title: Increasing use of mammography among older, rural African American women: results from a community trial.
abstract: OBJECTIVE
  A community trial was undertaken to evaluate the effectiveness of the North Carolina Breast Cancer Screening Program, a lay health advisor network intervention intended to increase screening among rural African American women 50 years and older.
  
  
  METHODS
  A stratified random sample of 801 African American women completed baseline (1993-1994) and follow-up (1996-1997) surveys. The primary outcome was self-reported mammography use in the previous 2 years.
  
  
  RESULTS
  The intervention was associated with an overall 6 percentage point increase (95% confidence interval [CI] = -1, 14) in community-wide mammography use. Low-income women in intervention counties showed an 11 percentage point increase (95% CI = 2, 21) in use above that exhibited by low-income women in comparison counties. Adjustment for potentially confounding characteristics did not change the results.
  
  
  CONCLUSIONS
  A lay health advisor intervention appears to be an effective public health approach to increasing use of screening mammography among low-income, rural populations.
authors.affiliation: Department of Health Behavior and Health Education, CB #7400, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7400, USA. jearp@sph.unc.edu
authors.forename: Jo Anne
authors.initials: JA
authors.lastname: Earp
authors.forename: Eugenia
authors.initials: E
authors.lastname: Eng
authors.forename: Michael S
authors.initials: MS
authors.lastname: O'Malley
authors.forename: Mary
authors.initials: M
authors.lastname: Altpeter
authors.forename: Garth
authors.initials: G
authors.lastname: Rauscher
authors.forename: Linda
authors.initials: L
authors.lastname: Mayne
authors.forename: Holly F
authors.initials: HF
authors.lastname: Mathews
authors.forename: Kathy S
authors.initials: KS
authors.lastname: Lynch
authors.forename: Bahjat
authors.initials: B
authors.lastname: Qaqish
mesh_terms: D001741:Black or African American / Q000193:education* / Q000706:statistics & numerical data; D000368:Aged; D005191:Family Characteristics; D005260:Female; D019538:Health Care Surveys; D006266:Health Education / Q000458:organization & administration*; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000458:organization & administration / Q000706:statistics & numerical data*; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data*; D009657:North Carolina / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010379:Peer Group; D011203:Poverty / Q000208:ethnology*; D015397:Program Evaluation; D012423:Rural Health; D016387:Women's Health