Results of a Randomized Trial to Increase Mammogram Usage among Samoan Women
- Shiraz I. Mishra1,
- Roshan Bastani3,
- Catherine M. Crespi4,
- L. Cindy Chang5,
- Pat H. Luce6 and
- Claudia R. Baquet2
- Departments of 1Family and Community Medicine and 2Medicine, the Office of Policy and Planning, and the Program in Oncology and the University of Maryland Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland; Departments of 3Health Services and 4Biostatistics, School of Public Health, and 5The Jonsson Comprehensive Cancer Center at the University of California, Los Angeles, California; and 6National Office of Samoan Affairs, Carson, California
- Requests for reprints:
Shiraz I. Mishra, University of Maryland School of Medicine, University of Maryland Statewide Health Network, 401 W. Redwood Street, Suite 100, Baltimore, MD 21201. Phone: 410-706-8887; Fax: 410-706-8891. E-mail: smishra{at}som.umaryland.edu
Abstract
Background: There are no effective breast cancer education programs targeting Samoan women. We tested the effectiveness of a theory-guided, culturally appropriate breast cancer education program (the intervention) designed to increase mammography use among Samoan women.
Methods: This community-based participatory cluster-randomized controlled intervention trial used a parallel two-group design. The sample consisted of 776 women aged 42 and older who had not had a mammogram in the preceding 2 years. The primary outcome was self-reported mammogram use between pretest and posttest.
Results: Overall, there was no statistically significant intervention effect, although the odds of self-reported mammogram use were higher in the intervention than the control group (odds ratio (OR), 1.26; 95% confidence interval (95% CI), 0.74, 2.14; P = 0.39). Exploratory subgroup analyses found that the intervention was effective only among women who were aware of mammograms but had never previously obtained one (OR, 1.99; 95% CI, 1.03, 3.85; P = 0.04). Low need for social support and lack of endorsement of culture-specific beliefs about breast cancer were associated with mammogram use in this group. In women unaware of mammography at pretest, high perceived susceptibility to breast cancer and endorsement of culture-specific beliefs were associated with mammogram use. For women who had previously obtained a mammogram, lower self-efficacy was associated with mammogram use. Intervention compared with control group women had significantly higher levels of knowledge of risk factors and lower endorsement of culture-specific beliefs at posttest.
Conclusions: Results suggest that a multifaceted education intervention may improve mammogram usage for certain subgroups of Samoan women. (Cancer Epidemiol Biomarkers Prev 2007;16(12):2594–604)
- breast cancer screening
- Samoan
- Pacific Islander
- minority
- women's health
- community-based participatory research
- mammography
- education program
- field trial
- culture
- behavior theory
- education theory
- education intervention
Footnotes
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Grant support: California Breast Cancer Research Program of the University of California (grant 4BB-1400) and the National Center for Minority Health and Health Disparities (P60MD000532). The contents of the article are solely the responsibility of the authors and do not necessarily represent the views of the funding agencies.
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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Note: At the time of the research, the first author was affiliated with the Department of Medicine and the Chao Family Comprehensive Cancer Center at the University of California, Irvine, CA.
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- Accepted September 19, 2007.
- Received February 15, 2007.
- Revision received September 12, 2007.
