title: Randomized community trial of a breast self-examination skills-building intervention for inner-city African-American women.
abstract: OBJECTIVE
  Breast cancer is the most common cancer in women, and African-American women are less likely to detect breast cancer at its early stages. Few controlled trials of interventions to increase breast self-examination (BSE) among low-income minority women have been conducted. Our objective was to test a small-group workshop intended to build BSE skills and promote BSE among low-income African-American women.
  
  
  METHODS
  A randomized community field trial tested a BSE skills-building workshop based on social cognitive theory of behavior change compared to a matched sexually transmitted diseases prevention workshop, with one- and three-month follow-ups for assessing increased practice of BSE.
  
  
  RESULTS
  Women who did not regularly practice BSE and participated in a BSE skills-building workshop were more likely to practice BSE than women in the comparison intervention at the one- (OR = 3.5, p = 0.04) and three-month follow-ups (OR = 4.9, p = 0.01). These results were not related to risk perceptions heightened by the intervention. Across conditions and controlling for covariates in a multivariate model, performing regular BSE was most closely associated with having received any formal BSE instruction.
  
  
  CONCLUSIONS
  BSE skills building can effectively increase use of BSE among low-income African-American women who face multiple and competing health risks. The small-group experience is an important element in fostering norms for practicing BSE and enhancing BSE practices.
authors.affiliation: Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, Milwaukee 53226, USA. sethk@mcw.edu
authors.forename: S C
authors.initials: SC
authors.lastname: Kalichman
authors.forename: E
authors.initials: E
authors.lastname: Williams
authors.forename: D
authors.initials: D
authors.lastname: Nachimson
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D001943:Breast Neoplasms / Q000517:prevention & control*; D016504:Breast Self-Examination / Q000706:statistics & numerical data; D003153:Community Health Services; D005260:Female; D006801:Humans; D008875:Middle Aged; D010353:Patient Education as Topic; D011203:Poverty; D014481:United States; D014504:Urban Health; D016387:Women's Health