Better Breast Health for Korean American Women

描述(由申请人提供)：韩裔美国(KA)女性的乳腺癌筛查率远远低于国家目标，也低于其他种族的报告筛查率。因此，KA妇女通常在癌症的后期被诊断出来，这可能会导致不良的预后、高死亡率以及随后的情感和经济负担。作为以第一代移民为主的群体，克族妇女在获得主流医疗保健系统提供的筛查服务和关键健康信息方面面临多重障碍。为了解决教育和促进获得定期筛查的迫切需要，我们提出了一个试点干预计划，利用基于社区的外展和教育战略。具体地说，基于调查团队先前对预防健康行为的社区评估以及社区卫生工作者(CHW)培训和干预的经验，我们建议进行一项可行性研究，以测试基于社区的外展计划，以促进遵循循证筛查指南在KA妇女中进行乳腺癌筛查。利用基于社区的参与性研究(CBPR)作为操作框架，研究人员和目标社区之间具有共同愿景的伙伴关系将成为实施这一干预措施和促进克族妇女健康的工具。这项研究的具体目的是：1)规范CHW对KA妇女进行乳腺癌教育和筛查随访的培训方案；2)测试CHW培训计划的效果；3)在100名40岁及以上的KA妇女中测试干预计划的效果。CHW干预的主要结果是自我报告收到并打算获得乳房X光检查。次要结果包括对CHW领导的教育会议和后续行动的满意度，其他筛查行为(即临床乳房检查和乳房自我检查)的变化，以及对乳腺癌的知识和信念。这项CBPR建议是在进行更大规模的社区试验之前进行的试点调查，以测试文化和语言敏感的CHW干预措施的有效性，以提高KA妇女的乳腺癌筛查率。通过开展这些研究活动，我们预计1)建立一个机制，为这一语言上与世隔绝的人群传播健康信息；以及(2)加强社区网络，促进社区获得乳癌筛查的机会。

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.