Testing the effectiveness of a community-based breast health education program for Amish women

Ohio contains the world's largest Amish settlement, with over 30,000 Amish living in one community. Additionally, the world's fourth largest settlement and several dozen other Amish settlements are scattered throughout Ohio in mostly rural, underserved communities where access to cancer screening services is limited or unavailable. Preliminary research has indicated that breast cancer mortality rates are disproportionately higher among Amish when compared to that of non-Amish women, possibly due in part to lack of breast health education.

Project Hoffnung (or “Hope”) was established in 1997 to address health disparities within Amish communities by understanding knowledge, attitudes beliefs and behaviors surrounding cancer issues. A culturally competent breast health program was developed through a series of focus groups, key informant interviews, and a community-led advisory team.

Between March 2010-December 2010, 296 women received a 15-minute education program prior to participating in a community screening for Amish and Mennonite women. The mean age was 52 years. The two-page survey consisted of the 13-item knowledge scale from Champion's Health Belief Model Scale (CHBMS) (1995).

A dependent means t-test was conducted to compare total correct scores on the 13-item CHBMS scale at Time 1 (prior to the education program) and Time 2 (three months after the intervention). The response rate was almost 50 percent. To date, the results indicated that total knowledge about breast cancer was significantly impacted by the intervention even at the three-month period. Final post-test surveys will be collected in March for a complete analysis of impact of the education intervention.