Breast cancer screening among Vietnamese Americans: a randomized controlled trial of lay health worker outreach

Am J Prev Med. 2009 Oct;37(4):306-13. doi: 10.1016/j.amepre.2009.06.009.

Abstract

Background: Vietnamese-American women underutilize breast cancer screening.

Design: An RCT was conducted comparing the effect of lay health workers (LHWs) and media education (ME) to ME alone on breast cancer screening among these women.

Setting/participants: Conducted in California from 2004 to 2007, the study included 1100 Vietnamese-American women aged > or = 40 years who were recruited through LHW social networks. Data were analyzed from 2007 to 2009.

Intervention: Both groups received targeted ME. The intervention group received two LHW educational sessions and two telephone calls.

Main outcome measures: Change in self-reported receipt of mammography ever, mammography within 2 years, clinical breast examination (CBE) ever, or CBE within 2 years.

Results: The LHW+ME group increased receipt of mammography ever and mammography in the past 2 years (84.1% to 91.6% and 64.7% to 82.1%, p<0.001) while the ME group did not. Both ME (73.1% to 79.0%, p<0.001) and LHW+ME (68.1% to 85.5%, p<0.001) groups increased receipt of CBE ever, but the LHW+ME group had a significantly greater increase. The results were similar for CBE within 2 years. In multivariate analyses, LHW+ME was significantly more effective than ME for all four outcomes, with ORs of 3.62 (95% CI=1.35, 9.76) for mammography ever; 3.14 (95% CI=1.98, 5.01) for mammography within 2 years; 2.94 (95% CI=1.63, 5.30) for CBE ever; and 3.04 (95% CI=2.11, 4.37) for CBE within 2 years.

Conclusions: Lay health workers increased breast cancer screening among Vietnamese-American women.Future research should focus on how LHWs work and whether LHW outreach can be disseminated to other ethnic groups [corrected].

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Asian Americans / psychology
  • Asian Americans / statistics & numerical data*
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / ethnology*
  • Breast Neoplasms / prevention & control*
  • Communications Media*
  • Community Health Planning / methods
  • Community Health Planning / organization & administration
  • Community Health Workers / organization & administration*
  • Community Health Workers / psychology
  • Female
  • Health Education / methods*
  • Health Education / organization & administration
  • Health Knowledge, Attitudes, Practice
  • Health Promotion / organization & administration
  • Humans
  • Mammography / statistics & numerical data*
  • Mass Screening / statistics & numerical data
  • Middle Aged
  • Multivariate Analysis
  • Patient Acceptance of Health Care / ethnology
  • United States
  • Vietnam / ethnology