ABSTRACT
PURPOSE: This study examines the effectiveness of the Witness Project, a culturally competent cancer education program that trains cancer survivors to promote early detection and increased breast self-examination and mammography in a population of rural, underserved, African American women. DESCRIPTION OF STUDY: The primary setting for the Witness Project-an intensive, community-based, culturally sensitive educational program that incorporates spirituality and faith-was the African American church. Baseline and 6-month follow-up surveys were obtained from 206 African American women in two intervention counties and from 204 African American women in two control counties in the rural Mississippi River Delta region of Arkansas. RESULTS: Witness Project participants significantly increased (P <.0001) their practice of breast self-examination and mammography (P <.005) compared with the women in the control counties. CLINICAL IMPLICATIONS: These results demonstrate that intensive, community-based, culturally sensitive educational programming incorporating the spiritual environment of the faith community, such as the Witness Project, can positively influence breast cancer screening behaviors among rural, underserved African American women. Through the use of community churches and cancer survivors, breast cancer screening activities can be improved in this population.
Subject(s)
Black or African American/education , Black or African American/statistics & numerical data , Breast Neoplasms/prevention & control , Community Health Workers/organization & administration , Health Education/organization & administration , Mammography/statistics & numerical data , Patient Acceptance of Health Care/ethnology , Patient Acceptance of Health Care/statistics & numerical data , Survivors , Adult , Black or African American/psychology , Arkansas , Breast Neoplasms/ethnology , Community Health Workers/education , Female , Health Knowledge, Attitudes, Practice , Humans , Medically Underserved Area , Middle Aged , Pastoral Care/organization & administration , Patient Acceptance of Health Care/psychology , Program Evaluation , Rural HealthABSTRACT
BACKGROUND: The five-year survival rate for African American women with breast cancer is notably lower than the rate for white women; thus, appropriate cancer education and screening efforts are needed to increase mammography and breast self-examination practices by African American women. METHODS: The Witness Project is a theory-based intervention designed to provide culturally sensitive messages, from African American breast cancer survivors, in churches and community organizations. These messages emphasize the importance of early detection to improve survival. RESULTS: Intervention research in eastern Arkansas with 204 African American women demonstrated a significant increase in the practice of breast self-examination (p < 0.001) and mammography (p < 0.001) after participation in the Witness Project. There was no significant difference between the pre- and postintervention scores for scaled items for the health-belief model and locus of control. CONCLUSIONS: Results demonstrate that culturally appropriate cancer education programs are able to change behavior by meeting the beliefs of participants rather than attempting to change their beliefs.
