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The Diabetes Educator

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Health Promotion Practice
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Abnormal Mammogram Follow-Up: Do Community Lay Health Advocates Make a Difference?

Sherry R. Crump, MD, MPH

Department of Labor Adjudication Services

Michèle P.-L. Shipp, MD, DrPH

Division of Health Behavior & Health Promotion at the Ohio State University, College of Public Health

Gail G. McCray, MA, CHES

Department of Community Health and Preventive Medicine, Morehouse School of Medicine, in Atlanta, Georgia

Selma J. Morris, MEd

Grady Memorial Hospital in Atlanta, Georgia

Joel A. Okoli, MD, MPH, FACS

Morehouse School of Medicine in Atlanta, Georgia

Lee S. Caplan, MD, PhD, MPH

Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Prevention Research Center, Morehouse School of Medicine, in Atlanta, Georgia

Stacy L. Thorne, MPH, CHES

Office of Smoking and Health, Epidemiology Branch, Centers for Disease Control and Prevention, in Atlanta, Georgia

Daniel S. Blumenthal, MD, MPH

Department of Community Health and Preventive Medicine, Morehouse School of Medicine, in Atlanta, Georgia

This pilot study evaluates a community lay health advocate (CLHA) intervention in promoting follow-up for abnormal mammograms among African American women. A controlled trial was implemented at an urban hospital in Atlanta, with 48 women in a CLHA intervention group and 35 in a usual care group. Participants were 25 or older and had an abnormal mammogram between March 25, 2002, and May 2, 2003. Intervention group women received CLHA support including encouragement of timely abnormal mammogram follow-up, reminders of follow-up appointments, identification and removal of barriers to follow-up, and accompaniment to follow-up appointments. Women in the intervention group were significantly more likely to keep their first abnormal mammogram follow-up appointment, all of their scheduled follow-up appointments, and their biopsy or fine needle aspiration appointment. CLHAs are effective in promoting abnormal mammogram followup among African American women and may be an important resource in reducing racial disparities in breast cancer mortality.

Key Words: community lay health advocates • follow-up compliance • mammogram • African American

Health Promotion Practice, Vol. 9, No. 2, 140-148 (2008)
DOI: 10.1177/1524839907312806
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