Culturally competent training program: a key to training lay health advisors for promoting breast cancer screening.

The lay health advisor (LHA) training program for breast cancer screening was conducted among Chinese- English bilingual trainees residing in Southeast Michigan. Guided by Bandura's Social Learning Theory, the development of the training curriculum followed the health communication process recommended by the National Cancer Institute. Data analysis based on questionnaires completed by 79 LHAs indicated that the breast cancer screening training program significantly increased LHAs' knowledge and self-efficacy (p < .01, t test, two-tailed) and LHAs had a positive perception with regard to the training manual. Regression analysis found that LHAs who were younger, employed, and demonstrated a positive perception of the training manual tended to have higher self-efficacy in promoting breast cancer screening (R(2) = .30). This study suggests that a culturally competent training program effectively increases LHAs' self-efficacy. The findings have implications for developing effective LHA training programs in Asian American communities where LHA interventions are rarely implemented.

Uncovering factors contributing to under-utilization of breast cancer screening by Chinese and Korean women living in the United States.

OBJECTIVE: This study investigated factors influencing breast cancer screening utilization by Chinese and Korean women, living in the United States, and examined similarities and differences between the 2 sub-populations. DESIGN: Population-based cross-sectional surveys were used for comparisons. METHODS: A random sample of 180 women (Chinese = 117, Korean = 63), aged 40 years and older, who resided in an urban county of Michigan participated in the mail survey. Existing English questionnaires were modified for cultural appropriateness, translated into Chinese and Korean, and pre-tested. Data analysis included descriptive statistics, testing differences between means/percentages, and logistic regression. RESULTS: The sample population, similar to the Asian American population in general, was composed predominantly of immigrants with varying socioeconomic and health status. Approximately 56% of the women had received mammograms in the past 2 years, about 21% lower than the statewide rate for Michigan. The logistic regression indicated that women's mammography use was significantly associated with their ability to speak English, availability of health insurance, and knowledge of mammography (P < .05). Similarities and differences between sampled Chinese and Korean women existed in terms of their socio-demographic characteristics and the factors influencing their use of breast cancer screening. CONCLUSIONS: Understanding minority women's cancer screening behavior has implications for designing appropriate interventions to meet their unique healthcare needs, thereby increasing screening rates and reducing mortality.

Challenges of identifying asian women for breast cancer screening.

PURPOSE/OBJECTIVES: To emphasize the need for multiple data sources to develop a comprehensive list of potential respondents for a study of breast cancer screening behavior among Asian American women. DESIGN: Descriptive, pilot. SETTING: An urban Michigan county. SAMPLE: 616 Chinese women age 40 and older. METHODS: Comparison of multiple data sources, including lists from membership directories of local Chinese organizations, a commercial survey company, health promotion events, and brief telephone interviews. FINDINGS: Of the 616 eligible women, 32% were identified through the membership directories of local Chinese organizations, 28% from a list obtained from the survey company, 22% from telephone directories, 10% from the attendance lists of health promotion events, and 8% from more than one source. CONCLUSIONS: Multiple sources are required to obtain a comprehensive list for specialized populations. Every data source has its advantages and disadvantages. The use of diverse sources helps to offset the limitations of each individual one. IMPLICATIONS FOR NURSING: Identifying potential participants from specialized populations represents a major issue for clinicians and researchers in nursing and other health-related disciplines. Strategies exist to facilitate the process.

Cancer screening promotion among medically underserved Asian American women: integration of research and practice.

Mammography and Pap smear tests are known to be effective early detection measures for breast and cervical cancers, respectively, but Asian Americans are reluctant to make visits for routine preventive care. Quantitative and qualitative research conducted by the Healthy Asian Americans Project (HAAP) between 1996 and 1999 indicated that Asian residents in southeastern Michigan, like the general Asian population in the US, underutilized early cancer screening programs due to cultural, psychosocial, linguistic, and economic barriers. This article reports how the HAAP's research findings guided the Michigan Breast and Cervical Cancer Control Program (BCCCP) promotion (conducted from 2000 to 2001 among medically underserved Asian women residing in southeastern Michigan), and how evaluation of the HAAP's BCCCP promotion will direct future research and health promotion programs. The article presents strategies used to improve access to cancer screening programs for diverse Asian sub-groups as well as outcomes of the 2-year HAAP's BCCCP promotion among the target population. Discussion regarding lessons and experiences gained from integration of research and practice has implications on design and implementation of the cancer screening promotion for the rapidly increasing Asian American population as well as other medically underserved minority populations in the US.