title: Effect of a cancer screening intervention conducted by lay health workers among inner-city women.
abstract: BACKGROUND
  We conducted a randomized controlled trial to determine if an in-home educational intervention conducted by lay health workers (LHWs) could increase adherence among low-income, inner-city, African-American women to breast and cervical cancer screening schedules.
  
  
  METHODS
  We recruited 321 African-American women from diverse inner-city sources. After baseline interviews, they were randomly assigned to either the intervention (n = 163) or the control (n = 158) group. Those in the intervention group were visited in their homes up to three times by LHWs who provided a culturally sensitive educational program that emphasized the need for screening.
  
  
  RESULTS
  Ninety-three (93) women in the intervention group and 102 in the control group completed the postintervention interview. For Pap smears, the increase in screening was similar in both groups. For clinical breast exams (CBEs), however, there was a modest increase in the intervention group. The improvement was greatest for mammography, for which there was a 10% to 12% increase. Among women who were not on recommended schedules at baseline, the improvement was substantial and greater in the intervention group.
  
  
  CONCLUSIONS
  LHWs' intervention appeared to improve the rate at which inner-city women obtained CBEs and mammograms, but had no effect on Pap smears. A high attrition rate weakened our ability to make conclusive statements about the exact impact of the intervention.
authors.affiliation: Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Morehouse College, Atlanta, Georgia, USA.
authors.forename: J F
authors.initials: JF
authors.lastname: Sung
authors.forename: D S
authors.initials: DS
authors.lastname: Blumenthal
authors.forename: R J
authors.initials: RJ
authors.lastname: Coates
authors.forename: J E
authors.initials: JE
authors.lastname: Williams
authors.forename: E
authors.initials: E
authors.lastname: Alema-Mensah
authors.forename: J M
authors.initials: JM
authors.lastname: Liff
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000208:ethnology / Q000517:prevention & control*; D016504:Breast Self-Examination; D003150:Community Health Workers; D003256:Community Participation / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005845:Georgia; D006266:Health Education / Q000379:methods*; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D011203:Poverty; D014505:Urban Population; D002583:Uterine Cervical Neoplasms / Q000208:ethnology / Q000517:prevention & control*