title: A socioecological approach to improving mammography rates in a tribal community.
abstract: This article highlights the processes and intermediate outcomes of a pilot project to increase mammography rates of women in an American Indian tribe in New Mexico. Using a socioecological framework and principles of community-based participatory research, a community coalition was able to (a) bolster local infrastructure to increase access to mammography services; (b) build public health knowledge and skills among tribal health providers; (c) identify community-specific knowledge, attitudes, and beliefs related to breast cancer; (d) establish interdependent partnerships among community health programs and between the tribe and outside organizations; and (e) adopt local policy initiatives to bolster tribal cancer control. These findings demonstrate the value of targeting a combination of individual, community, and environmental factors, which affect community breast cancer screening rates and incorporating cultural strengths and resources into all facets of a tribal health promotion intervention.
authors.affiliation: Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York 10032, USA. ke72@columbia.edu
authors.forename: Kevin C
authors.initials: KC
authors.lastname: English
authors.forename: Jo
authors.initials: J
authors.lastname: Fairbanks
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Finster
authors.forename: Alvin
authors.initials: A
authors.lastname: Rafelito
authors.forename: Jolene
authors.initials: J
authors.lastname: Luna
authors.forename: Marianna
authors.initials: M
authors.lastname: Kennedy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003256:Community Participation; D003466:Cultural Characteristics; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D007198:Indians, North American; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D009516:New Mexico; D012959:Socioeconomic Factors; D014481:United States; D016549:United States Indian Health Service / Q000458:organization & administration*