Importance of psychological variables in understanding risk perceptions and breast cancer screening of African American women.

African American women are less likely than white women to receive and perform adequate breast screening, and represent a group that has not been thoroughly researched in the area of breast cancer risk. In general, perceptions of risk and worry about cancer are both related to obtaining mammography and possibly other screening activities. We examine African American women's worry and beliefs about breast cancer, and their intentions to perform breast and genetic screening behaviors, using the self-regulatory model. Participants were recruited via media announcements; they completed questionnaires addressing several aspects of the self-regulatory model. Forty-one percent of participants were underestimators, 23% were overestimators, and 37% were extreme overestimators of their own personal risk for breast cancer. Several variables were significant predictors of willingness to undergo mammography and genetic screening, including ethnic identity, attitudes toward the physician, emotional distress, and risk overestimation. These data highlight the importance of psychological variables in understanding screening in African American women and hold promise for intervention design.