The feasibility of educating Korean American women via Web: breast cancer screening

Purpose/Aims: This pilot study was designed to test the feasibility and efficacy of delivering an established couple-based, theory-based culture-specific intervention designed to improve mammography uptake among Korean American (KA) women, Korean Immigrants & Mammography—Culture-Specific Health Intervention (KIM-CHI), via the WEB for its efficacy (mammography attainment and intention to get one between baseline and two-months follow-up), feasibility, and acceptability.

Rationale/Conceptual Basis/Background: Regular mammogram screening has proven to be effective in reducing breast cancer deaths. However, KA women’s mammography screening rates are lower than other ethnic groups. Although the Web has proven to be an effective delivery medium of health related information and has economic and logistic advantages over printed materials, no studies have tested Web-based educational interventions to improve KA women’s breast cancer screening uptakes.

Methods: A pre- and post-test randomized two group experimental design was used. Recruiting study participants, delivering the intervention, and collecting data were conducted via Web.

Results: Initially, a total of 198 women responded to a banner announcement posted on 3 Korean language Websites, but 16 women withdrew. The remaining 182 women and their husbands were randomized into either intervention (n = 88) or delayed control (n = 94) groups. A total of 136 women (75% completion rate) completed the baseline study. At 2 months post-baseline, a total of 75 women (75/136 = 55%, attrition rate of 45%) completed the survey. Women were on average 48 years old, with nearly 16 years of education. Although not statistically significant, a higher percentage of women in the intervention group had mammograms at follow-up than women in the control group (19.4% vs. 15.9%). At 2 months’ follow-up, intention to have a mammogram within the subsequent 12 months increased significantly in the intervention group compared to the control group (p = .005). Women who had fewer barriers, perceived greater benefits, and higher self-efficacy were more likely to be screened at follow-up.

Implications: These findings suggest that Web-based delivery of the KIM-CHI program is feasible and could improve KA women’s breast cancer screening intention and behavior. Combining off-line contact such as face-to-face or telephone contact for recruitment or data collection with online intervention material could successfully decrease attrition rate.