Abstract A20: Using intervention mapping to plan a breast health promotion program for African immigrant women: A proposal.
Authors: Odeneye Ebun O. 
Published: August 2014

Breast cancer among African women is described as aggressive and progressive in nature. In fact, many African women who have breast cancer are pre-menopausal. Like their African-American counterparts, African women also suffer from early onset of breast cancer with most cases occurring when they are younger than 50 years old. Although annual mammography screening is recognized as effective in reducing breast cancer-related morbidity and mortality, women of African descent are less likely to have mammography screenings, though they are at higher risk for getting the disease relative to other racial and ethnic groups. They are also more likely to present for treatment with late stage tumors.

Coupled with the above-described similarities between African American women and African immigrant women are unique cultural characteristics that shape these women's migration experiences in relation to breast health. Unfortunately, it is difficult to delineate epidemiological data between these two groups given that both groups are subsumed under the same broad category of “African-American”. As African immigrant women continue to maintain its current position as one of the fastest growing populations in this country, it will become more paramount to advance the science around behavioral and environmental factors driving these women's decisions about their health, specifically how to tailor effective breast cancer prevention strategies for this population.

The purpose of this research endeavor was to design a comprehensive breast health promotion program for African immigrant women in Houston, Texas using Intervention Mapping. Step 1, needs assessment, revealed low knowledge and exposure to Breast Health Information; shame, secrecy, stigma regarding breast health discourse; diverse explanations and treatments for breast cancer; access-related barriers; unique cultural factors and spiritual beliefs about breast cancer; and concerns regarding privacy and trust in healthcare settings. The Health Belief Model, Social Cognitive Theory and Social Support were found as the most salient theoretical underpinnings for this endeavor. Steps 2 through 6 of the Intervention Mapping approach yielded a comprehensive, community-based, culturally-appropriate breast health promotion for African immigrant women with a rigorous evaluation plan titled, “Get Screened, Be Whole, Stay Well”.

In summary, Intervention Mapping was useful in systematically planning a theory-based, comprehensive program for African immigrant women in Houston, Texas. Program planners can employ the Intervention Mapping approach to prioritize the health needs of underserved populations; target theoretical determinants for behavioral change; and identify effective methods, strategies and delivery channels for engendering sustainable behavioral change in cancer prevention. This iterative process also allows for collaboration with diverse stakeholders; it promotes transparency in the planning process for all parties involved; and tends to yield a more culturally appropriate program for the target population.

Citation Format: Ebun O. Odeneye. Using intervention mapping to plan a breast health promotion program for African immigrant women: A proposal. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr A20.