Which is the more effective setting for educating women in minority communities about breast cancer prevention: the sterile, frightening environment of a doctor’s office or clinic, or the comfortable, familiar surroundings of the neighborhood shops and beauty parlors that are a normal part of their everyday lives?
This is the philosophy behind Milwaukee’s “Shop Talk” program, a culturally competent community outreach project created by nurse educators at the University of Wisconsin-Milwaukee School of Nursing. The program brings information about breast cancer risks, prevention and screening to neighborhood grocery stores, hair salons and other women-oriented businesses, enlisting shop owners and hair stylists into the role of breast health educators. Shop Talk has become such a success in the city’s black neighborhoods that it is now expanding into the local Hmong and Laotian community.
Dr. Annye Nichols, clinical assistant professor of nursing at UWM, started the Shop Talk program five years ago because of her concern about the disparity in breast cancer death rates between African-American and white women. According to the National Cancer Institute, black women are 28% more likely to die from the disease than Caucasian women. Many experts link this higher death rate to black women’s lack of information about breast cancer screening and prevention, which results in their being diagnosed and treated when their disease is at a more advanced stage.
Today, more than 100 local African-American beauty shops are participating in Shop Talk. Carla Harris, a nurse clinician and breast health educator at the university’s House of Peace Community Nursing Center, is currently working on expanding the program into popular hair braiding salons as well.
Because spreading the word about breast cancer prevention to women in Hmong and Laotian immigrant communities also presents challenges, such as overcoming language and cultural barriers, Nichols and her House of Peace nursing colleagues recently launched a second phase of the Shop Talk program specifically targeted to these groups. Two Hmong nurse educators, Joyce Vang and Mai Yia Thao, work closely with the shopkeepers, providing information, translation services and transportation to UWM’s nursing center for clinical breast exams and mammograms.
The Shop Talk approach is a good cultural fit for this population, says Vang, because Hmong and Laotian women tend to seek advice from older, more respected women in the community, such as shop owners. Participating merchants receive breast cancer information materials, such as brochures and portable displays, that they can place near their cash registers to start conversations with customers. The materials are available in both Hmong and Laotian, and the House of Peace nurses also provide a breast cancer information hotline, which greets callers in Hmong.