Combined tailored interventions to increase mammography in African-American women

B27

Medically underserved African American women are at greatest risk for late stage breast cancer due to lack of consistent mammography screening. African American women may hold negative health beliefs about breast cancer and experience a variety of other barriers to screening. To decrease these obstacles, the purpose of this study was to develop and test an innovative tailored intervention to increase mammography screening in non-adherent African American women. We hypothesized that six months after intervention delivery, mammography adherence would be significantly greater for the combined intervention group than the standard care control group. The study's conceptual framework integrates concepts from the Health Belief Model and the Transtheoretical Model. The sample ultimately will consist of 200 African American women, ages 40-75, <250% of poverty, no breast cancer history and no mammogram in last 15 months, who are randomly assigned to an intervention and control group. The intervention includes training community women to become lay health advisors to deliver an interactive computer program tailored to health beliefs at baseline, provide counseling tailored to barriers to screening at baseline, 4, 8, and 14 weeks, and mail a post card tailored to stage of screening adoption at 18 weeks. Data are collected with a survey read by a research assistant and include health beliefs and barriers, participant satisfaction, and screening adherence at baseline, 2 and 24 weeks. Preliminary findings at baseline for 115 participants show that the leading barriers are beliefs that all breast lumps can be found without having a mammogram, unable to afford the screening, and fears that the treatment would be worse than the cancer. The majority of participants are satisfied or very satisfied with the interactive computer program and their lay health advisor at 2 and 24 week data collection points, respectively. These initial findings show possible promise for the feasibility of using a combination of tailored interventions to promote mammography in a population at risk for breast cancer disparity.