A Comparison of Compliance and Noncompliance in Breast Cancer Screening among African American Women.

African American women are more likely to be diagnosed with late stage breast cancer, due in part to low participation in screening procedures. The purpose of this study was to explore the differences among African American women who were compliant and noncompliant with standard mammography screening recommendations. The study participants were African American women (N = 599) over the age of 40 with no history of cancer, who were recruited to attend a local community health event. Findings revealed that 78 percent of the women reported having had a mammogram within the past year, whereas 22 percent had not. The most commonly reported reasons given by those who did not have a mammogram in the past year were that they simply did not think to do so, or that they were not told to do so by their doctor. Women who reported that they did not have a mammogram last year were significantly less likely to have health insurance, to have had a clinical breast exam at their last checkup, to have had their breasts examined by their doctor at least once per year, or to have previously had a mammogram. There were no group differences in the number of visits to a doctor during the past 12 months. The article concludes with a discussion of the implications for health care professionals and suggestions for future research.

Breast care screening for underserved African American women: Community-based participatory approach.

Traditional health promotion models often do not take into account the importance of shared cultural backgrounds, beliefs, and experiences unique to underserved African American women when designing community-based cancer screening and prevention programs. Thus, the purpose of this study was the development, implementation, and evaluation of a community-based participatory research (CBPR) program designed to increase breast cancer screening awareness in an underserved African American population by providing culturally appropriate social support and information. The study includes 357 African American women who participated in the program and completed the 6-month follow-up questionnaire. The program consisted of a 45-minute play, using community members and storytelling to honor and incorporate five different cultural experiences (skits) with breast care and cancer. Overall, findings indicate that the educational intervention was effective. In addition, these findings are consistent with the literature that suggests that educational interventions that include knowledge to alleviate concerns, dispel myths, and create awareness can increase breast cancer screening participation rates. Furthermore, these findings confirm the importance of CBPR in health promotion activities in reducing health and cancer disparities.

A Collaborative Team Teaching Model for a MSW Capstone Course.

This exploratory study was embedded in a formative process for the purposes of improving content delivery to an evidence-based practice class, and improving students' performance on a comprehensive exam. A learning and teaching model was utilized by faculty from a three-university collaborative graduate social work program to examine the extent to which course texts and assignments explicitly supported the process, application, and evaluation of evidence-based practices. The model was grounded in a collaborative culture, allowing each faculty to share their collective skills and knowledge across a range of practice settings as they revised the course curriculum. As a result, faculty found they had created a unique community that allowed a wider context for learning and professional development that translated into the classroom. Students enrolled in the revised course across all three universities showed improvement on the comprehensive exam. When faculty themselves invest in collaborative learning and teaching, students benefit.

Coping skills among African-American breast cancer survivors.

Women with a diagnosis of breast cancer, particularly African-American women, face multiple barriers to survival. Although research exists regarding the unique barriers faced by African-American breast cancer survivors, there has been little research into the various coping needs or coping strategies used among African-American women. The purpose of this article is to provide information from an exploratory study of data investigating the coping skills of 30 African-American women diagnosed and treated for breast cancer. Quantitative data was collected via a self-report questionnaire based on the pretest of the Breast Cancer Survivors Toolbox. The study sample was evaluated to determine overall coping skills followed by an analysis of individual categories of coping skills (e.g., communication, information seeking, negotiating, social support systems, cultural norms). Although limited by the non-random sampling technique and self-report, the results of the study support the need for further research regarding the use of interventions and strategies tailored to improve coping skills used by this population.

Integrated recovery management model for ex-offenders with co-occurring mental health and substance use disorders and high rates of HIV risk behaviors.

This paper provides outcomes from an evaluation of a federally funded program combining HIV prevention services with an integrated mental health and substance abuse treatment program to a population of primarily African American ex-offenders living with, or at high risk for contracting HIV in Memphis, Tennessee. During the 5-year evaluation, data were collected from 426 individuals during baseline and 6-month follow-up interviews. A subset of participants (n = 341) completed both interviews. Results suggest that the program was successful in reducing substance use and mental health symptoms but had mixed effects on HIV risk behaviors. These findings are important for refining efforts to use an integrated services approach to decrease (a) the effects of substance use and mental health disorders, (b) the disproportionate impact of criminal justice system involvement, and (c) the HIV infection rate in African American ex-offenders in treatment.

GPRA and the development of performance measures.

The Government Performance and Results Act (GPRA, 1993; P.L. 103-62) is the legislative framework that requires federally funded programs to define and report performance objectives. The intent of the GPRA is to improve federal management of multi-program systems, like those treating co-occurring substance and mental health disorders. This paper is designed to promote an understanding as to how GPRA was developed and implemented.

Social workers as patient navigators for breast cancer survivors: what do African-American medically underserved women think of this idea?

Patient navigation (PN) is a new initiative in health care aimed at reducing disparities by assisting patients in overcoming barriers within the health care system. As PN programs grow around the country, it is important to consult the key stakeholders in the development of these programs. The purpose of this qualitative study was to discuss the needs of medically underserved cancer patients and allow them the opportunity to provide input on models of care to meet their needs. Four focus groups were conducted in three major cities across Tennessee. Research participants (n = 36) were recruited by the staff in area cancer support programs and treatment programs across the state and through recruitment flyers at various treatment centers and community organizations. Findings revealed four key themes in the development of PN programs: (1) the PN needs to address access to quality care issues; (2) the PN needs to address the emotional and practical concerns of the cancer survivor, (3) the PN needs to address family concerns; (4) the PN needs to be involved across the continuum of care from time of diagnosis into long-term survivorship. Oncology social workers have a unique opportunity to meet the needs of medically underserved cancer patients through the PN movement. Our profession is a key stakeholder in this movement. We need to advocate for trained oncology social workers to actively pursue the role of patient navigators to ensure that the needs of medically underserved cancer survivors and their families are met.

Exploring the financial impact of breast cancer for African American medically underserved women: a qualitative study.

In addition to the physical suffering experienced by cancer survivors, there are considerable financial hardships and access barriers to quality health care. The current study explored the financial burden of breast cancer on African American medically underserved women. Four focus groups were conducted in three major cities across Tennessee. Research participants (N=36) were recruited by the staff of cancer support and treatment programs in the area. Findings revealed that participants' lack of insurance or inadequate insurance resulted in missed, delayed, or fewer treatment opportunities. The financial burden of cancer was not limited to the acute treatment phase. The women in the current study reported extreme economic hardship resulting from this disease into long-term survivorship. This exploratory study confirms the importance of providing care across the continuum to address the complex needs of low-income cancer survivors.