Interventions to Improve Breast Screening Uptake for Black African Women in High Income Countries: A Systematic Review

Aim

Black African women experience significant barriers and are less likely to attend breast screening. However, little is known about the interventions and the components of successful interventions for Black African women. The aim of this systematic review was to identify and evaluate interventions developed for Black African women to increase breast screening in high-income countries.

Methods

A systematic review was conducted using nine databases (AMED, the British nursing database, CINAHL, COCHRANE, EMBASE, MEDLINE, PSYCHINFO, Scopus and Web of Science). These databases yielded 1767 studies which were imported into Covidence and screened. 12 studies were included. Interventions were mapped to the behaviour change technique taxonomy (BCT) and evaluated using direction and magnitude of effect.

Results

All included studies were based in the United States (US). Interventions include health promotional messages through radio and print media, individual support and community support programs. 11 out of 12 studies showed that interventions were effective in increasing mammogram uptake, screening knowledge or mammogram intention. Individual support or patient navigation program with a problem-solving BCT appeared to be the most promising intervention and provides robust guidance to screening.

Conclusion

There were few studies which were all US based, suggesting that other countries have not developed interventions for this population group. Thus, population specific interventions should be explored in other countries. Most studies addressed individual barriers, there is a need for studies to address provider and health system barriers. Interventions with problem-solving approach should be explored in other countries.