We propose to conduct a group randomized controlled trial to implement and evaluate the effect of an innovative evidence-based breast health education intervention program compared to a control group (delayed intervention) to promote breast health screening among first generation Afghan immigrant women. Sensitivity to cultural, religious, and linguisfic factors is a key component ofthe proposed inten/ention. With funding from California's Breast Cancer Research Program, we have conducted the pilot work (see preliminary results) and findings from the pilot work to guide the content of the intervention. Consistent with the tenets of community based participatory research, the pilot project was administratively designed to ensure that the community was an equal partner with the academic research partners in terms of power and influence ^they received their own budget and are the owners of the data that was collected (these two issues have a history of being problematic in community based participatory research). Our research will test the hypothesis that women randomly assigned to a tailored breast health education program will show increased breast cancer knowledge and awareness and increased rates of having early detection (CBE and mammography). The details of this linguisfically, religious and culturally tailored (targeted there is contention in the field as to whether this is target or tailored, the latter being more specific) program designed for low literacy and taught by lay health advisors (LHAs) with follow-up counseling and facilitafion by community navigators and the support of their male relatives. The cultural/ religious/educational adaptations make our intervention specific to the needs of Muslim women and provide a unique program that distinguishes the Afghan Women's Health Project from other breast health promotion projects. Participants will be randomly assigned into the intervention or control (delayed intervention) group. The control group will receive the educational program after the postintervention survey. Pre-and post-intervention surveys will be used to measure changes in knowledge of prevenfion and in eariy detection behaviors. As part of the post-intervention survey, women will report whether they had (or have an appointment to have) a CBE and/or a mammogram and we will inquire about the facilitators and barriers for getfing a breast health screening examinations.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Specialized Center--Cooperative Agreements (U54)
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Special Emphasis Panel (ZCA1-PCRB-G)
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University of California Berkeley
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Hébert, James R; Braun, Kathryn L; Meade, Cathy D et al. (2015) Community-Based Participatory Research Adds Value to the National Cancer Institute's Research Portfolio. Prog Community Health Partnersh 9 Suppl:1-4
Hébert, James R; Satariano, William A; Friedman, Daniela B et al. (2015) Fulfilling Ethical Responsibility: Moving Beyond the Minimal Standards of Protecting Human Subjects from Research Harm. Prog Community Health Partnersh 9 Suppl:41-50
Shirazi, Mehra; Shirazi, Aida; Bloom, Joan (2015) Developing a culturally competent faith-based framework to promote breast cancer screening among Afghan immigrant women. J Relig Health 54:153-9
Shirazi, Mehra; Bloom, Joan; Shirazi, Aida et al. (2013) Afghan immigrant women's knowledge and behaviors around breast cancer screening. Psychooncology 22:1705-17