ABSTRACT
OBJECTIVES: We used a community-based research approach to test a culturally based breast cancer screening program among low-income Hmong women in central and southern California. METHODS: We designed a culturally informed educational program with measures at baseline and 1-year follow-up in 2 intervention cities and 1 comparison city. Measures included changes in breast cancer screening, knowledge, and attitudes. RESULTS: Compared with women in the comparison community, women in the intervention community significantly improved their attitudes toward, and increased their knowledge and receipt of, breast cancer screenings. Odds of women in the intervention group having had a mammogram, having had a clinical breast examination, and having performed breast self-examination was 6.75, 12.16, and 20.06, respectively, compared with women in the comparison group. CONCLUSIONS: Culturally informed education materials and intervention design were effective methods in conveying the importance of maintaining and monitoring proper breast health. The strength of community collaboration in survey development and intervention design highlighted the challenges of early detection and screening programs among newer immigrants, who face significant language and cultural barriers to care, and identified promising practices to overcome these health literacy challenges.
Subject(s)
Asian People , Breast Neoplasms/prevention & control , Breast Self-Examination/statistics & numerical data , Health Knowledge, Attitudes, Practice , Mammography/statistics & numerical data , Patient Education as Topic/methods , Adult , Breast Neoplasms/ethnology , California , Case-Control Studies , Emigrants and Immigrants , Female , Health Promotion , Humans , Male , Middle AgedABSTRACT
Cancer is the number one cause of death for Asian American women, yet they have the lowest rates of cancer screening. Contributing factors, particularly for Hmong women, include the lack of culturally and linguistically appropriate educational interventions. This study aimed to develop a culturally and linguistically appropriate intervention to improve the breast cancer screening rates among Hmong women in Fresno and San Diego, California. Intervention elements included the development of a flipchart, brochure, and video that presented basic breast health and screening information, along with the targeting of not only women but men to support their wives' breast cancer screenings. Analyses of pre- and post workshop surveys showed increases in knowledge and more positive attitudes among all participants, behavioral intentions for clinical breast examinations and mammograms among women, and support for such exams and possible cancer treatment among men. Implications for further research and practice are discussed.
Subject(s)
Breast Neoplasms/diagnosis , Cultural Diversity , Health Promotion/organization & administration , Language , Asian , California , Female , Humans , Male , Mass Screening , Middle Aged , Needs Assessment , Program EvaluationABSTRACT
BACKGROUND: No data exists on the breast and cervical cancer screening practices among Cambodian, Laotian, Thai, and Tongan women. In this article, we describe the efforts required to conduct a baseline survey among these non-English-speaking women using the participatory action research (PAR) approach. METHODS: We tailored small population sampling techniques to each of the populations in partnership with Community Health Outreach workers. RESULTS: A total of 1825 surveys were successfully conducted in 8 communities. CONCLUSION: PAR and the culturally based techniques used to conduct the survey proved successful in maintaining scientific rigor, developing true community-researcher partnership, and achieving over 99% participation.
Subject(s)
Asian People/statistics & numerical data , Breast Neoplasms/ethnology , Breast Neoplasms/prevention & control , Community Participation , Health Services Research , Native Hawaiian or Other Pacific Islander/statistics & numerical data , Uterine Cervical Neoplasms/ethnology , Uterine Cervical Neoplasms/prevention & control , Adult , Aged , California/epidemiology , Community Health Planning/organization & administration , Community-Institutional Relations , Female , Health Knowledge, Attitudes, Practice , Humans , Middle Aged , Sampling Studies , Surveys and Questionnaires , TranslatingABSTRACT
BACKGROUND: This paper evaluates the replicability of an NCI-funded didactic/experiential program to increase the diversity of doctorally-prepared cancer disparities investigators. METHODS: The program was developed and operated successfully for three years in Northern California when a replication was established at UCLA. Feasibility, process, impact, and outcome measures on UCSF and UCLA summer-institute participants were compared. RESULTS: Average participant rankings of the influence of the program on intention to apply for a doctorate were 9.1/10 (UCSF) and 8.6/10 (UCLA). A total of 22.5% of UCSF and 10% of UCLA participants have enrolled in, been accepted by, or completed doctoral programs. Among these alumni, 68% (21/31) of UCSF and 60% (3/5) of UCLA participants plan to conduct their doctoral research in cancer control. CONCLUSIONS: This program has been successfully replicated and has met its objective to increase the pipeline of ethnically diverse doctoral-level public health researchers. Expansion of the program to other regions of the US is feasible and indicated.
