About

TEAM: Tablet-based Education to Improve the Acceptance of Mammography 


Project Overview 

The overall goal of this study is to evaluate the effectiveness of an intervention to promote breast cancer screening (mammography) among women in the Chinle, Arizona Navajo Nation community. The intervention, “TEAM” (Tablet-based Education to improve the Acceptance of Mammography), was developed using a community-based participatory research process (IRB00009578). 

What we are doing 

We are conducting a 1:1 randomized waitlist control trial to test the effectiveness of TEAM compared to TEAM + Navigation for increasing mammography uptake among women with a referral for screening mammography. 

Women will be randomly assigned to receive one of the following: 

  • TEAM: a culturally tailored mammography education module delivered on a tablet 
  • TEAM + Navigation: the TEAM education module plus access to a Diné women’s health coach (patient navigator) 

All participants will complete assessments at baseline, 3-, and 6- months. Women in the TEAM group who have not received a mammogram at 3 months will be offered the patient navigation support if they wish. 

We are testing the following aims: 

  • Aim 1: To assess whether TEAM + Navigation leads to more women scheduling and completing a mammogram within 3 months of referral (compared to TEAM alone). 
  • Aim 2: To assess whether TEAM + Navigation improves women’s understanding and attitudes about mammogram screening and reduces barriers. 
  • Aim 3 (future aim): To explore how women and clinic staff view the acceptability, usability, and sustainability of TEAM through qualitative interviews. 

Why does this matter? 

  • Addresses urgent health concerns raised by Navajo Nation leaders about low breast cancer screening rates—only 29% of eligible women in Chinle received mammograms in 2020, down from 44% in 2015. 
  • Responds to real community barriers identified through previous research, including limited time during appointments to discuss screening, confusion about referrals, and lack of support and comfort in scheduling mammograms. 
  • Provides culturally tailored education developed specifically for Navajo women, based on local input and values, to improve understanding and trust around breast cancer screening. 
  • Connects women with trusted support by offering access to Diné women’s health coaches (patient navigators), who can guide and encourage them to complete mammograms. 
  • Helps the Chinle community by promoting earlier cancer detection, improving access to preventive care, and supporting long-term health outcomes for Navajo women through community-based and culturally grounded solutions. 

  • For More Information: 

    • Dr. Katie Nelson (Principal Investigator) – knelso46@jhmi.edu

    • Cheyenne Tortalita (Program Specialist) – ctortal1@jhu.edu

    • Office Phone: 928-674-3911 or 928-674-6824

Funders
Ralph Lauren Corporate Foundation 
Genentech Foundation
Irving Hansen Foundation

Resources
Community Resource Guide