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Sagong H, Tsai PF, Jang AR, Yoon JY. Impact of English Proficiency on Health Literacy in Older Korean Immigrants: Mediating Effects of Social Support and Acculturation. J Immigr Minor Health 2024; 26:81-90. [PMID: 37550523 DOI: 10.1007/s10903-023-01530-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/09/2023]
Abstract
Limited English proficiency (LEP) is one of the most influencing factors of personal health literacy (PHL) in the older immigrant population. Over the years, the proportion of older Korean immigrants with LEP has not improved and it is still noted as a major barrier to PHL. Therefore, organizational approaches are needed to enhance the PHL of older immigrants with LEP. This study aims to find the mediating effect of social support and acculturation between LEP and PHL by conceptualizing social support and acculturation as an organizational health literacy strategy. Data from 244 older Korean immigrants living in the states of Alabama and Georgia, USA, were used to conduct the study. Korean version of the Multidimensional Scale of Perceived Social Support (MSPSS), East Asian Acculturation Measure (EAAM), and Health Literacy Survey-12 Questionnaires (HLS-Q12) were used to measure the variables. The path analysis was conducted to find the serial mediation effects of social support and acculturation. The results showed that 77.5% of the participants reported not having fluent English proficiency. English proficiency (β =- 0.21, p = 0.007), social support (β = 0.17, p = 0.004), and acculturation (β = 0.18, p = 0.011) significantly predicted the PHL, and social support (β = 0.04, p = 0.028) and acculturation (β = 0.14, p < 0.001) mediated the relationship between LEP and PHL. Discussion: Health-related organizations and communities are encouraged to provide external social support and acculturation opportunities to enhance PHL in older Korean immigrants with LEP.
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Affiliation(s)
- Hae Sagong
- College of Nursing, Auburn University, 710 South Donahue Drive Auburn, Auburn, AL, USA.
| | - Pao-Feng Tsai
- College of Nursing, Auburn University, 710 South Donahue Drive Auburn, Auburn, AL, USA
| | - Ah Ram Jang
- Department of Nursing, Yeoju Institute of Technology, Yeoju, Republic of Korea
| | - Ju Young Yoon
- College of Nursing and Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
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Lee MH, Schwartz AJ, Luo Y, Lee HY. Mammogram Uptake among Korean American Women in the South: Do Health Beliefs Matter? Asian Pac J Cancer Prev 2022; 23:3693-3699. [PMID: 36444582 PMCID: PMC9930964 DOI: 10.31557/apjcp.2022.23.11.3693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Breast cancer is commonly diagnosed in Korean American women (KAW), and its incidence rates continue to increase. Despite the increasing burden of breast cancer diagnosis, screening rates among KAW remain low. There is a growing body of literature on breast cancer screening behaviors in this population; however, current knowledge regarding cultural influences and KAW's mammogram use is limited, particularly in the southern part of the United States. Using the Health Belief Model, this study examined the association of culturally embedded health beliefs and mammogram use among KAW. METHODS Cross-sectional data were obtained from 538 KAW recruited in North Carolina. A hierarchical binary logistic regression was conducted to examine cultural health beliefs associated with mammogram use. FINDINGS Preventive health orientation (OR=1.16, CI=1.02-1.32) and perceived susceptibility (OR=1.32, CI=1.10-1.58) were positively associated with having a mammogram in the past two years, while fear (OR=0.58, CI=0.36-0.94) was negatively related to getting screened in the past two years. CONCLUSIONS The current study findings inform future intervention strategies to promote mammogram screening among KAW in sociocultural context.
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Affiliation(s)
- Mi Hwa Lee
- School of Social Work, Faculty, East Carolina University, Greenville, United States. ,For Correspondence:
| | - Abby J. Schwartz
- School of Social Work, Faculty, East Carolina University, Greenville, United States.
| | - Yan Luo
- School of Social Work, PhD student, The University of Alabama, Tuscaloosa, United States.
| | - Hee Yun Lee
- School of Social Work, Faculty, The University of Alabama, Tuscaloosa, United States.
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Shirzadi S, Asghari-Jafarabadi M, Harrison MM, Allahverdipour H. Development and validation of the psychometric properties of the perceived barriers of mammography scale. Health Care Women Int 2022; 45:621-641. [PMID: 35587356 DOI: 10.1080/07399332.2021.1971671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 10/18/2022]
Abstract
We aimed to develop and test the psychometric properties of the Perceived Barriers of Mammography Scale (PBMS-23). Based on a mixed method design researchers generated item pool through qualitative data and literature review and next, 500 women ages 40 to 69 years completed the questionnaire. Based on exploratory and confirmatory Factor Analysis, 23 items, researchers revealed eight domains of fate and destiny, breast conflict, defense avoidance, inconveniences/difficulties of mammography screening, contrasting/competing priorities, fear, distrust of mammography, and lack of knowledge with appropriate fitness for the data. PBMS-23 is valid and reliable instrument for assessing perceived barriers of mammography.
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Affiliation(s)
- Shayesteh Shirzadi
- Department of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | | | | | - Hamid Allahverdipour
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Health Education & Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
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Lee M, Lee MA, Ahn H, Ko J, Yon E, Lee J, Kim M, Braden CJ. Health Literacy and Access to Care in Cancer Screening Among Korean Americans. Health Lit Res Pract 2021; 5:e310-e318. [PMID: 34905432 PMCID: PMC8668165 DOI: 10.3928/24748307-20211104-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Health literacy and access to care are critical facilitators for preventive health behaviors. After the passage of the Affordable Care Act in March 2010, little has been studied about how improved health insurance coverage has impacted the use of preventive health services among Korean Americans. OBJECTIVE The study assessed the impact of access to care, use of services, and health literacy on cancer screening among Korean Americans. METHODS A descriptive cross-sectional study of 377 Korean Americans age 18 years and older was conducted with a survey and convenient sampling in Texas. KEY RESULTS Although 79% of the sample had health insurance, 32% had never visited a health care provider, and 14% were delayed in care in the past 12 months. Only 11.6% were confident to complete medical forms, and 69.5% had limited levels of confidence. Cancer screening compliance rates were: mammography (50.4% at age 40-54 years; 46.6% at age 55 years and older), a Pap smear (29.4% at age 21-29 years; 78.4% at age 30-65 years; 72.2% at age 66 years and older), and colorectal cancer screening at age 45 years and older (stool tests 15.1%; sigmoidoscopy 27%; colonoscopy 51.3%). Multiple logistic regression analyses revealed that household income, gender, health insurance, and health literacy were significantly associated with self-reported cancer screening. CONCLUSIONS Korean Americans who participated in this study are characterized by marginalized health literacy, underused health care services, and significantly lower cancer screening compliance than the goals of Healthy People 2020. The following interventions are suggested to improve health literacy and health insurance literacy on cancer screening: culturally sensitive and linguistically appropriate education for the guidelines concordant with cancer screening, effective communication skills with health care providers, support for navigating the health care system, and development of internet- or social media-based health education programs to meet the preferred communication methods of this population. [HLRP: Health Literacy Research and Practice. 2021;5(4):e310-e318.] Plain Language Summary: Despite having improved health insurance coverage, Korean Americans of this study have marginalized health literacy, limited health insurance literacy, low cancer screening compliance, and underused health care services. The results of this study suggest several strategies to improve health literacy and health insurance literacy for Korean Americans, which may also apply to other groups with similar barriers.
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Affiliation(s)
- Moonju Lee
- Address correspondence to Moonju Lee, PhD, MSN, RN, University of Texas Health at San Antonio, School of Nursing, 7703 Floyd Curl Drive, San Antonio, TX 78229;
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Xie H, Li Y, Theodoropoulos N, Wang Q. Mammography Screening Disparities in Asian American Women: Findings From the California Health Interview Survey 2015-2016. Am J Health Promot 2021; 36:248-258. [PMID: 34814756 DOI: 10.1177/08901171211048136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE To identify mammography screening prevalence and predictors in Asian American women, focusing on the potential disparities in race and its influence on screening behaviors. DESIGN A secondary analysis utilized the California Health Interview Survey (CHIS) 2015-2016. SETTING California, U.S. SAMPLE Cisgender women who were non-Hispanic (NH) White, Chinese, Filipino, Vietnamese, Japanese, Korean, or "other Asian", aged 40 or above (unweighted N=13 451). MEASURES Socioeconomics, chronic health conditions, and preventive care utilization were mesuared as potential risk factors, where up-to-date mammography screening as the outcome variable. ANALYSIS Multivariable adjusted logistic regressions were generalized to identify the up-to-date mammography screening behaviors in relation to potential factors, stratified by race and ethnicity. RESULTS The prevalence for up-to-date mammography screening in NH-White and Asian American women were 68.06% and 65.97%, respectively. In NH-White women, receiving an up-to-date mammogram was associated with age, birthplace, smoking status, diabetes, hypertension, health insurance coverage, and a preventive care visit in the past 12 months, whereas only age and a preventive care visit were significant predictors in Asian women. CONCLUSIONS The findings indicate that utilization disparities exist in mammogram in relation to socioeconomics, chronic health conditions, preventive care utilization, when comparing between race and ethnicity. Asian American women with borderline hypertension and no preventive care visits may require more public health outreach and cancer education.
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Affiliation(s)
- Hui Xie
- Joseph J. Zilber School of Public Health, 14751University of Wisconsin-Milwaukee Milwaukee, WI, USA
| | - Yannan Li
- Dapartment of Medicine, 5925Icahn School of Medicine at Mount Sinai Morningside and West, New York, NY, USA
| | - Nickolas Theodoropoulos
- Dapartment of Medicine, 5925Icahn School of Medicine at Mount Sinai Morningside and West, New York, NY, USA
| | - Qian Wang
- Division of Hematology and Medical Oncology, Department of Medicine, 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Lee MH, Hong S, Merighi JR. The Association Between Fatalism and Mammography Use in Korean American Immigrant Women. HEALTH EDUCATION & BEHAVIOR 2021; 49:740-749. [PMID: 34396786 DOI: 10.1177/10901981211029253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Fatalism is reported as a salient cultural belief that influences cancer screening disparities in racial and ethnic minority groups. Previous studies provide a range of measures and descriptions of cancer fatalism, but no studies to our knowledge have analyzed how fatalistic views cluster together within subgroups to form distinct profiles, and how these profiles can be predicted. This study identified subgroups of Korean American immigrants with similar fatalistic beliefs toward cancer and examined the influence of fatalism, health belief variables, and health literacy on mammography use. A cross-sectional survey design was used to obtain a convenience sample of 240 Korean American immigrant women in Los Angeles, California. Latent class analysis was used to identify unobserved subgroups of fatalism. Hierarchical logistic regression models were used to identify predisposing, enabling, and need factors associated with recent mammography use. The latent class analysis model identified three cancer fatalism subgroups: high fatalism (17.8%), moderate fatalism (36.7%), and low fatalism (45.5%). Women in the high fatalism subgroup were more likely to have had a mammogram within the past 2 years than women in the low fatalism subgroup. Regression analysis revealed three facilitators of recent mammogram use: level of fatalism, perceived barriers to mammogram, and family history of cancer. Although cultural beliefs can have a powerful influence on health-seeking behavior, it is important to weigh individual and contextual factors that may weaken or mediate the relationship between fatalism and engaging in preventive care such as having a mammogram.
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Affiliation(s)
- Mi Hwa Lee
- East Carolina University, Greenville, NC, USA
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Rezaeimanesh M, Solhi M, Azar FEF, Sajjadi H, Rafiey H, Nejad FN, Gharehghani MAM, Najafi M, Hosseini SM, Karimi SE. Determinants of mammography screening in Tehranian women in 2018 based on the health belief model: A cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:119. [PMID: 34084866 PMCID: PMC8150056 DOI: 10.4103/jehp.jehp_339_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/26/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Breast cancer is the most common type of cancer among women. Mammography is the most sensitive and important method for screening and early diagnosis of breast cancer. Considering the importance of using mammography in breast cancer screening, this study was performed to evaluate mammographic determinants. MATERIALS AND METHODS In the cross-sectional study, we surveyed 985 women over 40 years in Tehran concerning demographic characteristics: age, socioeconomic status, a problem in the breast, alcohol use, drug use, and health belief model. Logistic regression was used to identify determinant factors associated with mammography performance. RESULTS The results of this study showed that 42.1% (95% confidence interval [CI]: 38, 45) participant performed mammography at least once during their lifetime. Age (odds ratio [OR] = 4.252; 95% CI = 2.041-8.857); housing situation (OR = 1.706; 95% CI = 1.178-2.469); having breast problems (OR = 5.224; 95% CI = 3.501-7.795); socioeconomic status (OR = 1.855; 95% CI = 1.035-3.325); family income level (OR = 1.998; 95% CI = 1.028-3.884); alcohol consumption (OR = 2.676; 95% CI = 1.344-5.328); smoking (OR = 2.824; 95% CI = 1.418-5.623); self-efficacy (OR = 1.935; 95% CI = 1.242-3.015); perceived barriers (OR = 2.017; 95% CI = 1.348-3.019); self-care (OR = 4.901; 95% CI = 3.152-7.620); perceived susceptibility (OR = 1.971; 95% CI = 1.271-3.057) and perceived severity (OR = 1.830; 95% CI = 1.170-2.860) were mammography behaviors determinants. CONCLUSION The findings indicated that the rate of mammography screening among Tehranian women is low and highlights the need for developing a comprehensive national breast cancer control program, which should be considered as the priority for health-care providers. Furthermore, the identification of these factors can help to design an appropriate educational intervention that focuses on the benefits of mammography screening.
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Affiliation(s)
- Masoumeh Rezaeimanesh
- PhD Candidate of Health Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Solhi
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Homeira Sajjadi
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hassan Rafiey
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Farhad Nosrati Nejad
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | | | - Sayedeh Mahboobeh Hosseini
- Clinical Research Development Unit, Ayatollah Kashani Hospital, Shahrekord University of Medical Science, Shahrekord, Iran
| | - Salah Eddin Karimi
- Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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Literacy of Breast Cancer and Screening Guideline in an Immigrant Group: Importance of Health Accessibility. J Immigr Minor Health 2021; 22:563-570. [PMID: 31956925 DOI: 10.1007/s10903-020-00973-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Little is known about predictors of breast cancer literacy among immigrant women. A cross-sectional survey investigated predisposing, enabling, and need factors of breast cancer literacy among 233 Korean American women living in a southeastern U.S. city. Breast cancer literacy was measured by questions that asked awareness of cancer screening methods and a 5-item questionnaire derived from the American Cancer Society's breast cancer screening guidelines and risk factors. Annual checkup was an enabling factor of awareness of Clinical Breast Exam (CBE) and mammogram, and also for breast cancer literacy covering the knowledge of breast cancer screening guidelines and risk factors. Health status was a need factor of CBE awareness. Marital status was a predisposing factor of mammogram awareness, and age and years of residence in the US were predisposing factors of breast cancer literacy. The findings of the study illuminate probable avenues of intervention to promote breast health knowledge for Korean American women.
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Adunlin G, Cyrus JW, Asare M, Sabik LM. Barriers and Facilitators to Breast and Cervical Cancer Screening Among Immigrants in the United States. J Immigr Minor Health 2019; 21:606-658. [PMID: 30117005 DOI: 10.1007/s10903-018-0794-6] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
To summarize the literature on barriers and facilitators to breast and cervical cancer screening among immigrants to the US. A literature review was conducted for studies on breast and cervical cancer screening among immigrant populations. A thematic analysis of 180 studies identified a variety of barriers and facilitators to screening at the personal and system levels. Personal barriers included lack of knowledge and insurance coverage, high cost of care, and immigration status. System barriers included poor access to services, lack of interpreter services, and insensitivity to patient needs. Facilitators to screening included knowledge of disease, access to information sources, physician recommendation, and social networks. Cultural norms and resource availability at the individual and system levels influence screening among immigrants. Health insurance coverage was found to be an important predictor of preventative screening use. Future research should seek to identify the best way to address this and other barriers to cancer screening among immigrants groups.
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Affiliation(s)
- Georges Adunlin
- McWhorter School of Pharmacy, Samford University, 2100 Lakeshore Dr, Homewood, AL, 35229, USA.
| | - John W Cyrus
- Tompkins-McCaw Library, Virginia Commonwealth University, 509 N 12th St, Richmond, VA, 23298-0430, USA
| | - Matthew Asare
- Department of Public Health, Baylor University, One Bear Place #97313, Waco, TX, 76798-7313, USA
| | - Lindsay M Sabik
- Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, 130 De Soto St., Pittsburgh, PA, 15261, USA
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Shon EJ, Townsend AL. Predictors of never having a mammogram among Chinese, Vietnamese, and Korean immigrant women in the U.S. PLoS One 2019; 14:e0224505. [PMID: 31693678 PMCID: PMC6834271 DOI: 10.1371/journal.pone.0224505] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/15/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Breast cancer is the most common cancer among Asian women in the U.S. The first objective was to investigate predictors (including ethnicity) of never having a mammogram in middle-aged and older Chinese, Vietnamese, and Korean immigrant women (main effects). The second objective was to explore whether relationships between predictors and never having a mammogram varied across the three groups (moderation effects of ethnicity). METHODS Merged (2005-2007-2009-2011) California Health Interview Survey data were utilized. Unweighted sample was 3,710 Asian women ages 40 years and older (Chinese = 1,389; Vietnamese = 1,094; Korean = 1,227). Replicate weighted total sample size was 1,710,233 (Chinese = 940,000; Vietnamese = 410,000; Korean = 360,000). Replicate-weighted multivariate logistic regression was applied. Interaction effects (moderator role of ethnicity) were also examined, using multivariate logistic regression, for the second objective. RESULTS For the first objective, odds of never having a mammogram were higher for women who were Korean (Ref = Vietnamese), unmarried, or a non-U.S. citizen. Odds were lower in women ages 50-59 or 60-69 (Ref = 70-85). Regarding the second objective, only for Chinese women, odds of never having a mammogram were lower as the number of physician visits got higher. CONCLUSION Culturally-sensitive outreach and services should be developed to target higher-risk groups. Patient-centered healthcare strategies tailored for the three groups could be effective. For Chinese women, in particular, regular information sessions or education programs could be provided for enhancing their physician visits.
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Affiliation(s)
- En-Jung Shon
- Department of Family Science and Social Work, Miami University, Oxford, OH, United States of America
| | - Aloen Louise Townsend
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States of America
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Elewonibi B, BeLue R. The influence of socio-cultural factors on breast cancer screening behaviors in Lagos, Nigeria. ETHNICITY & HEALTH 2019; 24:544-559. [PMID: 28678532 DOI: 10.1080/13557858.2017.1348489] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 06/02/2017] [Indexed: 06/07/2023]
Abstract
Culture has been shown to influence health beliefs and health-related behaviors by influencing the type of health information to which women have been exposed and shapes health and illness perceptions and practices. To increase screening rates, cultural influences should be considered as important correlates of screening behaviors for breast cancer. This study used semi-structured interviews of women attending a cancer screening facility in Lagos, Nigeria guided by the PEN-3 model to describe culturally relevant factors that shape attitudes toward breast cancer and breast cancer screening. Religion was the most prominent theme and was shown to have positive, negative and existential effect on breast cancer perceptions. Other major themes observed were related to family and traditional beliefs. The results from this study could be used to develop and implement culturally relevant cancer prevention interventions, strategies, and recommendations to overcome screening barriers in an effort to increase breast cancer participation and awareness among Nigerian women.
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Affiliation(s)
- Bilikisu Elewonibi
- a Department of Health Policy and Administration and Demography , The Pennsylvania State University , University Park , PA , USA
| | - Rhonda BeLue
- a Department of Health Policy and Administration and Demography , The Pennsylvania State University , University Park , PA , USA
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Kwok C, Lee MJ, Lee CF. Breast Cancer Perceptions and Screening Behaviours Among Korean Women in Australia. J Immigr Minor Health 2019; 22:126-133. [DOI: 10.1007/s10903-019-00876-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Shirzadi S, Allahverdipour H, Sharma M, Hasankhani H. Perceived Barriers to Mammography Adoption among Women in Iran: A Qualitative Study. Korean J Fam Med 2019; 41:20-27. [PMID: 30803223 PMCID: PMC6987031 DOI: 10.4082/kjfm.18.0054] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 07/19/2018] [Indexed: 01/14/2023] Open
Abstract
Background Breast cancer is the most commonly diagnosed tumorous cancer and the second leading cause of cancer-related deaths among women worldwide. This study aimed to qualitatively explore the barriers to mammography adoption among Iranian women. Methods This study is a qualitative component of a large research project on exploratory sequential mixed method design, utilizing conventional content analysis. In total, 24 participants were selected from among women who had participated in the first phase of the study. Data were collected through in-depth, semi-structured interviews. Results Five main themes were extracted, consisting of unawareness of mammography, fear control, priority of mammography needs, inadequate competency of mammography centers, and a sense of losing family support. Conclusion Different perceived barriers within various levels (individual, intrapersonal, health systems, and community) play influential roles in women’s decisions to participate in breast cancer screening program, which indicates the cultural aspect of perceived barriers in different communities and countries. The study provides the basis for intervention planning in this regard.
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Affiliation(s)
- Shayesteh Shirzadi
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Allahverdipour
- Research Center of Psychiatry and Behavioral Sciences, Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Manoj Sharma
- Department of Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
| | - Hadi Hasankhani
- Department of Nursing, Qualitative Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Development and Evaluation of Culturally and Linguistically Tailored Mobile App to Promote Breast Cancer Screening. J Clin Med 2018; 7:jcm7080181. [PMID: 30042291 PMCID: PMC6111615 DOI: 10.3390/jcm7080181] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 07/12/2018] [Accepted: 07/13/2018] [Indexed: 12/02/2022] Open
Abstract
Background: While a significant breast cancer burden exists for Korean American immigrant women, their cancer screening behavior is strikingly poor, and few interventions have focused on this population. To promote breast cancer screening behavior in Korean American immigrant women, a mobile phone multimedia messaging intervention (mMammogram) was developed. Objective: The current study explores the impact of mMammogram on changes to study participants’ screening behavior and proposes suggestions for how the intervention can be improved for wide dissemination and implementation in the Korean American community. Material and Methods: Data were collected through qualitative research methods. Three focus groups were conducted with 14 Korean immigrant women who completed the mMammogram. Findings: Three themes emerged: (1) better understanding of breast cancer and screening through mMammogram (e.g., increased knowledge on breast cancer and screening methods, increased understanding of the importance of regular mammography, and reduced anxiety about mammography); (2) health navigators as a trigger to promote mammography (e.g., providing resources for free or low-cost mammograms and scheduling mammogram appointments); and (3) suggestions for mMammogram (e.g., technical issues and program period). Conclusions: Mobile app intervention that is culturally tailored, along with health navigation services, can be a feasible, effective, and acceptable tool to promote breast cancer screening behaviors in underserved immigrant women. A mobile app can cover a broad range of breast cancer health topics and the health navigator can further help women overcome barriers to screening. A health navigation service is critical in overcoming language, transportation, and health accessibility barriers and triggering a positive change in their health screening behavior, especially for newly arrived immigrant populations.
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Hong HC, Lee H, Collins EG, Park C, Quinn L, Ferrans CE. Factors affecting trust in healthcare among middle-aged to older Korean American women. BMC WOMENS HEALTH 2018; 18:109. [PMID: 29929508 PMCID: PMC6013887 DOI: 10.1186/s12905-018-0609-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/15/2018] [Indexed: 01/02/2023]
Abstract
Background Predictors of trust in healthcare providers and the healthcare system have never been studied in Korean Americans (KA) despite the fact that trust plays an important role in health behaviors. The purpose of this study is to examine factors influencing trust in the healthcare system and providers among KA women. Methods Data were collected in 196 KA women examining the effects of perceived discrimination and trust on breast cancer screening in the Chicago metropolitan area. Path analysis was used to identify factors influencing trust in the healthcare system and providers. Results Acculturation was positively related to trust in healthcare providers (β = .15, p =. 002), and discrimination in the healthcare system was inversely related to trust in healthcare providers (β = −.60, p <. 001). Length of stay in the US was inversely related to distrust in the healthcare system (β = −.14, p <. 001), and discrimination in healthcare was positively related to distrust in the healthcare system (β = .60, p <. 001). Trust in healthcare providers and distrust in the healthcare system were moderately correlated (r = .51, p < .001). Conclusion Higher levels of acculturation and lower levels of perceived discrimination were identified as predictors of higher levels of trust in healthcare providers. A shorter stay in the US and higher levels of discrimination were identified as predictors of higher levels of distrust in the healthcare system. Perceived discrimination is a target for interventions to enhance trust in the healthcare system, and therefore reduce healthcare disparities in KAs.
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Affiliation(s)
- Hye Chong Hong
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
| | - Hyeonkyeong Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Eileen G Collins
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Chang Park
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Lauretta Quinn
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
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An S, Choi YJ, Lee HY, Yoon YJ, Platt M. Predictors of Breast Cancer Screening Among Korean American Women: Is Having an Annual Checkup Critical? Asian Pac J Cancer Prev 2018; 19:1281-1286. [PMID: 29802037 PMCID: PMC6031831 DOI: 10.22034/apjcp.2018.19.5.1281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 03/29/2018] [Indexed: 11/27/2022] Open
Abstract
Objective: Korean American (KA) immigrant women underutilize breast cancer screening. This study examined factors predicting breast cancer screening behavior among KA women in the United States. Methods: 233 KA women aged 19 to 85 were recruited in the metro area of Atlanta, Georgia. Andersen’s behavioral model theoretically guided the study. Result: Of the predisposing factors, age (OR=1.043, p<.01, 95% CI [1.017, 1.069]) and marital status (OR=2.154, p<.05, 95% CI [1.022, 4.539]) were significantly associated with clinical breast exam (CBE), while income (OR=2.289, p<.05, 95% CI [1.060, 4.945]) and annual checkup (OR=2.725, p<.01, 95% CI [1.342, 5.533]) were linked to CBE as enabling factors. For the receipt of mammographic screening, annual checkup was only significantly associated among enabling factors (OR=4.509, p<.05, 95% CI [1.263, 16.102]), while family cancer history was identified as the only significant need factor (OR=.112, p<.01, 95% CI [.023, .552]). Conclusion: Differing factors explained the receipt of CBEs and mammographic use among KA women. Specifically, the findings shed light on the importance of having an annual checkup for the uptake of both CBEs and mammographic use. Intervention strategies should focus on promoting health accessibility for KA women to adhere to recommended breast cancer screening.
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Affiliation(s)
- Soonok An
- Department of Social Work and Sociology, North Carolina A&T State University, Greensboro, NC, USA.
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Sterlingova T, Lundén M. Why do women refrain from mammography screening? Radiography (Lond) 2018; 24:e19-e24. [DOI: 10.1016/j.radi.2017.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 07/04/2017] [Accepted: 07/15/2017] [Indexed: 12/01/2022]
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18
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Hippman C, Moshrefzadeh A, Lohn Z, Hodgson ZG, Dewar K, Lam M, Albert AYK, Kwong J. Breast Cancer and Mammography Screening: Knowledge, Beliefs and Predictors for Asian Immigrant Women Attending a Specialized Clinic in British Columbia, Canada. J Immigr Minor Health 2018; 18:1441-1448. [PMID: 26706472 DOI: 10.1007/s10903-015-0332-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Screening mammography (MMG) reduces breast cancer mortality; however, Asian immigrant women underutilize MMG. The Asian Women's Health Clinic (AWHC) was established to promote women's cancer screening amongst this population. This study evaluated the rate, and predictors, of MMG amongst women attending the AWHC. Women (N = 98) attending the AWHC completed a questionnaire. Descriptive statistics and multivariable logistic regression evaluated rate and predictors of MMG. Most participants (87 %, n = 85) reported having had a mammogram. Significant MMG predictors were: lower perceived MMG barriers [lifetime: OR (CI) 1.19 (1.01-1.49); past 2 years: OR (CI) 1.11 (1.01-1.25)], and knowing someone with breast cancer [past year: OR (CI) 3.42 (1.25-9.85); past 2 years: OR (CI) 4.91 (1.32-2.13)]. Even amongst women using preventive medicine, 13 % report never having had a mammogram. More research is needed into innovative interventions, e.g. the AWHC, and breast cancer-related outcomes amongst Asian immigrant women.
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Affiliation(s)
- Catriona Hippman
- Women's Health Research Institute, Women's Hospital and Health Centre, Vancouver, BC, Canada. .,Department of Psychiatry, University of British Columbia, Translational Research Building, 3rd Floor-938 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada. .,BC Mental Health and Addictions Research Institute, BC Mental Health and Substance Use Services, Vancouver, BC, Canada.
| | - Arezu Moshrefzadeh
- Women's Health Research Institute, Women's Hospital and Health Centre, Vancouver, BC, Canada
| | - Zoe Lohn
- Women's Health Research Institute, Women's Hospital and Health Centre, Vancouver, BC, Canada
| | - Zoë G Hodgson
- Women's Health Research Institute, Women's Hospital and Health Centre, Vancouver, BC, Canada
| | - Kathryn Dewar
- Women's Health Research Institute, Women's Hospital and Health Centre, Vancouver, BC, Canada
| | - Melanie Lam
- Women's Health Research Institute, Women's Hospital and Health Centre, Vancouver, BC, Canada.,Asian Women's Health Clinic, Women's Hospital and Health Centre, Vancouver, BC, Canada
| | - Arianne Y K Albert
- Women's Health Research Institute, Women's Hospital and Health Centre, Vancouver, BC, Canada
| | - Juliet Kwong
- Asian Women's Health Clinic, Women's Hospital and Health Centre, Vancouver, BC, Canada
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Oh KM, Taylor KL, Jacobsen KH. Breast Cancer Screening Among Korean Americans: A Systematic Review. J Community Health 2018; 42:324-332. [PMID: 27678390 DOI: 10.1007/s10900-016-0258-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cancer is the leading cause of death for Korean Americans (KAs). Breast cancer (BC) is the most commonly occurring cancer among KA women, and its rate has been rapidly increasing. Low BC screening rates for KAs puts them at greater risk for late-stage breast cancer. We conducted a systematic review of the published literature on cancer screening among KAs, and identified 38 eligible studies. Despite significant increases in mammogram utilization over the past two decades, KAs have consistently lower rates of mammogram screening than other American populations. KA women also report lower rates of clinical breast examination and breast self-examination. Screening rates are higher among adults with higher socioeconomic status, greater acculturation to the United States, more cancer knowledge, higher perceived susceptibility to BC, more social support, and better access to health services. However, fear of finding something wrong, fear of embarrassment or lack of modesty, not knowing where to go for screening, believing that mammography is only necessary when symptoms are present, and perceived time and cost difficulties in accessing mammography were reported as barriers to mammogram screening. Coordinated efforts from clinicians, public health workers, KA cultural and religious organizations, and the broader breast cancer advocacy and awareness community are necessary for improving BC screening among KAs.
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Affiliation(s)
- Kyeung Mi Oh
- School of Nursing, George Mason University, 4400 University Drive 3C4, Fairfax, VA, 22030, USA.
| | - Karen L Taylor
- Department of Global and Community Health, George Mason University, 4400 University Drive 5B7, Fairfax, VA, 22030, USA
| | - Kathryn H Jacobsen
- Department of Global and Community Health, George Mason University, 4400 University Drive 5B7, Fairfax, VA, 22030, USA
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Lam M, Kwok C, Lee MJ. Prevalence and sociodemographic correlates of routine breast cancer screening practices among migrant-Australian women. Aust N Z J Public Health 2017; 42:98-103. [DOI: 10.1111/1753-6405.12752] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/01/2017] [Accepted: 10/01/2017] [Indexed: 12/19/2022] Open
Affiliation(s)
- Michelle Lam
- Discipline of Physiotherapy, Faculty of Health Sciences; The University of Sydney; New South Wales
| | - Cannas Kwok
- School of Nursing and Midwifery; Western Sydney University; New South Wales
| | - Mi-Joung Lee
- Discipline of Physiotherapy, Faculty of Health Sciences; The University of Sydney; New South Wales
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Hong HC, Ferrans CE, Park C, Lee H, Quinn L, Collins EG. Effects of Perceived Discrimination and Trust on Breast Cancer Screening among Korean American Women. Womens Health Issues 2017; 28:188-196. [PMID: 29223326 DOI: 10.1016/j.whi.2017.11.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 10/23/2017] [Accepted: 11/03/2017] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Korean American (KA) women continue to have lower breast cancer screening rates than other racial groups. Perceived discrimination and trust have been associated with breast cancer screening adherence, but little is known about the associations in KA women. METHODS Surveys were completed by 196 KA women in the Chicago metropolitan area. Multiple and Firth logistic regression analyses were performed to identify factors (perceived discrimination, trust, acculturation, cultural beliefs, health care access) influencing breast cancer screening adherence (mammogram). In addition, SPSS macro PROCESS was used to examine the mediating role of trust between perceived discrimination and breast cancer screening adherence. RESULTS Ninety-three percent of the women surveyed had health insurance and 54% reported having a mammogram in the past 2 years. Predictors of having a mammogram were knowing where to go for a mammogram, having a regular doctor or usual place for health care, greater trust in health care providers, and lower distrust in the health care system. Perceived discrimination had an indirect effect on breast cancer screening through trust. CONCLUSIONS The breast cancer screening rate among KA women is low. Perceived discrimination in health care, trust in health care providers, and distrust in the health care system directly or indirectly influenced breast cancer screening adherence in KA women. Trust is a factor that can be strengthened with educational interventions.
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Affiliation(s)
| | | | - Chang Park
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | | | - Lauretta Quinn
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Eileen G Collins
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
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22
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Lee H, Ghebre R, Le C, Jang YJ, Sharratt M, Yee D. Mobile Phone Multilevel and Multimedia Messaging Intervention for Breast Cancer Screening: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2017; 5:e154. [PMID: 29113961 PMCID: PMC5698632 DOI: 10.2196/mhealth.7091] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 07/08/2017] [Accepted: 07/29/2017] [Indexed: 12/20/2022] Open
Abstract
Background Despite the increasing breast cancer incidence and mortality rates, Korean American immigrant women have one of the lowest rates of breast cancer screening across racial groups in the United States. Mobile health (mHealth), defined as the delivery of health care information or services through mobile communication devices, has been utilized to successfully improve a variety of health outcomes. Objective This study adapted the principles of mHealth to advance breast cancer prevention efforts among Korean American immigrant women, an underserved community. Methods Using a randomized controlled trial design, 120 Korean American women aged 40 to 77 years were recruited and randomly assigned to either the mMammogram intervention group (n=60) to receive culturally and personally tailored multilevel and multimedia messages through a mobile phone app along with health navigator services or the usual care control group (n=60) to receive a printed brochure. Outcome measures included knowledge, attitudes, and beliefs about breast cancer screening, readiness for mammography, and mammogram receipt. The feasibility and acceptability of the mMammogram intervention was also assessed. Results The intervention group showed significantly greater change on scores of knowledge of breast cancer and screening guidelines (P=.01). The intervention group also showed significantly greater readiness for mammography use after the intervention compared with the control group. A significantly higher proportion of women who received the mMammogram intervention (75%, 45/60) completed mammograms by the 6-month follow-up compared with the control group (30%, 18/60; P<.001). In addition, the intervention group rated satisfaction with the intervention (P=.003), effectiveness of the intervention (P<.001), and increase of knowledge on breast cancer and screenings (P=.001) significantly higher than the control group. Conclusions A mobile phone app–based intervention combined with health navigator service was a feasible, acceptable, and effective intervention mechanism to promote breast cancer screening in Korean American immigrant women. A flexible, easily tailored approach that relies on recent technological advancements can reach underserved and hard-to-recruit populations that bear disproportionate cancer burdens. Trial Registration Clinicaltrials.gov NCT01972048; https://clinicaltrials.gov/show/NCT01972048 (Archived by WebCite at https://clinicaltrials.gov/archive/NCT01972048/2013_10_29)
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Affiliation(s)
- Hee Lee
- School of Social Work, College of Education and Human Development, University of Minnesota, Twin Cities, St Paul, MN, United States
| | - Rahel Ghebre
- Department of Obstetrics, Gynecology and Women's Health, School of Medicine, University of Minnesota, Twin Cities, Minneapolis, MN, United States
| | - Chap Le
- Division of Biostatistics, School of Public Health, University of Minnesota, Twin Cities, Minneapolis, MN, United States
| | - Yoo Jeong Jang
- Department of Educational Psychology, College of Education and Human Development, University of Minnesota, Twin Cities, Minneapolis, MN, United States
| | - Monica Sharratt
- School of Social Work, College of Education and Human Development, University of Minnesota, Twin Cities, St Paul, MN, United States
| | - Douglas Yee
- Division of Hematology, Oncology and Transplantation, School of Medicine and Pharmacology, University of Minnesota, Twin Cities, Minneapolis, MN, United States
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24
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Shirzadi S, Nadrian H, Asghari Jafarabadi M, Allahverdipour H, Hassankhani H. Determinants of mammography adoption among iranian women: What are the differences in the cognitive factors by the stages of test adoption? Health Care Women Int 2017; 38:956-970. [PMID: 28586294 DOI: 10.1080/07399332.2017.1338705] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Our aim in this cross-sectional study was to investigate the predictors of the stages of change in mammography adoption (MA) based on Health Belief Model among Iranian women. Through multistage cluster sampling, we recruited and interviewed 1131 women older than 40. After statistical adjustment for other risk factors, perceived barriers (OR D 0.84, 95% CI D .81-.87) and benefits (OR D 1.17, 95% CI D 1.11-1.24) were significant predictors for MA. Majority of the women were in the pre-contemplation and contemplation stages of change for MA. Our findings are informative for the development of targeted interventions to foster MA among women.
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Affiliation(s)
- Shayesteh Shirzadi
- a Department of Health Education and Promotion, Faculty of Health , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Haidar Nadrian
- a Department of Health Education and Promotion, Faculty of Health , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Mohammad Asghari Jafarabadi
- b Road Traffic Injury Research Center , Tabriz University of Medical Sciences , Tabriz , Iran.,c Department of Biostatistics and Epidemiology , Faculty of Health, Tabriz University of Medical Sciences , Tabriz , Iran
| | - Hamid Allahverdipour
- a Department of Health Education and Promotion, Faculty of Health , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Hadi Hassankhani
- d Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery , Tabriz University of Medical Sciences , Tabriz , Iran
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25
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Lee EE, Nandy K, Szalacha L, Park H, Oh KM, Lee J, Menon U. Korean American Women and Mammogram Uptake. J Immigr Minor Health 2017; 18:179-86. [PMID: 25669627 DOI: 10.1007/s10903-015-0164-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A high percentage of Korean American (KA) women have never had a mammogram, which puts them at greater risk for late-stage breast cancer. The aim of this study was to compare health beliefs and spousal support about breast cancer and screening between KA women with and without a history of mammogram completion. Cross-sectional data were obtained from 428 non-adherent married KA women. KA women who never had a mammogram were younger, had less access to health care, had less knowledge, and had lower perceived self-efficacy, benefits, and spousal support, and higher perceived barriers to breast cancer screening compared to women who had had a mammogram. Assessing differing characteristics between the two groups of KA women may lead to a better understanding of the variables influencing mammography screening in this population and possibly increase early screening.
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Affiliation(s)
- Eunice E Lee
- School of Nursing, University of California, Los Angeles, 700 Tiverton Ave. 4-258 Factor Building (Mail Code: 691821), Los Angeles, CA, 90095-6918, USA.
| | - Karabi Nandy
- Department of Biostatistics, Fielding School of Public Health, Translational Sciences Section, School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095-6918, USA
| | - Laura Szalacha
- The Ohio State University College of Nursing, 396 Newton Hall, 1585 Neil Ave., Columbus, OH, 43210, USA.
| | - HanJong Park
- Department of Health Systems Science, University of Illinois at Chicago College of Nursing, 845 S. Damen Ave., M/C 802, Chicago, IL, 60612-5998, USA.
| | - Kyeung Mi Oh
- School of Nursing, George Mason University, 4400 University Dr., Fairfax, VA, 22030, USA.
| | - Jongwon Lee
- College of Nursing, University of New Mexico, MSC07 4380, 1650 University Blvd. NE, Box# 9, Albuquerque, NM, 87102, USA.
| | - Usha Menon
- The Ohio State University College of Nursing, 140 Newton Hall, 1585 Neil Ave., Columbus, OH, 43210, USA.
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Health Behavioural Theories and Their Application to Women's Participation in Mammography Screening. J Med Imaging Radiat Sci 2017; 48:122-127. [PMID: 31047359 DOI: 10.1016/j.jmir.2016.12.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 10/19/2016] [Accepted: 12/06/2016] [Indexed: 11/22/2022]
Abstract
The most effective method of detecting breast cancer among asymptomatic women is by mammography screening. Most countries have this preventive measure in place for women within their society; however, most of these programs struggle with attendance. This article discusses four health behavioural theories and models in relation to mammography screening that may explain the factors affecting women's participation, including the health belief model, theory of planned behaviour, trans-theoretical model, and the theory of care seeking behaviour. In summary, analysis of these theories indicates that the theory of care seeking behaviour has value for exploring these factors because of its sensitivity to socioeconomic differences that exist among women in society and because it has a broader construct (such as habit and external factors) compared to the other health behavioural theories.
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Han HR, Song Y, Kim M, Hedlin HK, Kim K, Ben Lee H, Roter D. Breast and Cervical Cancer Screening Literacy Among Korean American Women: A Community Health Worker-Led Intervention. Am J Public Health 2016; 107:159-165. [PMID: 27854539 DOI: 10.2105/ajph.2016.303522] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To test a community health worker (CHW)-led health literacy intervention on mammogram and Papanicolaou test screening among Korean American women. METHODS We conducted a cluster-randomized trial at 23 ethnic churches in the Baltimore, Maryland-Washington, DC, metropolitan area between 2010 and 2014. Trained CHWs enrolled 560 women. The intervention group received an individually tailored cancer-screening brochure followed by CHW-led health literacy training and monthly telephone counseling with navigation assistance. Study outcomes included receipt of an age-appropriate cancer screening test, health literacy, cancer knowledge, and perceptions about cancer screening at 6 months. RESULTS The odds of having received a mammogram were 18.5 (95% confidence interval [CI] = 9.2, 37.4) times higher in the intervention than in the control group, adjusting for covariates. The odds of receiving a Papanicolaou test were 13.3 (95% CI = 7.9, 22.3) times higher; the odds of receiving both tests were 17.4 (95% CI = 7.5, 40.3) times higher. Intervention effects also included increases in health literacy and positive perceptions about cancer screening. CONCLUSIONS A health literacy-focused CHW intervention successfully promoted cancer-screening behaviors and related cognitive and attitudinal outcomes in Korean American women.
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Affiliation(s)
- Hae-Ra Han
- Hae-Ra Han and Kyounghae Kim are with the School of Nursing, Johns Hopkins University, Baltimore, MD. Youngshin Song is with the College of Nursing, Choongnam University, Choongchung-Do, Korea. Miyong Kim is with the School of Nursing, University of Texas, Austin. Haley K. Hedlin is with the Department of Medicine, Stanford University, Stanford, CA. Hochang Ben Lee is with the School of Medicine, Yale University, New Haven, CT. Debra Roter is with the Bloomberg School of Public Health, Johns Hopkins University
| | - Youngshin Song
- Hae-Ra Han and Kyounghae Kim are with the School of Nursing, Johns Hopkins University, Baltimore, MD. Youngshin Song is with the College of Nursing, Choongnam University, Choongchung-Do, Korea. Miyong Kim is with the School of Nursing, University of Texas, Austin. Haley K. Hedlin is with the Department of Medicine, Stanford University, Stanford, CA. Hochang Ben Lee is with the School of Medicine, Yale University, New Haven, CT. Debra Roter is with the Bloomberg School of Public Health, Johns Hopkins University
| | - Miyong Kim
- Hae-Ra Han and Kyounghae Kim are with the School of Nursing, Johns Hopkins University, Baltimore, MD. Youngshin Song is with the College of Nursing, Choongnam University, Choongchung-Do, Korea. Miyong Kim is with the School of Nursing, University of Texas, Austin. Haley K. Hedlin is with the Department of Medicine, Stanford University, Stanford, CA. Hochang Ben Lee is with the School of Medicine, Yale University, New Haven, CT. Debra Roter is with the Bloomberg School of Public Health, Johns Hopkins University
| | - Haley K Hedlin
- Hae-Ra Han and Kyounghae Kim are with the School of Nursing, Johns Hopkins University, Baltimore, MD. Youngshin Song is with the College of Nursing, Choongnam University, Choongchung-Do, Korea. Miyong Kim is with the School of Nursing, University of Texas, Austin. Haley K. Hedlin is with the Department of Medicine, Stanford University, Stanford, CA. Hochang Ben Lee is with the School of Medicine, Yale University, New Haven, CT. Debra Roter is with the Bloomberg School of Public Health, Johns Hopkins University
| | - Kyounghae Kim
- Hae-Ra Han and Kyounghae Kim are with the School of Nursing, Johns Hopkins University, Baltimore, MD. Youngshin Song is with the College of Nursing, Choongnam University, Choongchung-Do, Korea. Miyong Kim is with the School of Nursing, University of Texas, Austin. Haley K. Hedlin is with the Department of Medicine, Stanford University, Stanford, CA. Hochang Ben Lee is with the School of Medicine, Yale University, New Haven, CT. Debra Roter is with the Bloomberg School of Public Health, Johns Hopkins University
| | - Hochang Ben Lee
- Hae-Ra Han and Kyounghae Kim are with the School of Nursing, Johns Hopkins University, Baltimore, MD. Youngshin Song is with the College of Nursing, Choongnam University, Choongchung-Do, Korea. Miyong Kim is with the School of Nursing, University of Texas, Austin. Haley K. Hedlin is with the Department of Medicine, Stanford University, Stanford, CA. Hochang Ben Lee is with the School of Medicine, Yale University, New Haven, CT. Debra Roter is with the Bloomberg School of Public Health, Johns Hopkins University
| | - Debra Roter
- Hae-Ra Han and Kyounghae Kim are with the School of Nursing, Johns Hopkins University, Baltimore, MD. Youngshin Song is with the College of Nursing, Choongnam University, Choongchung-Do, Korea. Miyong Kim is with the School of Nursing, University of Texas, Austin. Haley K. Hedlin is with the Department of Medicine, Stanford University, Stanford, CA. Hochang Ben Lee is with the School of Medicine, Yale University, New Haven, CT. Debra Roter is with the Bloomberg School of Public Health, Johns Hopkins University
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Yoon H, Sohn M, Jung M. Media Use and the Cancer Communication Strategies of Cancer Survivors. J Cancer Prev 2016; 21:127-134. [PMID: 27722138 PMCID: PMC5051586 DOI: 10.15430/jcp.2016.21.3.127] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 09/04/2016] [Indexed: 11/16/2022] Open
Abstract
Communication related to health not only substantially affects perceptions and behaviors related to health but is also positively associated with the extent of health-information seeking and the practice of preventive behavior. Despite the fact that the number of cancer survivors has increased dramatically, there are few studies of the lack of health information, factors which act as barriers, and the difficulties in follow-up care experienced by cancer survivors. Therefore, we reviewed media utilization and the types of media used by cancer survivors with regard to risk communication and suggested appropriate strategies for cancer communication. According to the results, health communication contributed to health promotion by providing health-related information, consolidating social support factors such as social solidarity and trust, and reducing anxiety. In particular, participatory health communication may establish preventive programs which reflect the needs of communities, expand accessibility to better quality healthcare, and intensify healthy living by reducing health inequalities. Therefore, when people do not have an intention to obtain cancer screening, we need to intervene to change their behavior, norms, and degrees of self-efficacy. The findings of this study may help those involved in building partnerships by assisting in their efforts to understand and communicate with the public.
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Affiliation(s)
- Heesoo Yoon
- Department of Public Health Science and BK21Plus Program in Public Health Science, Korea University, Seoul, Korea
| | - Minsung Sohn
- Department of Public Health Science and BK21Plus Program in Public Health Science, Korea University, Seoul, Korea
| | - Minsoo Jung
- Department of Health Science, Dongduk Women's University, Seoul, Korea
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Vu M, Azmat A, Radejko T, Padela AI. Predictors of Delayed Healthcare Seeking Among American Muslim Women. J Womens Health (Larchmt) 2016; 25:586-93. [PMID: 26890129 DOI: 10.1089/jwh.2015.5517] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Delayed care seeking is associated with adverse health outcomes. For Muslim women, delayed care seeking might include religion-related motivations, such as a preference for female clinicians, concerns about preserving modesty, and fatalistic beliefs. Our study assesses associations between religion-related factors and delayed care seeking due to a perceived lack of female clinicians. MATERIALS AND METHODS Surveys were distributed to Muslim women attending mosque and community events in Chicago. Survey items included measures of religiosity, religious fatalism, discrimination, modesty, and alternative medicine utilization and worship practices. The outcome measure asked for levels of agreement to the statement "I have delayed seeking medical care when no woman doctor is available to see me." RESULTS Two hundred fifty-four women completed the survey with nearly equal numbers of African Americans (26%), Arab Americans (33%), and South Asians (33%). Fifty-three percent reported delays in care seeking due to a perceived lack of female clinicians. In multivariate analysis adjusting for sociodemographic factors, higher religiosity (odds ratio [OR] = 5.2, p < 0.01) and modesty levels (OR = 1.4, p < 0.001) were positively associated with delayed care seeking. Having lived in the United States for >20 years (OR = 0.22, p < 0.05) was negatively associated with delayed care seeking. CONCLUSION Many American Muslim women reported delays in care seeking due to a perceived lack of female clinicians. Women with higher levels of modesty and self-rated religiosity had higher odds of delaying care. Women who had lived in the United States for longer durations had lower odds of delaying care. Our research highlights the need for gender-concordant providers and culturally sensitive care for American Muslims.
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Affiliation(s)
- Milkie Vu
- 1 Initiative on Islam and Medicine, Program on Medicine and Religion, Department of Medicine, The University of Chicago , Chicago, Illinois.,2 Section of Emergency Medicine, Department of Medicine, The University of Chicago , Chicago, Illinois
| | - Alia Azmat
- 1 Initiative on Islam and Medicine, Program on Medicine and Religion, Department of Medicine, The University of Chicago , Chicago, Illinois
| | - Tala Radejko
- 1 Initiative on Islam and Medicine, Program on Medicine and Religion, Department of Medicine, The University of Chicago , Chicago, Illinois
| | - Aasim I Padela
- 1 Initiative on Islam and Medicine, Program on Medicine and Religion, Department of Medicine, The University of Chicago , Chicago, Illinois.,2 Section of Emergency Medicine, Department of Medicine, The University of Chicago , Chicago, Illinois.,3 MacLean Center for Clinical Medical Ethics, The University of Chicago , Chicago, Illinois
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Kwok C, Ogunsiji O, Lee CF. Validation of the Breast Cancer Screening Beliefs Questionnaire among African Australian women. BMC Public Health 2016; 16:117. [PMID: 26846341 PMCID: PMC4743245 DOI: 10.1186/s12889-016-2793-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 01/27/2016] [Indexed: 11/11/2022] Open
Abstract
Background The Breast Cancer Screening Beliefs Questionnaire (BCSBQ) has been designed as a culturally appropriate instrument for assessing women’s beliefs, knowledge and attitudes to breast cancer and breast cancer screening practices. While it has proved to be a reliable instrument when applied to women of Chinese, Arabic and Korean origin living in Australia, its psychometric properties among women from African backgrounds have not been tested. The aim of this study is to examine the psychometric properties of the BCSBQ among African Australian women. Methods The BCSBQ was administered to 284 African Australian women who were recruited from a number of African community organizations and churches. Factor analysis was conducted to study the factor structure. Construct validity was examined using Cuzick’s non-parametric test while Cronbach alpha was used to assess internal consistency reliability. Results Exploratory factor analysis results demonstrated that the African-Australian BCSBQ can be conceptualized as a 4-factor model. The third factor, viz. “barriers to mammography”, was split into two separate factors namely, “psychological” and “practical” barriers. The results indicated that the African-Australian BCSBQ had both satisfactory validity and internal consistency. The Cronbach’s alpha of the three subscales ranged between 0.84-0.92. The frequency of breast cancer screening practices (breast awareness, clinical breast-examination and mammography) were significantly associated with attitudes towards general health check-ups and perceived barriers to mammographic screening. Conclusions Our study provided evidence to support the psychometric properties of the BCSBQ.in African Australian women. The study moreover demonstrated that the use of the instrument can help health professionals to understand the beliefs, knowledge and attitudes to breast cancer among African Australian women and also the factors that impact on their breast cancer screening practices.
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Affiliation(s)
- Cannas Kwok
- School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia.
| | - Olayide Ogunsiji
- School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia.
| | - Chun Fan Lee
- Department of Biostatistics, Singapore Clinical Research Institute, Singapore, Singapore.
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Seo JY, Bae SH, Dickerson SS. Korean Immigrant Women’s Health Care Utilization in the United States. Asia Pac J Public Health 2016; 28:107-33. [DOI: 10.1177/1010539515626266] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A systematic literature review was performed to review empirical evidence, published between 1946 and 2015, regarding Korean immigrant women’s health care utilization and factors affecting their health care utilization in the United States. Andersen’s behavioral model of health services utilization was used as a framework and was expanded to analyze the pattern of health services utilization and to identify characteristics of access to health care. A total of 32 reports were included. Variables were categorized into 1 of 5 individual determinants: cultural, enabling, predisposing, need, and reinforcing factor. A total of 423 relationships were found between individual determinants and health care utilization. All reinforcing variables were effective in increasing Korean immigrant women’s health care utilization in a positive way. Interventions targeting multiple factors were strongly effective in encouraging Korean immigrant women to utilize health services for cancer screening. However, these studies yielded inconsistent findings related to outcome measures due to the variability of measurement criteria.
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Affiliation(s)
- Jin Young Seo
- Hunter-Bellevue School of Nursing, Hunter College, the City University of New York, NY, USA
| | - Sung-Heui Bae
- School of Nursing, The University of Texas at Austin, TX, USA
| | - Suzanne S. Dickerson
- School of Nursing, University at Buffalo, the State University of New York, Buffalo, NY, USA
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Kim J, Huh BY, Han HR. Correlates of misperception of breast cancer risk among Korean-American Women. Women Health 2015; 56:634-49. [PMID: 26580449 DOI: 10.1080/03630242.2015.1118722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In this study, the authors investigate the factors associated with misperception of breast cancer risk, including unrealistic optimism and unrealistic pessimism, among Korean-American women (KAW). Baseline data were collected between March 2010 and October 2011 from 421 KAW aged 40-65 years who participated in a community-based randomized intervention trial designed to promote breast and cervical cancer screening. Multivariate multinomial regression was performed to identify correlates of misperception of breast cancer risk among KAW. A total of 210 KAW (49.9%) had breast cancer risk perception consistent with their objective risk, whereas 50.1% of KAW in the study had some form of misperception of risk. Specifically, 167 participants (39.7%) were unrealistically optimistic about their own breast cancer risk; 44 (10.5%) were unrealistically pessimistic. In multivariate multinomial logistic regression analysis, living with a partner and higher education were significantly associated with higher odds of having unrealistic optimism. High social support is associated with a lower likelihood of having a pessimistic risk perception. Higher worry is associated with a higher likelihood of having unrealistic pessimism. Misperception of breast cancer risk among KAW and related factors must be considered when developing behavioral interventions for this population.
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Affiliation(s)
- Jiyun Kim
- a School of Nursing , Gachon University , Incheon , Korea
| | - Bo Yun Huh
- b School of Nursing , Johns Hopkins University , Baltimore , Maryland , USA
| | - Hae-Ra Han
- b School of Nursing , Johns Hopkins University , Baltimore , Maryland , USA
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Factors associated with breast and cervical cancer screening behavior among African immigrant women in Minnesota. J Immigr Minor Health 2015; 16:450-6. [PMID: 23334709 DOI: 10.1007/s10903-012-9766-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Immigrant populations in the United States (US) have lower cancer screening rates compared to none immigrant populations. The purpose of this study was to assess the rates of cancer screening and examine factors associated with cancer screening behavior among African immigrant women in Minnesota. A cross sectional survey of a community based sample was conducted among African immigrants in the Twin Cities. Cancer screening outcome measures were mammography and Papanicolau smear test. The revised theoretical model of health care access and utilization and the behavioral model for vulnerable populations were utilized to assess factors associated with cancer screening. Only 61 and 52% of the age eligible women in the sample had ever been screened for breast and cervical cancer respectively. Among these women, duration of residence in the US and ethnicity were significant determinants associated with non-screening. Programs to enhance screening rates among this population must begin to address barriers identified by the community.
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Lee SY. Cultural Factors Associated with Breast and Cervical Cancer Screening in Korean American Women in the US: An Integrative Literature Review. Asian Nurs Res (Korean Soc Nurs Sci) 2015; 9:81-90. [PMID: 26160234 DOI: 10.1016/j.anr.2015.05.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 02/03/2015] [Accepted: 02/05/2015] [Indexed: 11/16/2022] Open
Abstract
PURPOSE This study examined current research theories and methods, cultural factors, and culturally relevant interventions associated with breast and cervical cancer screening in Korean American (KA) women. METHODS Based on Ganong's guidelines, the literature on cultural factors associated with breast and cervical cancer screening in KA women was searched using MEDLINE and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Sixty-eight articles on breast cancer screening and 66 articles on cervical cancer screening were retrieved from both databases, and a total of 22 articles were included in the literature review based on the selection criteria. RESULTS Of the 22 studies reviewed, 14 (63.6%) were descriptive and 8 (36.4%) were interventional. Many studies have used individual focused cognitive theories such as health belief model and different types of operationalization for measures of cultural beliefs. Cultural factors associated with breast and cervical cancer screening in KA women that were identified in descriptive quantitative and qualitative studies included family, embarrassment, preventive health orientation, fatalism, and acculturation. Most culturally relevant interventional studies used education programs, and all education was conducted by bilingual and bicultural health educators at sociocultural sites for KA women. CONCLUSIONS Theories focusing on interpersonal relationships and standardized, reliable, and valid instruments to measure cultural concepts are needed to breast and cervical cancer screening research in KA women. Traditional cultural factors associated with cancer screening should be considered for practical implications and future research with KA women.
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Affiliation(s)
- Shin-Young Lee
- Department of Nursing, Chosun University, Gwangju, South Korea.
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Oh KM, Jun J, Zhao X, Kreps GL, Lee EE. Cancer Information Seeking Behaviors of Korean American Women: A Mixed-Methods Study Using Surveys and Focus Group Interviews. JOURNAL OF HEALTH COMMUNICATION 2015; 20:1143-1154. [PMID: 25950369 DOI: 10.1080/10810730.2015.1018578] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Despite the high risk of cancer to the population, Korean Americans are known to have lower knowledge about cancer related information and a lower level of adherence to cancer prevention guidelines. This indicates the necessity of cancer interventions targeting the Korean American population. To reach this population effectively, it is imperative to understand Korean Americans' cancer information seeking behaviors. This study (a) identified cancer information sources that are trusted and used by Korean American women and (b) examined how general media exposure and trust in cancer information sources are related to the use of these sources. It also (c) explored perceived usefulness and limitations of cancer information sources. A mixed methods study using seven focus group interviews with 34 Korean American women and surveys with 152 Korean American women was conducted in the Washington, DC, metropolitan area from 2011 to 2012. The results indicate that Korean American women viewed health care professionals as the most trusted cancer information source but used the Internet and Korean ethnic media more often for cancer information seeking because of language, cultural, and economic barriers. Korean American women were most likely to obtain cancer information from media they used frequently for general purposes. Correlations between usage frequency and trust in doctor/health providers and the Internet as cancer information sources were negligible. When seeking cancer information, important factors for Korean American women were accessibility, affordability, and language proficiency, cultural sensitivity, meeting immediate needs, understandability, convenience, and reliability of cancer information sources. Findings from this study support developing interventions using Korean language media, including print, television and the Internet for health promotion and cancer prevention targeting Korean American women.
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Affiliation(s)
- Kyeung Mi Oh
- a School of Nursing , George Mason University , Fairfax , Virginia , USA
| | - Jungmi Jun
- b Department of Communication , Wayne State University , Detroit , Michigan , USA
| | - Xiaoquan Zhao
- c Department of Communication , George Mason University , Fairfax , Virginia , USA
| | - Gary L Kreps
- d Center for Health and Risk Communication, Department of Communication , George Mason University , Fairfax , Virginia , USA
| | - Eunice E Lee
- e School of Nursing , University of California , Los Angeles , California , USA
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The role of social support and social networks in health information-seeking behavior among Korean Americans: a qualitative study. Int J Equity Health 2015; 14:40. [PMID: 25927546 PMCID: PMC4419489 DOI: 10.1186/s12939-015-0169-8] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 04/15/2015] [Indexed: 11/23/2022] Open
Abstract
Introduction This study used social network theory to explore the role of social support and social networks in health information–seeking behavior among Korean American (KA) adults. Methods A descriptive qualitative study using a web-based online survey was conducted from January 2013 to April 2013 in the U.S. The survey included open-ended questions about health information–seeking experiences in personal social networks and their importance in KA adults. Themes emerging from a constant comparative analysis of the narrative comments by 129 of the 202 respondents were analyzed. Results The sample consisted of 129 KA adults, 64.7% female, with a mean age of 33.2 (SD = 7.7). Friends, church members, and family members were the important network connections for KAs to obtain health information. KAs looked for a broad range of health information from social network members, from recommendations and reviews of hospitals/doctors to specific diseases or health conditions. These social networks were regarded as important for KAs because there were no language barriers, social network members had experiences similar to those of other KAs, they felt a sense of belonging with those in their networks, the network connections promoted increased understanding of different health care systems of the U.S. system, and communication with these network connections helped enhance feelings of being physically and mentally healthy. Conclusions This study demonstrates the important role that social support and personal social networks perform in the dissemination of health information for a large ethnic population, KAs, who confront distinct cultural challenges when seeking health information in the U.S. Data from this study also illustrate the cultural factors that influence health information acquisition and access to social support for ethnic minorities. This study provides practical insights for professionals in health information services, namely, that social networks can be employed as a channel for disseminating health information to immigrants.
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Park H, Park MS. Cancer information-seeking behaviors and information needs among Korean Americans in the online community. J Community Health 2014; 39:213-20. [PMID: 24198135 DOI: 10.1007/s10900-013-9784-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Korean Americans tend to have less access to health service and cancer screening tests than all US population. It is necessary to understand their current cancer information-seeking behaviors and information needs to more effectively provide adequate cancer information. However, there is little known about their cancer information seeking behaviors and needs. The purpose of the study was to understand cancer information seeking behaviors and information needs among Korean Americans. Data were collected from MissyUSA, which is one of the biggest websites for the Korean community in the USA. A total of 393 free-texts from January to June 2013 were reviewed; 120 were deleted because the messages were not related to cancer health information. A total of 273 posted free-texts were analyzed for this study, using an open source text-mining software program called AntConc 3.2.4. The extracted terms were categorized based on coding systems, after linguistic variations were handled. Terms such as "surgery," "breast cancer," "examination," "cancer" (unspecified), "Korea," and "pain" were most frequently identified. Medical topics accounted for 71.4 % of the main topics of the postings. Treatment was the most frequently discussed in the medical topics while in the non-medical category, the most frequently discussed topic was recommendations for hospitals or doctors. In relation to types of cancer, breast cancer was the greatest concern, followed by cervical and liver cancer. The findings from this study can help in establishing more effective strategies to provide better cancer information among Korean Americans by assessing their cancer information seeking trends and information needs.
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Affiliation(s)
- Hyejin Park
- College of Nursing, Florida State University, 98 Varsity Way, PO Box 3064310, Tallahassee, FL, 32306-4310, USA,
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Oh KM, Jacobsen KH. Colorectal cancer screening among Korean Americans: a systematic review. J Community Health 2014; 39:193-200. [PMID: 23982772 DOI: 10.1007/s10900-013-9758-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The incidence of colorectal cancer (CRC) among Korean Americans (KAs) has increased in recent years, even as the rate in nearly ever other population group in the United States has decreased. Reversing this trend will require improving screening rates, but a variety of sociocultural factors may inhibit this goal. We conducted a systematic review of the published literature on cancer screening among KAs, and identified thirteen eligible studies that examined CRC screening. KAs have CRC screening rates that are significantly lower than the national average. Only about one in four KAs ages 50 and older reports having ever had a fecal ocult blood test (FOBT) and only about 40 % have ever had a sigmoidoscopy or colonoscopy. KA adults are also significantly less likely than the general US population to say they have heard of FOBT, sigmoidoscopy, or colonoscopy. In the KA population, screening rates are higher among adults with higher socioeconomic status, greater acculturation to the United States, more cancer knowledge, more social support, and better access to healthcare services. Improving cultural and financial access to health education and healthcare services may increase CRC screening among KAs and reduce the incidence of the disease.
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Affiliation(s)
- Kyeung Mi Oh
- School of Nursing, George Mason University, 4400 University Drive MS 3C4, Fairfax, VA, 22030, USA,
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Survey of breast cancer mammography screening behaviors in Eastern Taiwan based on a health belief model. Kaohsiung J Med Sci 2014; 30:422-7. [DOI: 10.1016/j.kjms.2014.04.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 02/27/2014] [Accepted: 03/17/2014] [Indexed: 11/23/2022] Open
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Cha C. Health promotion and related factors among korean goose mothers. Asian Nurs Res (Korean Soc Nurs Sci) 2014; 4:205-15. [PMID: 25031203 DOI: 10.1016/s1976-1317(11)60005-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The purpose of this study was to further understand the health promotion behaviors of Korean goose mothers in the North America area. Health promotion behaviors measured in this study were self-actualization, health responsibility, physical activity, nutrition, interpersonal relations, and stress management. METHODS The study is part of a larger study which used surveys (N=140) and in-person interviews (n=18). In this study, analysis of survey results is presented. Advertisements and snowballing technique were used to recruit study participants. Pearson's correlation was used to explore the relationships between health promotion and social support, acculturation attitudes, and perceived family health. Multiple regressions were used to examine the predictors of health promotion behaviors. RESULTS Women in the study were most frequently engaging in self-actualization and least in physical activity. Physical activity did not correlate with any of the study variables. When multiple regressions were performed, the model for each health promotion behavior was found to be statistically significant except for that of physical activity. Overall, study variables worked differently across models. Social support predicted self-actualization, health responsibility, interpersonal relations, and stress management. None of the acculturation attitudes predicted health promotion behaviors. The subdimensions of perceived family health predicted health promotion behaviors except physical activity. CONCLUSIONS The findings of this study contributed to the body of knowledge of health promotion among international migrant populations by identifying the differential effects of social support, acculturation attitudes, and perceived family health for six areas of health promotion.
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De Gagne JC, Oh J, So A, Kim SS. The healthcare experiences of Koreans living in North Carolina: a mixed methods study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2014; 22:417-428. [PMID: 24621370 DOI: 10.1111/hsc.12098] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/21/2013] [Indexed: 06/03/2023]
Abstract
This study examined the healthcare experiences of Korean immigrants aged 40-64 living in the North Carolina Triangle area of the Southeastern United States. Using a mixed methods design, we collected quantitative data via a questionnaire from 125 participants and conducted a focus group with 10 interviewees from December 2010 to February 2011. The quantitative data were analysed using t-tests and chi-square tests, and a thematic analysis was used for the focus group study. Questionnaire findings showed that only 27.2% had sufficient English skills to communicate adequately. Participants with insurance were significantly more likely to be employed (P < 0.001), had higher incomes (P = 0.011) and higher education (P < 0.001), and had greater English-speaking ability (P = 0.011) than those without insurance. Participants who did not use healthcare services showed significantly less knowledge (P < 0.001) of and less satisfaction (P = 0.034) with the healthcare system than those using healthcare services. Sixty-two participants (49.6%) reported having no health insurance for one or more of the following reasons: high costs (75.8%), medical tourism (22.6%) and lack of information or knowledge (6.5%). The following themes emerged from the data collected during the focus group: (i) barriers to utilisation of healthcare services; (ii) facilitators of utilisation of healthcare services; and (iii) social support seeking for health management. Our mixed methods study findings indicate that healthcare disparities exist among Korean immigrants and that a number of factors, including health literacy, may contribute to their poor health outcomes. Continued collaboration among community members, healthcare professionals and academicians is needed to discuss the community's health concerns and to develop sustainable programmes that will ensure meaningful access to care for those with limited English proficiency and medically underserved populations.
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Lee HY, Stange MJ, Ahluwalia JS. Breast cancer screening behaviors among Korean American immigrant women: findings from the Health Belief Model. J Transcult Nurs 2014; 26:450-7. [PMID: 24848345 DOI: 10.1177/1043659614526457] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study examined the utilization of clinical breast examinations (CBEs) and mammograms among Korean American immigrant women and investigated how the six constructs of Health Belief Model (HBM) are associated with the receipt of breast cancer screening. Using a quota sampling strategy, 202 Korean American immigrant women were recruited in metropolitan areas in the northeastern United States. Approximately 64% of the participants reported having had at least one CBE in their lifetime, and about 81% of the sample had undergone at least one mammogram in their lifetime. Women who perceived themselves to be susceptible to breast cancer were more likely to have undergone a CBE, and women who had lower barriers to screening or demonstrated a higher level of confidence were more likely than their counterparts to undergo a mammogram. Findings suggest that HBM constructs such as susceptibility, barriers, and confidence should be considered when designing interventions aimed at promoting breast cancer screening.
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Affiliation(s)
- Hee Yun Lee
- University of Minnesota, Twin Cities, St. Paul, MN, USA
| | - Mia Ju Stange
- Free University of Amsterdam, Amsterdam, Netherlands
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Lee E, Menon U, Nandy K, Szalacha L, Kviz F, Cho Y, Miller A, Park H. The effect of a couples intervention to increase breast cancer screening among korean americans. Oncol Nurs Forum 2014; 41:E185-93. [PMID: 24769601 PMCID: PMC4153420 DOI: 10.1188/14.onf.e185-e193] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To assess the efficacy of Korean Immigrants and Mammography-Culture-Specific Health Intervention (KIM-CHI), an educational program for Korean American (KA) couples designed to improve mammography uptake among KA women. DESIGN A two-group cluster randomized, longitudinal, controlled design. SETTING 50 KA religious organizations in the Chicago area. SAMPLE 428 married KA women 40 years of age or older who had not had a mammogram in the past year. The women and their husbands were recruited from 50 KA religious organizations. METHODS Couples were randomly assigned to intervention or attention control groups. Those in the KIM-CHI program (n = 211 couples) were compared to an attention control group (n = 217 couples) at baseline, as well as at 6 and 15 months postintervention on mammogram uptake. MAIN RESEARCH VARIABLES Sociodemographic variables and mammography uptake were measured. Level of acculturation was measured using the Suinn-Lew Asian Self-Identity Acculturation Scale. Researchers asked questions about healthcare resources and use, health insurance status, usual source of care, physical examinations in the past two years, family history of breast cancer, and history of mammography. FINDINGS The KIM-CHI group showed statistically significant increases in mammography uptake compared to the attention control group at 6 months and 15 months postintervention. CONCLUSIONS The culturally targeted KIM-CHI program was effective in increasing mammogram uptake among nonadherent KA women. IMPLICATIONS FOR NURSING Nurses and healthcare providers should consider specific health beliefs as well as inclusion of husbands or significant others. They also should target education to be culturally relevant for KA women to effectively improve frequency of breast cancer screening.
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Affiliation(s)
- Eunice Lee
- School of Nursing, University of California, Los Angeles
| | - Usha Menon
- College of Nursing, Ohio State University in Columbus
| | - Karabi Nandy
- School of Nursing, University of California, Los Angeles
| | - Laura Szalacha
- Center for Research and Transdisciplinary Scholarship in the College of Nursing, Ohio State University
| | - Frederick Kviz
- Department of Community Health Sciences in the School of Public Health, University of Illinois at Chicago
| | - Young Cho
- School of Public Health, University of Wisconsin-Milwaukee
| | - Arlene Miller
- Department of Community, Systems, and Mental Health Nursing in the College of Nursing, Rush University, Chicago, IL
| | - Hanjong Park
- College of Nursing, University of Illinois at Chicago
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Lee SJ, Chung C. Comparisons of Health Conditions of Immigrant and Domestic Women in Korea and China Using Propensity Score Matching. Health Care Women Int 2013; 34:989-1004. [PMID: 23627370 DOI: 10.1080/07399332.2012.741636] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Oh KM, Zhou QP, Kreps G, Kim W. The influences of immigration on health information seeking behaviors among Korean Americans and Native Koreans. HEALTH EDUCATION & BEHAVIOR 2013; 41:173-85. [PMID: 23943681 DOI: 10.1177/1090198113496789] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Korean Americans (KAs) have low screening rates for cancer and are often not well informed about their chronic diseases. Reduced access to health-related information is one reason for gaps in knowledge and the widening health disparities among minority populations. However, little research exists about KAs' health information seeking behaviors. Guided by the Structural Influence Model, this study examines the influence of immigration status on KAs' trust in health information sources and health information seeking behaviors. Cross-sectional surveys were conducted in the Washington, D.C., metropolitan area as well as in the Gwangju metropolitan city in South Korea during 2006-2007. Two hundred and fifty-four KAs and 208 native Koreans who were 40 years of age or older completed the surveys. When comparing native Koreans to KAs, we found KAs were 3 times more likely to trust health information from newspapers or magazines (odds ratio [OR] = 3.13; 95% confidence interval [CI] = 1.49-6.54) and 11 times more likely to read the health sections of newspapers or magazines (OR = 11.35; 95% CI = 3.92-32.91) in multivariate adjusted models. However, they were less likely to look for health information from TV (OR = 0.29; 95% CI = 0.12-0.72) than native Koreans. Our results indicate that immigration status has profound influences on KAs' health information seeking behaviors. Increasing the availability of reliable and valid health information from printed Korean language magazines or newspapers could have a positive influence on increasing awareness and promoting screening behaviors among KAs.
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Huh J, Delorme DE, Reid LN, Kim J. Korean Americans' prescription drug information seeking and evaluation and use of different information sources. JOURNAL OF HEALTH COMMUNICATION 2013; 18:498-526. [PMID: 23472746 DOI: 10.1080/10810730.2012.743623] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This study examined Korean Americans' prescription drug information seeking, evaluation and use of different information sources, and communication with physicians, and compared the findings with those from the White American population. The results suggest that although Korean and White Americans were similar in extent of drug information seeking, Korean Americans tended to experience relatively greater difficulty finding information. Regarding perceived source usefulness, Korean Americans were significantly more likely to perceive higher usefulness in mass media and direct-to-consumer advertising sources than were Whites. Korean Americans were also more likely to use fewer sources, and less likely to use mass media and printed materials in drug information seeking. However, the hypothesized in-group source preference by Korean Americans was not found.
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Affiliation(s)
- Jisu Huh
- School of Journalism and Mass Communication, University of Minnesota, Murphy Hall 338, 206 Church Street SE, Minneapolis, MN 55455, USA.
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Lee HY, Ju E, Vang PD, Lundquist M. Breast and cervical cancer screening disparity among Asian American women: does race/ethnicity matter [corrected]? J Womens Health (Larchmt) 2013; 19:1877-84. [PMID: 20831437 DOI: 10.1089/jwh.2009.1783] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Ethnic minorities are frequently considered as one homogeneous group in research, and this trend is particularly true for Asian Americans. This article seeks to uncover the intragroup differences in cancer screening behavior among subgroups of Asian American women by disaggregating them into six subgroups. The subgroups were compared with non-Latina white women to examine differences in breast and cancer screening rates and relevant factors associated with receiving these screenings. METHODS Three-year merged data from the 2001, 2003, and 2005 California Health Interview Survey (CHIS) were used to investigate the subgroup differences. Samples for the current study were restricted to non-Latina white and Asian American women whose age was ≥ 18 years (n = 58,000) for cervical cancer screening and ≥ 40 years (n = 43,518) for breast cancer screening at the time of the interview. RESULTS Results showed marked differences in cancer screening rates among Asian American subgroups and between cancer types. Cervical cancer screening rates were noticeably higher than breast cancer screening rates in all groups. The Korean group consistently showed the lowest rates of both cancer screenings. Japanese ranked the highest (79.5%) in breast cancer screening but the second lowest (79.7%) in cervical cancer screening. Enabling factors, such as having private health insurance and a usual source of care, were found to be the strongest predictors of receiving both breast and cervical cancer screening. Screenings for both types of cancer increased if a woman was married or was born in the United States. CONCLUSIONS The findings of this study illustrate the heterogeneity that exists among Asian American subgroups in their cancer screening behaviors. Further development of culturally relevant and ethnic-specific cancer prevention strategies and policies that address the subgroup differences within the larger racial/ethnic population are needed. Public health outreach and cancer education should be prioritized to the Asian American women who are more recent arrivals in the United States and have minimal access to healthcare.
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Affiliation(s)
- Hee Yun Lee
- School of Social Work, University of Minnesota, Twin Cities, Saint Paul, Minnesota 55108, USA.
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Baysal HY, Polat H. Determination of the breast cancer risk levels and health beliefs of women with and without previous mammography in the eastern part of Turkey. Asian Pac J Cancer Prev 2012; 13:5213-7. [PMID: 23244137 DOI: 10.7314/apjcp.2012.13.10.5213] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE This research was conducted to determine the breast cancer risk levels of women with and without previous mammography and their beliefs on breast cancer and mammography. METHODS The sample for this descriptive research consisted of women aged 50 years or older who were registered at the Family Health Center in the city center of Erzurum. The research was conducted with a total of 420 women with at least one mammography (210) and without mammography (210) who presented to the center on Wednesdays and Thursdays for any reason between 1 January 2010 and 1 January 2011. Research data were collected using the personal information "Breast Cancer Risk Assessment Form" accepted and recommended by the Turkish Ministry of Health, and the Champion's Health Belief Model Scale for Breast Cancer and Screening (CHBMS). Data were evaluated using percentages and means with the t-test. RESULTS According to the research data, 89.8% of the women were found to be in the low risk group, 87.6% with and 91.9% without mammography. When the health beliefs of women with and without mammography were compared, it was found that susceptibility, seriousness, motivation, mammography benefit scores were higher among those with mammography (p<0.01). The mammography barrier score average was higher in the group without mammography (p<0.01). CONCLUSION Knowing women's health beliefs, which have positive and negative effects on participating in mammography screening, may increase the rate of mammography uptake among women. Moreover, women with high breast cancer risk may be determined by increasing society's level of knowledge on breast cancer and risk factors.
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Kumsuk S, Flick LH, Schneider CSJK. Development of the Thai breast cancer belief scale for Thai immigrants in the United States. J Nurs Meas 2012; 20:123-41. [PMID: 22988783 DOI: 10.1891/1061-3749.20.2.123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Asian American women have not benefited from the decline in breast cancer mortality and have lower rates of mammography use. Understanding mammography behaviors among these Asian American women requires culturally specific measures. Champion's belief scale was translated into Thai and cultural items were added. The Thai breast cancer belief scale (TBCBS), the Suinn-Lew self-identification acculturation, and the Asian values scale-revised were administered to 250 Thai immigrants. The TBCBS was tested for face validity, construct validity, and internal consistency. Factor analysis reflected the 4 constructs of the health belief model and accounted for 45.8% of the variance. Cronbach's alpha ranged from .77 to .90. Modest correlations were observed between TBCBS subscales and acculturation scales. Results indicate that the TBCBS measures breast cancer beliefs among Thai immigrant population.
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Wang JHY, Schwartz MD, Brown RL, Maxwell AE, Lee MM, Adams IF, Mandelblatt JS. Results of a randomized controlled trial testing the efficacy of a culturally targeted and a generic video on mammography screening among chinese-american immigrants. Cancer Epidemiol Biomarkers Prev 2012; 21:1923-32. [PMID: 22971901 DOI: 10.1158/1055-9965.epi-12-0821] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Research comparing the effects of culturally targeted and generic but linguistically appropriate intervention programs is limited. We conducted a randomized controlled trial comparing the efficacy of a culturally targeted video, a generic video, and a fact sheet (control) in promoting mammography screening among Chinese-American immigrants. METHODS We randomized 664 Chinese-American women from the Washington, DC, and New York City areas who were older than 40 years and nonadherent to annual mammography screening guidelines to three study arms (each with ∼221 women). The outcome was self-reported mammography screening 6 months post intervention. Measures of knowledge, Eastern cultural views, and health beliefs were administered before and after the intervention. RESULTS The culturally targeted video, the generic video, and the fact sheet increased mammography use by 40.3%, 38.5%, and 31.1% from baseline, respectively. A significant intervention effect was observed only in one subgroup: The culturally targeted video significantly increased mammography screening among low-acculturated women over the fact sheet [OR, 1.70; 95% confidence interval (CI), 1.04-2.78]. Overall, women who obtained a mammogram during the follow-up period reported significantly fewer barriers to screening after intervention than those who had not obtained screening. Both of the video groups reported fewer barriers after intervention than the control group. CONCLUSIONS Both theoretically guided videos increased the likelihood of mammography use to a similar extent. Cultural targeting was only effective for low-acculturated women. Both videos reduced perceived barriers to screening and consequently increased screening behavior. IMPACT The results of this study provide empirical evidence on the efficacy of cultural targeting for minority immigrants.
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Affiliation(s)
- Judy Huei-yu Wang
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20007, USA.
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