Using technology to connect rarely and never screened African American women to mammography

Considerable progress has been made in increasing breast cancer screening rates, yet behavioral interventions to increase use of mammography have been largely ineffective with rarely and never screened women. The Breast and Cervical Cancer Program (BCCP) provides free and low-cost mammograms but reaches only a small proportion of women who need its services. Identifying effective interventions that connect rarely and never screened women to BCCP could help eliminate breast cancer disparities. This study of more than 5,000 women is evaluating the feasibility of using new information and communication technologies (ICTs) to identify women who have never or rarely had mammograms and connect them with local BCCP providers. Computerized kiosks delivering an evidence-based breast cancer education intervention have been placed in African American neighborhoods in St. Louis, MO, where rates of late-stage breast cancer diagnosis are disproportionately high. These kiosks reach high proportions of women with limited cancer knowledge, who lack medical insurance, report no use of mammography or physician recommendation for screening, lack knowledge related to obtaining a mammogram, and live near the kiosk location. Enhanced kiosks equipped with ICTs identify rarely and never screened women and instantly connect them directly from the kiosk to the nearest BCCP location where the women can learn about BCCP services and schedule mammogram appointments. Findings related to six dimensions of feasibility will be discussed: implementation; integration; practicality; demand; acceptability; and limited efficacy. This innovative, technology-driven approach is a promising strategy for connecting to existing services women who will benefit most from screening mammography.