These results demonstrate that intensive, community-based, culturally sensitive educational programming incorporating the spiritual environment of the faith community, such as the Witness Project, can positively influence breast cancer screening behaviors among rural, underserved African American women. Through the use of community churches and cancer survivors, breast cancer screening activities can be improved in this population.
Minorities and indigent populations have low participation rates in breast cancer education and screening programs, and suffer from higher morbidity and mortality. Attitudes, norms, and values of such populations are best addressed by breast cancer patients of the same race and cultural background who serve as role models. This article describes the development and pilot study of an intervention program using role models as part of a "Witness" presentation. Programs were held in participants' local African-American churches and community centers. The organization of the program was based on an educational model (4MAT) that identified learning styles and brain hemisphere dominance. Preliminary results with 78 African-American women indicate that the program design is effective in reaching low-income, less-educated African-American women who did not believe themselves to be at high risk for breast cancer. Three-month follow-up demonstrated a significant increase in the practice of BSE and 19% had a mammogram.
Self-reported sugar-sweetened beverage consumption among undergraduates is substantial and likely contributes considerable non-nutritive calories, which may contribute to weight gain. Black undergraduates may be particularly vulnerable due to higher sugared beverage intake. Obesity prevention interventions targeting reductions in sugar-sweetened beverages in this population merit consideration.
Women were taught breast self-examination (BSE) two different ways using the same material. The 4MAT presentation (N = 49) was directed to four learning styles and both brain hemispheres; the American Cancer Society (ACS) presentation (N = 45) used a traditional lecture/discussion format. A control group (N = 58) was untrained. The mean age of the Cooperative Extension Home Demonstration Club participants was 57 years. A questionnaire, which was given before training, immediately after training, and 3 months later, assessed knowledge of breast cancer and BSE, confidence in performing BSE, and frequency of BSE. ANCOVAs and t tests showed that, compared with the ACS presentation, the 4MAT presentation produced better immediate acquisition and better 3-month retention of both knowledge and confidence. Both 4MAT and ACS participants were statistically superior to the control group on all three dependent variables, both in acquisition and 3 months later. The 4MAT instructional model is recommended for BSE and other health education presentations.
In 1988, Arkansas participated in a statewide effort to promote lowcost mammograms. Fewer than 2 pemnt of the women who participated were African Americans. Through intervim, surveys, and focus groups with African American women in Arkansas, the authors learned that very few of these women knew any cancer survivors. Most of their experiences involved friends and relatives dying from cancer. Our MissionAfrican American women have a lower incidence rate of breast cancer, but are more than twice as likely to die from it. And they are twice as likely to get cervical cancer and three times as likely to die from it. Often, these women were not aware they were at risk, nor did they want to hear about it. Our challenge was to educate them about their risk for breast or cervical cancer. This project required community-based education for adult learners. A strong theoretical foundation, which combined health education, learning styles, brain hemisphericity, and anthropology concepts, was essential.The Wltness PrOJect"The Witness ProjectTM was created in 1990 to increase cancer survivorship skills and awmess in the African American community. This non-traditional program was based on a simple concept-to provide culturally appmpriate role models who promote behaviors that find cancer early. The program is based out of The Arkansas Cancer Research Center at the University of Arkansas for Medical Sciences. 'ho objectives for the project were identified-to increase participation in cancer screening programs and to decrease death and sickness from cancerThe first program was held in 1991.The Witness ProjectTM meets the specific cultural, educational, knowledge, and learning style levels of rural, medically underserved African American women. Program sessions are conducted by a t e a m of AfricanAmerican cancer survivors who educate by t&ashg, or talking about their cancer experiences.centers. During a program session, these Witness Role Models (WRMS) share their experiences with cancer, stressing the importance of early detection and answering questions about their personal experiences, fears, and concern. Witnessing is done by two to fiw WRMs of small audiences up to twenty-fiw participants. After a program, women are empmwred to take care of their health needs and to owmme some of the fatalism so often found among this p u p of African American women.The program design is simple and yet complex. S iple, in that cancer survivors are trained to promote successful health behavios to othes who needed to hear them by wdmsing. Complex, in that we used three theories (Locus of Control, Transtheoretical, and Community Empowerment) and four models (W System", Precede-Proceed, Health Belief, and PEN-3) to structure the Witness PmjeCtTM. This foundation regards the social
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