Abstract C86: Launch of an intervention to improve mammographic screening adherence in women of one Bemidji Area tribe: The “No squeeze can defeat me: Mammograms for life!” project

Purpose: To increase women's adherence with one tribe's mammographic screening guidelines. This tribe recommends annual mammograms beginning at age 40. Currently, adherence stands at 36%. Our previous work identified a demographic feature and variables within four theoretical models of health behavior that significantly differentiated nonadherent women from adherent women. In “No Squeeze Can Defeat Me: Mammograms for Life!” (No Squeeze) we are developing a messaging menu (e.g., posters, pamphlets, videos, digital stories, articles, and letters) that is guided by the differentiating variables and features. The program also is developing a supplement to an existing intake form for women to complete before they see their providers for annual Well Woman exams. The supplement intake form will help providers tailor face-to-face messages to encourage screening of known nonscreeners, known nonadherent screeners, and women approaching screening age. Procedures: This program works through a Community Advisory Project Board (CAPB) consisting of tribal health, Indian Health Service, and community members of varied ages, screening status, and cancer history status. The CAPB members take the lead on all aspects of messaging and intake form design. In their role, they have designed a logo, determined wording and design of posters; identified locations for messaging; recruited community women for video interviews and use of their images on materials; determined incentive amounts; and delegated tasks to a project implementation team (PIT) made of tribal and IHS staff. PIT members' responsibilities include posting new messages every six to eight weeks, obtaining feedback on messaging and intake forms, implementing the intake form, and organizing video interviews and photographic sessions. At this time, effort is being devoted to poster development, placement, and a refreshment schedule and to final design of intake forms. Evaluation of progress on this project involves collection and analysis of community women's surveys related to messaging and intake forms, CAPB feedback on messaging, documentation of poster placements and refresh dates, and tracking changes in screening participation. First-year analysis covers a seven-month period ending on June 30, 2017. Data Summary: Early analysis shows that: 1) community women find poster messaging generally interesting, appealing, important, and mostly persuasive. They prefer images of community women and favor fewer words in most