WHAT

The key to surviving cancer is early diagnosis and treatment. For both breast and cervical cancer, black women have higher mortality rates than white women, due, in large part, to their later stage of diagnosis. Routine use of screening mammography can detect breast cancer early and reduce deaths from this disease by as much as 30% for women 50 years and older. Pap tests administered every 1-2 years and the follow up of abnormal results can virtually eliminate deaths from cervical cancer. Despite the availability and effectiveness of mammography and Pap testing for early detection of breast and cervical cancer, black women, particularly those who are older and living in rural communities, have relatively low breast and cervical cancer screening rates.

NC-BCSP efforts to increase mammography and Pap testing rates aim to improve quality and length of life for rural African American women and, ultimately, contribute to greater equality in health between black and white women.

Inreach and Access efforts aim to assure that the supply of high-quality, affordable mammography and Pap testing satisfy increased demand, stimulated, in part, by LHAs. InReach develops and disseminates training programs for radiologic technologists, primary care physicians, family nurse practitioners and physician assistants. Access efforts address barriers to mammography, particularly cost, transportation, and inconsistent patterns of referral for routine mammography, and follow up for abnormal mammograms or Pap tests.

NC-BCSP uses two approaches to measure its effectiveness. The primary outcome evaluation consists of a community trial with a quasi-experimental, pre-post-test design to compare changes in women's self-reported mammography use, attitudes and intentions between the five-county intervention and a similar five-county comparison area. Staff also conduct process evaluation activities to monitor immediate changes at the individual, practice and agency levels.