DESCRIPTION (provided by investigator): Breast cancer is the leading cause of death for Asian women, with the breast being the most frequent cancer site for Chinese Americans (55/100,000). Asian women who have immigrated to the United States have breast cancer incidence rates that are six times higher than those for Asian women who remain in their native countries. Most alarming is that although breast cancer mortality rates decreased for white and Hispanic women from 1990 to 1995, mortality rates rose for Asian and Pacific Islander women during the same period. As a result, they are more likely to be diagnosed with an advanced stage of breast cancer, making it much more difficult to receive effective treatment. Currently, there is an urgent need to promote breast cancer screening among the subgroups of Asian women along with the development of effective intervention strategies tailored to the unique needs of this population. This R21 application responds to PA-06-351 from the National Cancer Institute that invites research grant applications to conduct exploratory behavioral research in cancer control and to develop effective messages related to cancer screening among minority groups. The purpose of this study is to develop and test the feasibility of using individually tailored theoretically-based intervention strategies to promote mammography screening among non-adherent Chinese-American women. We aim to 1) develop a tailored telephone counseling intervention to demonstrate its feasibility and acceptability by Chinese American women, and 2) evaluate the intervention efficacy in increasing the a) outcome measures, i.e., uptake of mammography screening and stage of mammography adoption, and b) positive changes in mediators, i.e., improved knowledge about breast cancer risk and screening guidelines, increased perceived benefits and self-efficacy, and decreased barriers. Chinese American women who meet the eligibility criteria will be randomize into tailored telephone intervention, or control condition. The tailored group will receive an individually tailored intervention based on the results of the baseline assessment, and the control group will receive a pamphlet on mammography screening. This pilot study will provide useful information on how tailored intervention strategies can promote communication and informed decision-making in this minority group. If efficacious, the breast cancer control intervention could be tested in a large multi-site randomized trial with other Asian populations to investigate the effectiveness and cost-effectiveness in future R01 research project grant applications. PUBLIC HEALTH RELEVANCE: The project addresses the need for research assessing tailored communications/messages to increase mammography screening among Asian American women. If the program is shown to be successful, the intervention strategies may serve as a model with other Asian Americans and minority groups, and also improve the utilization of other types of cancer screening tests as well.
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