Cultural tailoring for mammography and fruit and vegetable intake among low-income African-American women in urban public health centers

Matthew W. Kreuter, Celette Sugg-Skinner, Cheryl L. Holt, Eddie M. Clark, Debra Haire-Joshu, Qiang Fu, Angela C. Booker, Karen Steger-May, Dawn Bucholtz

Research output: Contribution to journalArticlepeer-review

177 Scopus citations


Background. It is widely accepted that disease prevention efforts should consider cultural factors when addressing the needs of diverse populations, yet there is surprisingly little evidence that doing so enhances effectiveness. The Institute of Medicine has called for randomized studies directly comparing approaches that do and do not consider culture. Methods. In a randomized trial, 1227 lower-income African-American women from 10 urban public health centers were assigned to either a usual care control group, or to receive a series of six women's health magazines with content tailored to each individual. By random assignment, these magazines were generated from either behavioral construct tailoring (BCT), culturally relevant tailoring (CRT) or both (BCT + CRT). The CRT magazines were based on four cultural constructs: religiosity, collectivism, racial pride, and time orientation. All tailored magazines sent to women ages 40-65 promoted use of mammography; magazines sent to women ages 18-39 promoted fruit and vegetable (FV) intake. Analyses examined changes from baseline to 18-month follow-up in use of mammography and servings of FV consumed daily. Results. Women receiving BCT + CRT magazines were more likely than those in the BCT, CRT, and control groups to report getting a mammogram (76% vs. 65% vs. 64% vs. 55%, respectively), and had greater increases in FV servings consumed daily (+0.96 vs. + 0.43 vs. + 0.25 vs. + 0.59). Conclusions. Systematically integrating culture into tailored cancer prevention and control interventions may enhance their effectiveness in diverse populations.

Original languageEnglish (US)
Pages (from-to)53-62
Number of pages10
JournalPreventive Medicine
Issue number1
StatePublished - Jul 2005


  • Cancer prevention
  • Culture
  • Health communication
  • Health disparities
  • Health education
  • Minority health

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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