title: Increasing mammography practice by African American women.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Arkansas Cancer Research Center, Department of Surgical Oncology, University of Arkansas for Medical Sciences, Little Rock, USA. .
authors.forename: D O
authors.initials: DO
authors.lastname: Erwin
authors.forename: T S
authors.initials: TS
authors.lastname: Spatz
authors.forename: R C
authors.initials: RC
authors.lastname: Stotts
authors.forename: J A
authors.initials: JA
authors.lastname: Hollenberg
mesh_terms: D000328:Adult; D001741:Black or African American / Q000193:education* / Q000523:psychology / Q000706:statistics & numerical data*; D001131:Arkansas; D001943:Breast Neoplasms / Q000208:ethnology / Q000517:prevention & control*; D003150:Community Health Workers / Q000193:education / Q000458:organization & administration*; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008507:Medically Underserved Area; D008875:Middle Aged; D010327:Pastoral Care / Q000458:organization & administration; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000523:psychology / Q000706:statistics & numerical data*; D015397:Program Evaluation; D012423:Rural Health; D017741:Survivors