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J Natl Black Nurses Assoc. 2004 Jul;15(1):36-47.

Culturally appropriate breast health educational intervention program for African-American women.

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Capstone College of Nursing, University of Alabama, Tuscaloosa, AL 35487-0358, USA.


The purpose of this study was to provide a culturally specific intervention program for African-American women to alter selected behavioral risk factors, psychosocial responses, and breast self-care variables. Two primary directional hypotheses were tested with an alpha set at 0.05. These hypotheses were: (1) a Culturally Appropriate Breast Educational Intervention Program (CABHEIP) will lower selected behavioral risk factors (high fat intake, inadequate amount of physical activity, inadequate fiber intake) and selected psychosocial responses (perceived stress, negative coping, low self-efficacy, perceived barriers to Breast Self Examination [BSE] and Clinical Breast Examination [CBE]) in African-American women, 20 to 40 years of age, who participate in the program as compared to whose who do not participate; and (2) a CABHEIP will raise compliance with BSE, proficiency of BSE, and perceived benefits of BSE and CBE in African-American women, 20 to 40 years of age, who participate in the program as compared to those who do not participate. A sample of 120 (N = 120) African-American women was randomly assigned to the control and treatment groups (60 women per group; (n = 60 intervention group; n = 60 attention control group). The sample was obtained from a population of African-American women from four southern and three central Mississippi counties. The intervention group, in clusters of 3 to 9 women, received education on breast cancer, breast self-exams, healthy eating, exercise, and stress management; and heard stories from breast cancer survivors. The attention control group, in clusters of 3 to 8 women, received education on poison control in the home environment. Data was collected and analyzed using descriptive statistics, correlation coefficients, and repeated measures of analysis of covariance (ANCOVA) controlling for covariates. Significant differences between groups for BSE proficiency I (p < 0.0001), BSE proficiency II (p = 0.013), and benefit BSE (p = 0.053) were found. Compliance for BSE approached significance between groups (p = 0.053). Significance to nursing is that education can change outcomes in health promotion for breast cancer in African-American women. Further studies with similar interventions and larger sample sizes are needed to determine other avenues to decrease modifiable risk factors for breast cancer in African-American women.

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