Peer-Navigator Breast Cancer Screening Program for Korean-American Women
|Purpose||Designed to increase breast cancer screening among low-income Korean-American adults. (2010)|
|Program Focus||Awareness building, Behavior Modification and Self-efficacy|
|Population Focus||Medically Underserved|
|Topic||Breast Cancer Screening|
|Age||Adults (40-65 years), Older Adults (65+ years)|
|Funded by||NCI (Grant number(s): P30CA16042, R25CA87949), U.S. Army Medical Research and Materiel Command (Grant number(s): DAMD17-03-1-0676)|
The Implementation Guide is a resource for implementing this program. It provides important information about the staffing and functions necessary for administering this program in the user's setting. Additionally, the steps needed to carry out the research-tested program, relevant program materials, and information for evaluating the program are included. The Implementation Guide can be viewed and downloaded in the Products page.
Community Preventive Services Task Force Finding
Required resources to implement the program include the following:
-A trained English-Korean bilingual Korean-American peer navigator
-A Woman's Guide to Breast Cancer Treatment (English and Korean versions)
-Cancer Facts for Women (Korean version):
-Breast Cancer: Your Guide to Breast Self-Awareness video
-Initial Assessment and Intervention Form (English and Korean version)
About the Study
There were a total of 116 eligible women who participated in the study. Thirty nine percent were aged 40-49, 41 percent were aged 50-59, and 21 percent were aged 60 or older. The study was conducted in Koreatown, Los Angeles at two clinics that provided free screenings to women aged 40 and older with no or insufficient health insurance and income less than 200 percent of the poverty level. Korean-American women were identified by case managers based on their Korean first or last name. Women who missed their follow-up diagnostic appointments were eligible to participate in the study. The study used a post-randomization consent design in which women were allocated to the intervention group or a control group prior to obtaining informed consent. Women in the usual care condition received up to two telephone calls by a case manager and a registered letter, urging them to make an appointment for a follow-up exam. Women in the intervention condition received the peer navigator intervention in addition to usual care. A bi-cultural Korean-American peer navigator who was bi-lingual in English and Korean was used in the study. Their role included reminding women before an appointment, explaining the need for and the nature of the exam, providing transportation or meeting women at the referral clinic or hospital, helping them to complete forms, and providing information and emotional support. The peer navigator had an average of 3.8 contacts per woman, and 91 percent of the women who consented to be in the intervention arm of the study received at least one service. Almost all services were provided via telephone or when the peer navigator met the patient at the hospital. The peer navigator made only one home visit for one woman and provided transportation to the hospital for two women.
Six months after the women were identified, they completed a 20-minute telephone survey conducted by study staff that assessed self-reported completion of the recommended follow-up exam. Women in both arms of the study were also asked for permission to conduct a chart review to confirm self-reported completion of follow-up exams. Forty women in the intervention group and 10 in the control group gave permission to verify completion of follow-up appointments.
- Among women who completed the survey at 6-month follow-up (73.4 percent), self-reported completion of follow-up procedures was 97 percent for the intervention group and 67 percent for the control group (p<.001). Based on an intent-to-treat analysis of all women who were randomized and an assumption that at least 5 percent of women in both arms of the study who did not complete the survey did complete diagnostic follow-up procedures, the difference in completion of follow-up procedures is statistically significant at p<.05.
Maxwell AE, Jo AM, Crespi CM, Sudan M, Bastani R. (2010). Peer navigation improves diagnostic follow-up after breast cancer screening among Korean American women: results of a randomized trial. Cancer Causes and Control, 21 (11), 1931-1940.