Rural-urban differences in breast cancer screening among African American women.

This study reports on rural-urban differences in the effectiveness of a church-based educational program aimed at increasing breast cancer screening among African American women ages 40 and over. The data were drawn from an intervention study in urban Nashville, and a pilot extension of the study in five rural counties of West Tennessee. The partial program was equally effective in rural Tennessee (17.6% increase in mammography attainment from baseline to Time 3) and in urban Nashville (22.3% increase). The rural women reported more barriers to mammography screening than the urban women. The rural women were more likely not to get a mammogram because they did not perceive a need, because they thought mammography was embarrassing, and because of their religious beliefs. The results of this study demonstrate that an inexpensive church-based educational program was equally effective in both rural and urban Tennessee for increasing mammography rates among African American women.