Thursday, February 19, 2015

Evidence-Based Interventions to Reduce Psychosocial and Access Barriers to Breast Cancer Screening Among African American Women

Alycia A. Bellah, School of Psychology

Breast cancer is the second leading cause of cancer mortality among women in the United States. In an effort to decrease cancer mortality rates among women, national efforts have encouraged early detection and treatment of breast cancer through mammography. Although cancer impacts individuals across all racial and ethnic groups, African American women have lower rates of screening; higher rates of more lethal types of cancer; higher mortality rates and advanced stage cancer detection more often than their Caucasian counterparts. The purpose of this study was to investigate the impact of a theoretically driven psychological intervention, based on social cognitive theory and motivational interviewing techniques, combined with patient education materials on mammography completion among African American women. In addition, the study’s aim was to identify variables that predict mammography completion among African American women. This study explored the effectiveness of three distinct intervention modalities on the use of mammography among a group of 766 African American women. Results of multilevel analyses for nested data indicate that evidence-based psychological intervention aimed at known barriers to cancer care improves timely mammography completion among African American women [OR = 1.25; 95% CI (1.07, 1.46)].

The results also suggest that collaborative care between primary care and mental health providers may result in improved health outcomes, specifically when working with African American women. Results of the present study offer potential targets for future breast cancer screening campaigns targeted to African American women. The results also offer theoretically sound treatment suggestions to clinicians working with African American women in the field of cancer prevention.

Key Words: cancer, screening, mammography, barriers, collaborative care, integrated care, evidence-based interventions, African American women.

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