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Improving Mammogram Adherence in Black Women
Dissertation

Improving Mammogram Adherence in Black Women

Tammy Thi Tran
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2026
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Abstract

Background: Breast cancer is the most common cancer among women in the United States and the second-leading cause of cancer-related death. Mammography enables early detection and reduces mortality; however, Black women continue to face disproportionately higher mortality rates compared to other racial and ethnic groups. Purpose: The purpose of this project was to improve mammogram adherence among Black women by implementing culturally tailored adherence interventions through a community outreach initiative. Methods: A pre- and post-implementation quality improvement design was used among Black women aged 40–75 who were eligible for routine breast cancer screening. Guided by the Plan-Do-Study-Act (PDSA) model, the project was implemented over eight months. Interventions included culturally tailored educational flyers distributed throughout the clinic and mammogram vouchers distributed at a community outreach event to promote screening. Interventions focused on improving adherence, outreach participation, and appointment scheduling. Data were collected through audit reports and attendance records to evaluate changes over time. Findings: Mammogram adherence improved across all racial groups. Among Black/African American women, adherence increased from 36.24% to 56.25%. Improvements were also observed among White, Pacific Islander, and Asian women. Outreach participation among Black/African American attendees decreased from 57 to 33 participants, and male attendance decreased from 15 to 5. No appointments were scheduled through the outreach voucher system, as no follow-up calls were recorded. Discussion: These findings suggest that nurse-led, culturally tailored interventions can improve mammogram adherence among Black/African American women despite lower-than-anticipated outreach participation and a lack of appointments scheduled through the community outreach initiative. The observed outcomes highlight opportunities for practice changes, including real-time scheduling, patient navigation, and structured follow-up. These findings support the integration of culturally tailored interventions into routine practice to improve adherence and reduce disparities in breast cancer screening.
 Black women breast cancer culturally tailored adherence interventions mammogram adherence mammography

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