“We are a Powerful Movement”: Evaluation of an Endometrial Cancer Education Program for Black Women

Online Publication Date:
December 24, 2021
Publication Status:
Published Article MUSE Link:

**Published in Progress in Community Health Partnerships (PCHP) 15.4, December 2021. All rights reserved.**

Background: U.S. Black women with endometrial cancer (EC) have a 90% higher mortality rate than White women, driven in part by advanced stage at diagnosis. Black women have expressed reasons for care-seeking delay: misattribution of postmenopausal bleeding, symptom endurance, and community silence regarding vaginal bleeding.
Objectives: In this community-based participatory research study, we adapted, implemented, and evaluated an education program addressing these factors.
Methods: We adapted an evidenced-based education curriculum – Community Empowerment Partners (CEPs) – using Public Health Critical Race Praxis and the Health Belief Model. Black EC survivors completed CEPs-EC training and committed to lead community sessions. Our mixed-methods evaluation measured baseline and follow-up knowledge (10-point scale) and social and clinical empowerment (3 Likert-scaled items) and assessed change in each construct with linear mixed-effects models and Generalized Estimating Equation models, respectively. The process evaluation examined fidelity, feasibility, and acceptability using qualitative data from coaching and national peer educator calls, with directed content analysis.
Results: Thirteen ambassadors completed training; 10 completed community sessions with 109 total attendees, 62 with complete data. Among community participants, CEPs-EC participation was associated with increased knowledge of 2.02 points (95%CI:1.06-2.99;p=0.0001). Social empowerment increased (OR=8.85; 95%CI:1.90-41.20), reinforced by qualitative data. There was no change in clinical empowerment. Process data illustrated facilitators of success: session tailoring, leveraging social networks, mentorship, and group-level motivation.
Conclusions: This is the first intervention addressing endometrial cancer survival among Black women. Results demonstrate efficacy in improving EC knowledge and empowerment, providing the evidence base for a larger public health campaign.