Results of a randomized trial to increase mammogram usage among Samoan women.
BACKGROUND
There are no effective breast cancer education programs targeting Samoan women. We tested the effectiveness of a theory-guided, culturally appropriate breast cancer education program (the intervention) designed to increase mammography use among Samoan women.


METHODS
This community-based participatory cluster-randomized controlled intervention trial used a parallel two-group design. The sample consisted of 776 women aged 42 and older who had not had a mammogram in the preceding 2 years. The primary outcome was self-reported mammogram use between pretest and posttest.


RESULTS
Overall, there was no statistically significant intervention effect, although the odds of self-reported mammogram use were higher in the intervention than the control group (odds ratio (OR), 1.26; 95% confidence interval (95% CI), 0.74, 2.14; P = 0.39). Exploratory subgroup analyses found that the intervention was effective only among women who were aware of mammograms but had never previously obtained one (OR, 1.99; 95% CI, 1.03, 3.85; P = 0.04). Low need for social support and lack of endorsement of culture-specific beliefs about breast cancer were associated with mammogram use in this group. In women unaware of mammography at pretest, high perceived susceptibility to breast cancer and endorsement of culture-specific beliefs were associated with mammogram use. For women who had previously obtained a mammogram, lower self-efficacy was associated with mammogram use. Intervention compared with control group women had significantly higher levels of knowledge of risk factors and lower endorsement of culture-specific beliefs at posttest.


CONCLUSIONS
Results suggest that a multifaceted education intervention may improve mammogram usage for certain subgroups of Samoan women.
Mishra
Shiraz I
SI
Department of Family and Community Medicine, University of Maryland School of Medicine, University of Maryland Statewide Health Network, 401 W. Redwood Street, Suite 100, Baltimore, MD 21201, USA. smishra@som.umaryland.edu
Bastani
Roshan
R
Crespi
Catherine M
CM
Chang
L Cindy
LC
Luce
Pat H
PH
Baquet
Claudia R
CR
D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000517:prevention & control*; D003466:Cultural Characteristics; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic / Q000379:methods*; D018947:Samoa; D016387:Women's Health