The Role of Community Education in Increasing Knowledge of Breast Health and Cancer: Findings from the Asian Breast Cancer Project in Boston, Massachusetts

Abstract

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.

Familiarity, Navigation, and Comprehension: Key Dimensions of Health Literacy in Pap Test Use among Korean American Women

“…Specifically, familiarity and comprehension subscales were considered particularly challenging with 54% and 36% of the study sample scoring zero on the subscales, respectively. Limited English proficiency was highly relevant to the high prevalence of low health literacy observed among recent immigrants in the U.S. (Berger et al, 2017;Jun & Nan, 2018;Sentell & Halpin, 2006). Indeed, despite a high level of education (about 65% having some college+ education) with an average length of stay in the U.S. being 16.5 years, only less than a quarter (23.4%) of the KA sample indicated their English as being fluent.…”

“…Several studies have shown significant health literacy challenges in certain groups such as recent Asian immigrant in the U.S. who often lack English proficiency (Berger, Huang, & Rubin, 2017;Jun & Nan, 2018;Sentell & Halpin, 2006). KAs, one of the largest Asian populations in the U.S., are predominantly foreign born (92.5%) and monolingual (70% do not speak English well) (Shin, 2003).…”

Proposed biosimilar pegfilgrastim (LA-EP2006) compared with reference pegfilgrastim in Asian patients with breast cancer: an exploratory comparison from two Phase III trials

“…The need for well-controlled clinical studies is particularly important given the increasing incidence of breast cancer in Asian patients [6] and evidence that Asian patients may be more likely to die from breast cancer than other populations [7,13,14]. Evidence also suggests that patients are not treated according to international guidelines in some Asian populations [15,16], and there is a shortage of recommendations for use of G-CSF in Asian patients.…”

“…All but two of the patients in our study were based in India and Malaysia and as such represent two different patient populations, which in turn will differ to the Chinese and Japanese patients in the Zhang and Masuda studies. Evidence regarding breast cancer risk, prevalence and mortality from other continents suggests that Asian women in Western countries may be exposed to lifestyle factors that influence breast cancer incidence [18], and have differences in prevalence and mortality compared with other ethnic groups [7,13,14,19,20].…”

Health education in breast cancer prevention: experience report / Educação em saúde na prevenção ao câncer de mama: relato de experiência / Educación en salud en la prevención del cáncer de mama: informe de experiencia

“…Diante deste panorama é importante se realizarem ações de educação em saúde que possam estimular a participação da população por meio de rodas de conversas, palestras educativas e demonstrações práticas da autopalpação de mama. Isto se faz importante para que as mulheres possam ser sensibilizadas quanto a importância da adoção de hábitos saudáveis, como: praticar atividade física, alimentar-se de forma saudável, manter o peso corporal adequado, evitar o consumo de bebidas alcoólicas, amamentar, evitar uso de hormônios sintéticos -anticoncepcionais e terapias de reposição hormonal (9,16) .…”