Digital Divide

Increasing Breast Cancer Screening, Risk Assessment, and Preventive Services Use Among African American Women: Discovering the Feasibility of Web-based Outreach and Service

This pilot project proposes to test the feasibility of using web-based technology to provide breast cancer screening and risk assessment information to urban African American women. The project will support the effort to provide effective service to this chronically underserved population by providing a basis for incorporating locally expressed values, expectations, and concerns into preventative outreach programs. We will explore the feasibility of web based delivery of information and services because a) this mode of delivery and outreach is increasingly important in strategies employed by healthcare providers and b) given that urban African American populations tend to use web-based technologies less than the norm, providers' increasing reliance on such technologies threatens to exacerbate the preexisting problem of underservice to these communities.

A key element of the approach taken in this research is the recognition that the effectiveness of any new technology is determined not only by the competence of the technology itself, but also by the characteristics of the social system into which it is inserted. Thus, the project is unique in that it will use ethnographic data to inform technology-driven outreach strategies, rather than expecting the social environment to adjust to the insular trends of information technology. This will be done in two steps.

The project team will use qualitative methods such as observation and in-depth interviews to gather data on how members of the Detroit African American community might use the Internet to gather information. By teaming with the engineering program at Focus:HOPE, the project will be able to recruit respondents who are already well-versed in the use of Internet technologies and have had substantial access to it. Interviews will take place at computers, allowing respondents to comment on specific sites of their own, or the interviewers', choosing.

Upon developing data concerning the practices, expectations, and concerns of African American Detroiters when evaluating information on the Internet, the project will turn to the specific issue of breast cancer. African American women who have elected to be screened for breast cancer will be asked to evaluate sites specifically devoted to breast cancer prevention and care.

The research team will develop recommendations for breast cancer-related communications and services aimed at Detroiters based upon the data gathered in the first two steps. Project respondents will constitute a focus group tasked with evaluating these recommendations, as a further means of insuring they engage African American Detroiters' concerns and expectations.

Principal Investigator: Mark Luborsky

Co-investigators: David Brawn, Darin Ellis, Ellen Jones, William Stengle

Research Partners: The Barbara Ann Karmanos Cancer Institute, The Midwest Cancer Information Service

Sponsor: Michigan Department of Community Health (State Initiative to Combat Cancer, Phase VII)