Recruitment for the National Breast and Cervical Cancer Early Detection Program Cam T. Escoffery, PhD, MPH, Michelle C. Kegler, DrPH, MPH, Karen Glanz, PhD, MPH, Tracie D. Graham, MPH, Sarah C. Blake, MA, Jean A. Shapiro, PhD, Patricia D. Mullen, DrPH, Maria E. Fernandez, PhD Background: To reduce disparities in breast and cervical cancer in the U.S., it is essential that programs such as CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP) use evidence-based strategies. Recommendations for interventions to increase breast and cervical cancer screening have been disseminated by national public health organizations. To increase screening, cancer control planners would benefıt from use of evidence-based strategies for recruit- ment of participants in their communities. Purpose: The purpose of the study was to inventory recruitment activities for cancer screening within NBCCEDP programs and assess if activities used to increase cancer screening are evidence- based. Methods: Interviews were conducted with 61 recruitment coordinators in 2008 to elicit their recruitment activities, use of evidence-based resources, and barriers to using evidence-based inter- ventions (EBIs). Study data were analyzed in 2009. Results: Of the 340 activities reported, many were categorized as educational materials, one-on-one education, mass media, group education, and special events. Two thirds of inventoried activities matched an EBI. Coordinators reported that colleagues and the CDC are their primary sources of information about EBIs and few coordinators had used evidence-based resources. Lack of money or funding, questionable applicability to priority populations, limited staffıng or staff time, and insuf- fıcient evidence-based research were the most important barriers to EBI use. Conclusions: Although the majority of NBCCEDP recruitment activities were evidence-based, one third were not. Additional training and technical assistance are recommended to help public health agencies adopt the use of these strategies. (Am J Prev Med 2012;42(3):235–241) © 2012 American Journal of Preventive Medicine Introduction D espite progress in screening uptake, increasing breast and cervical cancer screening use contin- ues to be an important public health objective. Certain subgroups of women experience increased mor- bidity and mortality from cancer. African-American women experience higher mortality from breast cancer, and Hispanic women have a higher incidence of cervical cancer than other groups. 1 Disparities in screening also exist; 68% of white women aged 40 years have received a mammogram in the past 2 years, compared with only 61% of Hispanic women. 2 For cervical cancer screening, although 77% of white women and 79% of African- American women aged 18 years have been tested in the past 3 years, only 74% of Latinas in this age group have been screened. 2 Women with lower SES or no health insurance have lower rates of both mammography and Pap testing. 2 Barriers to screening include lack of health insurance, language, geography, cultural differences, provider biases, 3 women’s perception of low risk, 4 lack of social support, 5,6 and lack of reminders. 7 The National Breast and Cervical Cancer Early Detec- tion Program (NBCCEDP) was created by the U.S. Con- gress after passage of the Breast and Cervical Cancer From the Department of Behavioral Sciences and Health Education (Es- coffery, Kegler) and the Department of Health Policy and Management (Blake), Division of Cancer Prevention and Control (Shapiro), CDC, At- lanta, Georgia; the Schools of Medicine and Nursing (Glanz), University of Pennsylvania, Philadelphia, Pennsylvania; and the Division of Health Pro- motion and Behavioral Sciences (Mullen, Fernandez), University of Texas School of Public Health, Houston, Texas Address correspondence to: Cam T. Escoffery, PhD, MPH, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, 5th Floor, Atlanta GA 30322. E-mail: cescoff@emory.edu. 0749-3797/$36.00 doi: 10.1016/j.amepre.2011.11.001 © 2012 American Journal of Preventive Medicine. All rights reserved. Am J Prev Med 2012;42(3):235–241 235