Increasing mammography and breast self-examination in African American women using the Witness Project model

J Cancer Educ. Winter 1996;11(4):210-5. doi: 10.1080/08858199609528430.


Background: The five-year survival rate for African American women with breast cancer is notably lower than the rate for white women; thus, appropriate cancer education and screening efforts are needed to increase mammography and breast self-examination practices by African American women.

Methods: The Witness Project is a theory-based intervention designed to provide culturally sensitive messages, from African American breast cancer survivors, in churches and community organizations. These messages emphasize the importance of early detection to improve survival.

Results: Intervention research in eastern Arkansas with 204 African American women demonstrated a significant increase in the practice of breast self-examination (p < 0.001) and mammography (p < 0.001) after participation in the Witness Project. There was no significant difference between the pre- and postintervention scores for scaled items for the health-belief model and locus of control.

Conclusions: Results demonstrate that culturally appropriate cancer education programs are able to change behavior by meeting the beliefs of participants rather than attempting to change their beliefs.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • African Americans*
  • Aged
  • Arkansas
  • Breast Neoplasms / ethnology
  • Breast Neoplasms / prevention & control*
  • Breast Neoplasms / psychology
  • Breast Self-Examination*
  • Culture*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Internal-External Control
  • Mammography*
  • Matched-Pair Analysis
  • Middle Aged
  • Models, Psychological
  • Patient Education as Topic / methods*
  • Poverty
  • Rural Health
  • Social Environment