Berger Samantha, Huang Chien-Chi, Rubin Carolyn L
Tufts University Friedman School of Nutrition Science and Policy, 150 Harrison Ave, Boston, MA, 02111, USA.
Asian Women for Health/Asian Breast Cancer Project, 83 Wallace, Somerville, MA, 02114, USA.
J Cancer Educ. 2017 Mar;32(1):16-23. doi: 10.1007/s13187-015-0911-3.
In the past decade, cancer rates have significantly decreased in the USA, but breast cancer survival is lower in Asian American women, likely due to lower rates of screening behaviors in Asian Americans compared to other ethnicities, which could lead to later stage cancer diagnosis and increased mortality. This paper reports on the Asian Breast Cancer (ABC) Project, a three-phase peer-led community program designed to promote cancer prevention by improving breast cancer screening rates among Chinese and Vietnamese women in the Greater Boston area. The three phases of planning and coalition building, community health worker training, and the community workshop intervention are described. The workshop intervention was evaluated by comparing pre- and post-workshop questionnaires evaluating knowledge about breast cancer screening and prevention. Two hundred fifty-two women participated in the program across 14 workshops. Each participant completed questionnaires about demographics, access to health care, and a five-item self-administered questionnaire about breast cancer knowledge. Results showed that the majority of the women had received a clinical breast exam or mammogram in the past 12 months (69 and 59 %, respectively), and older women were more likely to get a mammogram (85 %) or clinical breast exams (74 %) compared to younger women. Eighty-one percent of women were interested in reminder systems. Baseline knowledge was high for three survey questions about mammograms and breast cancer risk (88-97 %). For questions with fewer correct answers at baseline, knowledge about the meaning of lumps in the breast significantly increased (69 to 80 % correct, p < 0.0001), as well as knowledge about frequency of clinical breast exam (48 to 67 % correct, p < 0.0001). This pilot project indicated a partial effectiveness of the community workshop in a population with high baseline knowledge. The education workshop increased knowledge about breast lumps and clinical exam frequency. We also identified that reminder systems and appointment assistance are desired by this population. Our findings inform future cancer screening strategies for Asian Americans.
在过去十年中，美国的癌症发病率显著下降，但亚裔美国女性的乳腺癌生存率较低，这可能是因为与其他种族相比，亚裔美国人的筛查行为率较低，这可能导致癌症诊断较晚并增加死亡率。本文报道了亚洲乳腺癌（ABC）项目，这是一个由同伴主导的三阶段社区项目，旨在通过提高大波士顿地区华裔和越南裔女性的乳腺癌筛查率来促进癌症预防。文中描述了规划与联盟建设、社区卫生工作者培训以及社区工作坊干预这三个阶段。通过比较工作坊前后评估乳腺癌筛查和预防知识的问卷对工作坊干预进行了评估。共有252名女性参加了14个工作坊的项目。每位参与者都完成了关于人口统计学、医疗保健可及性的问卷，以及一份关于乳腺癌知识的五项自填问卷。结果显示，大多数女性在过去12个月内接受了临床乳房检查或乳房X光检查（分别为69%和59%），与年轻女性相比，老年女性更有可能接受乳房X光检查（85%）或临床乳房检查（74%）。81%的女性对提醒系统感兴趣。对于关于乳房X光检查和乳腺癌风险的三个调查问题，基线知识水平较高（88%-97%）。对于基线时正确答案较少的问题，关于乳房肿块含义的知识显著增加（正确答案从69%提高到80%，p<0.0001），以及关于临床乳房检查频率的知识也显著增加（正确答案从48%提高到67%，p<0.0001）。这个试点项目表明，在基线知识水平较高的人群中，社区工作坊有部分成效。教育工作坊增加了关于乳房肿块和临床检查频率的知识。我们还发现，这一人群希望有提醒系统和预约协助。我们的研究结果为亚裔美国人未来的癌症筛查策略提供了参考。
