Pilot Project

我们建议进行一项分组随机对照试验，以实施和评价 创新循证乳腺健康教育干预方案与对照组比较 （延迟干预），以促进第一代阿富汗移民妇女的乳房健康检查。 对文化、宗教和语言因素的敏感性是拟议意图的关键组成部分。 在加州乳腺癌研究项目的资助下，我们进行了试点工作（见 初步结果）和试点工作的调查结果，以指导干预的内容。符合 基于社区参与性研究的原则，该试点项目的行政设计是， 确保社区与学术研究伙伴在权力方面是平等的伙伴， 他们收到自己的预算，是收集的数据的所有者（这两个 问题在基于社区的参与性研究中有问题的历史）。 我们的研究将测试一个假设，即妇女随机分配到一个定制的乳房健康 教育计划将显示乳腺癌知识和意识的增加， 早期检测（CBE和乳房X光检查）。这种语言、宗教和文化的细节 tailored（targeted）：在这个领域中，关于这是目标还是量身定制的存在争议，后者更重要 专门针对低识字率人群，由非专业健康顾问教授，并提供后续咨询 社区导航员的帮助和男性亲属的支持。 文化/宗教/教育的适应性使我们的干预措施具体针对穆斯林的需求。 妇女，并提供了一个独特的方案，使阿富汗妇女的健康项目从其他 乳房健康促进项目。参与者将被随机分配到干预组或对照组 延迟干预组。对照组在干预后接受教育程序 调查.干预前和干预后的调查将用于衡量知识的变化， 预防和早期检测行为。作为干预后调查的一部分，妇女将报告 他们是否有（或有预约有）CBE和/或乳房X光检查，我们将询问 乳腺健康检查的促进因素和障碍。

We propose to conduct a group randomized controlled trial to implement and evaluate the effect of an innovative evidence-based breast health education intervention program compared to a control group (delayed intervention) to promote breast health screening among first generation Afghan immigrant women. Sensitivity to cultural, religious, and linguisfic factors is a key component ofthe proposed inten/ention. With funding from California's Breast Cancer Research Program, we have conducted the pilot work (see preliminary results) and findings from the pilot work to guide the content of the intervention. Consistent with the tenets of community based participatory research, the pilot project was administratively designed to ensure that the community was an equal partner with the academic research partners in terms of power and influence¿^they received their own budget and are the owners of the data that was collected (these two issues have a history of being problematic in community based participatory research). Our research will test the hypothesis that women randomly assigned to a tailored breast health education program will show increased breast cancer knowledge and awareness and increased rates of having early detection (CBE and mammography). The details of this linguisfically, religious and culturally tailored (targeted¿there is contention in the field as to whether this is target or tailored, the latter being more specific) program designed for low literacy and taught by lay health advisors (LHAs) with follow-up counseling and facilitafion by community navigators and the support of their male relatives. The cultural/ religious/educational adaptations make our intervention specific to the needs of Muslim women and provide a unique program that distinguishes the Afghan Women's Health Project from other breast health promotion projects. Participants will be randomly assigned into the intervention or control (delayed intervention) group. The control group will receive the educational program after the postintervention survey. Pre-and post-intervention surveys will be used to measure changes in knowledge of prevenfion and in eariy detection behaviors. As part of the post-intervention survey, women will report whether they had (or have an appointment to have) a CBE and/or a mammogram and we will inquire about the facilitators and barriers for getfing a breast health screening examinations.