DISCUSSION
Persuading asymptomatic people at risk to undergo routine cancer screening and prevention activities has been found to be difficult. NPs and other health care professionals must be cognizant of the considerable hold that cultural beliefs have on patient' health perceptions, health-seeking activities, and practices. This list, of course, includes adherence to prescribed regimens. Providers are in the best position to increase the knowledge base, dispel cancer myths, break down barriers, and be a true patient advocate, no matter the level of difficulty. The first step should be an aim at increasing the knowledge base and confidence of AA women through the development of culturally sensitive group training that will empower AA women and make them aware of their cancer screening measures.
The second step should address specific cultural barriers, such as cancer fatalism, fear, and perceived risk, the greatest obstacles to overcome and the key to improving AA women's participation in breast cancer prevention and health maintenance. This may lead to an increase in BSE performance, and annual CBE, thus a decrease in breast cancer mortality rates in AA women and other minorities.
Lastly, NPs can start reaching out to community leaders through advocacy groups churches in AA communities. Glanz et al4 found that core cultural values emphasizing family, interdependence, religion, and a holistic view of health to be important factors that influence screening behaviors. Interventions aimed at teaching women about BSE, thus truly decreasing the mortality rate of breast for Caucasian and AA women, is major objective that all health care professionals should undertake.