Mortality rates from breast cancer in low income women far exceed those of the general population, due in part to the lack of early detection. The study proposes to explore how low income African American women process, interpret, and act on health education messages regarding mammography because past cost effective interventions have had very limited success in improving mammography rates. A video was developed using focus group discussions of the beliefs specific to the targeted low-income, urban community. The structure of the video is based on social influence theories shown to increase deeper processing of information. Deeper processing has been associated with more enduring change in attitudes and beliefs. In this longitudinal, experimental study (Solomon Four design) low-income African American women visiting an urban health clinic will be randomly assigned to one of four groups. Each group will be presented with a different combination of pre-test, post-test, and viewing of the video. Both how the women process the information (deep or shallow) and the process by which the women decide whether to obtain a mammogram will be assessed. Evidence of change will be measured in three ways: actual change in beliefs and endurance of that change, changes in stage of adoption towards obtaining annual mammograms, and actual mammogram obtained within a six month follow-up period. ? ?
