Purpose: This study was a two-year educational intervention and research project aimed at increasing the awareness of breast cancer and the utilization of Clinical Breast Examination (CBE) services and Self-Breast Examination (SBE) among elderly rural and urban African American women who are Medicare beneficiaries. Design: The study was implemented in four phases. In Phase 1, we obtained Center for Medicare and Medicaid Services (CMS) data collected for a one-year period and computed the annual mammography screening and clinical breast examination rates for elderly African American and Caucasian women who are participants in the Medicare programme. Phase 2 was conducted concurrently with Phase 1 to collect and analyze pertinent data. During Phase 3, the one-year educational intervention component of the project was implemented, in conjunction with the American Cancer Society's Sisters Alive programme, and with the Health Advisory Council. In Phase 4, we obtained the claims data from CMS to compute annual mammography rates to evaluate the impact of the intervention. Findings: The results suggest the following: (1) one of the primary reasons elderly women do not utilize CBE services is because they do not consider it necessary when they experience no symptoms or pain; (2) elderly African American women have moderate awareness of the incidence and prevalence of breast cancer; and (3) they are generally aware of the benefits of CBE. Analysis of the pre- and post-tests data failed to provide evidence of the impact of this project on the utilization of CBE among elderly African American women. (Contains 3 tables.)