Making technology work for breast cancer prevention: An innovative DVD intervention focused on Gulf-South African-American women

BACKGROUND: Breast Cancer mortality rates for African-American women (42.6%) are significantly higher than White women (28.6%) in the New Orleans region, largely due to breast cancer diagnosis for African-Americans at a much later stage in disease. This gap can be significantly diminished with an increase in mammography adherence. Innovative information technology to reach large population segments with educational messages facilitating mammography screening is needed for non-adherent un- and under- insured African-American women. METHODS: A Community Advisory Board was convened bi-monthly from regional faith-based holistic ministries and frontline community healthcare providers to inform study design and production of a mammography promotion DVD. Focusing on three interdependent public health challenges our communities face: high cancer mortality; limited success of population-based cancer preventive practices; and a fragile healthcare infrastructure limiting access to care, this CBPR study developed an interactive DVD and will validate the effectiveness of this tailored intervention to promote mammography adherence. Preliminary focus group and standardized survey data were used as a foundation for adaptation of existing computerized media relevant to promote mammography adherence. RESULTS: The research study, informed by community members, and driven by preliminary qualitative and quantitative data measuring the necessary message adaptation to existing computerized media incorporated preliminary findings determining the behavioral health messages, cultural characteristics, message style, and locality parameters requiring adaptation to have relevance for Gulf-South African-American women. Additional data on demographic and psychosocial factors and their relationship to health behaviors across race, SES, and geographic areas determined that mental health functioning increased in association with the psychosocial burden of discrimination among African-American women and appears to play a significant role in mammography adherence. Using these findings, a strategy to strengthen breast cancer prevention and early detection was developed and a DVD produced titled, Abreast on the Boat of Hope: Mammography, the Life Saver. CONCLUSION: The project serves as a framework for future intervention studies and a conduit for comparative studies aimed at addressing cancer health disparities. Piloting the DVD across Gulf-South communities is necessary to measure validity and to collect data to increase feasibility for broader, potentially national application, across cancer types and geographic settings.