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Mammography Promotion Intervention for Korean-American Immigrant Women
Background : Breast cancer is the most frequently diagnosed cancer among Korean-American (KA) women, and immigrant KA women present with larger tumor size and more advanced-stage cancer than Caucasian women, implying that KA women adhere less to breast cancer screening. Immigrant KA women have higher breast cancer rates than women in their native country. Because early detection through routine screening contributes to a decrease in breast cancer mortality, the particularly low rates of adherence to breast cancer screening guidelines among minority subpopulations such as KA women is disconcerting. Objective : The objective of this study is to develop and test a culturally relevant intervention designed specifically for low income KA immigrant women to promote mammography use. Aims : 1. Identify predictors of stage of mammography use; 2. Assess the effect of a targeted, stage-based culturally relevant educational program called GO EARLY on mammography use among KA women; and 3. Establish an infrastructure linking low-income KA women with breast health services. Design : A sample of 300 KA women, aged 40 or older will attend stage-based educational sessions at the Korean American Senior Center, which is a community-based organization (CBO). The study will be conducted in Korean-language. Community Navigators (CNs) will recruit women to the study, assist with conducting educational sessions , and follow up interviews. The CNs will assist women with obtaining a mammogram post-education and link women with diagnostic and treatment services as needed, to provide support through what may well be a difficult and confusing time. The process evaluations will be conducted to assess effect of the education and the process of working with the CBO. Study results will be disseminated to the KA community via a series of presentations at the CBO and articles in Korean newspapers. Outcomes/Benefits : Outcomes include development of a culturally relevant breast health education program for KA women and gaining new information on predictors of mammography use among KA women. Participants will gain knowledge and information about breast health and strategies to overcome possible barriers of mammography use. The educational program will be refined based on study results for easy implementation through KA-serving CBOs in Chicago and nationally.
Korean-Americans (KAs) are one of the most rapidly growing immigrant populations of the last decade. Breast cancer is the most frequently diagnosed cancer among immigrant KA women, and they have higher breast cancer rates than women in their native country (16.9 vs. 10.9 per 100,000). Furthermore, KA women had the lowest rate of mammography use for early breast cancer screening: 50% of KA women never had a mammography compared to 21% of Caucasians. Asian Americans and Pacific Islanders are often combined as one ethnic group, yet they represent more than 25 ethnic groups with origins in many different geographic areas. Grouping Asian Americans and Pacific Islanders in studies or analyses has hindered efforts to understand potentially distinct influencing factors for under-use of mammography service and to develop culturally competent and effective interventions to promote mammography use. Thus, we would like to develop and test a culturally competent and interactive intervention, named GO EARLY specifically designed to increase mammography use among low-income KA immigrant women 40 years or older. Through this study, we will try to understand why KA immigrant women do not adhere to recommended mammography guidelines, how traditional Korean cultural beliefs impact mammography use. Additionally, we will test the effect of our educational program, GO EARLY , on KA women’s readiness to have a mammogram. A total 300 KA immigrant women aged 40 or older will attend educational sessions at the Korean American Senior Center (KASC), which is a community-based organization (CBO) in Chicago. Each participant will be surveyed in person: answer a pre-intervention questionnaire (Time 1), attend GO EARLY sessions, and complete a post-intervention questionnaire at 6 weeks (Time 2). We will also assist women with obtaining a mammogram as needed to provide support due to language barrier. This study can be a foundation for developing a culturally relevant breast health education program for KA immigrant women and help us garner new information on predictors of mammography use among KA women. The study participants will gain knowledge and information about breast cancer risk factors, benefits of mammography use, and strategies to overcome possible barriers of mammography use. Based on study findings, the educational program will be refined for easy implementation through the CBO, as well as disseminated to other KA serving CBOs in Chicago and nationally.