Developing and Evaluating Culturally Relevant Interventions to Improve Breast Cancer Screening

The goal of this study is to evaluate the relative benefits of an intervention to promote breast cancer screening among women in the White Mountain Apache (WMA) community. Women will be randomized to receive CARE, a culturally tailored mammography education module, or CARE+COACH, which is the CARE education module plus access to an Apache paraprofessional women's health coach (i.e., patient navigator). The CARE intervention was developed through a community-based participatory research process. The primary outcome is mammography uptake within 2 months of a referral.

Inclusion Criteria:Referral for screening mammography from a Whiteriver Indian Health Service providerSelf-identify as American Indian or Alaska Native (AIAN)FemaleLive on within 60 miles of the Fort Apache Indian ReservationExclusion Criteria:Women who have received a mammogram within the prior 12 monthsWomen with a personal history of breast cancerUnable to participate in full intervention or evaluation due to an anticipated event (e.g., planned move)Unwilling to be randomized