) The specific aim of the proposed research is to better understand how Hispanics over 65, living near the poverty level, make decisions about using breast-cancer screening services, thereby in the long run, providing a stronger base for determining public policies that expand the participation of women in this underserved group. Current literature suggests that nonuse by this population is affected by more than standard factors such as cost and availability. Understanding what the breast cancer screening decision factors are and how they singly and in combination affect utilization decisions is paramount to deciding how to influence nonusers to participate. In an excursion from standard statistical techniques, this research will apply modern psychological measurement methods (advancements to traditional Conjoint and Functional Measurement). Judgment experiments will be constructed that allow tests of how Hispanic women value and trade-off hypothesized factors (e.g., cost, gender and ethnicity of service provider) in their utilization decisions. Respondent's values are obtained from an algebraic decision making model (e.g., utility theory, multiplicative model) that passes its tests in accounting for respondent's data where alternative models have failed. The model may be used to predict utilization frequencies under a range of policies that affect the decision factors. This notion of basing respondent's values and decision process on hypothesis testing is new to cancer research although it is used extensively in other research areas. To address the question of who values what, respondent's survey data on sociodemographics, attitudes towards breast cancer screening, and life style, will be used in innovative multivariate factor analyses that include respondent's factor values obtained from the judgment experiment. This research would provide a better understanding of what factors affect breast cancer screening decisions by Hispanic women and a model for investigating the effects of different policies on those decisions; further, it would introduce a new research method for examining similar decisions associated with breast cancer (e.g., treatments). Both would be valuable long term contributions.
