Increasing mammography practice by African American women

PURPOSE: This study examines the effectiveness of the Witness Project, a cu lturally competent cancer education program that trains cancer survivors to promote early detection and increased breast self-examination and mammogra phy in a population of rural, undeserved, African American women. DESCRIPTION OF STUDY: The primary setting for the Witness Project - an inte nsive, community-based, culturally sensitive educational program that incor porates spirituality and faith - was the African American church. Baseline and 6-month follow-up surveys were obtained from 206 African American women in two intervention counties and from 204 African American women in two co ntrol counties in the rural Mississippi River Delta region of Arkansas. RESULTS: Witness Project participants significantly increased (P < .0001) t heir practice of breast self-examination and mammography (P < .005) compare d with the women in the control counties. CLINICAL IMPLICATIONS: These results demonstrate that intensive, community- based, culturally sensitive educational programming incorporating the spiri tual environment of the faith community, such as the Witness Project, can p ositively influence breast cancer screening behaviors among rural, underser ved African American women. Through the use of community churches and cance r survivors, breast cancer screening activities can be improved in this pop ulation.