Mishra 2007.
Methods |
Study design: cluster‐randomized controlled trial Sampling frame: women from 68 Samoan‐speaking churches in 2 southern California counties, aged > 42, who had not had a mammogram in preceding 2 years Sampling method: screening interviews by trained bilingual Samoan interviewers Collection method: pre‐test and post‐test survey (n = 776) Description of the community coalition: Coalition described as collaborative effort between National Office of Samoan Affairs and University of California at Irvine and at Los Angeles |
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Participants |
Communities: Samoan women in Los Angeles and Orange County, California Country: USA Ages included in assessment: women > age 42 Reasons provided for selection of intervention community: Breast cancer is the most common cancer among Samoan women; it accounts for 22% to 27% of cancers among Samoan women in Los Angeles County and Hawaii. Regional surveys show that a high percentage of Samoan women have never heard of mammography Intervention community (population size): 32 churches from sample; general population not reported; ˜45,000 Samoans reside in the 2 counties Comparison community (population size): 29 churches from sample |
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Interventions |
Name of intervention: Breast Cancer Education Program for Samoan Women Theory: Health Behavior Framework, Freire's Empowerment Pedagogy Aim: to increase mammogram usage among Samoan women Description of costs and resources: not reported Components of the intervention: Intervention included 3 components: culturally tailored educational booklets, skill building and behavioral exercises, and interactive group discussions led by trained bilingual Samoan lay health educators. Culturally appropriate breast cancer education booklets in English and Samoan language. Session held in churches, at Pacific Islander festival, or in private residence. Cash incentive for completing each survey Start date: July 1998 Duration: study conducted July 1998 to June 2001; recruitment, intervention, and follow‐up occurred between March 1999 and October 2000 |
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Outcomes |
Outcomes and measures: self reported mammogram use Time points: baseline pre‐test and 8‐month follow‐up |
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Notes | Funding source: government | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Churches stratified on denomination and congregation size, then randomly assigned |
Allocation concealment (selection bias) | Unclear risk | Allocation concealment not described |
Baseline outcome measurement similar | Unclear risk | Baseline rates of mammogram receipt not presented for intervention or control |
Baseline characteristics similar | Low risk | Study authors state in text:that control and intervention groups were similar on demographics and on all HBF constructs at pre‐test; data not provided |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Interviewers were blind to study group status |
Incomplete outcome data (attrition bias) All outcomes | Low risk | 96% of participants completed study |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Not reported |
Protection against contamination | Unclear risk | Not described |
Selective reporting (reporting bias) | Low risk | Relevant outcomes reported |