Han Hae-Ra, Song Youngshin, Kim Miyong, Hedlin Haley K, Kim Kyounghae, Ben Lee Hochang, Roter Debra
Hae-Ra Han and Kyounghae Kim are with the School of Nursing, Johns Hopkins University, Baltimore, MD. Youngshin Song is with the College of Nursing, Choongnam University, Choongchung-Do, Korea. Miyong Kim is with the School of Nursing, University of Texas, Austin. Haley K. Hedlin is with the Department of Medicine, Stanford University, Stanford, CA. Hochang Ben Lee is with the School of Medicine, Yale University, New Haven, CT. Debra Roter is with the Bloomberg School of Public Health, Johns Hopkins University.
Am J Public Health. 2017 Jan;107(1):159-165. doi: 10.2105/AJPH.2016.303522. Epub 2016 Nov 17.
To test a community health worker (CHW)-led health literacy intervention on mammogram and Papanicolaou test screening among Korean American women.
We conducted a cluster-randomized trial at 23 ethnic churches in the Baltimore, Maryland-Washington, DC, metropolitan area between 2010 and 2014. Trained CHWs enrolled 560 women. The intervention group received an individually tailored cancer-screening brochure followed by CHW-led health literacy training and monthly telephone counseling with navigation assistance. Study outcomes included receipt of an age-appropriate cancer screening test, health literacy, cancer knowledge, and perceptions about cancer screening at 6 months.
The odds of having received a mammogram were 18.5 (95% confidence interval [CI] = 9.2, 37.4) times higher in the intervention than in the control group, adjusting for covariates. The odds of receiving a Papanicolaou test were 13.3 (95% CI = 7.9, 22.3) times higher; the odds of receiving both tests were 17.4 (95% CI = 7.5, 40.3) times higher. Intervention effects also included increases in health literacy and positive perceptions about cancer screening.
A health literacy-focused CHW intervention successfully promoted cancer-screening behaviors and related cognitive and attitudinal outcomes in Korean American women.
测试由社区卫生工作者（CHW）主导的健康素养干预措施对韩裔美国女性乳房X光检查和巴氏试验筛查的影响。
2010年至2014年期间，我们在马里兰州巴尔的摩 - 华盛顿特区大都市地区的23个种族教会开展了一项整群随机试验。经过培训的社区卫生工作者招募了560名女性。干预组收到一份量身定制的癌症筛查手册，随后接受由社区卫生工作者主导的健康素养培训以及每月一次的电话咨询和导航协助。研究结果包括在6个月时接受适合年龄的癌症筛查测试、健康素养、癌症知识以及对癌症筛查的看法。
在对协变量进行调整后，干预组接受乳房X光检查的几率比对照组高18.5倍（95%置信区间[CI]=9.2, 37.4）。接受巴氏试验的几率高13.3倍（95% CI = 7.9, 22.3）；接受两项检查的几率高17.4倍（95% CI = 7.5, 40.3）。干预效果还包括健康素养的提高以及对癌症筛查的积极看法。
以健康素养为重点的社区卫生工作者干预措施成功促进了韩裔美国女性的癌症筛查行为以及相关的认知和态度结果。
