Among patients with a BI-RADS category 0, mobile unit patients were more likely than fixed-clinic users to not adhere to follow-up (17.0% at mobile unit vs 2.6% at fixed site)
Vyas et al, 2013 (15)
West Virginia: mobile mammography unit operated by university hospital; fixed unit operated by university medical center	Low-income and/or uninsured Appalachian women; Appalachian women from other income groups and insured Appalachian women also included (n = 1,161 at mobile unit; n = 1,104 at fixed unit).	Cross-sectional survey: questionnaire consisting of personal health history, menstrual and pregnancy history, family history of cancer, cancer risk assessment and screening history, views on breast cancer screening, breast cancer awareness, preventive care and wellness history, nutrition and exercise history, dental, smoking and alcohol consumption history, and demographics	Past 2 years	Mobile, 48.2%; fixed, 92.3%	Compare characteristics of women who use mobile unit vs fixed mammography	Women using mobile unit, compared with women using the fixed unit, were • More likely to be obese (OR, 1.87), smoke (OR, 1.77), or not visit a doctor in the past year (OR, 1.38) • Less likely to report consuming alcohol (OR, 0.54) or having transportation barriers (OR, 0.50) • More likely to have lower adherence to other preventive screenings (OR, 1.60) and to have lower levels of perceived 5-year risk of developing breast cancer (OR, 0.48)
Studies Examining Mobile Mammography Sites Only
Brooks et al, 2013 (16)
Jefferson County, Kentucky: mobile mammography unit operated by private hospital	Uninsured African American and Hispanic women; non-Hispanic white women also included (n = 3,923).	Retrospective review of electronic medical records	Past 5 years	29%	Evaluate mammographic screening outcomes and their predictors	Women with abnormal mammograms (BI-RADS category 4,5, or 6) were more likely than women with normal mammograms (BI-RADS category 1, 2, or 3) to be • Aged <50 y (OR, 1.65) • Hispanic (OR, 1.87) • Uninsured (OR, 1.63) And less likely to report • Not smoking (OR, 0.65) • Not having a relative diagnosed with cancer before age 50 (OR, 0.64).
						Women with BI-RADS category 0 mammograms were less likely than women with BI-RADS category 1, 2, or 3 to • Have been screened within the past 5 years (OR, 0.64) • Be African American (OR, 0.68) And were more likely to not have a primary care physician (OR, 1.50)
Drake et al, 2015 (17)
St. Louis, Missouri: mobile mammography unit operated by university hospital	African American women; non-Hispanic white women also included (n = 8,450).	Secondary data analysis: mammography outreach registry with data on patient demographics and quality of mammography experience	Not reported	Not reported	Identify factors associated with repeat use of mobile mammography	Repeat visits were more likely to occur among women who were • Aged 50–65 (OR, 1.15) vs aged 40–50 • Uninsured (OR, 1.32) vs insured • African American (OR, 1.26) vs non-Hispanic white Repeat visits were less likely among women who were • Aged <40 (OR, 0.34) vs aged 40–50 • Unemployed (OR, 0.86) vs employed • Living in a rural area (OR, 0.49) vs suburban
LeMasters et al, 2014 (18)
West Virginia: mobile mammography operated by university hospital	Low-income or uninsured Appalachian women; Appalachian women from other income groups and insured Appalachian women also included (n = 1,182).	Cross-sectional survey: questionnaire on demographics, personal health history, menstrual and reproductive history, family history of cancer, breast cancer risk perceptions, breast cancer knowledge, perceived benefits and barriers to mammography, anxiety about developing breast cancer, clinical preventive care, health status, and health behavior/lifestyle	Past 1 year and 2 years	Past 1 year: 11.8%; past 2 years: 48.0%	Describe characteristics of women who responded “don’t know” when asked about their perceived 5-year risk of developing breast cancer	Women who responded “don't know” to their perceived 5-year breast cancer risk, compared with women who made an accurate or inaccurate response, • Were from lower-income families • Had less education • Were uninsured or had Medicare • Reported less knowledge about breast cancer
Mizuguchi et al, 2015 (19)
Jefferson County, Kentucky, and surrounding areas: mobile mammography operated by university hospital	Uninsured African American or Hispanic women; non-Hispanic white women and “other” racial/ethnic group also included (n = 21,857).	Retrospective chart review: electronic medical records and data from patient information history form	Not reported	Not reported	Assess repeat use of mobile mammography	• Most (54%) patients used mobile mammography only once. • African American and Hispanic women used mobile mammography at a disproportionately higher rate than non-Hispanic white women. • Uninsured women made up the largest percentage (43.1%) of mobile mammography users. • African American women (30.5%) and women with Medicare insurance (31.5%) had the highest frequency of ≥3 repeat screenings at the mobile clinic among all racial/ethnic groups studied (non-Hispanic white, Hispanic, other) and other insurance types (private, Medicaid, uninsured), respectively. • Hispanic women were least likely group to be repeat users
Roen et al, 2013 (20)
Reservations in North Dakota, South Dakota, Nebraska, and Iowa: mobile mammography operated by Indian Health Service	American Indian women only (n = 1,771).	Retrospective chart review of mammogram records	Past 2 years	40%	Determine adherence to screening mammography	• Women aged 41–49 were less likely (OR, 0.65) to have been adherent to screening mammogram guidelines compared with women aged 65 or older. • American Indian women using mobile mammography reported lower adherence (39.9%) than did American Indian women (59.8%), non-Hispanic white women (77.6%), and all ethnicities combined (74.3%) in the Breast Cancer Surveillance Consortium.
Vyas et al, 2012 (21)
West Virginia: mobile mammography operated by university hospital	Low-income, uninsured Appalachian women; Appalachian women from other income groups and insured Appalachian women also included (n = 686).	Cross-sectional survey: questionnaire on personal health history, menstrual and pregnancy history, family history of cancer, cancer risk assessment and screening history, views on breast cancer screening, breast cancer awareness, preventive care and wellness history, nutrition and exercise history, dental, smoking and alcohol consumption history, and demographics	Past 2 years	46%	Identify predictors of adherence in women who use mobile mammography	Women who were adherent were more likely to • Be older (OR, 3.88) • Be extremely or morbidly obese (OR, 1.93 and 2.36, respectively) • Have a family history of breast cancer (OR, 1.87) • Have a history of breast problems (OR, 1.90) • Have low knowledge of screening (OR, 2.17) And less likely to: • Be nonadherent to Papanicolaou (Pap) guidelines (OR, 0.16) • Have low rates of completion of other preventive screenings (OR, 0.52)

Abbreviations: BI-RADS, Breast Imaging Reporting and Data System; OR, odds ratio.