Pacific Breast Care Outreach Project: Using community-participatory principles to develop a peer educator cancer awareness and screening program for Pacific Island women

Background. Women from the US Associated Pacific jurisdictions —including the Republic of the Marshall Islands (RMI) and the Federated States of Micronesia (FSM)—are among Hawaii's newest immigrants and have very low rates of participation in breast and cervical cancer screening. The purpose of this project was to increase this population's utilization of breast and cervical cancer screening on the island of Oahu.

Methods. We followed the Health Belief Model and used the following CBPR principles to convene, train and increase the capacity of community lay educators to: build community trust, conduct assessments, skills transfer, and empowerment. The lay educators received a small stipend to identify, educate and refer their peers to screening.

Findings. A Micronesian in-language curriculum was developed and 16 peer educators were trained. During the one year project period, 16 peer educators reached 567 Micronesian women with breast health education and when appropriate, peer educators referred and facilitated women get screened. Of the total reached, 146 women were linked to breast and cervical cancer screening providers including the Hawaii BCCCP. Five breast cancers were diagnosed among this group. Lay educators noted increases in their own self esteem and have requested to expand their knowledge and skills, and outreach to other Micronesian women.

Discussion. A peer educator model is effective with this population. Plans are to translate the curriculum to more Pacific Island languages, train women on the neighbor islands, and expanding the lay educators' expertise to other health topics such as diabetes and immunization.