DESCRIPTION: (Applicant's Description)
Breast cancer is the most frequently diagnosed cancer for Chinese in the
United States As Chinese women move to the United States from China and other
Asian countries, their chances of getting breast cancer increase, and the risk
of breast cancer in successive generations also increases. Breast cancer
mammography screening is known to be an effective early detection measure, but
Chinese Americans are reluctant to make visits for routine or preventive care.
Preliminary studies suggest that cultural beliefs about health and disease
prevention have important influences on Chinese women's health behavior, such
as mammography screening. The complex nature of doing research with Asian
Americans requires cultural appropriateness of the assessment instruments.
However, adequate research instruments with established reliability and
validity to measure the association between women' s cultural beliefs and
their cancer screening behaviors are lacking. The objective of the proposed
study is to establish the psychometric properties of a Chinese-English
"Cultural Beliefs and Cancer Screening (CBCS)" questionnaire that measures the
full range of concepts derived from prior empirical and promising theoretical
work. Guided by culturally-specific adaptations made to the health belief
model (HBM), we will adopt existing instruments when necessary (e.g.,
Champion's Breast Cancer Screening Belief Scales and Mood's Cultural
Affiliation Scale), translate and pre-test the bilingual Chinese-English CBCS
questionnaire that measures theoretically and empirically-derived concepts
thought to be related to mammography use (Aim I). Based on data from Chinese
American women using a culturally sensitive sampling methodology, we will then
assess reliability and validity of each component of the CBCS questionnaire
using culturally appropriate qualitative and quantitative research (Aim 2).
Finally, we will evaluate the adequacy of the independent variables in the
CBCS questionnaire as predictors of mammography use (Aim 3). Lower utilization
of breast cancer screening is probably responsible for a greater proportion of
tumors found at a later stage among Chinese American women compared to United
States white women. The CBCS questionnaire will facilitate development of
future intervention programs that succeed in increasing the use of mammography
screening by Chinese American women. It is anticipated that the CBCS
questionnaire will also benefit a variety of studies designed for the United
States minority populations, especially Asian Americans, in which cultural
beliefs about cancer and cancer screening are important elements for
performing cancer early detection.
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