Breast and Cervical Cancer Screening Literacy Among Korean American Women: A Community Health Worker-Led Intervention
Breast and Cervical Cancer Screening Literacy Among Korean American Women: A Community Health Worker-Led Intervention
复制标题
DOI：
10.2105/ajph.2016.303522
复制
发表时间：
2017-01-01
影响因子：
12.7
通讯作者：
Roter, Debra
中科院分区：
文献类型：
--
作者：
Han, Hae-Ra;Song, Youngshin;Roter, Debra
目标。目的探讨社区卫生工作者(CHW)主导的健康素养干预对韩裔美国女性乳房X光检查和巴氏筛查的影响。2010至2014年间，我们在马里兰州巴尔的摩-华盛顿特区大都会地区的23个种族教堂进行了一项整群随机试验。受过培训的CHW招募了560名妇女。干预组接受了一份量身定做的癌症筛查手册，随后是CHW领导的健康素养培训，以及每月在导航帮助下进行的电话咨询。研究结果包括接受适合年龄的癌症筛查测试，健康素养，癌症知识，以及在6个月时对癌症筛查的看法。调整协变量后，干预组接受乳房X光检查的几率是对照组的18.5倍(95%可信区间[CI]=9.2，37.4)。接受巴氏测试的几率是13.3(95%CI=7.9，22.3)倍；接受两种测试的几率是17.4(95%CI=7.5，40.3)倍。干预效果还包括健康素养的提高和对癌症筛查的积极看法。以健康素养为重点的CHW干预成功地促进了韩裔美国女性的癌症筛查行为以及相关的认知和态度结果。
Objectives. To test a community health worker (CHW)-led health literacy intervention on mammogram and Papanicolaou test screening among Korean American women.Methods. We conducted a cluster-randomized trial at 23 ethnic churches in the Baltimore, Maryland-Washington, DC, metropolitan area between 2010 and 2014. Trained CHWs enrolled 560 women. The intervention group received an individually tailored cancer-screening brochure followed by CHW-led health literacy training and monthly telephone counseling with navigation assistance. Study outcomes included receipt of an age-appropriate cancer screening test, health literacy, cancer knowledge, and perceptions about cancer screening at 6 months.Results. The odds of having received a mammogram were 18.5 (95% confidence interval [CI] = 9.2, 37.4) times higher in the intervention than in the control group, adjusting for covariates. The odds of receiving a Papanicolaou test were 13.3 (95% CI = 7.9, 22.3) times higher; the odds of receiving both tests were 17.4 (95% CI = 7.5, 40.3) times higher. Intervention effects also included increases in health literacy and positive perceptions about cancer screening.Conclusions. A health literacy-focused CHW intervention successfully promoted cancer-screening behaviors and related cognitive and attitudinal outcomes in Korean American women.