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This version was published on June 1, 2008
Health Education & Behavior, Vol. 35, No. 3, 396-409 (2008)
DOI: 10.1177/1090198106290396
© 2008 Society for Public Health Education

A Socioecological Approach to Improving Mammography Rates in a Tribal Community

Kevin C. English, RPh, MPH

Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, ke72{at}columbia.edu

Jo Fairbanks, PhD

Masters in Public Health Program, University of New Mexico School of Medicine, Albuquerque, New Mexico

Carolyn E. Finster, MSHA

Pine Hill Health Center, Pine Hill, New Mexico

Alvin Rafelito, MSHA

National Indian Council on Aging, Albuquerque, New Mexico

Jolene Luna, MS

Pine Hill Health Center, Pine Hill, New Mexico

Marianna Kennedy, MSW, MPA, MPH

Albuquerque Area Indian Health Board, Albuquerque, New Mexico

This article highlights the processes and intermediate outcomes of a pilot project to increase mammography rates of women in an American Indian tribe in New Mexico. Using a socioecological framework and principles of community-based participatory research, a community coalition was able to (a) bolster local infrastructure to increase access to mammography services; (b) build public health knowledge and skills among tribal health providers; (c) identify community-specific knowledge, attitudes, and beliefs related to breast cancer; (d) establish interdependent partnerships among community health programs and between the tribe and outside organizations; and (e) adopt local policy initiatives to bolster tribal cancer control. These findings demonstrate the value of targeting a combination of individual, community, and environmental factors, which affect community breast cancer screening rates and incorporating cultural strengths and resources into all facets of a tribal health promotion intervention.

Key Words: American Indians • breast cancer • capacity building • community-based participatory research • socioecological model • mammography


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