Promoting Adherence to Mammography Use in Chinese Ameri*

描述（由申请人提供）：美籍华人增长迅速，是美国亚裔人口最多的群体。这个少数群体的特点是70%是移民。乳腺癌是最常见的癌症，也是华裔移民女性癌症死亡的第二大原因。尽管乳房x光检查的使用率有所提高，但有证据表明，华裔美国女性的筛查率仍然低得多，更有可能被诊断为较大的肿瘤，诊断后的生存率也比白人低。几项研究表明，中国女性乳房x光检查参与率较低与她们独特的文化信仰和态度有关。然而，在这个少数群体中，很少有文化敏感的干预措施被开发和评估。为了填补这一空白，我们为这一弱势群体开发了两种理论驱动、文化定制和语言适当的干预材料（印刷小册子和包含医生建议的多因素戏剧视频）。材料开发以健康信念模型为指导。本研究将进行一项随机试验，以评估与常规护理相比，多模式文化定制干预材料对增加中国妇女乳房x光检查使用的功效。该试验将招募264名年龄在40岁及以上的中国女性，她们在过去12个月内没有做过乳房x光检查（“非依从性”）。参与者将完成基线电话访谈，并被随机分配到两组中的一组：文化定制干预组（印刷宣传册+视频）或常规护理对照组。干预后4个月，参与者将接受访谈，评估乳房x光检查的使用、知识、态度和信仰的变化，以及对材料的可接受性。主要结果将是自我报告的乳房x光检查使用情况。二次分析将探讨干预效果是否由文化、知识和健康信念介导。本研究解决了NCI癌症控制重点领域，并将首次评估多方面干预在促进非依从性中国妇女使用乳房x光检查方面的作用。这种类型的干预措施将是可行的，具有广泛的潜在影响，并有望减少研究不足和不断增长的少数民族人口的结果差异。

DESCRIPTION (provided by applicant): Chinese Americans are rapidly growing and the largest US Asian population. This minority sub-group is distinctive in that 70% are immigrants. Breast cancer is the most common cancer and the second leading cause of cancer deaths among immigrant Chinese American women. Despite improving rates of mammography use, evidence shows that Chinese American women still have much lower screening rates, are more likely to be diagnosed with larger tumors, and experience poorer survival following diagnosis than Whites. Several studies suggest that the lower rate of mammography participation seen among Chinese women is associated with their unique cultural beliefs and attitudes. However, few culturally sensitive interventions have been developed and evaluated in this minority population. To fill this gap, we have developed 2 types of theorethically-driven, culturally-tailored, and linguistically appropriate intervention materials (print brochures and a multifacted drama video that incorporates physician recommendations) for this vulnerable population. The material development was guided by the Health Belief Model. This study will conduct a randomized trial to evaluate the efficacy of the multi-modality culturally tailored intervention materials for increasing mammography use in Chinese women compared to usual care. This trial will recruit a community-based sample of 264 Chinese women aged 40 and older who have not had a mammogram in the previous 12 months ("non-adherent"). Participants will complete a baseline telephone interview and be randomized to 1 of the 2 arms: a culturally tailored intervention group (print brochure + video) or the usual care control group. Participants will be interviewed 4-months post intervention to assess mammography use, changes of knowledge, attitudes, and beliefs, as well as acceptability of the materials. The primary outcome will be self-reported mammography use. Secondary analyses will explore whether intervention effects are mediated by culture, knowledge, and health beliefs. This research addresses NCI cancer control priority areas and will be the first assessment of the role of a multifaceted intervention to promote mammography use in non-adherent Chinese women. This type of intervention will be feasible to disseminate, has broad potential reach, and holds the promise of decreasing disparities in outcomes in this understudied and growing minority population.