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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): Chinese Americans are rapidly growing and the largest US Asian population. This minority sub-group is distinctive in that 70% are immigrants. Breast cancer is the most common cancer and the second leading cause of cancer deaths among immigrant Chinese American women. Despite improving rates of mammography use, evidence shows that Chinese American women still have much lower screening rates, are more likely to be diagnosed with larger tumors, and experience poorer survival following diagnosis than Whites. Several studies suggest that the lower rate of mammography participation seen among Chinese women is associated with their unique cultural beliefs and attitudes. However, few culturally sensitive interventions have been developed and evaluated in this minority population. To fill this gap, we have developed 2 types of theorethically-driven, culturally-tailored, and linguistically appropriate intervention materials (print brochures and a multifacted drama video that incorporates physician recommendations) for this vulnerable population. The material development was guided by the Health Belief Model. This study will conduct a randomized trial to evaluate the efficacy of the multi-modality culturally tailored intervention materials for increasing mammography use in Chinese women compared to usual care. This trial will recruit a community-based sample of 264 Chinese women aged 40 and older who have not had a mammogram in the previous 12 months ("non-adherent"). Participants will complete a baseline telephone interview and be randomized to 1 of the 2 arms: a culturally tailored intervention group (print brochure + video) or the usual care control group. Participants will be interviewed 4-months post intervention to assess mammography use, changes of knowledge, attitudes, and beliefs, as well as acceptability of the materials. The primary outcome will be self-reported mammography use. Secondary analyses will explore whether intervention effects are mediated by culture, knowledge, and health beliefs. This research addresses NCI cancer control priority areas and will be the first assessment of the role of a multifaceted intervention to promote mammography use in non-adherent Chinese women. This type of intervention will be feasible to disseminate, has broad potential reach, and holds the promise of decreasing disparities in outcomes in this understudied and growing minority population.