3236.0: Monday, November 13, 2000 - 7:00 PM

Abstract #15457

Closing the Black-White gap in mammography use

Jo Anne L. Earp, ScD, Department of Health Behavior and Health Education, School of Public Health, University of North Carolina at Chapel Hill, CB# 7400, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599-7400, (919) 966-3918, jearp@sph.unc.edu, Garth Rauscher, MPH, Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, CB# 7400, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599-7400, and Michael S. O'Malley, PhD, Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, CB# 7295, Chapel Hill, NC 27599.

Purpose: To determine if a lay health advisor intervention, supplemented by professional education and activities to improve access, has reduced the racial gap in breast cancer screening among among rural women ages 50 years and older in eastern North Carolina.

Methods: Beginning in 1994, approximately 140 trained lay health advisors (all African American women over age 50) have promoted breast cancer screening in five rural intervention counties but not in five neighboring comparison counties. We compared the change (baseline to first follow-up) in self-reported mammography use in the past two years among 391 African American and 408 White women in the five intervention counties. Follow-up response rates were 79% and 81%, respectively.

Results: Overall, the intervention was associated with a reduction in the racial gap in mammography use in the past two years from 27% at baseline to 16% at follow-up (p=0.002). Among lower income women (annual income <$12,000), the gap was reduced from 18% to 1% (p=.004). Similar trends were seen for other measures of mammography use (ever had a mammogram, had a mammogram in the past year, and ever heard of mammography).

Conclusion: When racial disparities in breast cancer screening exist, a "natural helper" lay health advisor intervention appears effective in reducing the racial gap, especially among lower income women.

Learning Objectives:

  1. Describe a community-based controlled trial to increase mammography use by rural African American women.
  2. Identify an effective strategy for increasing mammography use by low-income, rural African American women.
  3. Articulate differences in the effectiveness of a lay health advisor intervention in low-income (<$12,000)versus higher income(>$12,000)women.

Keywords: Mammography, Outcomes Research

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA