A community-based Wellness Circles Program was designed and implemented at 13 sites in California to evaluate a culturally appropriate community-based health care model for American Indian families. Data obtained from the Behavioral Risk Factor Surveillance System (BRFSS) that was administered to a subset of women demonstrate that American Indian women continue to underutilize breast cancer-screening procedures. American Indian breast cancer-screening rates were compared to national and state general populations. On all measures, screening procedures among the study population were found to be below that reported by the state of California and national BRFSS data reports and the Healthy People 2010 objectives. Despite the availability of many cancer-screening tests, a significant number of American Indian women do not follow recommended screenings. Barriers to participation are complex and often involve cultural values and beliefs. Even when, for example, mammography appointments have been scheduled, many Indian women fail to keep them, and the noncompliance rate among American Indian women is particularly high. The need for improved screening rates and the need to address barriers to screening among rural Indian groups are essential if cancer is to be prevented and controlled in these groups. (Contains 2 tables and 18 notes.)