Loretta Lacey

Smoking-related behavior, beliefs, and social environment of young black women in subsidized public housing in Chicago.

Survey data indicate that young Black female smokers living in public housing are heavier smokers and have weaker motivation to quit, health beliefs and social environment less conducive to cessation, and less knowledge of where to get help to quit than other young Black female smokers in metropolitan Chicago. Compared with White women, the latter, other Black women smoke fewer cigarettes daily and have a stronger desire to quit and more concern about health reasons for quitting, but have a weaker belief in the risk of lung cancer from smoking, greater concern about quitting difficulties, and less knowledge of where to get help to quit. Low education, not race, is associated with higher smoking prevalence and less social pressure to quit or support for quitting.

Measuring readiness and motivation to quit smoking among women in public health clinics

We conducted a pilot test of an instrument to assess stage of readiness and level of motivation to change smoking behavior among 495 women smokers in public health clinics. The stages of readiness were based on those proposed by Prochaska and DiClemente but with finer discrimination within the precontemplation stage, where a substantial minority (41%) of the target smokers were situated. Subdividing this earliest group, we found that 8% of the total sample planned no change in smoking ever; 8% were seriously thinking of cutting down; and 25% were seriously thinking of quitting but not within 6 months. Scales in the questionnaire included general motivation to change smoking behavior and confidence in ones ability to do so. The womens scores differed on these scales and on action toward quitting across the five stages of readiness, except that the lowest two groups did not differ on confidence. Pregnancy enhanced readiness to quit. The instrument accommodates the brevity and low literacy requirements for use in these applied settings and is suitable for use in either self-administered questionnaire or interview format.

Referral adherence in an inner city breast and cervical cancer screening program

Background. Early detection and immediate follow‐up treatment for cancer of the breast and cervix can reduce morbidity and mortality. This report describes adherence to follow‐up appointments for suspected breast and cervical malignancies in a population of low‐income black women who participated in a community‐based nurse‐managed screening program.

Use of lay health educators for smoking cessation in a hard-to-reach urban community

A description of the use of indigenous lay health educators as they participated in the implementation of a community-based smoking cessation program is provided. The target population was young black women who resided in several urban public housing developments. The intervention, which was conducted in tandem with a larger televised smoking cessation program, consisted of either class sessions conducted by or reminder visits from community lay health educators. The lay health educators were successful in organizing this population, often viewed as difficult to reach, to become more aware of the dangers of smoking and to become more interested in participating in a structured smoking cessation program. They motivated 235 individuals to sign up for the program; of these, 141 attended at least one class session or accepted at least an initial reminder visit. The results suggest that lay health educators may be able to mobilize this population to participate in health promotion programs. However, due to differences in this population related to smoking, the findings indicate that new methods must be developed for sustaining their involvement after they have been reached.

Results of an intervention to improve compliance with referrals for evaluation of suspected malignancies at neighborhood public health centers.

A study was conducted at Neighborhood Health Centers to evaluate procedures to improve compliance with referrals of patient at risk for cancer. Intervention consisted of a standardized communication from the exit nurse, a patient form to be returned after compliance, and one written and one telephone reminder as needed. Compliance was 68.2 percent in a control group and 89.0 percent among patients who received the experimental intervention, a significant increase of 20.8 percent (95% CI: 12.5, 29.1).

Cancer prevention and early detection strategies for reaching underserved urban, low-income black women : barriers and objectives

To achieve national health goals set for reduction of cancer by the year 2000, populations with higher cancer mortality and lower survival must be reached with proven advances for use in cancer prevention and early detection. This article focuses on one segment of those populations that continues to have a poor cancer experience: urban, low‐income black women. Barriers for them to cancer prevention and early detection are identified and discussed from studies conducted in Chicago. Specifically tailored interventions that have been used to bring services to this population are described, and implications from the outcomes of this work are discussed.

Patterns of breast and cervical cancer screening at three public health centers in an inner-city urban area.

In an effort to examine breast and cervical cancer screening patterns among poor African-American urban women, medical records were abstracted at three public health centers located in the inner city of Chicago. The proportions of eligible women at these three centers who received Pap smears, breast examinations, and mammograms were computed. These proportions were notably low and differed significantly among the three centers. Because the literature is now suggesting that an appropriate sequence best defines adequate screening, sequences of screenings were also determined and were found to be lacking. All of these screening histories fall far below the screening objectives set by the National Cancer Institute for the year 2000. This information suggests that interventions are needed that will help health centers serving poor women to deliver more frequent cancer screening.

The involvement of low literate elderly women in the development and distribution of cancer screening materials

Older women are at increased risk for both breast and cervical cancer. Yet, they are less likely to undergo routine screening procedures and to possess accurate information about cancer. Furthermore, traditional messages and educational approaches may not be as effective in changing attitudes or behavior in this group due to lower reading skills. The current study focused on the use of a peer participant model to develop and distribute a new breast and cervical cancer screening brochure to low literate older women. Findings strongly support the feasibility and acceptability of employing a peer helper approach to impart cancer early detection messages to low literate older women.

An intervention to increase breast and cervical cancer screening in low income African-American women

Although early screening and treatment are effective against breast and cervical cancer, screening remains far below the National Cancer Institute goals for the year 2000. Furthermore, the disenfranchised are often least screened. In response, an intervention was designed to increase the proportion of poor African-American women receiving Pap smears, breast examinations, and mammograms. The proportion of women who received Pap smears rose from 12% at baseline to 26% after the intervention, the proportion receiving breast examinations rose from 6% to 18%, and the proportion receiving mammograms rose from 3% to 11%. Screening proportions decreased in the control group.