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面向服务不足的韩裔美国人的社区结直肠癌干预。

Community-based colorectal cancer intervention in underserved Korean Americans.

机构信息

Department of Public Health, Center for Asian Health, College of Health Professions, Temple University, Philadelphia, PA 19122-0843, USA.

出版信息

Cancer Epidemiol. 2009 Nov;33(5):381-6. doi: 10.1016/j.canep.2009.10.001. Epub 2009 Nov 14.

Abstract

BACKGROUND

Despite evidence of a decline in both incidence and prevalence of colorectal cancer nationwide, it remains the second most commonly diagnosed cancer and the third highest cause of mortality among Asian Americans, including Korean Americans. This community-based and theoretically guided study evaluated a culturally appropriate intervention program that included a bilingual cancer educational program among Korean Americans including information on CRC risks, counseling to address psychosocial and access barriers, and patient navigation assistance.

METHODS

A two-group quasi-experimental design with baseline and post-intervention assessment and a 12-month follow-up on screening was used in the study. Korean Americans (N=167) were enrolled from six Korean churches. The intervention group received culturally appropriate intervention program addressing accessibility and psychosocial barriers, and navigation assistance for screening. The control group received general health education that included cancer-related health issues and screening.

RESULTS

There was a significant difference (p<0.05) between the post-intervention and control groups in awareness of CRC risk factors. There was also a significant improvement in the pre-post across HBM measures in the intervention group for perceived susceptibility (p<0.05) and benefits and barriers to screening (p<0.001). At baseline, 13% of participants in the intervention group and 10% in control group reported having had a CRC cancer screening test in the previous year. At the 12-month post-intervention follow-up, 77.4% of participants in the intervention group had obtained screening compared to 10.8% in the control group.

CONCLUSION

While health disparities result from numerous factors, a culturally appropriate and church-based intervention can be highly effective in increasing knowledge of and access to, and in reducing barriers to CRC screening among underserved Koreans.

摘要

背景

尽管全国范围内结直肠癌的发病率和患病率都有所下降,但它仍是亚裔美国人中第二大常见癌症,也是第三大死亡原因,包括韩裔美国人。这项基于社区和理论指导的研究评估了一种文化上适宜的干预计划,该计划包括为韩裔美国人提供双语癌症教育计划,内容包括 CRC 风险信息、解决心理社会和获取障碍的咨询、以及患者导航协助。

方法

本研究采用了两组准实验设计,在干预前后进行评估,并在 12 个月后进行了筛查随访。从六所韩国教堂招募了 167 名韩裔美国人。干预组接受了文化上适宜的干预计划,以解决可及性和心理社会障碍,并为筛查提供导航协助。对照组接受了包括癌症相关健康问题和筛查的一般健康教育。

结果

干预组在 CRC 风险因素的认识方面与对照组在干预后有显著差异(p<0.05)。干预组在 HBM 测量方面也在前后测中表现出显著改善,对筛查的感知易感性(p<0.05)和筛查的益处和障碍(p<0.001)均有所改善。在基线时,干预组有 13%的参与者和对照组有 10%的参与者在过去一年中进行了 CRC 癌症筛查测试。在干预后 12 个月的随访中,干预组有 77.4%的参与者进行了筛查,而对照组只有 10.8%。

结论

尽管健康差距是由许多因素造成的,但基于文化和教会的干预措施可以非常有效地提高服务不足的韩国人对 CRC 筛查的认识、获得途径,并减少筛查障碍。

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