Improving Mammography Rates of African*American Women: Sisters Educated in Emergency Departments

Purpose:

The purpose of this presentation is to describe a series of studies conducted to develop an intervention to promote mammography screening among African American women while they wait for non urgent care in Emergency departments.

Methods:

 Three projects were conducted to meet the overall aim of developing and piloting an intervention. The studies were formative (mixed methods), developmental, and a pilot RCT. 

Results:

Study 1: formative: mixed methods designed to examine cultural, social and personal factors that are barriers or benefits of mammography use among African American women who use the ED for non urgent care. Brochures were designed based on the findings from this formative study. Study 2: Developmental: focus groups were conducted to assist in development of stage matched, culturally targeted brochures and a motivational interviewing intervention to be delivered in the ED. Study 3: Three armed pilot of an RCT designed to compare the effects of a brief motivational  interview delivered by a lay health worker with those of a culturally targeted brochure and a usual care control group. 23% of the sample reported having never had a mammogram prior to the study. There were no group differences by mammography status at the 3 month interview. More than one-quarter of those retained in the study indicated that they had received a mammogram during the study.

Conclusion:

These studies demonstrate how one develops an intervention from formative research to pilot. While there were no group differences in the initial pilot this lays the foundation for future work in this vulnerable population by demonstrating recruitment techniques in an innovative setting, the use of a lay health workers in a clinical setting, and targeted MI and brochure use. Further refinement of the pilot intervention that includes more intensive dosing for the intervention group is necessary to detect a significant difference. The developmental techniques demonstrated across the studies will be helpful for other health disparities researchers interested in developing targeted interventions for vulnerable populations.