Developing a community-based intervention to increase breast cancer screening and early detection among low-income, African-American women Free

B39

African-American women are more likely to die of breast cancer than are white women (35.7 vs. 27.3 per 100,000 women) or any other racial/ethnic group. Breast cancer deaths can be reduced through increased adherence with recommendations for regular mammography screening and early detection of tumors. Low-income women and women with little education are least likely to have had a timely mammogram. The recent decrease in deaths from breast cancer in white females is attributed to greater use of breast cancer screening in regular medical care. However, deaths due to breast cancer in African American females continue to increase, in part, because breast cancer is diagnosed at later stages in African American females.
 In order to address this disparity in breast cancer mortality, we designed a 3-phased study to gain a deep understanding of the target audience and to develop a community-based pilot intervention to motivate African American women eligible for no-cost mammograms through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to participate in mammography screening. The Persuasive Health Message Framework (Witte, 1995) was used to guide development of concepts, messages, materials, and channels for the design of a community-based, pilot intervention.
 In 2005, Phase 1 of this study conducted eight formative focus groups with African American women in Savannah and Macon, Georgia. The groups were segmented by women's age (40-49 years and 50-64 years) and screening status (recently screened or unscreened in the past 3 years). The objective was to investigate knowledge and awareness of the NBCCEDP and participant ideas about channels, messages, and sources to reach African American women. SPSS.v.10.0 and ATLAS.ti.5.0 were used to analyze the data. The findings indicated that radio and print media are viable channels to disseminate health information in this population, and the audience preferred to receive health messages about breast cancer and mammography from other African American women and/or breast cancer survivors.
 In 2007, Phase 2 of this study conducted eight focus groups with African American women. The groups were again conducted in Savannah and Macon, and were segmented by age (40-49 years and 50-64 years). The objective was to test the clarity and potential effectiveness of concepts and audio messages developed based on Phase 1 findings. Using SPSS.v.13.0 and a note-based, thematic analysis, we found that participants were most attentive to images vs. messages or concepts in print media, valued images and discussion of family relationships, and valued testimonials about mammography and breast cancer from African American breast cancer survivors.
 The findings from Phase 1 and 2 are being used to design and evaluate a culturally-appropriate, community-based intervention using "Black Radio" to: (a) increase knowledge and awareness of breast cancer and the availability of low- or no-cost screening services, and (b) motivate low-income African American women to get screened for breast cancer. The study suggests that interventions addressing racial/ethnic health disparities should consider using multiple channels such as print media and particularly "Black Radio" using cancer or other disease survivors to disseminate health information in the African American community.