The Witness Project
|Program Title||The Witness Project|
|Purpose||Community-based program designed to increase breast cancer screening and promote the practice of mammography among underserved African American women. (1999)|
|Program Focus||Awareness building and Behavior Modification|
|Population Focus||Medically Underserved|
|Topic||Breast Cancer Screening|
|Age||This information has not been reported.|
|Gender||This information has not been reported.|
|Race/Ethnicity||This information has not been reported.|
|Setting||This information has not been reported.|
|Funded by||NCI (Grant number(s): CA66800)|
|User Reviews||(Be the first to write a review for this program)|
Breast cancer screening through annual mammography and breast physical examinations is highly successful in diagnosing early onset of the disease and improving survival rates among women over 50. However, among ethnic minority groups such as African American women, particularly in rural areas, there are barriers to participation in these screening activities. For African American women, particularly in rural areas, these include economic barriers, problems with transportation, access-related factors, inconvenience and lack of time, lack of physician recommendation, psychological factors such as fear and fatalism, lack of knowledge and awareness of breast cancer, and misunderstanding of recommended screening frequency. Factors such as these contribute to African American women's higher rates of mortality in all stages of breast cancer, despite the fact that they have a somewhat lower incident rate of breast cancer overall. The Witness Project is a theory-based program designed specifically for African Americans to increase awareness and screening for breast cancer. This program has been implemented in many states across the country.
Note: While breast self examination (BSE) has not been shown to be an effective early detection method, BSE training and processes are used in the educational program and agenda of the Witness Project as a behavior change modifier that has been shown to lead African American women to: 1) be more comfortable with their bodies and pay more attention to changes that might occur and 2) be more likely to decide to obtain clinical breast examinations (CBE) and mammograms. (Bloom JR, Grazier K, Hodge F, Hayes WA: Factors affecting the use of screening mammography among African-American women. Cancer Epidemiology Biomarkers and Prevention 1:75-82, 1991)
The Witness Project has been implemented in 25 sites with 401 volunteers, delivering cancer education and screening programs to over 10,000 women. One quasi-experimental pretest and post-test study was conducted for rural, underserved women in eastern Arkansas. Key findings include:
- Mammography screening behavior was examined for women age 40 years and older, with results indicating a significant increase in ever having had a mammogram for the intervention group (baseline: 52.4 percent, follow-up: 64.4 percent), but no significant difference from baseline (60.4 percent) to follow-up (63.3 percent) in the control group.
Erwin, D. O., Spatz, T. S., Stotts, R. C., Hollenberg, J. A., & Deloney, L. A. (1996). Increasing mammography and breast self-examination in African American women using The Winess Project Model. Journal of Cancer Education, 11, 210-215.
Erwin, D. O., Ivory, J., Stayton, C., Willis, M., Jandorf, L., Thompson, H., Womack, S., & Hurd, T. C. (2003). Replication and dissemination of a cancer education model for African American women. Cancer Control, 10(5), 13-21.
Erwin, D. O., Spatz, T. S., & Turturro, C. L. (1992). Development of an African-American role model intervention to increase breast self-examination and mammography. Journal of Cancer Education, 7(4), 311-319.
Spatz, T. S., Erwin, D. O., Deloney, L. A., & Stayton, C. (1996). Witnessing to save lives!!. Adult Learning, 7 (6), 23-25.
Hurd, T. C., Muti, P., Erwin, D. O., & Womack, S. (2003). An evaluation of the integration of non-traditional learning tools into a community based breast and cervical cancer education program: The witness project of Buffalo. BMC Cancer, 3(18), 1-17.
Bailey, E. J., Erwin, D. O., & Belin, P. (2000). Using cultural beliefs and patterns to improve mammography utilization among African-American women: The Witness Project. Journal of the National Medical Association, 92(2), 136-142.
Erwin, D. O., Deloney, L., Dai, H., & Erkman, L. (1996). The role of the cancer registry in building outreach programs: The Witness Project Example. Journal of Registry Management, 23 (2), 7-10.
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