ABSTRACT
This pilot study evaluates a community lay health advocate (CLHA) intervention in promoting follow-up for abnormal mammograms among African American women. A controlled trial was implemented at an urban hospital in Atlanta, with 48 women in a CLHA intervention group and 35 in a usual care group. Participants were 25 or older and had an abnormal mammogram between March 25, 2002, and May 2, 2003. Intervention group women received CLHA support including encouragement of timely abnormal mammogram follow-up, reminders of follow-up appointments, identification and removal of barriers to follow-up, and accompaniment to follow-up appointments. Women in the intervention group were significantly more likely to keep their first abnormal mammogram follow-up appointment, all of their scheduled follow-up appointments, and their biopsy or fine needle aspiration appointment. CLHAs are effective in promoting abnormal mammogram followup among African American women and may be an important resource in reducing racial disparities in breast cancer mortality.
Subject(s)
Black or African American , Breast Neoplasms/diagnostic imaging , Community Health Workers , Continuity of Patient Care , Mammography/methods , Patient Advocacy , Patient Compliance , Adult , Aged , Breast Neoplasms/ethnology , Breast Neoplasms/prevention & control , Female , Follow-Up Studies , Health Knowledge, Attitudes, Practice , Health Services Accessibility , Humans , Mammography/psychology , Middle Aged , Pilot Projects , Social Support , Socioeconomic FactorsABSTRACT
PURPOSE/OBJECTIVES: To test the efficacy of innovative, age- and race-sensitive, self-monitored, video breast health kits in increasing knowledge about breast cancer risk and screening and breast self-examination (BSE) proficiency. DESIGN: Quasi-experimental pretest and post-test design. SETTING: Dual-site study in community-based settings in the Northeast and Southeast United States. SAMPLE: 328 women (206 in the intervention group, 122 in the control group) aged 60 or older; predominantly African American (77%); mean education of 10.8 years; annual income below $10,000 (50%). METHODS: Individual pretest and post-test interviews conducted by nurses at two-week intervals assessed knowledge about breast cancer risk and screening and BSE proficiency as demonstrated on vested breast models. Intervention subjects used video breast health kits in ethnic editions designed for the study. Control subjects received educational pamphlets. MAIN RESEARCH VARIABLES: Dependent variables were knowledge about breast health and BSE proficiency measured by demonstration of inspection and palpation skills and detection of lumps in a simulation model. FINDINGS: Three multiple analyses of covariance revealed statistically significant differences in outcome variables between the intervention and control groups. CONCLUSIONS: The intervention was effective in increasing knowledge about breast cancer risk and screening and BSE proficiency in this sample of older women. IMPLICATIONS FOR NURSING: These and other educational interventions designed specifically for age and race sensitivity may enhance cancer screening with vulnerable populations. Future studies with more diverse multicultural groups are needed to improve understanding of how to best influence breast health behaviors of older women.
