The save our sisters project. A social network strategy for reaching rural black women

Why are older black women screened less for breast cancer? What can be done to narrow the racial gap in mammography screening? These are the questions addressed by the Save Our Sisters (SOS) Project, a pilot demonstration study funded by the National Cancer Institute in a rural county of North Carolina. The target population is 2600 black women 50-74 years of age residing in the county. To assist these women to obtain annual mammograms, SOS has recruited and trained 64 black women who are "natural helpers" to serve as lay health advisors. The lay health advisors reach older black women through their existing kin, friendship, and job networks. Responses from 14 focus group interviews found that when it is a matter of older black women's health concerns, women turn to certain women for social support. Responses revealed factors related to the individual woman and her social network that influence rural black women's seeking breast cancer screening. These results were applied to the Social Change model for designing the training and three network intervention strategies: (1) providing social support (information and referrals, emotional caring, and tangible assistance) through interpersonal counseling with women in their social networks; (2) working as a group, planning and implementing breast cancer control and prevention activities through community-based organizations to which advisors belong (e.g., church groups, civic groups, and social groups); and (3) establishing themselves as a non-profit, community-based SOS Association to sustain project interventions after the funding period. The SOS Community Advisory Group and the advisors developed innovative methods of recruitment, implementation, and follow-up. The community programs they have initiated are: (1) the Adopt-A-Sister Program, which assists black women who cannot afford the cost of a mammogram; (2) a committee on understanding the health care system, which assists women in negotiating regulations and using health care providers; (3) a training committee, which recruits and trains additional advisors; (4) a support group for black women with diagnoses of breast cancer; and (5) a speakers bureau, which has produced a 10-minute video, brochure, and tee-shirts as community education materials.