In the United States, cases of invasive cervical cancer have declined in recent decades due to earlier detection through the Pap smear and improved forms of treatment. Significant regional variations exist across the country in mortality rates from cervical cancer, and the Appalachian region stands out as having high rates. It is also an area characterized by poverty, lack of transportation, and low rates of health insurance.
Faith Moves Mountains (FMM) is a health care project supported by the National Cancer Institute which seeks to reduce cervical cancer mortality in southeastern Kentucky. FMM targeted women aged 40-64 years, an age when women in the region typically stop getting Pap smears. The program followed a community-based participatory approach that is implemented through churches. Its aim is to increase cancer screening (Pap tests) through educational programming and health counseling. FMM was initiated by a team of medical faculty at the University of Kentucky.
Since many of the factors that serve as barriers to cervical cancer prevention cannot be changed, FMM took an “assets approach.” In Appalachia, two major assets are churches and social networking. The researchers arranged dates for educational workshops through churches. In order to forge links between the local people and medical care providers, they implemented a lay health advisor (LHA) program which involved local women as peer advisors. So far, the program has recruited 421 women who were rarely or never screened. While this number may not seem impressive to readers, given the logistical difficulties of working in Appalachia and the relatively sparse population, it is actually substantial.
Along the way, the researchers learned valuable lessons about how to work with the culture rather than in an outsider-driven way. For example, invitations mailed to churches asking them to participate were “returned to sender” or left unopened on the preacher’s desk. So, the researchers learned that they had to do door-to-door visits and build relationships. Also, taking notes on a laptop computer had to be abandoned as it distanced the researchers from the participants.
Image: “Blue house,” from Flickr user dok1, licensed with Creative Commons.
anthropologyworks 
It always bothers me at the doctor’s office when they sit there with their laptops and type your responses about how you’re feeling, etc. without even looking up at you! This reminded me of that. I think it’s an issue that really does distance you from the people you’re supposed to be interacting with. Interesting post 🙂
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