title: Design and results of a culturally tailored cancer outreach project by and for Micronesian women.
abstract: BACKGROUND
  In 2005, approximately 26% of Micronesian women aged 40 or older in Hawai'i used mammography for breast cancer screening. We describe an 18-month project to increase screening participation in this population by tailoring educational materials and using a lay educator approach.
  
  
  OBJECTIVE
  New immigrants to Hawai'i are Marshallese from the Republic of the Marshall Islands and Chuukese, Pohnpeians, and Kosraeans from the Federated States of Micronesia. In Hawai'i, these 4 groups refer to themselves collectively as Micronesians, although each group has its own distinct culture and language.
  
  
  METHODS
  From 2006 through 2007, we applied principles of community-based participatory research--trust building, joint assessment, cultural tailoring of materials, and skills transfer--to develop and track the reach of Micronesian women lay educators in implementing a cancer awareness program among Micronesian women living in Hawai'i.
  
  
  RESULTS
  Using our tailored in-language materials, 11 lay educators (5 Chuukese, 3 Marshallese, 2 Pohnpeians, and 1 Kosraean) provided one-on-one and small group in-language cancer information sessions to 567 Micronesian women (aged 18-75 years). Among the 202 women aged 40 or older eligible for mammography screening, 166 (82%) had never had a mammogram and were assisted to screening appointments. After 6 months, 146 (88%) of the 166 had received a mammogram, increasing compliance from 18% to 90%. Lay educators reported increases in their skills and their self-esteem and want to extend their skills to other health issues, including diabetes management and immunization.
  
  
  CONCLUSIONS
  Tailoring materials and using the lay educator model successfully increased participation in breast cancer screening. This model may work in other communities that aim to reduce disparities in access to cancer screening.
authors.affiliation: Papa Ola Lokahi, 894 Queen St, Honolulu, HI 96813, USA. nia-aitaoto@uiowa.edu
authors.forename: Nia
authors.initials: N
authors.lastname: Aitaoto
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Braun
authors.forename: Julia
authors.initials: J
authors.lastname: Estrella
authors.forename: Aritae
authors.initials: A
authors.lastname: Epeluk
authors.forename: JoAnn
authors.initials: J
authors.lastname: Tsark
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006254:Hawaii; D006266:Health Education / Q000379:methods; D006282:Health Personnel; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data; D008849:Micronesia / Q000453:epidemiology; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander; D009369:Neoplasms / Q000517:prevention & control*; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D055815:Young Adult