Increasing Breast Cancer Screening in Refugee Communities: Identifying Best Practices Among Lay Health Educators

Introduction. Utilization of trained Lay Health Educators (LHEs) is a promising method to increase health education and screening. LHEs conduct education sessions for disadvantaged and medically underserved women.

Objective. The objective of this study was to determine the current practices of local LHEs that best correlate with increasing mammography screening in Burlington, Vermont's African refugee community.

Methods. A fifteen question survey was administered to the LHEs to identify their attitudes and practices, as well as barriers to their success.

Results. Our study suggested that the LHEs are highly motivated and confident. Respondents cited a lack of resources as the most significant barrier to providing adequate education about mammography screening. LHEs further cited culture, language, emotions, and time constraints as among the most significant barriers faced by African refugee women in seeking screening mammography.

Discussion. The barriers and ongoing lifestyle adjustments faced by recent African immigrants to Burlington, coupled with the relative lack of cancer screening in this community, are primary reasons underlying the importance and promise of the Lay Health Educator program. To assess the efficacy of LHEs' work, future studies should correlate LHE practices with mammogram usage as the end point. Since outcome data was not yet available, we focused on what we learned from our experiences: 1) Infrastructure is needed for data collection and tracking; 2) Projects involving several organizations should consider strategies, such as developing protocols, that will facilitate collaboration and maximize organizational resources and strengths. Both these recommendations will help future efforts to increase screening rates.