Date of Conferral



Doctor of Public Health (DrPH)


Public Health


Jacqueline Fraser


In 2009, 713,220 new cases of cancer were diagnosed for women in the United States with more than a quarter million deaths. African American women and lesbians exhibit behavioral risk factors as well as diminished access to and utilization of breast cancer screening that reduces opportunities for early detection. This secondary analysis of a national convenience-based study examined screening compliance among 647 African American lesbian and bisexual women. Barriers to accessing screening represented the theoretical framework for this study. Bivariate chi square analysis was used to assess the association between independent variables: sociodemographic characteristics; participation in wellness activities; sexual orientation/gender identity; and experience with health care providers and the three dependent breast cancer screening compliance variables: breast self-examination (BSE), clinical breast examination (CBE), and mammography screening. Statistically significant associations between dependent and independent variables at the .05 level were further analyzed with logistic regression. Results of the ten regression models found that BSE was predicted by socioeconomic characteristics and participation in wellness activities. Compliance with CBE guidelines was predicted by sociodemographic characteristics, wellness activities, sexual orientation/gender identity and provider experience. Sociodemographic variables and provider experience also predicted mammography screening. Overall compliance was predicted by sociodemographic characteristics, namely insurance status. The social change implications of this research are an improved understanding of African American lesbian and bisexual women's screening behavior and guidance toward interventions that can improve and breast cancer screening compliance with guidelines.