Better Breast Health for Korean American Women

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DESCRIPTION (provided by applicant): Breast cancer screening rates for Korean American (KA) women are far below the national goal, and below rates reported for other ethnic groups. As a result, KA women are often diagnosed at a later stage of cancer which can lead to a poor prognosis, high mortality, and subsequent emotional and financial burden. As a predominantly first generation immigrant group, KA women face multiple barriers to obtaining screening services and critical health information available in the mainstream health care system. To address the urgent need for educating and facilitating access to regular screening, we propose a pilot intervention program that utilizes community-based outreach and education strategies. Specifically, building upon the investigative team's previous community assessment of preventive health behaviors and experience with community health worker (CHW) training and intervention, we propose a feasibility study to test a community-based outreach program to promote breast cancer screening among KA women following the evidence-based screening guidelines. Using community-based participatory research (CBPR) as an operational framework, the partnership between researchers and the target community with shared vision will serve as a vehicle to implement this intervention and promote health of KA women. The specific aims of this study are to: 1) standardize the training protocol for CHWs to conduct breast cancer education and screening follow-up for KA women; 2) test the efficacy of the CHW training program; and 3) test the efficacy of the intervention program in 100 KA women aged 40 and older. The primary outcomes of the CHW intervention are self-reported receipt of, and intention to obtain mammography. Secondary outcomes include satisfaction with CHW-led education sessions and follow-up, changes in other screening behaviors (i.e., clinical breast exam and breast self-exam), and knowledge and beliefs about breast cancer. This CBPR proposal is a pilot investigation before conducting a larger scale community trial to test the effectiveness of a culturally and linguistically sensitive CHW intervention to improve breast cancer screening rates in KA women. Through initiation of these research activities, we expect 1) to establish a mechanism for disseminating health information for this linguistically isolated population, and (2) to enhance a community network which will facilitate community access to breast cancer screening.