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Stepped-Care, Community Clinic Interventions to Promote Mammography Use among Low-Income Rural African American Women

University of Arkansas Medical Sciences, College of Public Health, Little Rock.

Paul Greene, PhD

University of Arkansas Medical Sciences, College of Public Health, Little Rock.

LeaVonne Pulley, PhD

University of Arkansas Medical Sciences, College of Public Health, Little Rock.

Polly Kratt, PhD

University of Alabama at Birmingham, School of Medicine, Birmingham.

Stacy Gore, PhD

University of Alabama at Birmingham, School of Medicine, Birmingham.

Heidi Weiss, PhD

Breast Center, Houston, Texas.

Nicole Siegfried, PhD

Department of Psychology, Samford University, Birmingham, Alabama.

Few studies have investigated community clinic-based interventions to promote mammography screening among rural African American women. This study randomized older low-income rural African American women who had not participated in screening in the previous 2 years to a theory-based, personalized letter or usual care; no group differences in mammography rate were evident at 6-month follow-up. Women who had not obtained a mammogram were then randomized to a tailored call delivered by community health care workers or a tailored letter. There were no group differences in mammography rates after the second 6-month follow-up. However, among women who had never had a mammogram, the tailored call was more effective in promoting mammography use. Tailored counseling may be an effective screening promotion strategy for hard-to-reach rural African American women with no history of screening. Further research into this strategy may facilitate efforts to reduce health disparities in underserved low-income rural African American populations.

Key Words: women’s health • African American women • mammography • breast cancer • prevention

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