The North Carolina Breast Cancer Screening Program (NC-BCSP) is a community-based intervention to increase mammography use by African American women in eastern North Carolina. The primary strategy is a network of 140 volunteer lay health advisors (LHAs) who promote mammography across 5 rural counties. In each county, LHA activities are coordinated by a paid, full-time Community Outreach Specialist (COS). COSs, like LHAs, are older, African American women with local reputations for being "natural helpers."
The COSs, as conceptualized by NC-BCSP, are unique. They are "boundary spanners" who link traditionally under-served communities with resources administered by local health agencies. Each COS is paid through a local health department or rural health center where she maintains an office. Her responsibilities, however, are defined largely by NC-BCSP. This arrangement has enabled the COSs to retain their focus over the past 6 years on organizing LHAs to promote mammograms, despite being situated within agencies that have limited resources and multiple, often competing, agendas.
Two factors appear to be instrumental to NC-BCSP's success in mobilizing African American women in these rural counties to initiate mammography: 1) positioning COSs in established agencies that are part of the local infrastructure for health care delivery; and 2) defining the COSs' role so that they are authorized to use innovative outreach strategies, departing, when necessary, from health agency procedures and norms. The COS role is integral, both in implementing LHA interventions and in generating community investment in outreach goals.
Learning Objectives:
Keywords: Community-Based Health Promotion, Breast Feeding
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.