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Cancer Control Research

5R03CA086594-02
Yu, Mei-Yu
CULTURAL BELIEFS AND BREAST CANCER SCREENING

Abstract

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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