228336 Making technology work for breast cancer prevention: An innovative DVD intervention focused on Gulf-South African-American women

Sunday, November 7, 2010

Farah A. Arosemena, MPH , Department of Environmental Health Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
Thy Ho-Pham, BS (c) , Xavier University of Louisiana, New Orleans, LA
Danielle Levine, MPH (c) , School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
Maureen Y. Lichtveld, MD, MPH , School of Public Health and Tropical Medicine, Department of Environmental Health Sciences, Tulane University, New Orleans, LA
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.

Learning Areas:
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Define population specific behavioral messages and psychosocial predictors affecting mammography decision-making among uninsured women non-adherent to mammography. Demonstrate the value of a community-based participatory approach to intervention design. Discuss the importance of population specific tailored interventions. Identify implications for future intervention research focusing on culturally competent, linguistic, and literacy specific strategies to strengthen cancer prevention and early detection for broader, potentially national application across cancer types, age, gender, and geographic setting.

Keywords: Mammography Screening, Communication Technology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a qualified presenter serving as a Program Manager for intervention, cancer prevention and health disparity studies.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.