Rates of mammography screening are particularly low for minority women, with only 42% of Latin American (Latino) women in the U.S. reporting having a mammogram in the last year as compared to 53% of non-Latino White (Anglo) women [1]. Minority patients are more likely to report negative healthcare encounters with their health professionals [2; 3], which may result in less favorable cultural stereotypes about healthcare professionals and more negative emotional reactions. Guided by Betancourt’s Integrative Model of Culture, Psychological Processes, and Health Behavior [4] and the Stereotype Content Model [5], the aim of the present research was to examine the extent to which Latino (foreign born and US born) and Anglo American women’s stereotypes about health professionals influence negative screening emotions and mammography compliance. Multi-stage stratified sampling resulted in a sample of 104 Latino (64 foreign born, 40 U.S. born) and 113 Anglo women at least 40 years of age. Preacher and Hayes PROCESS Macro [6-8] for moderated mediation was employed to test the hypothesis that warm/cold and competent/incompetent stereotypes about health professionals would influence mammography compliance directly and/or indirectly through negative screening emotions. For foreign born Latino women, stereotypes did not influence screening emotions or mammography compliance. For U.S. born Latino women, cold, competent, and cold x competent stereotypes were associated with negative screening emotions. The interaction revealed that perceiving a health professional to be cold and incompetent resulted in higher levels of negative emotions, which in turn resulted in lower mammography compliance. For Anglo women, cold and cold x competent were associated with negative screening emotions. However, emotions were not in turn associated with mammography compliance. These findings illustrate the applicability of Betancourt’s Integrative Model of Culture and the Stereotype Content Model to the understanding of health behavior and patient-professional relations among culturally diverse populations

LLU Discipline

Clinical Psychology




School of Behavioral Health

First Advisor

Flynn, Patricia M.

Second Advisor

Betancourt, Hector M.

Third Advisor

Boyd, Kendal C.

Fourth Advisor

Herbozo, Sylvia M.

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Mammography; Mass Screening; Attitude of Health Personnel; Clinical Competence; Health Behavior - Ethnology; Emotions; Cultural Diversity; Needs Assessment; Stereotyping

Subject - Local

Mammography Screening; Latino Women; Negative Healthcare Encounters; Negative Screening Emotions; Mammography Compliance



Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives