Effects of Computerized Tailored Health Messages on Knowledge, Self-Efficacy, and Intention to Receive Cancer Screening among Korean-American Women

Purpose: Despite recent evidence to support tailoring of health information to promote early detection of cancer, the efficacy of this approach is unclear among individuals with diverse cultural backgrounds. The purpose of this study was to compare the effects of computerized-tailored health messages and generic health message on knowledge, self-efficacy, and intention to receive breast and cervical cancer screening among Korean American immigrant women.

Methods: A total of 560 Korean immigrant women aged 21-65 years who had not had a mammogram and/or a Pap test within the past 24 months completed baseline surveys and then were randomly assigned to either the intervention (n=278) or control (n=282) groups. Within 1-2 weeks, computer-generated individually-tailored health information brochures were mailed to the participants in the intervention group. The contents of the health information were tailored to known risk factors for breast and cervical cancer, level of education, and stages of change as identified from baseline surveys. The control group received publicly available generic health information about risk factors for breast and cervical cancer and how to detect them early. After 2 weeks, participants were reassessed for cancer knowledge, self-efficacy, and intention to receive cancer screening.

Results: Participants were generally middle-aged (mean age=46±9), married (85%), uninsured (62%), and having been in the United States for 16(±10) years. In addition, 60% to 69% of the study sample indicated intent to receive a cancer screening test at baseline. At follow-up, more than 90% indicated that they had read their health information brochure partially or completely. The intervention group had significant increases in cancer knowledge, so did the control group with no between-group difference. The intervention group had a significantly higher increase in cancer screening-related self-efficacy than the control group but only in relation to breast cancer. Both groups had increases in the number of participants who had intention to screen; no group differences were observed, however. 

Conclusion: Both tailored and generic health information significantly improved breast and cervical cancer knowledge among non-adherent Korean American  immigrant women. Tailored health information was more effective than generic one in improving breast cancer screening related self-efficacy. Though no between-group difference was observed in terms of intent to screen, the result might have been an artifact of the study sample including non-adherent women who were already contemplating to receive a screening test at the time of study enrollment. Future research is warranted to investigate long-term effects of this tailored approach in promoting actual receipt of screening tests.