Background. While much progress has been made in increasing breast cancer screening rates, there remains a significant proportion of women ages 40 and older who have never had a mammogram or not had one in the last 2 years. Behavioral interventions to increase mammography use have not been particularly effective among these women. The Breast and Cervical Cancer Program (BCCP) provides free and low-cost screening but reaches only a small proportion of women who need its services. Finding effective interventions that connect rarely- and never-screened women to BCCP could help eliminate breast cancer disparities.
Aim. This study will test the feasibility of using a telephone-equipped kiosk in Laundromats and libraries to identify African American women who have never or rarely been screened for breast cancer and connect them with local BCCP mammography services. Study objectives are consistent with research priorities of the National Cancer Institute's Applied Cancer Screening Research Branch. Methods and evaluation. The kiosk contains an interactive computer program. Kiosk users answer questions on a touch screen, and the computer uses this information to generate and print for each user an evidence-based, tailored magazine promoting mammography use. When appropriately placed, the kiosks attract women with limited cancer knowledge, who lack medical insurance, report no use of mammography or physician recommendation for screening, lack knowledge related to obtaining a mammogram, and live near the kiosk location. Guided by previous dissemination research, kiosks will be placed in Laundromats and libraries located near BCCP providers in predominantly African American neighborhoods in St. Louis, MO. The telephone-equipped kiosks will connect users who have never or rarely had a mammogram to BCCP staff at the nearest provider location. This technology-enabled approach will proactively identify women most in need of mammograms, immediately connect them to screening programs in their community, and enable BCCP providers to schedule appointments, provide reminders and offer transportation services to women they might otherwise miss. Six dimensions of feasibility will be evaluated: (1) implementation;(2) integration;(3) practicality;(4) demand;(5) acceptability;and (6) limited efficacy. These outcomes will be measured using BCCP data, kiosk user data and interview data from Laundromat and library patrons and BCCP staff. Potential contribution. The study will provide a better understanding how to efficiently connect to existing services those women who will benefit most from screening mammography.
This project is relevant to public health because it addresses a critical barrier to eliminating breast cancer disparities. We have not yet developed behavioral interventions that adequately increase mammography use among rarely- and never-screened women. This study will identify potentially successful strategies for increasing cancer screening among rarely- and never-screened populations.
