Breast Cancer Early Detection Intervention at Community Health Centers in China

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DESCRIPTION (provided by investigator): Breast cancer continues to be the primary cause of death among East and Southeast Asian women. Studies indicated a consistent rise in breast cancer rates among Chinese women over the past two decades in the absence of breast cancer screening. Although mammography technology is available in China's large hospitals of urban cities, its use in early detection is limited due to a general lack of public awareness of mammography and to the absence of standard guidelines for the application of this technology in screening programs. However, interest in using mammography for breast cancer screening remains high among Chinese public health officials and scientists. The overall goal of this proposed project is to: 1) adapt and pilot test a community health center (CHC) intervention to increase breast cancer early detection for women in China~ and 2) strengthen a research capacity and collaboration between the U.S. NIH-funded established principal investigator and researchers in China. To accomplish this goal, we will build on our experienced interdisciplinary, bilingual/bicultural research team to conduct a community health center intervention research in China to achieve the following specific aims:1) modify a culturally tailored educational curriculum and behavioral intervention t increase breast cancer screening among Chinese women at community health centers in China~ 2) conduct a pilot intervention trial and evaluate the feasibility, acceptability and evidence of success of the community health center-based intervention in increasing knowledge, changing attitudes and improving breast cancer screening rate~ and 3) strengthen/expand research capacity between the NIH-funded U54 Principal Investigator in the U.S. and LMIC scientists in China on breast cancer intervention through mentored research project, visiting scholars and lectures designed to build knowledge and skills for conducting cancer intervention research. In line with recent China's healthcare reform in changing hospital-care to community care, the study will be carried out at four community health centers in Nanjing, China, two of which will be assigned to intervention group and two to control group (N=400~ 100 from each site). The primary outcome of the study is to examine the impact of a community health center intervention on increasing breast cancer screening rates at six months after receiving the intervention. This application is an extension of Principal Investigator's NIH-NCI funded U54 Asian Community Cancer Health Disparities Center (9/10-9/15) that directly relates to its goals of reducing incidence and risk behaviors of cancer by increasing early detection~ and stimulating partners' collaboration in training and research capacity building on cancer control. This is the first study to test a community health center intervention to increase breast cancer screening in China, addressing a significant globl health problem, breast cancer. It is a highly relevant project for China's urban cities, which hav an alarming increase in incidence rates of breast cancer and underutilization of mammography technology. It also represents a new model practice in using mammography for proactive early detection rather than as a diagnostic tool only.