Date of Award


Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)



First Advisor

Jacqueline Fawcett

Second Advisor

Ling Shi

Third Advisor

Suha Ballout


Aim: This Newman System Model-guided health policy study aimed to examine the associations of modesty, acculturation, and breast cancer knowledge, controlling for demographic factors (age, educational level, family history of breast cancer, length of stay in the U.S. and the use of Arabic language when answering the survey), with breast cancer screening (mammography) of Arab Muslim women living in the New England Area aged 40 years and older within the context of the 2015 American Cancer Society screening guidelines and the 2018 reported Healthy People 2020 rates. Study Design: A community-based self-administered survey of 136 Arab Muslim women was applied to collect data using a Background Data Sheet for demographics, the Vancouver Index of Acculturation to measure acculturation, the Islamic Modesty Scale to measure modesty, and the Breast Cancer Knowledge Test (BCKt) to measure breast cancer knowledge with ever having had a mammogram. Results: A total of 118 surveys was analyzed. The median age of participants was 48.9 years. Of these respondents, 60.2% reported using mammography within the past two years. This compared to 65.3% among a representative sample of the U.S population reported in 2015 in the National Health Interview Survey (National Center for Health Statistics, 2016). However, among participants 50 years and older, the screening rates was 56.8%, statistically significantly lower than that of 71.2% in the general US population. In the multivariate analysis revealed that modesty was negatively associated with having had a mammogram. Acculturation and breast cancer knowledge were not significantly associated with mammography screening after controlling for demographics.


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