Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Nola A. Schmidt


Despite the advances in medical technology, breast cancer is the most common cancer among women and is the second leading cause of death in African-American and Caucasian women in the United States. Mammography has shown to be one of the best methods to reduce late detection of breast cancer. The American Cancer Society recommends monthly self-breast examination (SBE), clinical breast examinations every 3 years, and yearly mammography starting at the age of 40. Despite the recommendations, there is still significant disparity among different racial groups, when it comes to death rates, which can be attributed to low screening rates. The breast cancer screening rates are lower for certain subgroups, including low-income African-American and Hispanic women. The purpose of this evidence-based project was to determine if culturally sensitive education, based on evidence of best practices, would affect mammography screening and breast cancer awareness among African female immigrants. An extensive literature review revealed that culturally sensitive educational strategies can improve breast cancer awareness and mammography use among minority immigrants. The Health Belief Model (Janz & Becker, 1984) and the Model of Diffusion of Innovation (Rogers, 1995) were used to guide this project. African immigrants were recruited from a local immigrant church in the Midwest. Apart from the culturally sensitive awareness session, an African immigrant/breast cancer survivor also spoke to the participants. Project evaluation included the use of a breast cancer awareness measurement as a pre- and post-test. Three months post-implementation, a telephone survey was completed to determine if the participants underwent mammogram screenings. Descriptive statistics, non-parametric tests, and paired t tests were used to analyze the data. The project consisted of 14 participants. At the end of this project, 60% (n = 6) of participants who were eligible for mammogram self-reported that they had completed mammogram screening. The EBP project significantly increased the participants’ awareness of breast cancer. Findings support the importance of using culturally sensitive awareness among immigrants in mammogram use and breast cancer awareness.