Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20007, USA.
Cancer Epidemiol Biomarkers Prev. 2012 Nov;21(11):1923-32. doi: 10.1158/1055-9965.EPI-12-0821. Epub 2012 Sep 12.
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.
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.
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.
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.
The results of this study provide empirical evidence on the efficacy of cultural targeting for minority immigrants.
比较具有文化针对性和通用但语言适宜的干预项目效果的研究有限。我们进行了一项随机对照试验,比较了针对文化的视频、通用视频和情况说明书(对照)在促进华裔美国移民进行乳房 X 光筛查方面的功效。
我们随机选择了来自华盛顿特区和纽约市地区的 664 名年龄在 40 岁以上且不符合年度乳房 X 光筛查指南的华裔美国女性,将她们分为三个研究组(每组约 221 名女性)。结果是干预后 6 个月的自我报告乳房 X 光筛查情况。在干预前后测量了知识、东方文化观点和健康信念。
与基线相比,具有文化针对性的视频、通用视频和情况说明书分别使乳房 X 光检查使用率提高了 40.3%、38.5%和 31.1%。仅在一个亚组中观察到了显著的干预效果:与情况说明书相比,具有文化针对性的视频显著增加了低同化女性的乳房 X 光筛查率[比值比,1.70;95%置信区间(CI),1.04-2.78]。总体而言,在随访期间接受乳房 X 光检查的女性在干预后报告的筛查障碍明显少于未接受筛查的女性。与对照组相比,两个视频组在干预后报告的障碍都更少。
这两种理论指导的视频在提高乳房 X 光检查使用率方面效果相当。文化针对性仅对低同化女性有效。两种视频都减少了对筛查的感知障碍,从而增加了筛查行为。
这项研究的结果为少数族裔移民的文化针对性提供了实证证据。