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Breast cancer is a pressing public health concern. It is the
most common cancer and the second leading cause of cancer
death among African American women. Screening mammography is
the single most effective method of early detection of
breast cancer; however, African American women are screened
at suboptimal rates, with only 53 percent of African American women
aged 40 and older having had a mammogram within the past
year. Low income women, women without health insurance, and
those without a usual source of health care have even lower
screening rates of 44 percent, 34 percent, and 28 percent respectively. Many of
these women use the emergency department as the only source
of medical care. Through a training plan of mentoring by a
team of interdisciplinary cancer control and nursing
scientists, formal class work, and seminars, this K01 Award
will provide the applicant with the opportunity to develop
and conduct a study that pilot tests a culturally tailored,
stage-matched intervention delivered by peer educators to
increase mammography use among African American women
visiting the emergency department.
The specific aims of the study are:
- to examine the barriers and benefits that influence
the use of screening mammography among African American
women and develop a peer educator delivered intervention
and tailored educational materials;
- to develop and evaluate culturally tailored, stage
appropriate mammography educational materials for
African American women to determine cultural
acceptability, readability, and applicability for women
visiting the emergency department;
- to compare, in a randomized controlled trial with a
sample of African American women, the effect of two
different interventions (a culturally tailored,
stage-matched peer educator breast cancer intervention
versus tailored educational materials only) on receipt
of a screening mammogram and knowledge of and intent to
follow screening guidelines.
The proposed study’s conceptual framework integrates
concepts from both the Health Belief Model and the
Transtheoretical Model. These specific aims correspond to
three phases: a qualitative phase, a developmental phase,
and an intervention phase.
The combination of this progressive research project and
the structured training plan will prepare the applicant to
meet the long-term goal of becoming an independent
investigator, by allowing her to develop skills in mixed
methodology, refine skills in advanced quantitative research
methods, incorporate communication in cancer control theory
and principles, and demonstrate the ability to integrate
knowledge and experience related to health disparities and
cancer control into the design and implementation of a
randomized controlled clinical trial. In addition, the
results from the proposed project will form the foundation
for further research to promote the use of screening
mammography among this vulnerable group of women.
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