Two community outreach strategies to increase breast cancer screening among low-income women.

BACKGROUND: Two approaches were designed for low-income women to promote their use of mammography screening. METHODS: During 1995-96, as part of a community outreach project in a Florida city, 1,157 women aged 45 years or older attended group education sessions on breast cancer screening, while another 1,450 participated in one-on-one talks about screening at display tables in various public places. County mammography registry data were used to assess changes in the use of mammography screening. RESULTS: Among women 55 years old or older, especially whites, the one-on-one approach was more often associated with subsequent mammography screening than was the group approach. African American women and Latina women appeared to benefit more from the group approach than from the one-on-one approach. CONCLUSIONS: Group or one-on-one breast cancer screening education can improve screening behaviors among low-income women, depending on the age and ethnicity of the women targeted.

Comparison of breast screening outcomes from a cancer control intervention for African-American and white women in western New York.

This study's purpose was to compare breast screening outcomes, health practices, and risk factors for low-income African-American and white women who participated in a multistrategy cancer control intervention. Subjects were recruited from their communities to participate in breast screening activities (clinical breast examination and mammography testing). Data were collected via a screening intake form for a 2-year period (mid- 1994 to mid- 1996). As a result of the recruitment. 1444 women enrolled for breast screening services. They included 282 African Americans. 1079 whites, and 83 other minorities. African-American and white women alike reported deficiencies in monthly breast self-examination practices and previous mammography use. However, more African-American women than white women reported monthly breast self-examination practice (P < 001). More white than African-American women reported having had a previous mammogram (P < .002). Examination of selected risk factors showed that both African-American women and white women had minimum family history. A comparison of breast screening outcomes showed that African-American women presented with slightly more abnormalities than did white women after undergoing clinical breast exams and mammography. However, no significant difference was found when comparing these variables. Overall, African-American women were as likely as white women to participate in screening activities. There was little difference between these groups when comparing screening outcomes, health practices, and risk factors.

Breast screening by African-American women: insights from a household survey and focus groups.

This study uses quantitative and qualitative information to examine the relationships between predisposing, reinforcing, and enabling factors from a health education planning model and levels of mammography screening, clinical breast exam (CBE), and breast self-exam (BSE) among African-American women. We analyzed data from a random sample household survey of African-American women in a Florida community (n = 281) and three age-homogenous focus groups from the same population. Two thirds of the random sample and all of the focus group participants had less than a high school education and household incomes below $10,000. Even though both samples of women were likely to have a physician they see regularly, most had never had a mammogram and could not accurately describe more than two major techniques for BSE. Knowing guidelines for mammography, CBE, and BSE (predisposing factors), believing their screening behavior mattered to at least some family members (reinforcing factor), seeing a physician for health care and advice, and having been taught BSE in a physician's office (enabling factors) predicted one form of breast screening behavior or another in multivariate logistic regression analyses. In addition, knowing mammography and BSE guidelines and having been taught BSE in a physician's office were significant predictors of breast-screening behavior for both low- and moderate-income women. Focus-group participants unanimously reported a willingness to listen to physician instructions regarding breast screening and to receive a mammogram if their physician recommended one. Both survey and focus group results emphasize the particular importance of physicians in promoting breast screening among African-American women regardless of their income.

Clinical trial participation. Viewpoints from racial/ethnic groups.

BACKGROUND: Racial/ethnic groups' participation in clinical trials is a relatively new area of research that warrants attention. Although racial/ethnic groups have been included in experimental studies since the 1940s, they were not included in significant numbers in clinical trials for cancer. Clinical trials play a dominant role in clinical oncology. Despite this state-of-the-art cancer treatment, however, there is mounting concern that this scientific progress is not being shared equitably by all segments of the U.S. population. There is underrepresentation of members of racial/ethnic groups in cancer clinical trials, which suggests that participation may be a critical issue. Unfortunately, little is known or documented about these groups' participation in clinical trials. METHODS: This paper discusses racial/ethnic groups' views and opinions about clinical trial participation. Diagnostic research was conducted as a beginning phase to investigate this new area of research. African Americans, Hispanics, and Native Americans in three Buffalo, New York, communities were selected as study subjects. Data were collected via telephone surveys. Qualitative methods were employed for data analysis and reporting. RESULTS: Findings showed that study subjects knew little about cancer clinical trials and basically had no opportunity to participate. They believed that participation in clinical trials could be beneficial. In each of the three groups, however, there were cultural factors believed to influence participation. A primary concern was "mistrust of white people" and the feeling of being treated like "guinea pigs." CONCLUSIONS: Based on study findings, it was evident that recruitment for improving participation requires strategic planning that involves participants representative of the study population. To yield results, the plan should be tailored to the target group, presented as a credible study, designed to reflect trust in the medical care team, and implemented through a continuous educational process.

Breast cancer screening in older black women.

The objective of this study was to report findings about older black women's responses to breast health education and screening. Findings were reported from a community-based intervention designed to improve breast screening services for women in Erie County, New York. A 34-foot mobile screening and education clinic was used to overcome barriers such as accessibility and cost. Results from a sample of 271 older black women showed that they participated in breast health education programs and received clinical breast examinations when these services were offered in their neighborhoods. However, there was low participation in screening mammography offered at a local hospital. Low participation was attributed to structural and functional barriers in the delivery system. This study emphasizes the particular importance of education and screening offered as one unit of service. Further, it emphasizes the need to examine older black women's reported experiences after participation in screening.

Post-training brain catecholamine levels: lack of response to water-motivated training.

Rats were trained in a one-trial appetitive task using water motivation. Brain catecholamine and metabolite levels were assessed in samples collected 10 min after training. There was no evidence that brain NE levels were modified by training, although catecholamine levels increased when the animals were placed in a novel environment. These results differ from those obtained after avoidance training where the extent of a post-training decrease in brain norepinephrine predicts later retention performance.

Modulation of long-term potentiation: effects of adrenergic and neuroleptic drugs.

A variety of drugs which either mimic or antagonize the effects of norepinephrine and dopamine were tested for their ability to modulate long-term potentiation (LTP) in the rat hippocampus in vitro. Neither administration of norepinephrine, amphetamine or adrenergic antagonists, nor pretreatment with reserpine or DSP4 (which selectively destroys noradrenergic afferents to the hippocampus) had any significant effect on the magnitude of LTP. Isoproterenol, a beta-adrenergic receptor agonist, was able to partially block LTP, but this did not appear to be due to a direct action of isoproterenol on LTP. Neuroleptic drugs such as trifluoperazine were able to block LTP almost completely; however, this action was not stereospecific. Other dopamine antagonists such as sulpiride had no effect on LTP. The ability of neuroleptics to antagonize LTP was more closely related to their ability to block calmodulin than to their relative potencies as dopamine antagonists. It would appear that neither norepinephrine nor adrenergic antagonists influence the amount of LTP elicited by repetitive stimulation; however, drugs which have been shown to interfere with calmodulin-mediated cellular processes do antagonize this phenomenon.