Saturday, November 3, 2007

This presentation is part of : Healthcare Promotion Strategies
Enhancing Access to Breast Cancer Screening among Korean American Women: Community Health Workers Hold a Key
Hae-Ra Han, RN, PhD1, Hanju Lee, PhD, RN1, Kim B. Kim, PhD2, Miyong T. Kim, RN, PhD1, and Victoria Mock, DNSc, FAAN3. (1) School of Nursing, The Johns Hopkins University, Baltimore, MD, USA, (2) Korean Resource Center, Baltimore, MD, USA, (3) School of Nursing, Johns Hopkins University, Baltimore, MD, USA
Learning Objective #1: discuss the benefits of using the community health worker model in hard-to-reach Asian women.
Learning Objective #2: discuss the efficacy of a culturally tailored intervention using trained community health workers in improving breast cancer screening rates in Korean American women.

Despite considerable progress in U.S. cancer control over the past 20 years, recent immigrants, including Korean Americans (KA), face an unequal cancer burden related to the significant language and cultural barriers they face in attempting to navigate the U.S. healthcare system. This study was designed to test the efficacy of a culturally tailored community health worker (CHW) intervention to promote breast cancer screening, following evidence-based screening guidelines, in KA women over age 40. Trained CHWs from the KA community provided one 2-hr education session and 6 months of follow-up counseling and assistance in navigating the healthcare system to a total of 100 eligible women. Sixty-one KA women of 91 who completed the 6-month follow-up survey reported receiving a mammogram. Navigation assistance provided by CHWs included making an appointment for a mammogram (30%), offering updated information about state cancer screening programs available for low-income women (28%), providing information about a mammogram facility near the participant’s home (27%), and providing transportation and translation (15%). Analysis from focus group interviews with a subset of women (n = 10) revealed that the women had a very positive view of their experience with the CHW intervention. Those who decided not to get a mammogram cited mistrust of the healthcare system, fear of finding cancer, or overconfidence in their health and belief in God. Focus group interview with CHWs indicated that a tailored approach to mammography promotion among CHWs is readily accepted. Our results demonstrate that the CHW model is both feasible and effective in reaching traditionally underscreened KA women and providing an intervention that increases the number of KA women who adhere to breast cancer screening guidelines.