Tailored lay health worker intervention improves breast cancer screening outcomes in non-adherent Korean-American women

Abstract

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.

Determining the Awareness of and Compliance with Breast Cancer Screening among Turkish Residential Women

“…If a woman or a first degree relative (mother, sister or daughter) has had breast cancer, the woman has 2-4 times higher risk of having breast cancer (Merey, 2002;Koc et al, 2009;Han et al, 2009;Eroglu et al, 2010;American Cancer Society, 2012). In our study, previous breast cancer histories were found in first-degree relatives of 8.7% of the participants, and only 2.2% of the participants had a history of breast cancer.…”

“…However, in studies that have analyzed participation in screening programs, the rate of doing regular BSE is between 7% and 38.8%, even though women have information about BSE (Petro-Nustas et al, 2002;Jahan et al, 2006;Okobia et al, 2006;Wong-Kim et al, 2006;Tu et al, 2006;Montazeri et al, 2008). The rate of undergoing CBE varies between 18% and 92% (Cohen, 2006;Jahan et al, 2006;Avci et al, 2007;Montazeri et al, 2008;Koc et al, 2009;Han et al, 2009). When early diagnosis studies in Turkey (Merey, 2002;Dundar et al, 2006;Koc et al, 2009;Urkmez, 2009) are compared with studies in other countries (Buki et al, 2007;Zackrisson et al, 2007;Ryerson et al, 2008;Wall et al, 2008), they reveal that women in Turkey have fewer mammograms.…”

Assessment of the Effects of Breast Cancer Training on Women Between the Ages of 50 and 70 in Kemalpasa, Turkey

“…In another study of the same researcher where he conducted his study with African-American women, no significant difference was determined in any of the sub-dimensions of the scale in the intervention group (Hall et al, 2007). Han et al's study demonstrated that the education intervention made no significant difference in the perception of benefit, sensitivity and barrier of women after 6 months (Han et al, 2009). …”

The Effects of Education Program on Knowledge and Intention of Breast Cancer Screening in Taiwan

“…Many studies have shown that education has a positive impact on women's knowledge of breast cancer and increases their participation in prevention and screening (Burgess et al, 2008;Kim and Menon, 2009;Ceber et al, 2010;Gözüm et al, 2010;Secginli and Nahcivan, 2011). Han et al (2009) found that a 120-min classroom training program combined with follow-up counseling significantly increased mammography, clinical breast exam, and BSE rates. In addition to discussing the benefits of screening, health professionals should also emphasize screening timeliness (Ritvo et al, 2012).…”