# Developing and evaluating scalable and culturally relevant interventions to improve breast cancer screening among White Mountain Apache women

> **NIH NIH S06** · WHITE MOUNTAIN APACHE TRIBE · 2024 · $284,843

## Abstract

PROJECT SUMMARY
White Mountain Apache (WMA) leaders have voiced an urgent need to prioritize breast cancer screening
research in NARCH XI due to concern about low screening rates. As of 2018, screening rates among
eligible WMA women were more than 2 times lower than the Healthy People 2020 target, 39.1%
compared to 81.1%, and substantially lower than screening rates among AI/AN women nationally. In
Arizona (AZ), where the WMA tribal lands are located, 32% of AI women are diagnosed at later stage
disease (i.e., either regional or distant vs. local disease) compared to 25% of AZ women overall. There is
a great need for culturally appropriate interventions to improve screening rates and reduce mortality and
morbidity from breast cancer in the WMAT population.
This project will support the WMA-JHU partners and our established cancer care Community Advisory
Board to design two motivational tools based on findings regarding barriers and facilitators to breast
screening among Apache women, and he shortage of providers’ time and resources to provide clinic-
based education. The first tool will be delivered on a tablet in the clinic with highly graphic, culturally
congruent breast-cancer screening information. It is named Tablet-based Education to improve
Acceptance of Mammography” or “TEAM.” The second tool will be an Individual-based one-to-one
peer-educational module delivered by a paraprofessional Apache women’s health coach, called
“COACH,” to address individuals’ personal barriers and facilitators to breast cancer and screening
concerns and provide one-to-one support for scheduling, transportation and completing a mammogram.
We will evaluate these intervention tools through an RCT with n= 500 women aged 50+ who receive a
mammography referral after a local outpatient visit. Women will be stratified by prior history of
mammography (never or ever) and age (<65 or 65+), and then randomized 1:1 to receive either TEAM
alone or TEAM+Coach. The WMA-JHU partners bring extensive experience building and evaluating
motivational behavior change curricula delivered one-on-one and with mobile health tools that have now
been scaled to >140 tribal communities across 21 states.

## Key facts

- **NIH application ID:** 10798108
- **Project number:** 5S06GM142120-03
- **Recipient organization:** WHITE MOUNTAIN APACHE TRIBE
- **Principal Investigator:** Mary Allison Barlow
- **Activity code:** S06 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $284,843
- **Award type:** 5
- **Project period:** 2021-09-24 → 2026-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10798108

## Citation

> US National Institutes of Health, RePORTER application 10798108, Developing and evaluating scalable and culturally relevant interventions to improve breast cancer screening among White Mountain Apache women (5S06GM142120-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10798108. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*