Persistent racial and ethnic disparities and rural-urban disparities in breast cancer mortality in North Carolina require attention. The Pitt County Breast Wellness Initiative-Education (PCBWI-E) provided culturally tailored breast cancer education and navigation to age-appropriate screening services (mammography and clinical breast exams) for uninsured and underinsured Black and Latina women age 25 and older in two rural counties in North Carolina (Pitt and Edgecombe Counties). Using a lay health model, the PCBWI-E trained 23 community members and public health undergraduate students as lay breast health educators. Breast health educators educated 735 women across the 2-year program. Baseline knowledge about breast health was low at year 1 and 2 (mean knowledge score = 59%, SD = 0.21 and 57%, SD = 0.22, respectively) and was higher at follow-up post-intervention for both years 1 and 2 (mean knowledge score = 78%, SD = 0.18 and 75%, SD = 0.19, respectively) (p < 0.001). In terms of navigation, almost three-quarters (72%) of those recommended to receive a mammogram, received one. Of the population served by the PCBWI-E who were aged 40 and above, 34% had never received a mammogram. Of those women who had never received a mammogram, 68% received one through the PCBWI-E program. The PCBWI-E was successful in increasing both breast health knowledge and access to age-appropriate breast cancer screening among uninsured and underserved Latina and Black women in rural eastern North Carolina. Future efforts should support the large-scale implementation of successful evidence-based culturally appropriate models like this one in the reduction of racial, ethnic, and rural breast cancer disparities.
Keywords: Breast cancer; Breast health educators; Cancer health disparities; Cancer prevention; Community-based program.