Development and Evaluation of a Cancer Literacy Intervention to Promote Mammography Screening Among Navajo Women: A Pilot Study

Abstract

Purpose: Develop and evaluate a mammography intervention that provides hope about cancer prevention and treatment. Design: Pilot randomized controlled trial. Setting: Two communities on the Navajo Nation. Participants: Navajo women and support persons. Intervention: Both groups received standard care: one home visit discussing mammography pros/cons and barriers. The treatment group received an intervention based on Navajo language via an additional home visit with health education materials (written and oral) in English and Navajo, including a Navajo Cancer Glossary with a new descriptive phrase for cancer. Analysis: Between control and intervention conditions, we compared baseline sociodemographics; changes from baseline to 3 months on mammography completion and breast cancer literacy scores. Measures: (1) intervention feasibility; (2) self- and clinic-reported mammography screening completion; (3) breast cancer literacy. Results: A total of 25 participants were randomly assigned (13 treatment, 12 control), with 7 support persons in each arm. Mean age was 53 years, 90% had a high school degree or higher, 86% spoke Navajo and English. At 3 months, 44% had a clinically verified mammogram. Mammography completion was 57% among those with a support person and 27% among those without ( P = .14). Intervention women reported more breast cancer beliefs consistent with mammography ( P = .015). Conclusions: Increases in breast cancer beliefs consistent with mammography show promise. Findings highlight a need to tailor education materials to Navajo culture/language and focus on enhancing support.