Impact of a Culturally Appropriate Intervention on Breast and Cervical Screening among Native Hawaiian Women,

Background. Native Hawaiian women have the highest breast and cervical cancer mortality rates and lowest screening rates in Hawaiʹi. This paper summarizes impacts of a breast and cervical cancer screening intervention spearheaded by a Native Hawaiian community. Methods. Six hundred seventy-eight randomly selected Native Hawaiian women completed two telephone surveys assessing their cancer screening behaviors: 318 women from a community that implemented an intervention, known as a Kokua Group, to provide culturally tailored education and support in a group setting and 360 women from communities without this intervention. The surveys were conducted before intervention implementation and 3 years later, 4 to 5 months after the last intervention session. Results. At posttest, intervention community women reported positive changes in 4 of 12 screening activities (P ≤ 0.05), while no changes were found among controls. Some women in both communities had heard about and/or participated in Kokua Groups. Hierarchical logistic regression showed that controlling for community, demographics, and pretest scores, Kokua Group knowledge or participation was a significant predictor (P < 0.05) of 9 of 12 screening-related behaviors. Conclusions. Positive changes in screening activities among women aware of the intervention support the importance of information diffusion by community consumers. Diffusion may occur beyond the boundaries of the community as defined.