Engaging diverse underserved communities to bridge the mammography divide

Engelman, Kimberly K.; Cupertino, Ana Paula; Daley, Christine M.; Long, Trish; Cully, Angelia; Mayo, Matthew S.; Ellerbeck, Edward F.; Geana, Mugur V.; Greiner, Allen
January 2011
BMC Public Health;2011, Vol. 11 Issue 1, p47
Academic Journal
Background: Breast cancer screening continues to be underutilized by the population in general, but is particularly underutilized by traditionally underserved minority populations. Two of the most at risk female minority groups are American Indians/Alaska Natives (AI/AN) and Latinas. American Indian women have the poorest recorded 5-year cancer survival rates of any ethnic group while breast cancer is the number one cause of cancer mortality among Latina women. Breast cancer screening rates for both minority groups are near or at the lowest among all racial/ ethnic groups. As with other health screening behaviors, women may intend to get a mammogram but their intentions may not result in initiation or follow through of the examination process. An accumulating body of research, however, demonstrates the efficacy of developing 'implementation intentions' that define when, where, and how a specific behavior will be performed. The formulation of intended steps in addition to addressing potential barriers to test completion can increase a person's self-efficacy, operationalize and strengthen their intention to act, and close gaps between behavioral intention and completion. To date, an evaluation of the formulation of implementation intentions for breast cancer screening has not been conducted with minority populations. Methods/Design: In the proposed program, community health workers will meet with rural-dwelling Latina and American Indian women one-on-one to educate them about breast cancer and screening and guide them through a computerized and culturally tailored "implementation intentions" program, called Healthy Living Kansas - Breast Health, to promote breast cancer screening utilization. We will target Latina and AI/AN women from two distinct rural Kansas communities. Women attending community events will be invited by CHWs to participate and be randomized to either a mammography "implementation intentions" (MI²) intervention or a comparison general breast cancer prevention informational intervention (C). CHWs will be armed with notebook computers loaded with our Healthy Living Kansas - Breast Health program and guide their peers through the program. Women in the MI² condition will receive assistance with operationalizing their screening intentions and identifying and addressing their stated screening barriers with the goal of guiding them toward accessing screening services near their community. Outcomes will be evaluated at 120-days post randomization via self-report and will include mammography utilization status, barriers, and movement along a behavioral stages of readiness to screen model. Discussion: This highly innovative project will be guided and initiated by AI/AN and Latina community members and will test the practical application of emerging behavioral theory among minority persons living in rural communities. Trial Registration: ClinicalTrials (NCT): NCT01267110.


Related Articles

  • Women who did not undergo mammography accounted for 75% of breast cancer deaths. Harris, Jason // Hem/Onc Today;11/10/2009, Vol. 10 Issue 21, p19 

    The article discusses a research by Blake Cady of Harvard Medical School and colleagues indicating that 20% women who did not undergo mammography constituted for almost three-quarters of breast cancer deaths, and was presented at the 2009 Breast Cancer Symposium held in San Francisco, California...

  • What's a Girl to Do? Carroll-Johnson, Rose Mary // Oncology Nursing Forum;Apr2002, Vol. 29 Issue 3, p445 

    Editorial. Deals with issues concerning mammography. Value of mammography in reducing mortality rate; Realities of the statistics that the risk-versus-benefit ratios become less clear the younger a woman is; Shift to breast conservation surgery.

  • Introduction of organised mammography screening in tyrol: results of a one-year pilot phase. Oberaigner, Willi; Buchberger, Wolfgang; Frede, Thomas; Daniaux, Martin; Knapp, Rudolf; Marth, Christian; Siebert, Uwe // BMC Public Health;2011, Vol. 11 Issue 1, p91 

    Background: Efficiency and efficacy of organised mammography screening programs have been proven in large randomised trials. But every local implementation of mammography screening has to check whether the well established quality standards are met. Therefore it was the aim of this study to...

  • Investigating the Contribution of Benefits and Barriers on Mammography Intentions of Middle Class Urban Indian Women: An Exploratory Study. Agarwal, Vinita // Communication Research Reports;Jul2011, Vol. 28 Issue 3, p235 

    Few studies on screening behaviors have examined socio-cognitive correlates of cancer beliefs for South Asian women to inform message design in health communication campaigns (Airhihenbuwa & Obregon, 2000). This exploratory study investigates the contribution of benefits and barriers in...

  • Breast cancer screening. Newson, Louise // GP: General Practitioner;4/27/2007, p41 

    The article presents information on breast cancer screening. Mammography is currently offered to all women aged 50-70 years to reduce breast cancer mortality in Great Britain. Overdetection of breast cancer may cause harm to a patient. Most women are receiving inadequate information on the...

  • The positive predictive value of the breast imaging reporting and data system (BI-RADS) as a method of quality assessment in breast imaging in a hospital population. Zonderland, Harmine; Pope, Thomas; Nieborg, Arend // European Radiology;Oct2004, Vol. 14 Issue 10, p1743 

    Evaluation of the diagnostic performance of mammography and US in our hospital, based upon the positive predictive value (PPV) for breast cancer of the breast imaging reporting and data system (BI-RADS) final assessment categories, has been performed. A follow-up study of 2,762 mammograms was...

  • Physician Predictors of Mammographic Accuracy. Smith-Bindman, Rebecca; Chu, Philip; Miglioretti, Diana L.; Quale, Chris; Rosenberg, Robert D.; Cutter, Gary; Geller, Berta; Bacchetti, Peter; Sickles, Edward A.; Kerlikowske, Karla // JNCI: Journal of the National Cancer Institute;3/2/2005, Vol. 97 Issue 5, p358 

    Background: The association between physician experience and the accuracy of screening mammography in community practice is not well studied. We identified characteristics of U.S. physicians associated with the accuracy of screening mammography. Methods: Data were obtained from the Breast Cancer...

  • Fewer Mammography Facilities May Cause Access Problems In The Future, Experts Say.  // JNCI: Journal of the National Cancer Institute;10/4/2006, Vol. 98 Issue 19, p1361 

    The article cites key research findings indicating a decline in the number of mammography facilities worldwide between 2001 and 2004. The decline is primarily attributed to the financial difficulties of running the facilities. Even though the U.S. has adequate mammography facilities, the drop in...

  • Primary Sarcoid of the Breast with Incidental Malignancy. Isley, Laura M.; Cluver, Abbie R.; Leddy, Rebecca J.; Baker, Megan K. // Journal of Clinical Imaging Science;Jan-Mar2012, Vol. 2 Issue 1, Special section p1 

    Breast sarcoidosis is rare and usually presents in patients with known sarcoid involving other organ systems. In the breast, sarcoidosis may mimic malignancy which must be excluded by core biopsy. We report a very unusual case of primary breast sarcoidosis with incidentally discovered breast...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics