Does four minutes makes a difference? Delivering culturally competent breast cancer education to Amish & Mennonite women

Melissa Thomas, Walden University


Ohio is home to the world’s largest and fourth largest Amish settlements, with over 55,000 Amish living in these communities. Additionally, several dozen settlements are scattered throughout Ohio in mostly rural, underserved communities where screening services and education are severely limited. Disproportionately high breast cancer mortality rates were found in these communities, and lack of screening and knowledge contributed to the cancer health disparities. To reduce such barriers, the community-led Project Hoffnung (Hope) provides annual women’s health screenings and culturally competent breast health education. The intent of this study was to determine if a shortened version of the standard validated education program increases knowledge for repeat participants.

All participants were mailed a breast cancer knowledge pre-test one week before the program. Participants who had received the education within the last two years received a shortened, four minute version, while all other participants received the standard education. Pre- and post-tests were compared to determine if the shortened education program increased knowledge.

586 women participated in 32 education sessions from 5/1/13-04/30/14, and around 55% were previous participants. The mean age was 51.1 years, and the response rate to the post-test was around 45%. A Wilcoxon Signed Ranks Test showed that a shortened version of the culturally competent education program did statistically increase breast cancer knowledge among Amish and Mennonite women (Z=-4.757, p<.001). Results of the study highlight the importance of targeting messages to repeat participants for continued engagement and retention of key breast cancer facts.

Learning Areas:

Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related education

Learning Objectives: Evaluate the impact on knowledge to women receiving culturally competent breast cancer education. Identify barriers for Amish and Mennonite women to follow recommended breast cancer guidelines.