Health Education Research Advance Access published online on May 7, 2008
Health Education Research, doi:10.1093/her/cyn021
Tailored lay health worker intervention improves breast cancer screening outcomes in non-adherent Korean-American women
1 School of Nursing, Johns Hopkins University, 525 North Wolfe Street, Baltimore, MD 21205, USA
2 Nursing Policy Research Institute, Yonsei University, Sinchon-Dong, Seodaemun-Gu, Seoul 120-752, South Korea
3 Korean Resource Center, 3201 Rogers Avenue, Suite 203, Ellicott City, MD 21043, USA
Correspondence to: * Correspondence to: H.-R. Han. E-mail: hhan{at}son.jhmi.edu
Despite rapidly increasing incidence rates of breast cancer, recent immigrants such as Korean-American (KA) women report disproportionately lower utilization of screening tests compared with other ethnic groups. Early screening of breast cancer for this population may be greatly facilitated by indigenous lay health workers (LHWs). We conducted an intervention trial with a 6-month follow-up. Trained LHWs recruited 100 KA women 40 years of age or older who had not had a mammogram during the past 2 years. Ninety-three completed follow-up questionnaires. A 120-min, in-class education combined with LHW follow-up counseling and navigation assistance through the health care system was provided. Rates of breast cancer screening behaviors significantly increased at 6 months (P < 0.001); changes between pre- and post-intervention were 31.9% for mammography, 23% for clinical breast examination and 36.2% for breast self-examination. Modesty toward screening significantly decreased over time, but we did not find any significant differences in breast cancer knowledge and beliefs before and after the intervention. Results support the efficacy of this neighborhood-based, culturally sensitive intervention. Further research should seek to replicate these findings and to incorporate more self-care skills such as health literacy when designing an intervention program for linguistically and culturally isolated immigrant women.
H. Lee was a post-doctoral fellow at the School of Nursing, Johns Hopkins University, at the time of the study. Received on August 6, 2007; accepted on March 20, 2008