A Value-Based Approach to Increase Breast Cancer Screening and Health-Directed Behaviors among American Indian Women

American Indian/Alaska Native (AI/AN) women have the lowest cancer-screening rate of any ethnic or racial group; AI/AN women in all regions are less likely than non-Hispanic white women to be diagnosed with localized breast cancer; and those AI/AN women presenting with breast cancer have the lowest 5-year survival rate compared to other ethnic groups. This study found that cultural beliefs are more of a factor in mammography screening behavior than other barriers such as access; and that a more holistic educational intervention designed by AI/AN women prompted individual intent and actions to seek mammograms among AI/AN women >40 and to change unhealthy eating and sedentary lifestyles

Peer navigation improves diagnostic follow-up after breast cancer screening among Korean American women: results of a randomized trial

To test an intervention to increase adherence to diagnostic follow-up tests among Asian American women. Korean American women who were referred for a diagnostic follow-up test (mainly diagnostic mammograms) and who had missed their follow-up appointment were eligible to participate in the study. Women from two clinics (n = 176) were randomly allocated to a usual care control arm or a peer navigator intervention arm. A 20-min telephone survey was administered to women in both study arms six months after they were identified to assess demographic and socio-economic characteristics and the primary outcome, self-reported completion of the recommended follow-up exam. Among women who completed the survey at six-month follow-up, self-reported completion of follow-up procedures was 97% in the intervention arm and 67% in the control arm (p < 0.001). Based on an intent-to-treat analysis of all women who were randomized and an assumption of no completion of follow-up exam for women with missing outcome data, self-reported completion of follow-up was 61% in the intervention arm and 46% in the usual care control arm (p < 0.069). Our results suggest that a peer navigator intervention to assist Korean American women to obtain follow-up diagnostic tests after an abnormal breast cancer screening test is efficacious

Cancer among elder Native Americans.

The objectives of this case-based study are identified as; 1) compare cancer incidence, mortality and survival for specified cancer sites in the population compared with that in older non-Indians; 2) list risk factors for the more common types of cancer; 3) describe the role of traditional healing within the cancer diagnosis, treatment, and recovery processes; 4) identify barriers which affect the diagnosis, treatment, and recovery from cancer in older populations; and 5) define diagnosis, treatment, and management protocols. The data compiled includes age-adjusted rates by the direct method. These rates allow comparison of cancer morbidity or mortality data between Northeastern and Southeastern tribes as though the age distributions were comparable. The "age-adjusted rate" calculation required that the data of interest be compared with a standard population. Most national databases use 1970 U.S. population as the standard. Older American Indians and Alaska Natives are low users of early cancer detection programs in comparison with other racial groups. Numerous barriers explain the low utilization and participation rates. Barriers, which affect American Indian and Alaska Native participation in cancer early detection and screening programs, include poverty, psychosocial, and sociocultural issues. Cancer disease rates continue to increase among elder Native Americans. Many types of cancer are best addressed through prevention efforts and early detection. Providers need to increase cancer prevention, awareness, early detection screening programs, and support groups to provide emotional and spiritual support to Native people affected by cancer. Additionally, traditional Native American healers, using therapy and ceremonies working conjunction with scientific providers allows for the patients spiritual healing, guidance, and cleansing