A RCT TO PROMOTE MAMMOGRAPHY ADHERENCE AMONG CHINESE IMMIGRANT WOMEN

一项旨在促进中国移民女性坚持乳房X光检查的随机对照试验

• 批准号: 8591384
• 负责人: Judy Huei-yu Wang
• 金额: $ 52.46万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2016-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8591384
• 关键词: Acculturation; Adherence; Age; American Cancer Society; Area; Asian Americans; Asians; Behavior; Behavioral; Belief; Breast Cancer Detection; California; Cancer Control; Caring; Caucasians; Caucasoid Race; Chinese American; Chinese People; Cities; Communities; Community Health; Control Groups; Data; Diagnosis; District of Columbia; Enrollment; Evaluation; Fostering; Future; Guidelines; Health; Health Educators; Healthy People 2010; Home environment; Immigrant; Individual; Interdisciplinary Study; Intervention; Intervention Trial; Investigation; Knowledge; Lead; Life; Long-Term Effects; Los Angeles; Mails; Maintenance; Mammography; Mediating; Methods; Minority; Minority Groups; Modeling; New York; New York City; Outcome; Participant; Population; Printed Media; Process Assessment; Protocols documentation; Qualifying; Randomized; Randomized Controlled Trials; Reading; Recruitment Activity; Relative (related person); Research; Risk; Site; Social Network; Social support; Stress; Structure; Telephone Interviews; Testing; Theoretical model; Training; Translating; Translations; Underserved Population; Universities; Woman; Work; arm; base; cancer health disparity; cancer site; community based practice; efficacy testing; experience; follow-up; group intervention; health belief; health training; innovation; intervention effect; intervention program; malignant breast neoplasm; metropolitan; mortality; multidisciplinary; peer; post intervention; primary outcome; programs; public health relevance; screening; secondary outcome; social; theories; therapy design; tool; tumor; volunteer

DESCRIPTION (provided by applicant): Chinese-Americans are the largest Asian population in the US, of which 70% are immigrants. In contrast to the generally high use of mammography screening and decline in breast cancer mortality seen in the total US population, Chinese-American women have much lower mammography screening rates and their breast cancer mortality rates are not yet declining. Chinese immigrant women with breast cancer are more likely to be diagnosed with large tumors and die within 5 years than their US-born counterparts. Their low rates of mammography use are associated with knowledge, cultural and attitudinal barriers to screening. Guided by the Health Belief Model, we developed a culturally sensitive video for Chinese women. Our preliminary research showed that viewing the cultural video at home (single video mode) effectively increased Chinese women's mammography use by 12 percentage points over reading a print medium (control group) after a 6-month follow-up. The cultural video also significantly increased knowledge and reduced cultural and attitudinal barriers compared to the control group. However, our data show that a high proportion of Chinese women (59%) still had not had a mammogram after the video intervention, suggesting that a more intensive approach is needed for this population. Thus, guided by Social Network Theory, we pilot tested the video in a small- group setting in which women viewed the video together followed by a peer-led discussion (small-group video discussion). The small-group video discussion enhanced Chinese women's mammography use six-months post-intervention more than the single video mode. We do not know whether small-group video discussion through social support and networks significantly changes personal beliefs and barriers and further promotes screening behavior and whether these two intervention approaches can have long-term effects on behavioral changes. To fill these gaps, our multidisciplinary research team proposes a randomized controlled trial to identify the best intervention approach for increasing mammography adherence among Chinese immigrant women. In this proposed trial, we will recruit 910 Chinese women through Chinese community partnerships in greater Washington DC, New York, and southern California. These women will be immigrants who are non- adherent to the American Cancer Society guidelines that recommend annual mammograms for women over age 40. Participants will be randomized to the two arms: 1) small-group cultural video discussion and 2) single cultural video mode. Participants will be telephone interviewed before and after intervention to assess their changes in key barriers and receipt of mammograms by 6 months and 18 months post-intervention. The small- group video discussion will be led by a trained Chinese community health educator and a research staff using a standardized protocol at all sites. If our theoretically-guided, community-led intervention programs are effective, these programs can be disseminated in Chinese-American communities at large and be translated to other Asian groups to promote overall mammography screening rates among Chinese and Asian women.

描述（由申请人提供）：华裔美国人是美国最大的亚裔人口，其中70%是移民。与美国总人口中普遍使用乳房X光检查筛查和乳腺癌死亡率下降相反，华裔美国妇女的乳房X光检查筛查率要低得多，其乳腺癌死亡率尚未下降。患有乳腺癌的中国移民女性更有可能被诊断出患有大肿瘤，并在5年内死亡。她们使用乳房X光检查的比率低与筛查的知识、文化和态度障碍有关。在健康信念模型的指导下，我们为中国女性开发了一个文化敏感的视频。我们的初步研究表明，在6个月的随访后，在家观看文化视频（单一视频模式）有效地使中国女性的乳房X光检查使用率比阅读印刷媒体（对照组）高出12个百分点。与对照组相比，文化视频还显着增加了知识，减少了文化和态度障碍。然而，我们的数据显示，很高比例的中国女性（59%）在视频干预后仍然没有进行乳房X光检查，这表明需要对这一人群采取更密集的方法。因此，在社会网络理论的指导下，我们在一个小组环境中对视频进行了初步测试，在小组环境中，女性一起观看视频，然后进行同伴主导的讨论（小组视频讨论）。小组视频讨论提高了中国女性干预后6个月乳腺X线摄影的使用率，高于单一视频模式。我们不知道通过社会支持和网络进行的小组视频讨论是否会显著改变个人信念和障碍，并进一步促进筛查行为，以及这两种干预方法是否会对行为改变产生长期影响。为了填补这些空白，我们的多学科研究团队提出了一项随机对照试验，以确定提高中国移民妇女乳腺X线检查依从性的最佳干预方法。在这项拟议的试验中，我们将通过大华盛顿特区、纽约和南加州的华人社区合作伙伴关系招募910名华人女性。这些妇女将是移民谁是不遵守美国癌症协会的指导方针，建议每年乳房X光检查的妇女超过40岁。受试者将被随机分为两组：1）小组文化视频讨论和2）单一文化视频模式。参与者将在干预前后接受电话采访，以评估他们在干预后6个月和18个月的关键障碍和接受乳房X光检查的变化。小组视频讨论将由一名训练有素的中国社区健康教育者和一名研究人员领导，在所有研究中心使用标准化协议。如果我们的理论指导，社区主导的干预计划是有效的，这些计划可以在美国华人社区广泛传播，并转化为其他亚洲群体，以提高中国和亚洲妇女的整体乳房X光检查筛查率。

项目成果

Chinese American and Non-Hispanic White Breast Cancer Patients' Knowledge and Use of BRCA Testing.

• DOI: 10.3390/ijerph20043384
• 发表时间: 2023-02-15
• 期刊: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
• 作者: Wang, Haocen;Chen, Lei-Shih;Hsiao, Hsin-Yi;Hsiao, Suh Chen;Han, Tian;Chang, Emily;Assoumou, Bertille;Wang, Judy Huei-Yu
• 通讯作者: Wang, Judy Huei-Yu

Evaluating the Training of Chinese-Speaking Community Health Workers to Implement a Small-Group Intervention Promoting Mammography.

• DOI: 10.1007/s13187-018-1361-5
• 发表时间: 2019-08
• 期刊: Journal of cancer education : the official journal of the American Association for Cancer Education
• 作者: Gu J;Maxwell AE;Ma GX;Qian X;Tan Y;Hsieh HC;Tu SP;Wang JH
• 通讯作者: Wang JH