Increasing Use of Mammography Among Older, Rural African American Women: Results From a Community Trial

• Published in: American journal of public health (1971) 2002-04, Vol.92 (4), p.646-654
• Main Authors: Earp, Jo Anne, Eng, Eugenia, O'Malley, Michael S, Altpeter, Mary, Rauscher, Garth, Mayne, Linda, Mathews, Holly F, Lynch, Kathy S, Qaqish, Bahjat
• Format: Article
• Language: English
• Subjects: Advisors; African Americans; African Americans - education; African Americans - statistics & numerical data; Aged; Biological and medical sciences; Black American people; Breast cancer; Cervical cancer; Community; Community based programmes; Data collection; Design; Family Characteristics; Female; Focus groups; General aspects; Genital system. Mammary gland; Health Care Surveys; Health Education - organization & administration; Health facilities; Households; Humans; Increases; Intervention; Interviews; Investigative techniques, diagnostic techniques (general aspects); Low income groups; Mammography; Mammography - statistics & numerical data; Mass Screening - organization & administration; Mass Screening - statistics & numerical data; Medical sciences; Medical screening; Middle Aged; Minority Groups - statistics & numerical data; North Carolina; North Carolina - epidemiology; Older people; Older women; Patient Acceptance of Health Care - ethnology; Peer Group; Planification. Prevention (methods). Intervention. Evaluation; Poverty - ethnology; Program Evaluation; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Race; Racial differences; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Research and Practice; Rural areas; Rural Health; Screening; Uptake; USA; White people; Women's Health; Womens health
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.92.4.646

A community trial was undertaken to evaluate the effectiveness of the North Carolina Breast Cancer Screening Program, a lay health advisor network intervention intended to increase screening among rural African American women 50 years and older. A stratified random sample of 801 African American women completed baseline (1993-1994) and follow-up (1996-1997) surveys. The primary outcome was self-reported mammography use in the previous 2 years. The intervention was associated with an overall 6 percentage point increase (95% confidence interval [CI] = -1, 14) in community-wide mammography use. Low-income women in intervention counties showed an 11 percentage point increase (95% CI = 2, 21) in use above that exhibited by low-income women in comparison counties. Adjustment for potentially confounding characteristics did not change the results. A lay health advisor intervention appears to be an effective public health approach to increasing use of screening mammography among low-income, rural populations.