Increasing use of mammography among older, rural African American women: results from a community trial.
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.
Earp
Jo Anne
JA
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
Eng
Eugenia
E
O'Malley
Michael S
MS
Altpeter
Mary
M
Rauscher
Garth
G
Mayne
Linda
L
Mathews
Holly F
HF
Lynch
Kathy S
KS
Qaqish
Bahjat
B
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