Breast cancer is the second leading cause of cancer mortality in African American women. Low rates of cancer screening participation have been documented in inner-city elderly African American populations. Knowledge and beliefs about breast cancer and screening, and self-efficacy in performing breast self-examinations, are important components in an educational program aimed at increasing participation in breast cancer screening. The objectives of this study were to determine the breast cancer knowledge of subjects, their level of confidence when performing breast self-examination, and if individual instruction, one-to-one practice, and feedback on performance made a difference in screening practices. The findings suggest that a more intensive training intervention sustains breast examination self-efficacy.