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Socioecological determinants of mammography screening in Mexican rural areas

Ana Paola Sanchez-Lezama (Pathogen Molecular Biology, London School of Hygiene and Tropical Medicine - LSHTM, London, UK)
Judith Cavazos-Arroyo (Department of Marketing, Universidad Popular Autonoma del Estado de Puebla, Puebla, Mexico)
Cidronio Albavera-Hernández (Hospital General Regional, Instituto Mexicano del Seguro Social, Morelos, Mexico)
Aarón Salinas-Rodríguez (Center for Evaluation and Surveys Research, National Institute of Public Health)
Mario Lagunes-Pérez (CIP, Universidad Popular Autonoma del Estado de Puebla, Puebla, Mexico)
Beatriz Perez-Armendariz (CIP, Universidad Popular Autonoma del Estado de Puebla, Puebla, Mexico)

International Journal of Pharmaceutical and Healthcare Marketing

ISSN: 1750-6123

Article publication date: 7 September 2015




The purpose of this paper is to determine which socioecological factors encourage rural women to participate in mammographies rather than avoiding taking the test.


The study mainly uses data from the 2007 Rural Households Evaluation Survey (ENCEL-2007). These crossover data are analyzed using the framework proposed in the Spatial-Interaction Model of Mammography Use (SIMMU), through a three-level logistic regression model to examine the likelihood that a woman will choose to participate in a mammography.


At the woman-household level, the completion of the Pap smear and the asset index is the strongest determinant of mammography participation. Obtaining preventive medicine services or being enrolled in the Popular Insurance System prevent women from undergoing screening. At the interpersonal level, the probability of screening use decreases with lower social coverage. At the intermediate level, availability of health centers is negatively related to the use of screening.

Research limitations/implications

The study fails to take into account the fact that women’s propensity to have a mammography may vary over time relatively to life changes. Moreover, findings were restricted to women ages from 40 to 49 and limited due to the lack of published data or data quality issues.

Practical implications

The results of this research can give health planners, policymakers and social marketers a platform for how to approach social change and promote the cancer screening health behavior through the marketing mix (price, place, promotion and product) in the design of their programs.


In addition to be informative and persuasive with people to change their behavior, this paper also seeks to provide a direction for using commercial marketing tools through social marketing to “sell” the health behavior. Due to target population variation, this paper addresses the health behavior change strategy by audience segmentation, regarded as essential to successful health communication campaigns.



Sanchez-Lezama, A.P., Cavazos-Arroyo, J., Albavera-Hernández, C., Salinas-Rodríguez, A., Lagunes-Pérez, M. and Perez-Armendariz, B. (2015), "Socioecological determinants of mammography screening in Mexican rural areas", International Journal of Pharmaceutical and Healthcare Marketing, Vol. 9 No. 3, pp. 237-258.



Emerald Group Publishing Limited

Copyright © 2015, Emerald Group Publishing Limited

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