Mary A. Garza, PhD, MPH¹, Marcela Blinka, MSW, LCSWC², Charlotte E Neuhaus, MHS³, Iris Farabee-Lewis, MDiv, DD⁴, James R Zabora, ScD⁵, and Jean Ford, MD¹. (1) Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, 624 N. Broadway, HH-750, Baltimore, MD 21205, 4106141382, mgarza-a@jhsph.edu, (2) The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 1909 McElderry Street, The Hackerman-Patz House, Baltimore, MD 21205, (3) Community Programs & Research, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 1909 McElderly Street, The Hackerman-Patz House, Baltimore, MD 21205, (4) Centennial-Caroline Street United Methodist Church, 1029 Monument St., Baltimore, MD 21202, (5) National Catholic School of Social Service, The Catholic University of America, 620 Michigan Ave., Washington, D. C., DC 20064

BACKGROUND: Low-income African-American women have the worst breast cancer indices. In Maryland, breast cancer outreach initiatives have typically failed to engage women from very low-income neighborhoods. In Baltimore, within the census tracts with the lowest median household incomes, only few women participated in a no-cost breast cancer-screening program. RATIONALE: A specially designed multi-modality outreach initiative may succeed in recruiting low-income African-American women, and increase the rate of mammography use by this population. METHODS: We designed a multi-modality intervention (a problem solving approach with spiritual and cultural components) based on the Health Belief Model and the PRECEDE-PROCEED framework, and used a modified time series design. We also employed an innovative recruitment strategy, targeting specific census tract areas (household incomes <$10,000). Data collected includes mammography history and responses to standardized instruments measuring knowledge and beliefs related to breast cancer and mammography adherence. RESULTS: We found a high level of participant- and community satisfaction with the program. We reached 127 women ages 40 and older, through door-to-door recruitment; 71% of the women have < $6,000 annual income and > 50% have no health insurance. Over 50% are misinformed or do not know basic cancer information. Ninety four percent (94%)of the women followed up for both the 2nd and 3rd assessments. CONCLUSIONS: Our results indicate that low-income African American women in Baltimore can be reached, engaged, and retained in an educational intervention promoting breast cancer screening. Bivariate and multivariate analyses will help identify predictors of completion of breast cancer screening in the study population.

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