Mammography Education for Breast Cancer

Overseen By Katie Nelson, PhD

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: Johns Hopkins Bloomberg School of Public Health

Disqualifiers: Non-AIAN, Male, Age, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

200 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial evaluates how effectively a new tablet-based education program aids women in one Navajo Nation community in understanding and accepting mammograms for breast cancer screening. The program, called TEAM (Tablet-based Education to improve the Acceptance of Mammography), includes culturally-tailored lessons, and some participants will also receive additional support from a Diné peer-navigator. Women who identify as American Indian or Alaska Native, have not had a mammogram in the last year, and are registered at Chinle Comprehensive HealthCare Facility may be suitable for this trial. As an unphased trial, this study provides a unique opportunity to contribute to culturally relevant healthcare solutions.

Do I need to stop taking my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this intervention is safe?

Research has shown that using tablets to teach women about breast cancer and mammograms is generally well-received. One study found that tablets can collect information about breast cancer risk without causing harm or discomfort to participants, making this educational method safe and easy to use.

For the TEAM + Navigation approach, studies have shown that a patient navigator can increase the number of women getting mammograms. The navigation component involves personal support from someone familiar with the community, which participants have found helpful. This approach has been used safely in similar settings and effectively encourages screenings.

Overall, both educational methods—using tablets and having a personal navigator—are safe. They have proven effective in similar programs without causing negative effects. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it aims to improve the acceptance of mammography using a tablet-based educational approach. This method is unique because it uses technology to provide accessible and engaging information about mammography, potentially overcoming barriers like misinformation or fear. Additionally, one arm of the trial includes 1:1 support from a Diné peer-navigator, offering personalized guidance and emotional support. This combination of digital education and personalized navigation could enhance understanding and acceptance more effectively than traditional methods alone.

What evidence suggests that this trial's interventions could be effective for promoting breast cancer screening?

This trial will compare two approaches to increase breast cancer screenings: the TEAM program and TEAM + Navigation. Studies have shown that the TEAM program, which uses a tablet for education, helps women learn about breast cancer signs and how to perform self-exams. Between 77% and 90% of women using TEAM correctly identified warning signs. Research has also found that these educational tools increased the number of women doing monthly self-exams, with up to 91% participating. Meanwhile, adding navigation, which includes one-on-one support, improved mammogram rates. Reviews have found that such support systems help more women get screened, especially in rural areas. Both TEAM and TEAM + Navigation aim to increase breast cancer screenings, reducing the risk of late diagnoses. ^{6 7 8 9 10}

Who Is on the Research Team?

Katie Nelson, PhD

Principal Investigator

Johns Hopkins University

Are You a Good Fit for This Trial?

This trial is for Native American women in a specific community on the Navajo Nation who are due for breast cancer screening. It aims to improve mammography rates using culturally-tailored education and support.

Inclusion Criteria

Willing to be randomized

Self-identify as American Indian or Alaska Native (AIAN)

Are a registered patient at Chinle Comprehensive HealthCare Facility (CCHFC)

Exclusion Criteria

Do not self-identify as American Indian or Alaska Native (AIAN)

Are not a registered patient at CCHCF

Do not live within 80 miles of CCHCF

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive TEAM or TEAM + Navigation intervention to promote mammography acceptance

3 months

Monthly 1:1 support sessions

Follow-up

Participants are monitored for mammography uptake and effectiveness of the intervention

3 months

What Are the Treatments Tested in This Trial?

Interventions

• Tablet-based Education to improve the Acceptance of Mammography (TEAM)
• Tablet-based Education to improve the Acceptance of Mammography (TEAM) + Navigation

Trial Overview The study compares two approaches: one group receives tablet-based education (TEAM) about mammography, while the other gets TEAM plus monthly personal support from a Diné peer-navigator (TEAM + Navigation).

How Is the Trial Designed?

Group I: TEAM + Navigation Experimental Treatment 2 Interventions

TEAM (Tablet-based Education to improve the Acceptance of Mammography) and Navigation (provision of 1:1 support from a Diné peer-navigator)

Group II: TEAM Active Control 1 Intervention

TEAM (Tablet-based Education to improve the Acceptance of Mammography)

Who Is Running the Clinical Trial?

Johns Hopkins Bloomberg School of Public Health

Lead Sponsor

Trials

441

Recruited

2,157,000+

Genentech Foundation

Collaborator

Published Research Related to This Trial

The Outcomes4Me mobile app was successfully integrated into routine breast cancer care, with 60% of the 107 patients engaging with it at least three times over a 12-week period, surpassing the feasibility target of 40%.

Patients reported that the app improved their ability to track symptoms and increased their interest in clinical trial enrollment, indicating potential benefits for patient education and decision-making in breast cancer treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of introducing a smartphone navigation application into the care of breast cancer patients (The FIONA Study). Isakoff, SJ., Said, MR., Kwak, AH., et al.[2023]

Patient navigation (PN) was successfully implemented in resident clinics, leading to a significant increase in biennial screening mammography adherence among patients, particularly in vulnerable populations.

Residents expressed satisfaction with the PN process and showed interest in continuing its use, indicating that PN is a feasible and effective intervention in improving cancer screening rates in these settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of patient navigation in resident primary care practice: a screening mammography quality improvement initiative. Shroff, S., McCoy, ME., Sherman, BJ., et al.[2016]

A tailored web-based educational program for radiologists showed a 12% increase in the odds of positive mammographic results shortly after the intervention, suggesting some potential efficacy in improving screening outcomes.

However, the overall impact on reducing excessive recall rates was not statistically significant, indicating that a single 1-hour intervention may not be sufficient to effect lasting change in radiologists' practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of an educational intervention designed to reduce unnecessary recall during screening mammography. Carney, PA., Abraham, L., Cook, A., et al.[2021]

Citations

1. reporter.nih.gov reporter.nih.gov/search/HaCPQzHfG0OlA6_Uu-26GQ/project-details/11062360

Project Details 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 ...

2. cih.jhu.edu cih.jhu.edu/programs/cancer-care-initiative-supporting-care-along-the-continuum-in-native-american-communities/

Cancer Care Initiative: Supporting Care Along the ... The intervention, “TEAM” (Tablet-based Education to improve the Acceptance of Mammography), was developed using a community-based participatory research process ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10393532/

Effectiveness of a telehealth patient education intervention ... After the intervention, 77–90 percent of women correctly identified warning signs of BC; 91 percent performed breast self-exam monthly; and 60–99 percent were ...

4. mhealth.amegroups.org mhealth.amegroups.org/article/view/63290/html

Acceptability of an mHealth breast cancer risk-reduction ... This study assessed the acceptability of a tablet-based breast cancer risk assessment and educational intervention in the primary care setting for both patients ...

5. bmj.com bmj.com/content/390/bmj-2025-085029

First mammography screening participation and breast ... Conclusions This study shows that first screening non-participants represent a large population at long term risk of dying from breast cancer, ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9877062/

Use a web-app to improve breast cancer risk factors and ... This study aimed to evaluate the preliminary effectiveness of an educational intervention using a web-app to improve knowledge of breast cancer risk factors ...

7. researchgate.net researchgate.net/publication/344908348_Using_Tablets_to_Collect_Breast_Cancer_Risk_Information_in_an_Underserved_Population

Using Tablets to Collect Breast Cancer Risk Information in ... The authors tested the use of tablets to collect breast cancer risk data and compared the approach against paper-based scantrons. The goal was to examine ...

8. link.springer.com link.springer.com/article/10.1007/s13187-021-02116-w

Implementation of an Evidence-Based Intervention with ... The Peace of Mind Program is an evidence-based intervention to improve mammography appointment adherence in underserved women.

9. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9383665/

Text-Based Intervention Increases Mammography Uptake ... This study analyzed whether a text-based intervention with reminder and scheduling components could increase mammography uptake at 3 months compared with usual ...

10. jamanetwork.com jamanetwork.com/journals/jamainternalmedicine/fullarticle/2818196

Behavioral Interventions to Improve Breast Cancer ... This report of 2 randomized clinical trials evaluates whether bulk ordering, text messaging, and clinician endorsement increase breast ...