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The Effects of a Culturally Specific Intervention for Breast Health
Breast cancer is the most common malignant disease and second leading cause of cancer mortality among Asian American women. According to the Surveillance, Epidemiology and End Results Program (SEER) in California, breast cancer is the most common form of cancer in Vietnamese American females. When diagnosed, Vietnamese American women are likely to have treatment but are more likely than non-white minority women to perceive barriers to having a mammogram. This may result from differences in access experienced by recent immigrants who report difficulties getting care due to language and acculturation issues. Researchers recognize the link between health communication, culture, and the use of materials written in different languages and views, yet whether the use of culturally specific materials makes any difference is largely untested. Using community participatory strategies, we designed and produced a culturally specific breast health video and now propose a project to ascertain the effect of this as an educational intervention for Vietnamese-speaking women with the objective of determining if there are differences for those who receive culturally specific information compared with women who do not. We hypothesize that women exposed to culturally specific education will gain knowledge about breast health and participate in screening more than women receiving standard care only. Specific aims of this experimental, randomized pretest, post test control group design are: to identify the incidence rate for mammogram, CBE (clinical breast exam) and BSE (breast self-exam) at baseline and post intervention; to examine knowledge gained in two experimental and one control group; and to explore providers' and women’s perceptions of benefits and barriers to the use of culturally specific materials related to breast health. One experimental group will receive the culturally specific intervention, the other translated written materials, and the control group will receive standard care. The benefit of this research is determining if the use of a culturally specific tool is more effective than a standard translation. We expect women who received culturally specific content will exhibit more knowledge and positive behaviors related to breast cancer screening. We expect both Vietnamese women and providers will report fewer barriers to breast cancer screening and more perceived benefits when using culturally specific materials.
Background: Breast cancer is the most common cancer and second leading cause of cancer death among Asian (Chinese, Filipino, Japanese, Vietnamese) women, but we have limited data specifically about Vietnamese American women. When diagnosed, Vietnamese American women are likely to have treatment for cancer, but they are more likely than other women to report barriers to having a mammogram. The reasons for the barriers may be language differences and the process of Vietnamese immigrants entering American culture with limited understanding of American attitudes and beliefs. Researchers recognize the link between health communication, culture, and the use of materials written in different languages and views, yet whether the use of culturally specific materials makes any difference is largely untested. Using strategies involving the Vietnamese community, we designed and produced a culturally specific breast health video for Vietnamese women. Objective/Hypothesis: The purpose of this proposed study is to determine how Vietnamese women respond to culturally specific breast health information, compared with standard forms of information (pamphlets) translated from English to Vietnamese. We believe that women who receive culturally specific information will learn about breast health and participate in breast cancer screening more than women receiving standard forms of information. Specific aims/study design: The goals of this study will be: to count the number of times women have appropriate breast cancer screening; to see how women answer questions about breast health and breast cancer screening; to determine physicians' and women's ideas about the use of culturally specific versus standard information and, factors that have helped or kept women from screening. Women who consent to participate will be assigned to either a group that sees the video, a group that receives materials written in Vietnamese, or a group that does not receive either. Benefits: The benefit of this research is determining if the use of a culturally specific video is more effective than translated materials or standard care to increase participation in breast cancer screening. We expect that women who watch the video will have greater knowledge and participate in screening more than women receiving translated materials or standard care. Both physicians and women are likely to report greater benefits and fewer barriers to breast cancer screening when using culturally specific materials.