Tailored Telephone Intervention to Address Barriers to Breast Cancer Screening for African American Women

African American women experience disproportionately higher breast cancer mortality rates despite lower incidence compared to White women. Contributing factors include limited healthcare access and non-medical drivers of health which can delay screening and diagnosis. Evidence supports one-on-one health education as an effective strategy to promote breast cancer screening (BCS). This study describes the adaptation and pretesting of a telephone intervention to increase BCS among African American women in a southern United States metropolitan area who were due or overdue for screening. A team of Certified Health Education Specialists adapted an evidence-based script originally developed by the National Cancer Institute using the Transtheoretical Model of Health Behavior Change and principles of culturally responsive communication. The iterative process included expert review and two rounds of cognitive interviews with African American women to ensure clarity, cultural relevance, and motivational framing. Script modifications emphasized progress-oriented messaging, empathetic tone, and barrier-specific counseling, addressing more than 40 commonly reported challenges such as cost and transportation. Pretesting results indicated that participants found the adapted script clear, culturally appropriate, and motivating. Feedback informed refinements to language word choice and tone, barrier responses, and resource integration. The final script provides actionable guidance for health educators and navigators to deliver personalized health education and connect patients to local resources. This project demonstrates the importance of culturally tailored interventions to reduce screening disparities and highlights the potential of telephone-based education to improve preventive care. Future steps include piloting the intervention and adapting the approach for other populations and preventive services.