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RESEARCH AND PRACTICE |
Jo Anne Earp and Eugenia Eng are with the Lineberger Comprehensive Cancer Center and the Department of Health Behavior and Health Education, University of North Carolina at Chapel Hill. Michael S. O'Malley is with the Lineberger Comprehensive Cancer Center and the Department of Health Policy and Administration, University of North Carolina at Chapel Hill. Mary Altpeter is with the Institute on Aging, University of North Carolina at Chapel Hill. Garth Rauscher is with the Lineberger Comprehensive Cancer Center and the Department of Epidemiology, University of North Carolina at Chapel Hill. Linda Mayne is with the School of Nursing, East Carolina University, Greenville, NC. Holly F. Mathews is with the Department of Anthropology, East Carolina University. Kathy S. Lynch is with the Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill. Bahjat Qaqish is with the Lineberger Comprehensive Cancer Center and the Department of Biostatistics, University of North Carolina at Chapel Hill.
Correspondence: Requests for reprints should be sent to Jo Anne Earp, ScD, Department of Health Behavior and Health Education, School of Public Health, CB# 7400, University of North Carolina, Chapel Hill, NC 27599-7400 (e-mail: jearp{at}sph.unc.edu).
Objectives. A community trial was undertaken to evaluate the effectiveness of the North Carolina Breast Cancer Screening Program, a lay health advisor network intervention intended to increase screening among rural African American women 50 years and older.
Methods. A stratified random sample of 801 African American women completed baseline (1993–1994) and follow-up (1996–1997) surveys. The primary outcome was self-reported mammography use in the previous 2 years.
Results. The intervention was associated with an overall 6 percentage point increase (95% confidence interval [CI] = –1, 14) in communitywide mammography use. Low-income women in intervention counties showed an 11 percentage point increase (95% CI = 2, 21) in use above that exhibited by lowincome women in comparison counties. Adjustment for potentially confounding characteristics did not change the results.
Conclusions. A lay health advisor intervention appears to be an effective public health approach to increasing use of screening mammography among low-income, rural populations.
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