BREAST CANCER EDUCATION FOR OLDER URBAN MINORITY WOMEN

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DESCRIPTION: (Applicant's Abstract) Older low-income urban minority women have high incidence and late detection of breast cancer due to avoidable diagnostic delays. Breast cancer screening is underutilized by this group and established interventions have been largely ineffective. They have the greatest need for breast cancer education among large well-defined United States subpopulations. This need will be met by implementing a community- based breast cancer education program among peer team leaders in two low- income independent living facilities. A peer-volunteer program coordinated by a large social service agency in urban St. Louis will collaborate in the study. Developed on a community organization model in the early 1980s with input from neighborhood residents, this volunteer program supports independent living of older (60 plus) adults. Volunteer team leaders from the program maintain contact with designated team member peers. Proposed curriculum for team leaders is grounded in theories of health education and community organization. It will emphasize screening and follow-up for apparent breast problems, stress increased probability of favorable outcomes via early detection and treatment seeking among team members. A controlled quasi-experimental research design with switching replication is proposed to evaluate cognitive and behavioral outcomes among 100 volunteer team leaders (50 per site) who receive the eduction and the 600 team members (300 per site) whom they serve. Sites will be randomly assigned to act as: 1) the index breast cancer education program site; or 2) a comparison site not receiving the program until one year later. We will evaluate:i) implementation of the core educational program to team leaders in the volunteer community organization; ii) team leaders' choices of additional (optional) education sessions; iii) means by and degree to which team leaders pass along information/encouragement to team members; iv) knowledge and attitudes about breast cancer, screening, and treatment seeking among team leaders and members before and after the eduction initiative; v) activities planned and conducted by team leaders following their education; and vi) participation in breast cancer screening among team leaders and their team members before and after the education initiative.If successful, this program's implementations for breast cancer education through volunteer programs coordinated by social service agencies would be substantial.