This study developed and evaluated a culturally tailored video guided by the health belief model to improve Chinese women's low rate of mammography use. Focus-group discussions and an advisory board meeting guided the video development. A 17-min video, including a soap opera and physician-recommendation segment, was made in Chinese languages. A pretest/posttest pilot was conducted to evaluate the efficacy of the video in changing knowledge, beliefs, and screening intentions among Chinese women (age >or= 40) who were nonadherent to current National Cancer Institute's mammography guidelines (n=52). The results showed that the video significantly increased these women's screening intentions, knowledge, perceived risk for breast cancer, and perceived benefits of mammography. Chinese immigrant women were less likely to hold an Eastern view of health care and report barriers to screening after viewing the video. This video might have the potential to increase adherence to mammography screening in Chinese women.

BACKGROUND: Chinese-American women have much lower mammography screening rates than the gen-

Background: Asian American women have higher cervical cancer mortality rates than non-Hispanic White women, yet have lower Pap screening rates than their White counterparts. This study examined whether ethnic differences in the use of Pap screening were associated with differences in cultural views, controlling for demographic and access factors. Methods: Cross-sectional survey data from the Commonwealth 2001 Health Care Quality Survey were used. Non-Hispanic White (n = 2,146) and Asian American women (including Chinese, Vietnamese, Korean, Filipino, and Japanese; n = 259) were included in this study. Eastern cultural views were measured by beliefs in the role of self-care and luck. Access factors (having health insurance, regular providers, and communication with providers) and demographics of patients and providers were measured. The outcome was receipt of a Pap test in the past 2 years.

To develop and validate quantitative scales that measure Chinese cultural views about health and cancer, cultural views were assessed by a 30-item scale through telephone interviews with 438 Chinese-American women aged 50 and older. Cultural subscales were identified using principal component analysis and validated by their associations with age at immigration and breast, cervical, and colorectal cancer (CRC) screening patterns. The overall scale had good reliability (Cronbach's alpha = .79). Factor analysis yielded seven cultural subscales-fatalism, hot-cold balance, use of herbs, self-care, medical examination, lifestyle, and Western medicine (alpha = .39 to .82). The majority of the cultural subscales were significantly associated with age at immigration (p < .001). Fatalism, Self-Care, and Medical Examination subscales consistently predicted nonadherence to breast, cervical, and CRC screening recommendations, even after considering other factors. Chinese cultural views consist of at least seven domains and may influence older women's breast, cervical, and CRC screening.