Korean Immigrants & Mammography-Culture-Specific Health Intervention (KIM-CHI)

描述(由申请人提供)：乳腺癌是韩裔美国女性中最常见的癌症，也是最常见的癌症死亡原因，但在韩裔美国女性中，乳房X光检查的使用仍然不是最理想的。大多数对KA妇女的乳腺癌筛查研究都是描述性和相关性的，但在这个为期4年的项目中，我们将测试韩国移民&乳房摄影-文化特定健康干预(KIM-CHI)对遵守推荐的乳腺癌筛查方案的影响。具体目的是：(1)比较接受金池组和注意对照组获得乳房X光检查的结果，包括获得乳房X光检查的数量(0，1，或2)，如果获得，在15个月时进行生存分析，获得第一次乳房X光检查的时间；(2)使用重复测量多变量方差分析，比较两组在2周和15个月时的健康信念、知识、自我效能、配偶支持和乳房自我检查(BSE)实践的中介变量；以及(3)使用结构方程模型，确定健康信念、知识、自我效能、配偶支持和在2周时的BSE实践对15个月后获得乳房X光检查结果的中介作用。我们已经测试了以KA女性为对象的Kim-chi计划的可行性，方法是纳入特定于文化的策略，以改变(1)对乳腺癌和筛查的信念，(2)乳腺癌和癌症筛查的知识，以及(3)获得乳房X光检查和向医生请求转介乳房X光检查的自我效能。使用随机分配到干预或控制条件的韩国教会，总共400名40岁或40岁以上的KA妇女和她们的丈夫作为单独的小组，将参加一个小组会议，其中包括教育DVD、疯牛病技能练习、同伴讨论，以及让夫妇俩随后在家进行讨论的任务。关于乳房X光检查结果和中介变量的数据将在基线以及基线后2周和15个月收集。这项建议的一个优点是测试了一种成本保守的协议，通过使用韩国榜样、母语和男性医生认证以及纳入配偶来提高KA妇女的乳房X光检查成绩，以小组方式提供一致的健康行为信息。

DESCRIPTION (provided by applicant): Breast cancer is the most commonly occurring cancer and most common cause of cancer mortality among Korean American (KA) women, but mammography utilization among KA women remains suboptimal. Most breast cancer screening studies with KA women have been descriptive and correlational, but in this 4-year project we will test the effects of Korean Immigrants & Mammography-Culture-Specific Health Intervention (KIM-CHI) on adherence to recommended breast cancer screening protocols. The specific aims are to: (1) compare the group receiving KIM-CHI with an attention control group on mammogram attainment outcomes including number of mammograms obtained (0, 1, or 2) and if obtained, length of time to obtain the first mammogram, at 15 months using survival analysis; (2) compare the two groups on the mediating variables of health beliefs, knowledge, self-efficacy, spousal support and breast self-examination (BSE) practice at 2 weeks and 15 months using repeated measures multivariate analysis of variance; and (3) identify the mediating effects of health beliefs, knowledge, self-efficacy, spousal support, and BSE practice at 2 weeks on mammogram attainment outcomes at 15 months, using structural equation modeling. We have tested the feasibility of the KIM-CHI program targeting KA women by incorporating culture-specific strategies for changing (1) beliefs about breast cancer and screening, (2) knowledge of breast cancer and cancer screening, and (3) self-efficacy for obtaining a mammogram and requesting a referral for a mammogram from a physician. Using Korean churches randomly assigned to intervention or control conditions, a total sample of 400 KA women 40 years of age or older who have not had a mammogram within the past 2 years, along with their husbands in a separate group, will participate in a group session incorporating an educational DVD, BSE skill practice, peer discussion, and an assignment for the couple to have a discussion afterwards at home. Data on mammography attainment and the mediating variables will be collected at baseline and at 2-weeks and 15-months post-baseline. A strength of this proposal is the testing of a cost- conservative protocol with group delivery of consistent health behavior information using Korean role models, native Korean language, and male physician authentication as well inclusion of spouses for improving KA women's mammography attainment.