An urban community-based cancer prevention screening and health education intervention in Chicago.

Most types of cancer are disproportionately present in black populations. Among all ethnic and racial groups, black people have the highest incidence of all types of cancer combined, experiencing the highest mortality and the worst survival rate. A major intervention effort has begun in Chicago, targeting women living in 10 south side community areas whose populations are almost all black and among the poorest in the city. The purposes of the intervention are to develop and evaluate ways to reduce morbidity and mortality from breast and cervical cancer. Three outcome measures are being used, the proportion of women who receive Papanicolaou smears, breast examinations, and mammograms; the scores derived from a knowledge, attitudes, and practices survey; and the stage of diagnosed cancer. The results are being evaluated in three locations, the 10 target community areas, a Chicago Health Department clinic located in the community, and Fantus Clinic at Cook County Hospital. The intervention consists of reducing barriers to care at both public clinic sites and delivering education and information within the community. Public health outreach workers who are culturally sensitive to the population bring word of the program to places frequented by women, including local businesses (such as beauty shops, grocery stores, pharmacies, and currency exchanges), public housing developments (one being the largest in the country), and facilities belonging to city services programs. The intervention was developed to permit its ready adoption in similar environments should the evaluation results prove its usefulness.