Targeted intervention strategies to increase and maintain mammography utilization among African American women: REACH 2010 Outcomes

Background: Breast cancer is the most common cancer diagnosis among African American women. Studies have shown that when African American women follow the same preventive measures as white women, their death rates from breast cancer are very similar. However, African American women are more likely than white women to be diagnosed at later stages of the disease and are more likely to die from it. Objective: To examine the impact of a theory-based, culturally relevant intervention to increase mammography screening among African American women in eight underserved counties in Alabama.

Methods: Principles derived from the Stages of Change, Community Health Advisor, and Community Empowerment models were used to develop strategies to increase mammography screening. Trained volunteers (N=143) provided tailored messages to encourage mammography adoption and maintenance. Baseline and follow-up data were collected on 1,513 community women. The goal was to decrease the number of women in Stage 1 (never screened) while increasing the number of women in Stages 2 (infrequently screened) and 3 (regularly screened).

Results: At baseline, 14% (n=211) of the women were in Stage 1, 16% (n=247) in Stage 2, and 70% (n=1,055) in Stage 3. After the two-year intervention, 4% (n=61) remained in Stage 1, 20% (n=306) were in Stage 2, and 76% (n=1146) in Stage 3.

Conclusions: Tailored motivational messages and peer support can increase mammography screening rates for African American women.