Previous studies have documented that merely having access to mammography may not be sufficient to improve screening rates in racial and ethnic minority and low-income women. Fear of pain, distrust of the medical system, and fear of cancer-related costs are significant barriers for mammography uptake among underserved women, and these factors influence the acceptability of mobile mammography units.

The Dallas Cancer Disparities Coalition, created in 2007, has developed and pilot-tested an effective, culturally-sensitive, community-based approach to significantly improving knowledge and perceptions related to breast cancer among underserved women, but a remaining need is the provision of sc...

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Previous studies have documented that merely having access to mammography may not be sufficient to improve screening rates in racial and ethnic minority and low-income women. Fear of pain, distrust of the medical system, and fear of cancer-related costs are significant barriers for mammography uptake among underserved women, and these factors influence the acceptability of mobile mammography units.

The Dallas Cancer Disparities Coalition, created in 2007, has developed and pilot-tested an effective, culturally-sensitive, community-based approach to significantly improving knowledge and perceptions related to breast cancer among underserved women, but a remaining need is the provision of screening, follow-up and maintenance services.

This application proposes a comprehensive, integrated breast cancer prevention program, including outreach and education, delivery of screening services, follow-up navigation, and cancer-preventive behavior maintenance, targeted to the highest risk women in Dallas County. Specific aims of this program are: (1) To expand an evidence-based breast cancer primary prevention program targeting high risk women in Dallas County; (2) To increase screening mammography uptake among high risk women in Dallas County; and (3) To enhance sustainability of these efforts through increasing community capacity for prevention and ensuring behavior maintenance.

While we will include all women age 40 and older who are noncompliant with current breast cancer screening guidelines, we will primarily target Dallas County women who have not had a screening mammogram in the previous 5 years. This program will enroll, at a minimum, 600 women in the program over a 3 year period. Furthermore, we will provide 850 mammograms and clinical breast exams and will reach more than 2,000 women with breast health educational materials during the program.

This prevention program brings together a diverse group of partners, including universities, a governmental housing agency, nonprofit organizations, a cancer advocacy group, and multiple health care systems. Our innovative plan is grounded in community input and participation and will be directed by the Dallas Cancer Disparities Coalition Community Advisory Board. The Coalition’s long-term goal is to create sustainable cancer prevention models that can be replicated in other parts of Texas in similar communities to reduce breast cancer disparities.

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