This eight-year project will develop and evaluate a community breast screening promotion program. Program activities will be organized under the auspices of a community coalition, and will be administered through a Breast Screening Program office. Program components will promote mammography screening and training in breast palpation and breast self-examination instruction for medical practitioners, while community organization approaches will provide direct breast screening education to women in the community. During Year 1, community assessment and planning efforts will be initiated. In Year 2, the community program will be implemented to enhance existing breast screening efforts with full project support; during subsequent years, support for selected program elements will be transferred to community resources with consultation from project staff. Measurement of program effects will be achieved through telephone surveys (using random digit dialing) of 1,000 women in the intervention community, 1,000 usual-practice controls and 1,000 women in additional control groups; a 25% sample will have palpation skills verified in a home interview. Breast palpation and BSE education skills by medical practitioners will be measured in personal interviews. Surveys and interviews will be conducted before interventions begin, at intervals of one and three years after they begin, and in Year 7, two years after programs have been transferred to local resources.
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