Increasing use of mammography among older, rural African American women: results from a community trial

Am J Public Health. 2002 Apr;92(4):646-54. doi: 10.2105/ajph.92.4.646.


Objectives: A community trial was undertaken to evaluate the effectiveness of the North Carolina Breast Cancer Screening Program, a lay health advisor network intervention intended to increase screening among rural African American women 50 years and older.

Methods: A stratified random sample of 801 African American women completed baseline (1993-1994) and follow-up (1996-1997) surveys. The primary outcome was self-reported mammography use in the previous 2 years.

Results: The intervention was associated with an overall 6 percentage point increase (95% confidence interval [CI] = -1, 14) in community-wide mammography use. Low-income women in intervention counties showed an 11 percentage point increase (95% CI = 2, 21) in use above that exhibited by low-income women in comparison counties. Adjustment for potentially confounding characteristics did not change the results.

Conclusions: A lay health advisor intervention appears to be an effective public health approach to increasing use of screening mammography among low-income, rural populations.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • African Americans / education*
  • African Americans / statistics & numerical data
  • Aged
  • Family Characteristics
  • Female
  • Health Care Surveys
  • Health Education / organization & administration*
  • Humans
  • Mammography / statistics & numerical data*
  • Mass Screening / organization & administration
  • Mass Screening / statistics & numerical data*
  • Middle Aged
  • Minority Groups / statistics & numerical data*
  • North Carolina / epidemiology
  • Patient Acceptance of Health Care / ethnology*
  • Peer Group
  • Poverty / ethnology*
  • Program Evaluation
  • Rural Health*
  • Women's Health*