Breast and Cervical Cancer Screening in Korean-Americans

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The long-term objective of this program of research is to develop, implement, and evaluate a culturally tailored intervention to increase the rates of obtaining mammogram, CBE, and Pap smear screens and practicing BSE in Korean American (KA) women. Dr. Choi's goals during this proposed training are to: 1) Gain advanced skills in developing culturally valid instruments; 2) Enhance her understanding of health promotion and disease prevention issues; 3) Generate knowledge related to KA women's utilization of the cancer screening tests; and 4) Generate knowledge related to health care providers' recommendations of the screening tests for KA women. The theoretical framework of this proposed project is based on Anderson's Behavioral Model supplemented with the Cultural Explanatory Model. The specific aims of this proposed study of KA immigrant women older than 40 years of age and their utilization of these tests are: 1) To develop culturally appropriate instruments and test them; 2) To test the hypothesis that KA women's predisposing variables; enabling variables, and need variables will be related to their utilization of the screening tests; and 3) To identify culturally specific and demographic variables that influence physicians' recommendation or practice of the screening tests. To achieve the specific aims, this proposed project will be conducted in 5 phases: 1) individual interviews with 30 KA women; 2) six focus groups with KA women; 3) modification of existing instruments and/or development of new instruments based on the results of individual interviews and focus groups; 4) individual interviews with 10 KA and 10 Caucasian American physicians; and 5) a survey with a community based random sample of 350 KA women in order to pilot test and to establish psychometric properties of the instruments. This proposed project is innovative since no published project has approached cancer screening services from the perspectives of both recipients as well as their providers to provide a comprehensive understanding of the reasons KA women have lower utilization rates of these tests. This project is significant in generating culturally accurate information and instruments to be used in both epidemiological research and culturally tailored intervention research for cancer screening test utilization in KA women.