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breast cancer screening, cervical cancer screening, early detection of cancer, health education, mammography, Native Americans, Pap smear, women's health



  1. Orians, Carlyn E.
  2. Erb, Julie
  3. Kenyon, Kathryn L.
  4. Lantz, Paula M.
  5. Liebow, Edward B.
  6. Joe, Jennie R.
  7. Burhansstipanov, Linda


A 1993 amendment to the authorizing legislation for the Center of Disease Control and Prevention's National Breast and Cervical Cancer Early Detection Program allows direct funding to tribal organizations and urban Native health centers. This study examined tribal programs' implementation of the public education and outreach component utilizing a multisite case study design implemented in partnership with tribal programs. Data were collected from 141 semistructured interviews with key informants and 16 focus groups with program-eligible women. Innovative strategies built on native iconography and personal encounters have encouraged participation and made the programs culturally relevant, providing insights for other communities with little experience in providing early detection services.