Empowering high-risk women to prevent breast cancer: The Dallas Cancer Disparities Coalition

Background: The Dallas Cancer Disparities Community Coalition was created in 2007 to address the disproportionate burden of cancer mortality in South Dallas. Using a community-based participatory approach, the Coalition's first intervention was a program designed to increase valid knowledge of chief contributing factors for breast cancer, increase awareness of the importance of mammograms, and increase the proportion of women who are compliant with breast cancer screening guidelines. We describe the results of the program to date here. Methods: The 8-week breast health education program, built on tenets of the Health Belief Model and Social Cognitive Theory, is open to women in Dallas County age 40 and older who are eligible for a screening mammogram. Lay health educators recruit and retain participants and navigate women with abnormal results. Sustainability is promoted through a year-long health behavior maintenance program. Results: To date, 188 women have participated in the 8-week program, of which 48% had never received a mammogram and another 25% had not had a mammogram in over 5 years. Of the 112 women that have received screening mammograms, at least 29% required follow up for abnormal results. Statistically significant improvements in breast cancer knowledge and breast self-examinations have been demonstrated. Conclusions: Keys to success include building respectful relationships with women; providing incentives for participation; and focusing on empowerment. Lessons learned from this community-based program to date can be used to create sustainable models of breast cancer prevention programs targeting racial/ethnic minority and hard-to-reach women that can be replicated in other communities.