Abstract B018: A tribal-academic multi-theory-driven messaging intervention to increase mammography participation is well-received by community women
Authors: Nicometo Ann , Vierkant Robert A. , Petersen Wesley O. 
Published: September 2020

Purpose:: “No Squeeze Can Defeat Me: Mammograms for Life!” (locally, “My Life Matters: Mammograms for Life!”) was funded 2016-2019 by the Minnesota State Department of Health. It implemented a low-cost, low-tech intervention that used theory-based messaging to increase tribal women’s participation in annual mammograms and their adherence to local screening guidelines. Messaging was grounded in elements of theoretical models of health behavior that our previous research showed significantly differentiated adherent women from non-adherent women. Procedures: An 8-member tribal Community Advisory Project Board, including a 3-person Project Implementation Team, guided and carried out the intervention. The team developed and distributed 48 unique posters and placed 4-5 new posters every 6-8 weeks in 82 locations across four reservation communities. A convenience sample of women evaluated the posters. Posters had varied messages that were shaped by at least one influential element and theoretical model (e.g., Perceived Benefit from the Health Beliefs Model). 84% of displayed posters contained images of adherent tribal women. Pairwise associations of survey variables were examined using Fisher’s exact tests. Results: 229 women evaluated posters (32% under the age of 40, 64% between 40-70 years, 4% older than 70). Approximately 80% of women age 40 and older reported having at least one mammogram in their lifetime. 71% of all women said they learned something new. 96% of women said messages were personally important and 99% thought them important for other women. Of women finding the messages personally important, 99% were greater than age 40 compared to 90% who were less than age 40 (p=0.002). In those reporting they learned something new, 98% were greater than age 40 compared to 91% who were less than 40 (p=0.05). 97% of women said they would continue reading the messages when new ones were posted, underscoring the interest raised by the intervention. 164 women reported recognizing women featured on a poster. Of these, 77% said that recognition made the poster more interesting; only 2 said it made the poster less interesting. When asked if they would be more or less willing to get a mammogram if they knew others got one every year, 63% of women said they would get one regardless, 34% would be more willing, less than 1% would be less willing, and 3% said they would not get a mammogram regardless. Conclusions: Overall, women very positively regarded the posters. The sample was diverse by age, with almost one-third not yet age-eligible for screening. Across all ages and screening histories, a great majority of women agreed: 1) the posters were personally important and important for others; 2) were interested in seeing additional posters; and 3) appreciated seeing photos of adherent women on them. With 34% of viewers being more inclined to get mammograms upon knowing of others who had them, increases in monthly mammograms may be expected.

Citation Format: Ann Nicometo, Robert A. Vierkant, Wesley O. Petersen. A tribal-academic multi-theory-driven messaging intervention to increase mammography participation is well-received by community women [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B018.