2.  Breast cancer awareness is a preventative treatment › Earlier detection provides a better treatment and survival outcome  High prevalence of breast cancer in minority women › higher mortality from late stage diagnosis of breast cancer  Program intervention to promote knowledge and skills  Information-Motivation-Behavioral Skills (IMB) Model

3.  in 2005, the breast cancer mortality rate for black women was 43.2/100,000, and the rate for white women was 21.8/100,000  Screening mammograms among white women 65% compared to 59% in black women  the chance of a woman getting breast cancer is 1 in 8; with breast cancer being the second leading cause of death in women

4.  African American age 40 years of age and older

5. Health behavior change Behavioral skills InformationMotivation Information Acquire knowledge relative to the health behavior Motivation Perceptions related to the behavior Behavioral Skills Self efficacy and actual skill

6. Breast Health Education Among Hispanic Women Precede-Proceed Model and the Health Beliefs Model successful increase in compliance with mammogram and breast self exams increase in knowledge base decrease in beliefs of the disease Increase breast and cervical cancer screening among Filipino women Health Belief Model, Theory of Reasoned Action and Planned Behavior and the Precede Model one group received cancer screening module (intervention)control group received physical activity no difference between the two groups, but intervention was effective among new immigrant Filipinos Increase mammography screening among older women Health Belief Model assessed cost- effectiveness of targeted mailing that encourages women to have a mammogram effective since the intervention increased mammography among long-term noncompliant older women

7.  Involve community leaders and church based organizations  2 hour long sessions, taught by a black health educator  Information › Breast models, hand outs  Motivation › Breast cancer survivor  Behavioral skills › Return demonstration of breast self exam › Schedule mammogram

8. Hopefully, as the women’s knowledge base increases their skills of breast health awareness improve and they maintain the intended behavior change. Further intervention is needed to address socio-economic status, education level and geographic location which may be contributory risk factors for the high incidence of breast cancer among this group of women

9. American Cancer Society. (2013). Breast cancer facts & figures 2013-2014. Retrieved from http://www.cancer.org/acs/groups/content/@research/documents/document/acspc-042725.pdf http://www.cancer.org/acs/groups/content/@research/documents/document/acspc-042725.pdf Brantley-Sieders, D. M., Kang-Hsien, F., Deming-Halverson, S. L., Yu, S., Cook, R. S., & Niccolai, L. M. (2012). Local Breast Cancer Spatial Patterning: A Tool for Community Health Resource Allocation to Address Local Disparities in Breast Cancer Mortality. Plos ONE, 7(9), 1-11. doi:10.1371/journal.pone.0045238 DiClemente, R., Salazar, L., & Crosby, R. (2013). Health Behavior Theory for Public Health. Burlington, MA: Jones & Bartlett Learning Maxwell, A. E., Bastani, R., Vida, P., & Warda, U. S. (2003). Results of a randomized trial to increase breast and cervical cancer screening among Filipino American women. Preventive medicine, 37(2), 102-109. Oliver-Vázquez, M., Sánchez-Ayéndez, M., Suárez-Pérez, E., Vélez-Almodóvar, H., & Arroyo-Calderón, Y. (2002). Breast cancer health promotion model for older Puerto Rican women: results of a pilot programme. Health promotion international, 17(1), 3-11. Rauscher, G. H., Allgood, K. L., Whitman, S., & Conant, E. (2012). Disparities in Screening Mammography Services by Race/Ethnicity and Health Insurance. Journal Of Women's Health (15409996), 21(2), 154- 160. doi:10.1089/jwh.2010.2415 Van Harrison, R., Janz, N. K., Wolfe, R. A., Tedeschi, P. J., Chernew, M., Stross, J. K.,... & McMahon Jr, L. F. (2003). Personalized targeted mailing increases mammography among long-term noncompliant Medicare beneficiaries: a randomized trial. Medical care, 41(3), 375-385. Yarbrough, S., & Braden, C. (2001). Utility of health belief model as a guide for explaining or predicting breast cancer screening behaviors. Journal of Advanced Nursing, 33(5), 677-688. doi:10.1046/j.1365- 2648.2001.01699.x