“Health is strength”: A community health education program to improve breast and cervical cancer screening among Korean American Women in Alameda County, California

140 Warren Hall, Center for Family and Community Health, School of Public Health, University of California, Berkeley, Berkeley, CA 94720-7360, USA.
Cancer Detection and Prevention (Impact Factor: 2.52). 01/2007; 31(2):173-83. DOI: 10.1016/j.cdp.2007.02.002
Source: PubMed


A 48-month community intervention was conducted to improve breast and cervical cancer (BCC) screening among Korean American (KA) women in Alameda County (AL), California. KA women in Santa Clara (SC) County, California served as a comparison group.
Random samples of KA women from each county were surveyed by telephone in 1994 (n=818) and 2002 (n=1084). Propensity score analyses were used to estimate the difference between counties in changes over time in screening (Pap tests, breast self-examinations, clinical breast examinations, and mammography), and to estimate differences in screening between participants and non-participants in an educational workshop among women in AL in 2002.
Mammography screening and clinical breast examinations increased over time in both counties. Pap tests increased in AL but not SC, and breast self-examinations did not change significantly in either county. None of the intervention-comparison group differences over time were significant. In 2002, compared to non-participants, women who attended a workshop were more likely to report a recent Pap test (P<.08).
Although our overall intervention did not appear to enhance screening practices at the community-level, attendance at a women's health workshop appears to have increased cervical cancer screening.

15 Reads
  • Source
    • "Program log and test community-sensitive research principles directed one study (Moskowitz et al. 2007; Wismer et al. 2001), and the Quality Health Outcome Model guided one study (Sin et al. 2005). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective Because little is known about promising interventions to prevent and control chronic disease in Korean Americans, we conducted a systematic literature review to investigate: (1) theoretical frameworks and strategies employed by interventions targeting Korean Americans; (2) cultural factors considered by these interventions; and (3) the extent of their success in engaging Korean participants and improving their health.DesignFollowing the PRISMA guidelines, PubMed, PsycInfo, and Web of Science were searched to identify primary research articles evaluating interventions to prevent or control chronic disease, tailored to Korean Americans, and published from 1980 through 2011. Of 238 articles identified, 21 articles describing16 unique intervention tests met inclusion criteria. These interventions targeted cancer (10), hypertension (2), diabetes (1), mental health (1), tobacco cessation (1), and general health (1).ResultsAll included studies were published since 2000, reflecting the relatively recent establishment of intervention research with Korean Americans. All 16 programs delivered linguistically appropriate messages and education. The 11 programs that realized significant intervention effects also provided or coordinated social support from culturally relevant and well-trained lay health workers, nurses, or family members during an intervention and/or follow-up period.Conclusions Culturally matched and linguistically appropriate messages and education may not be enough to prevent or control chronic disease among immigrant Korean Americans. Culturally sensitive and committed social support should be provided to catalyze behavioral changes and sustain the effect of the interventions.
    Ethnicity and Health 11/2013; 19(1). DOI:10.1080/13557858.2013.857766 · 1.67 Impact Factor
  • Source
    • "Therefore, women should be aware of early detection and prevention methods [breast self-examination (BSE), mammography, clinical breast examination (CBE)] of breast cancer which poses a great risk for them. However, in several studies on the issue, it has been reported that women lack knowledge about the prevention methods and early detection of breast cancer (Aydemir et al., 2003; Seçginli and Nahcivan, 2004; Çeber et al., 2005; Dişcigil et al., 2007; Moskowitz et al., 2007). Since breast cancer risk is not the same for every woman, it is important to determine women's risk for breast cancer by distinguishing which risk group they are in. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: The aim of the study was to determine breast cancer risk and early diagnosis applications in women aged ≥50. Materials and methods: This cross-sectional, descriptive field study focused on a population of 4,815 in Mansurog?lu with a 55.1% participation rate in screening. In the study, body mass index (BMI) was also evaluated in the calculation of breast cancer risk by the Breast Cancer Risk Assessment Tool (BCRA) (also called the "Gail Risk Assessment Tool") . The interviewers had a three-hour training provided by the researchers, during which interactive training methods were used and applications were supported with role-plays. Results: The mean age of the women participating in the study was 60.1±8.80. Of these women, 57.3% were in the 50-59 age group, 71.7% were married, 57.3% were primary school graduates and 61.7% were housewives. Breast-cancer development rate was 7.4% in the women participating in the study. When they were evaluated according to their relationship with those with breast cancer, it was determined that 73.0% of them had first- degree relatives with breast cancer. According to the assessment based on the Gail method, the women's breast cancer development risk within the next 5 years was 17.6%, whereas their calculated lifetime risk was found to be as low as 0.2%. Statistically significant differences (P=0.000) were determined between performing BSE - CBE and socio-demographic factors. Conclusions: It was determined that 17.6% of the participants had breast cancer risk. There was no statistically significant difference between the women with and without breast cancer risk in terms of early diagnosis practices, which can be regarded as a remarkable finding. It was planned to provide training about the early diagnosis and treatment of breast cancer for people with high-risk scores, and to conduct population-based breast cancer screening programs.
    Asian Pacific journal of cancer prevention: APJCP 10/2013; 14(10):5877-82. DOI:10.7314/APJCP.2013.14.10.5877 · 2.51 Impact Factor
  • Source
    • "Small group discussions with health professionals were not found to be effective in increasing cancer screening among Filipino Americans in Los Angeles [62]. In the “Tell a Friend” Alameda 1994–2002 study, a wide-range of community-based interventions were not shown to be effective in enhancing breast or cervical cancer screening among Korean Americans at the community level [66]. In the Lay Health Workers Outreach 1992–1996 study, media campaigns and the distribution of culturally sensitive print materials, was supplemented by community-based small group sessions delivered by lay health workers [69]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background The Asian population is one of the fastest growing ethnic minority groups in western countries. However, cancer screening uptake is consistently lower in this group than in the native-born populations. As a first step towards developing an effective cancer screening intervention program targeting Asian women, we conducted a comprehensive systematic review, without geographic, language or date limitations, to update current knowledge on the effectiveness of existing intervention strategies to enhance breast and cervical screening uptake in Asian women. Methods This study systematically reviewed studies published as of January 2010 to synthesize knowledge about effectiveness of cancer screening interventions targeting Asian women. Fifteen multidisciplinary peer-reviewed and grey literature databases were searched to identify relevant studies. Results The results of our systematic review were reported in accordance with the PRISMA Statement. Of 37 selected intervention studies, only 18 studies included valid outcome measures (i.e. self-reported or recorded receipt of mammograms or Pap smear). 11 of the 18 intervention studies with valid outcome measures used multiple intervention strategies to target individuals in a specific Asian ethnic group. This observed pattern of intervention design supports the hypothesis that employing a combination of multiple strategies is more likely to be successful than single interventions. The effectiveness of community-based or workplace-based group education programs increases when additional supports, such as assistance in scheduling/attending screening and mobile screening services are provided. Combining cultural awareness training for health care professionals with outreach workers who can help healthcare professionals overcome language and cultural barriers is likely to improve cancer screening uptake. Media campaigns and mailed culturally sensitive print materials alone may be ineffective in increasing screening uptake. Intervention effectiveness appears to vary with ethnic population, methods of program delivery, and study setting. Conclusions Despite some limitations, our review has demonstrated that the effectiveness of existing interventions to promote breast and cervical cancer screening uptake in Asian women may hinge on a variety of factors, such as type of intervention and study population characteristics. While some studies demonstrated the effectiveness of certain intervention programs, the cost effectiveness and long-term sustainability of these programs remain questionable. When adopting an intervention program, it is important to consider the impacts of social-and cultural factors specific to the Asian population on cancer screening uptake. Future research is needed to develop new interventions and tools, and adopt vigorous study design and evaluation methodologies to increase cancer screening among Asian women to promote population health and health equity.
    BMC Public Health 06/2012; 12(1):413. DOI:10.1186/1471-2458-12-413 · 2.26 Impact Factor
Show more