Knowledge, perceptions, and mammography stage of adoption among older urban women.

INTRODUCTION: Mammography is under-used among older minority women. Identifying differences in their attitudes and beliefs by stage of mammography adoption will guide interventions for these under-studied and under-served women. METHODS: A total of 253 older urban women were interviewed, assessing breast cancer knowledge, perceived mammography benefits and barriers, stage of mammography adoption, personal experience with breast cancer, physical and cognitive functioning, smoking status, source and frequency of regular medical care, and demographics. Analyses compared scale scores and individual items by stage of mammography adoption. Multivariate analysis used linear and logistic regression with stepwise model selection. RESULTS: Sample mean age was 72.5 years; 88% were African American. About half (52%) had had a mammogram within the past 2 years (i.e., action stage of mammography adoption). Of the rest, 16% were thinking about having a mammogram in the next 6 months (contemplators) and 32% were not thinking about having a mammogram within 6 months (precontemplators). Knowledge and benefit scores were lowest for precontemplators. Overall barrier scores were highest for precontemplators (P < .001), but contemplators were most likely to worry about finding a lump (P < .05). Lower perceived barriers, provider recommendation, regular medical care somewhere other than a private physician's office, and age < 75 years were independently associated with more favorable mammography stage (R2 = .47). CONCLUSION: Mammography interventions for older urban women should combine provider recommendations with barrier-reducing interventions. Knowledge is associated with mammography contemplation, but barriers may affect whether contemplation leads to action. Precontemplators may need explanation of the rationale for screening; contemplators may need intervention to assuage fears.

Learn, share, and live: breast cancer education for older, urban minority women.

Among older urban minority women, for whom breast cancer risk is high and the propensity to be screened is low, both social support and breast cancer knowledge have been linked to mammography use. The authors describe a theory-based breast cancer education program implemented via an existing informal network for low-income urban elderly coordinated by a social service agency. The program is both structured and flexible. Core education sessions include delineated content and methods and are led by health professionals. Participants choose from a variety of follow-up activities to promote screening within their community. Pre- and posttests administered among 80 program attendees in two sites indicate significant improvement in knowledge (p < .001). Program attendees in each site also planned and participated in follow-up activities to promote screening among their peers. Learn, Share, and Live seems to be an effective program for promoting breast cancer screening among older, urban, primarily minority women.

Faculty authoring of course-specific software for disadvantaged nursing students using LinkWay: a case study.

This article adds to the literature on the use of hypermedia systems for software development in nursing education by describing design and authoring considerations in the construction of course-specific remediating software. In 1991, under the guidance of an instructional designer, faculty members developed LinkWay folders on aspects of the endocrine system for remedial use by students in Project Get Ahead in Nursing at Southern Illinois University at Edwardsville. Existing content outlines were modified according to design criteria, including representing information graphically, making the software translation interactive, embedding visual prompts and cues, and conforming to a specific design protocol. The use of LinkWay in facilitating the implementation of both procedural of both procedural and screen protocol is discussed, and several screen templates are presented, including menus, multiple choice, short answer, multiple choice browsing, and end-of-section evaluation. Current project status and conclusions for remediation using a hypermedia approach are discussed.

Acceptability and feasibility of a community approach to asthma management: the Neighborhood Asthma Coalition (NAC).

Understanding of asthma and co-management between patient and physician improves outcome. Feasibility of programs to achieve these goals in underserved settings is not documented. We used the Precede-Proceed model to document (a) community acceptance of a program to engage peer support of asthma management and care; (b) program revision to emphasize greater attention to availability of care and promotional events as channels for education; (c) engagement of intended audiences in planning and implementation; (d) participation of parents in program activities; and (e) peer-based education/support to reach parents, including socially isolated parents whose children experience heightened morbidity.