Increasing Breast and Cervical Cancer Screening Among Filipino American Women

Highlights
Program Title Increasing Breast and Cervical Cancer Screening Among Filipino American Women
Purpose Designed to increase breast and cervical cancer screening among Filipino women. (2003)
Program Focus Awareness building
Population Focus Medically Underserved
Topic Breast Cancer Screening, Cervical Cancer Screening
Age Adults (40-65 years), Older Adults (65+ years)
Gender Female
Race/Ethnicity Asian
Setting Community, Home-based, Religious establishments
Origination United States
Funded by NCI (Grant number(s): CA74576)
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Details about Reach
Reach
60.0%
Details about Effectiveness
Effectiveness
66.7%
Details about Adoption
Adoption
16.7%
Details about Implementation
Implementation
42.9%
The Need

Asian-American women fall short of the HHS year 2010 goal of regularly screening 70% of age-eligible women for breast cancer and 90% of women for cervical cancer. Among Filipino women, specifically, rates are as low as 48% and only as high as 63% for breast and cervical cancer screening, respectively. Further, among Filipino women, breast cancer is the leading cause of cancer death (incidence rate of 73.1 per 100,000). Albeit cervical cancer is not a leading cause of death, it is one of the few cancers for which an effective screening test is available. Filipino women are one of the fastest growing segments of the population. Nonetheless, few studies have been specifically developed for Filipino women.

The Program
Description

The program aims to increase breast and cervical cancer screening among Filipino women by combining elements from the Health Belief Model, the Theory of Reasoned Action/Planned Behavior, and the Precede Model. Women are made aware of screening guidelines for breast and cervical cancer, that age and length of stay in the United States are risks factors for developing cancer, and that screening procedures are critical to early detection and successful treatment. Individual barriers, such as cost, fear of radiation and of finding cancer, and embarrassment are discussed and women who have undergone cancer screening provide peer support and peer norms. Drawing on the cultural values of collectivism, inter-dependence, and community -- common among many Asian groups -- the importance of staying healthy to enjoy life and take care of family members and friends is emphasized.

Implementation Guide

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
Guide to Community Preventive Services This program uses an intervention approach recommended by the Community Preventive Services Task Force: group education interventions (Breast Cancer Screening). This program also uses the following intervention approach for which the Community Preventive Services Task Force finds insufficient evidence: group education interventions (Cervical Cancer Screening). Insufficient evidence means the available studies do not provide sufficient evidence to determine if the intervention is or is not effective. This does not mean that the intervention does not work. It means that additional research is needed to determine whether the intervention is effective.

To expand understanding of this intervention category consider communicating with members from NCI's Research to Reality (R2R) community of practice who may be able to help you with your research efforts. Following is a link to start an online discussion with the R2R community of practice, after completing registration on the R2R site: https://researchtoreality.cancer.gov/discussions.

Time Required

The group sessions last between 60 and 90 minutes.

Intended Audience

Participants were Filipino women over 40 years of age from nine community based organizations and six churches in Los Angeles County.

Suitable Settings

This intervention is suitable for implementation in community-based organizations, churches, or private homes.

Required Resources

The curriculum for the intervention session is required, as are delivery agents who are fluent in both English and Tagalog. Take-home packets, in English and Tagalog, should include a list of local facilities where free mammograms and Pap smears are available. No cost information is available.

For the study, participants were given tote bags with the study's logo, personalized certificates of completion, and traditional Filipino snacks.

Two brochures were used in the intervention that can be acquired from the publishers:

  • "A Mammogram Saved My Life" from Education Programs Associates, Inc., 1 West Campbell Avenue, Suite 40, Campbell, CA 95008, (408) 374-3720.
  • "What You Need To Know About Your Pap Exam" from Krames Health and Safety Education, www.staywell.com.
About the Study

A total of 530 Filipino women over 40 years of age were randomly assigned to either the intervention group (a cancer screening module) or the control group (a physical activity module). Delivered by two physicians and three nurses, participants received a culturally tailored, cancer screening session that reviewed risks of developing cancer, advantages of early detection, and solutions to individual barriers, among other things. Practical advice on how to get ready for a mammogram and a Pap test and how to remember to get tested on a yearly basis was also provided. Numerous attempts were made to ensure cultural appropriateness: data collectors and delivery agents were born and raised in the Philippines and fluent in English and Tagalog; sessions were delivered in Taglish, a combination of English and Tagalog; and traditional snacks were also served. Information packets were provided in English and Tagalog and included a list of local facilities where free mammogram and Pap smears were available and the telephone number of the Cancer Information Service (CIS).

Results indicated:

  • No intervention effects were found in breast and cervical cancer screening rates between the intervention and the control group at 12 month follow-up.
  • However, the intervention was effective among relatively recent immigrants who had spent less than 10 years in the United States. In this subgroup, mammography screening rates increased more from baseline to follow-up in the intervention group compared to the control group (27% vs 6%, p<0.05).
Graph of Study Results
Related Programs
The Increasing Breast and Cervical Cancer Screening Among Filipino American Women program is related to the following:

Please click on the related program(s) to review.

Peer-Navigator Breast Cancer Screening Program for Korean-American Women in that:

  • They are by the same developer/investigator with the same theoretical basis, focus but have different materials that are designed for different target audiences.

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Updated: 07/05/2017
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Please note that RE-AIM stands for Reach, Effectiveness, Adoption, Implementation and Maintenance. However, since “Maintenance” occurs after a program has been implemented, a notes section for this is not included as a part of this tool.