Increasing mammography practice by African American women.

PURPOSE This study examines the effectiveness of the Witness Project, a culturally competent cancer education program that trains cancer survivors to promote early detection and increased breast self-examination and mammography in a population of rural, underserved, African American women. DESCRIPTION OF STUDY The primary setting for the Witness Project-an intensive, community-based, culturally sensitive educational program that incorporates spirituality and faith-was the African American church. Baseline and 6-month follow-up surveys were obtained from 206 African American women in two intervention counties and from 204 African American women in two control counties in the rural Mississippi River Delta region of Arkansas. RESULTS Witness Project participants significantly increased (P <.0001) their practice of breast self-examination and mammography (P <.005) compared with the women in the control counties. CLINICAL IMPLICATIONS These results demonstrate that intensive, community-based, culturally sensitive educational programming incorporating the spiritual environment of the faith community, such as the Witness Project, can positively influence breast cancer screening behaviors among rural, underserved African American women. Through the use of community churches and cancer survivors, breast cancer screening activities can be improved in this population.

[1]  M. Dignan,et al.  Use of process evaluation to guide health education in Forsyth County's project to prevent cervical cancer. , 1991, Public health reports.

[2]  J. Skelly,et al.  Breast screening by African-American women: insights from a household survey and focus groups. , 1995, American journal of preventive medicine.

[3]  C. Burnett,et al.  Barriers to breast and cervical cancer screening in underserved women of the District of Columbia. , 1995, Oncology nursing forum.

[4]  Thorn Moore.  The African-American Church: A Source of Empowerment, Mutual Help, and Social Change , 1991 .

[5]  Claire I. Viadro,et al.  The North Carolina Breast Cancer Screening Program: foundations and design of a model for reaching older, minority, rural women , 1995, Breast cancer research and treatment.

[6]  J. Moormeier.  Breast Cancer in Black Women , 1996, Annals of Internal Medicine.

[7]  R. Mickey,et al.  Breast cancer screening and associated factors for low-income African-American women. , 1995, Preventive medicine.

[8]  P. Wingo,et al.  Cancer statistics for African Americans, 1996 , 1996, CA: a cancer journal for clinicians.

[9]  H. Toutenburg.  Fleiss, J. L.: Statistical Methods for Rates and Proportions. John Wiley & Sons, New York‐London‐Sydney‐Toronto 1973. XIII, 233 S. , 1974 .

[10]  R. Severson,et al.  Racial differences in survival of female breast cancer in the detroit metropolitan area , 1996, Cancer.

[11]  T. G. Freedman.  "Why don't they come to Pike Street and ask us"?: Black American women's health concerns. , 1998, Social science & medicine.

[12]  E. Long.  Breast cancer in African-American women. Review of the literature. , 1993, Cancer nursing.

[13]  D. Lane,et al.  The use of mammography vans by low-income women: the accuracy of self-reports. , 1994, American journal of public health.

[14]  D. Erwin,et al.  Increasing mammography and breast self-examination in African American women using the Witness Project model. , 2009, Journal of cancer education : the official journal of the American Association for Cancer Education.

[15]  K. Ferraro,et al.  Religion and Health among Black and White Adults: Examining Social Support and Consolation , 1994 .

[16]  C. Smart,et al.  Breast cancer detection guidelines for women aged 40 to 49 years: Rationale for the american cancer society reaffirmation of recommendations , 1994, CA: a cancer journal for clinicians.

[17]  S. Coughlin,et al.  Mammography Use Helps To Explain Differences in Breast Cancer Stage at Diagnosis between Older Black and White Women , 1998, Annals of Internal Medicine.

[18]  B. Rimer.  Interventions to increase breast screening: Lifespan and ethnicity issues , 1994, Cancer.

[19]  P. Romano,et al.  Cancer screening among African-American women: their use of tests and social support. , 1994, American journal of public health.

[20]  D. Erwin,et al.  Witnessing to Save Lives!! , 1996 .

[21]  M. Dignan,et al.  Development of a community cancer education program: the Forsyth County, NC cervical cancer prevention project. , 1989, Public health reports.

[22]  V. Vogel,et al.  Who uses screening mammography regularly? , 1995, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[23]  V. Strecher,et al.  Physicians' recommendations for mammography: do tailored messages make a difference? , 1994, American journal of public health.

[24]  P. Kornguth,et al.  Strategies to encourage mammography use among women in senior citizens' housing facilities. , 1998, Journal of cancer education : the official journal of the American Association for Cancer Education.

[25]  D. Lannin,et al.  Coming to terms with advanced breast cancer: black women's narratives from eastern North Carolina. , 1994, Social science & medicine.

[26]  S. Fox,et al.  The influence of ethnicity, socioeconomic status, and psychological barriers on use of mammography. , 1991, Journal of health and social behavior.

[27]  R. Lau,et al.  Refinements in the Measurement of Health-Specific Locus-of-Control Beliefs , 1981, Medical care.

[28]  D. Forte.  Community-based breast cancer intervention program for older African American women in beauty salons. , 1995, Public health reports.

[29]  D. Erwin,et al.  Development of an African-American role model intervention to increase breast self-examination and mammography. , 1992, Journal of cancer education : the official journal of the American Association for Cancer Education.

[30]  J. Phillips,et al.  Adherence to breast cancer screening guidelines among African‐American women of differing employment status , 1995, Cancer nursing.

[31]  A. Bartolucci,et al.  Breast cancer early detection: differences between African American and white women's health beliefs and detection practices. , 1995, Oncology nursing forum.

[32]  N. Urban,et al.  Mammography utilization, public health impact, and cost-effectiveness in the United States. , 1993, Annual review of public health.

[33]  J. Zapka,et al.  Mammography use among sociodemographically diverse women: the accuracy of self-report. , 1996, American journal of public health.

[34]  R. Curry,et al.  Explanatory models for cancer among African-American women at two Atlanta neighborhood health centers: the implications for a cancer screening program. , 1994, Social science & medicine.

[35]  J. Lemkau,et al.  Maximizing the referral of older women for screening mammography. , 1996, Archives of family medicine.