Community Based Participatory Research with Underserved African American Women with Breast Cancer: Lessons Learned
Methods: This study utilized Community Based Participatory Research (CBPR) to develop and test the effectiveness of providing a breast cancer educational program to underserved African American women. A 45 minute skit, Hats off to Cancer, was developed by key stakeholders in the community and used storytelling to honor and incorporate five different cultural experiences with breast cancer prevention and diagnosis. The program was evaluated using a pre-test questionnaire and 3 month follow-up telephone questionnaire regarding breast cancer attitudes, knowledge, and behavior. The culturally sensitive approach to this program took into account the socio-economic and psychosocial barriers impeding a woman’s access to breast health information and services. To appropriately address the issues, testimonials and stories ranged from personal experiences dealing with self-breast examinations (SBE), clinical breast examinations (CBE), early detection, diagnosis and survivorship with an emphasis on early detection. A total of 496 African American women completed the program and pre/post test questionnaires.
Results: Findings revealed significant changes in pre and post test breast cancer attitudes, knowledge, and behavior (p=.01). Results also showed that 99% of participants strongly agreed or agreed they would recommend the Hats off to Cancer program to a friend. Similarly, over 98% strongly agreed or agreed they enjoyed and learned something new from the program.
Implications: Identifying and engaging key stakeholders and community leaders is essential in the success of providing services and conducting CBPR in underserved, minority communities. The current project involved an agency that had worked many years to establish respect and trust among community leaders in providing culturally relevant health promotion programs. The early commitments of the agency, to provide education and support to empower women to better understand and practice appropriate breast care, have evolved into a “shared ownership” with surrounding communities.