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.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Education Projects (R25)
Project #
5R25CA066820-03
Application #
2110308
Study Section
Special Emphasis Panel (SRC (11))
Project Start
1994-09-30
Project End
1998-08-31
Budget Start
1996-09-01
Budget End
1998-08-31
Support Year
3
Fiscal Year
1996
Total Cost
Indirect Cost
Name
Washington University
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
062761671
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
Skinner, C S; Arfken, C L; Waterman, B (2000) Outcomes of the Learn, Share & Live breast cancer education program for older urban women. Am J Public Health 90:1229-34
Skinner, C S; Arfken, C L; Sykes, R K (1998) Knowledge, perceptions, and mammography stage of adoption among older urban women. Am J Prev Med 14:54-63
Skinner, C S; Sykes, R K; Monsees, B S et al. (1998) Learn, share, and live: breast cancer education for older, urban minority women. Health Educ Behav 25:60-78