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An Interdisciplinary Innovative Approach to Promote Breast Cancer Screening Among New Immigrant Women from Southeastern and Southern Asia
Breast cancer is the leading diagnosed cancer in Asian American women. Although Asian American women have a lower reported breast cancer incidence rate compared with Caucasian and African American women, they are more likely to receive a diagnosis in the advanced stages of the disease, primarily because of late detection. Immigrant women from southeastern and southern Asia (SSA) have unique needs in breast cancer screening (BCS) because of their socioeconomic and cultural backgrounds, which include language barriers, economic status, and other lifestyle issues. Understanding cultural barriers and the breast cancer screening practices of SSA women and developing culturally appropriate programs to promote their receipt of BCS has become an urgent need in southeastern Michigan, where the southeastern and southern Asian population has been growing. The objective of the proposed project is to reduce breast cancer-related health disparities in southeastern and southern Asian women residing in southeastern Michigan through promoting tailored and comprehensive health education on BCS and providing access to screening services in the community for these women. The three specific aims of this exploratory descriptive study are: (1) to investigate utilization of breast cancer screening (breast self-exam, clinical breast examination, and mammography) by SSA women; (2) to examine cultural barriers of BCS and characterize those women who are likely to underutilize these examinations; and (3) to develop and implement a culturally competent breast cancer control program to increase screening rates tailored to the unique cultural needs of this population. Special emphasis will be placed on identifying strategies to reduce the barriers to receiving BCS identified by these women and approaches to increase their self-efficacy. At the completion of this study, it is expected that the immigrant women participating in this health education program will have increased knowledge and decreased barriers toward breast cancer and BCS activities and increased receipt of screening services. By involving nursing, medical, and social work students in developing and implementing this program in this Asian community, these beginning health professionals will develop a better understanding of immigrant cultures and the impact of their cultural beliefs and practices on breast cancer screening behaviors and ultimately, improve patient care and patient-provider interaction.
Asian Americans are one of the fastest growing populations in southeastern Michigan, particularly those from southeastern Asia (Philippines, Vietnam) and southern Asia (India, Bangladesh, and Pakistan). For Asian American women, cancer is the leading cause of death, and breast cancer is the most frequently diagnosed cancer in these women (except in Vietnamese women). Most Asian American women, however, receive their diagnoses at a late stage, and fewer receive regular clinical or mammography screening for breast cancer. Immigrant women from southeastern and southern Asia have unique needs in breast cancer screening (BCS) activities (breast self-exam, clinical breast examination, and mammography) because of their socioeconomic and cultural backgrounds, which include language barriers, economic status, and other lifestyle issues. It is important for health professionals to understand cultural barriers and the breast cancer screening practices of southeastern and southern Asian women so culturally appropriate programs can be developed to promote their receipt of breast cancer screening. The goal of the proposed project is to increase breast cancer-related awareness and reduce barriers toward breast cancer screening in southeastern and southern Asian women. This study will include the following activities: (1) conducting focus group interviews to determine knowledge, attitudes, and beliefs about breast cancer and screening and to identify barriers to receiving BCS; (2) designing, implementing, and evaluating a culturally appropriate health education on BCS and effective screening strategies targeting southeastern and southern Asian women; and (3) reducing structural barriers by providing access to free clinical breast examinations and referrals through a state-wide Breast Cancer Cervical Control Program that provides free mammograms for eligible women. Nursing, medical, and social work students will work with the research team to develop and implement the proposed intervention program in this identified Asian community. The culturally appropriate materials developed for this project can be utilized and replicated for use in other communities working with these populations. The emphasis on careful assessment of these women¡¦s cultural barriers and the development of a tailored and comprehensive health education program in this proposed project will not only promote early detection and prevention of breast cancer screening in this underserved population, but will also help health professionals to better understand this immigrant population and their needs.