Increasing Mammography Practice by African American Women

PURPOSE: This study examines the effectiveness of the Witness Project, a culturally competent cancer education program that trains cancer survivors to promote early detection and increased breast self-examination and mammography in a population of rural, underserved, African American women. DESCRIPTION OF STUDY: The primary setting for the Witness Project-an intensive, community-based, culturally sensitive educational program that incorporates spirituality and faith-was the African American church. Baseline and 6-month follow-up surveys were obtained from 206 African American women in two intervention counties and from 204 African American women in two control counties in the rural Mississippi River Delta region of Arkansas. RESULTS: Witness Project participants significantly increased (P <.0001) their practice of breast self-examination and mammography (P <.005) compared with the women in the control counties. CLINICAL IMPLICATIONS: These results demonstrate that intensive, community-based, culturally sensitive educational programming incorporating the spiritual environment of the faith community, such as the Witness Project, can positively influence breast cancer screening behaviors among rural, underserved African American women. Through the use of community churches and cancer survivors, breast cancer screening activities can be improved in this population.