Randomized trial of a lay health advisor and computer intervention to increase mammography screening in African American women

Kathleen M. Russell, Victoria L. Champion, Patrick O. Monahan, Sandra Millon-Underwood, Qianqian Zhao, Nicole Spacey, Nathan L. Rush, Electra D. Paskett

Research output: Contribution to journalArticle

43 Scopus citations


Background: Low-income African American women face numerous barriers to mammography screening. We tested the efficacy of a combined interactive computer program and lay health advisor intervention to increase mammography screening. Methods: In this randomized, single blind study, participants were 181 African American female health center patients of ages 41 to 75 years, at ≤250% of poverty level, with no breast cancer history, and with no screening mammogram in the past 15 months. They were assigned to either (a) a low-dose comparison group consisting of a culturally appropriate mammography screening pamphlet or (b) interactive, tailored computer instruction at baseline and four monthly lay health advisor counseling sessions. Self-reported screening data were collected at baseline and 6 months and verified by medical record. Results: For intent-to-treat analysis of primary outcome (medical record-verified mammography screening, available on all but two participants), the intervention group had increased screening to 51% (45 of 89) compared with 18% (16 of 90) for the comparison group at 6 months. When adjusted for employment status, disability, first-degree relatives with breast cancer, health insurance, and previous breast biopsies, the intervention group was three times more likely (adjusted relative risk, 2.7; 95% confidence interval, 1.8-3.7; P < 0.0001) to get screened than the low-dose comparison group. Similar results were found for self-reported mammography stage of screening adoption. Conclusions: The combined intervention was efficacious in improving mammography screening in low-income African American women, with an unadjusted effect size (relative risk, 2.84) significantly higher (P < 0.05) than that in previous studies of each intervention alone.

Original languageEnglish (US)
Pages (from-to)201-210
Number of pages10
JournalCancer Epidemiology Biomarkers and Prevention
Issue number1
StatePublished - Jan 2010

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

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