INTRODUCTION: African-American women experience disparities in breast cancer mortality and are often diagnosed at later stages of disease resulting in poorer health outcomes. This study aims to explore the relationship of co-morbid conditions and breast cancer mammography intention. METHODS: Cross-sectional surveys and cognitive interviews were employed to test the psychometric properties of the Illness Perspectives scale, developed to describe affective mood or attitudes towards chronic illness burden, and determine participant mammography attitudes, knowledge and intention. Univariate, Bivariate, and multivariate linear regression were employed to assess predictors for mammography intention. RESULTS: Overall 242 respondents completed surveys with 149 surveys included in psychometric analyses and 201 in multivariate analyses. The Illness Perspectives scale was reliable instrument with two factors, Illness in the Foreground (=.83) and Illness in the Background (=.78). In multivariate analyses, having higher educational attainment (Some college or higher) (=.826-1.055, p=.000) and having a more positive attitude towards mammography (Decisional Balance) (=.296, p=.001) were statistically significant factors amongst women with higher mammography intention. CONCLUSION: The Illness Perspectives Scale is a reliable tool to assess African American womens current attitudes towards chronic disease. Decisional balance and participant demographics, particularly education, can be used to predict mammography intention to tailor health education efforts.