Engaging diverse underserved communities to bridge the mammography divide

Authors: Kimberly K Engelman, Ana Paula Cupertino, Christine M Daley, Trish Long, Angelia Cully, Matthew S Mayo, Edward F Ellerbeck, Mugur V Geana, Allen Greiner

Breast cancer screening continues to be underutilized by the population in general, but is particularly underutilized by traditionally underserved minority populations. Two of the most at risk female minority groups are American Indians/Alaska Natives (AI/AN) and Latinas. American Indian women have the poorest recorded 5-year cancer survival rates of any ethnic group while breast cancer is the number one cause of cancer mortality among Latina women. Breast cancer screening rates for both minority groups are near or at the lowest among all racial/ethnic groups. As with other health screening behaviors, women may intend to get a mammogram but their intentions may not result in initiation or follow through of the examination process. The formulation of intended steps in addition to addressing potential barriers to test completion can increase a person’s self-efficacy, operationalize and strengthen their intention to act, and close gaps between behavioral intention and completion. In the proposed program, community health workers will meet with rural-dwelling Latina and American Indian women one-on-one to educate them about breast cancer and screening and guide them through a computerized and culturally tailored “implementation intentions” program, called Healthy Living Kansas – Breast Health, to promote breast cancer screening utilization. This highly innovative project will be guided and initiated by AI/AN and Latina community members and will test the practical application of emerging behavioral theory among minority persons living in rural communities.