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Symposium: Interventions to Address Cancer Disparities

Kin Keeper: A model to teach black women and their family members about breast and cervical cancer prevention.

Michigan State University, East Lansing, MI

Abstract

SY01-01

The reticulate family relationships that exist among Black women represent an important strong dynamic. Women in the family (mother, grandmother, aunts, and sisters) are a support system for each other and learning is ever-present. This bond is forged through communication and is not merely a top-down approach, where younger women are learning from their elders. Rather it is knowledge-driven. Whoever possesses the knowledge, insight, or experience has the right and is almost obligated to share it with others in the family. The bond exists in the midst of both matriarchal and patriarchal families. Previous studies demonstrated that health care providers have a strong influence on a woman's participation in cancer prevention and or early detection programs[1]. However, little is known about the family's influence. The author conducted two studies[2][3] that indicated family strongly influences Black women's decision to participate in cancer prevention practices. As a result, the author developed an intervention model, Kin Keeper, which is based on the premise that the natural ways that Black women communicate various health messages to females in their families can be used to influence them to engage in cancer prevention and screening practices. Building on this generational and cultural behavior, the Kin Keeper model integrates health literacy by reaching women who are connected to the health care system through community health workers. Thus the community health worker enters the family circle and presents the cancer prevention and early detection intervention.

The first stage of implementing the Kin Keeper model (funded by the Michigan Department of Community Health) was to design the cancer literacy assessment tools and the curriculum to cross train community health workers. Using a community-based participatory research method, the oral cancer literacy assessment tools were developed with the community health workers input. The critical indicators that exhibited a woman's functional understanding of cancer prevention were developed with women who reflected the targeted population. The Kin Keeper curriculum was informed by the results of a telephone survey of women who were enrolled in the Breast and Cervical Cancer Control program. To accommodate the literacy range that exists among peer educators, such as community health workers the curriculum was written at a fifth grade level.

The training included two sets of experienced community health workers and their supervisors. Thirteen, who were from the western side of Michigan served as maternal child health community health workers. The eight who were skilled in administering a diabetes and cardiovascular intervention came from the southeastern section of the State. All community health workers and their supervisors had prior experience in community-based participatory research. A 16-hour training on the campus of Michigan State University provided a similar travel distance for each group. At the request of the community health workers, the training was scheduled over a weekend. Two outside training facilitators were contracted. Both were experienced in designing and administering breast and cancer community education projects with Black women. One was a retired masters prepared nurse and the other was a community education coordinator for a comprehensive cancer center in another State. They were charged with teaching the basics of breast and cervical cancer education. The author was tasked with reviewing human research subjects training, teaching the community health workers how to administer the oral cancer literacy assessment tools as well as their involvement of the home visitations and follow-ups.