Gender differences in factors associated with body weight misperception.

OBJECTIVE: Gender analysis in health research is important to strengthen our health system. The current study aimed to explore factors related to body weight misperception in a national sample of the general Korean population. DESIGN: Cross-sectional study. SETTING: South Korea, general population. PARTICIPANTS: 12,900 adults enrolled from the Seventh Korea National Health and Nutrition Examination Survey (2016-2018). RESULTS: Disadvantageous socio-economic status was considered a predictor of participants' misperceptions of themselves as being of a healthy weight despite being overweight and as underweight despite being of a healthy weight, mainly in men. Favourable socio-economic status was considered a predictor of participants' misperceptions of themselves as being of a healthy weight despite being underweight and as overweight despite being of a healthy weight, mainly in women. Living in an urban area was an independent predictor of men's misperception of themselves as being of a healthy weight despite being overweight and women's misperception of themselves as being underweight despite being of a healthy weight. Physical inactivity was a predictor of most misperceptions in women. Psychological variables, such as stress and depression, were not significant predictors of misperception. CONCLUSIONS: The current study highlighted the gender differences in factors related to body weight misperception. These differences suggested that more sophisticated policies should be formulated to identify solutions to health problems related to body weight.

Factors Related to the Behavior of People Who Have Never Used the Internet for Voluntary Reasons: Cross-Sectional Survey Study.

BACKGROUND: If there are people who do not want to use the internet despite having the circumstances and conditions for using it, another policy consideration will be needed. OBJECTIVE: The purpose of this study was to explore the factors related to the behavior of people who do not voluntarily use the internet. METHODS: A cross-sectional survey was conducted in 2018. It used a proportional quota random sampling design to select a representative sample of Koreans. Accordingly, 6150 participants were included in the study. Multiple logistic regression methods were used to explore the predicting factors of the act of voluntarily not using the internet. RESULTS: Age, education level, bonding and bridging social capitals, and daily life satisfaction for health status were found to be factors related to the behavior of not voluntarily using the internet. However, gender, household income, occupation, family size, and community type were not related to voluntary nonuse of the internet. CONCLUSIONS: It was found that sociodemographic factors, such as age and education level, which are difficult to modify, along with psychosocial factors located deeper than the visible living conditions, such as social capital and life satisfaction, are involved in voluntary internet nonuse. These results also suggest that it is not desirable to proceed with policies related to information and communications technology on a separate track, but rather that they should be comprehensively approached with other social policies that design various social interventions in order to enhance equity within the society.

Gap between Perceived eHealth Literacy and Ability to Use Online Cancer-Related Information.

BACKGROUND: The effective evaluation of health information available online is an important skill. However, consumers' self-perceptions of their eHealth literacy levels do not reflect their actual capabilities. The goal of this experimental study of online search behavior is to identify differences between self-perceived eHealth literacy and actual ability to use the accuracy of cancer information available online. METHODS: Thirty-one adults participated in the study conducted on July 15 and 16, 2017. We first measured perceived eHealth literacy and then asked participants 5 questions concerning cancer. Bandicam (v3.3.0) and BrowsingHistoryView were used to record search behavior and uniform resource locators, respectively. A Mann-Whitney U test and Fisher's exact test were performed. RESULTS: The results showed that participants most frequently searched for cancer information on blogs and café websites. Regarding search behavior, those who perceived higher knowledge in available resources tended to solve the given problem with significantly smaller number of webpages to answer a weight management question. Participants who perceived higher knowledge in helpfulness of information tended to use significantly smaller number of webpages to answer questions on red ginseng's preventive effects on caner and weight management. However, there was no proof that the high eHealth literacy group had significantly higher rates of correct answers than the low eHealth literacy group. Further, regarding cancer screening, the rates of correct answers were low for groups who considered their ability higher to find helpful resources and perceived higher knowledge in helpfulness of information. CONCLUSION: There is a gap between perceived eHealth literacy and the actual ability to use online cancer-related information. To fundamentally improve eHealth literacy, it is important to evaluate the actual abilities concerning each eHealth literacy component and to provide customized education.

Patient-family communication mediates the relation between family hardiness and caregiver positivity: Exploring the moderating role of caregiver depression and anxiety.

Purpose: Despite the theoretical and empirical significance of positive aspects of caregiving in caregiver well-being, relatively little is known regarding family-related predictors of caregiver positivity. This study examines whether patient-family communication (p-f communication) mediates the relation between family hardiness and caregiver positivity and whether the mediating effects of p-f communication are moderated by the levels of caregiver depression and anxiety. Design/Sample: This study used secondary data obtained from a large-scale cross-sectional national survey conducted in South Korea. Participants were 544 spousal cancer patient-caregiver dyads recruited from the National Cancer Center and nine government-designated regional cancer centers in South Korea. Methods: To test the hypotheses, a simple mediation model and two moderated mediation tests were conducted using the PROCESS macro for SPSS. Findings: Higher family hardiness was related to higher p-f positive communication and higher caregiver positivity. The effects of family hardiness were partially mediated by p-f communication, controlling for caregiver sex, education, health status, depression and anxiety, time spent caregiving, and patient depression and anxiety, cancer stage, and time since diagnosis. The mediating effects of p-f communication were not significantly moderated by caregiver depression and anxiety. Conclusions/Implications: Health care professionals could consider p-f communication as a reasonable target of intervention to increase caregiver positivity, even for caregivers with heightened depression and anxiety.

Patients' and family caregivers' understanding of the cancer stage, treatment goal, and chance of cure: A study with patient-caregiver-physician triad.

OBJECTIVE: Accurate understanding of the extent of disease, treatment goal, and prognosis is a prerequisite for patients with cancer and their caregivers to make informed decision. We sought to evaluate patients' and family caregivers' understanding of the cancer stage, treatment goal, and chance of cure taking their own physician's evaluation as reference. METHODS: A national survey was performed with 750 patient-caregiver dyads (75.5% participation rate) recruited by 134 oncologists in 13 cancer centers (93% participation rate) in South Korea. Both patients and caregivers were asked to report their knowledge of patient's cancer stage, treatment goal, and chance of cure. Concordance was evaluated with percentage agreement and weighted κ, and predictors of discordance of patient and caregiver's response with that of physician's were explored by multivariate regression analyses with mixed effect model. RESULTS: The agreement rates between patient-physician and caregiver-physician were 63.0% and 65.9% for disease stage, 69.0% and 70.0% for treatment goal, and 41.4% and 45.1% for chance of cure. When discordance occurs, patients and caregivers often had an optimistic view. Distant stage, older age, female sex, and absence of depression were associated with optimistic view of patients, and there was significant between-physician variance for all 3 outcomes. CONCLUSION: The discordance revealed that our study suggests the need for better communication between physician and patients, as well as the caregivers. Research is needed to develop a comprehensive strategy to improve the understanding of the patients and family so that treatment decisions are made based on realistic estimation.

Type 1 diabetes mellitus and risk of cancer: a meta-analysis of observational studies.

OBJECTIVE: Previous observational studies have focused on the link between type 2 diabetes and the risk of cancer. However, the association between type 1 diabetes and the risk of cancer has not been well addressed. This study aimed to investigate the association between type 1 diabetes and the risk of cancer by using a meta-analysis of observational studies. METHODS: We searched PubMed and EMBASE for observational studies that examined the association between type 1 diabetes and cancer in April 2017. We calculated the pooled odds ratios (ORs) or relative risks (RRs) with confidence intervals (CIs) from individual studies based on a random-effects model meta-analysis. RESULTS: We included a total of 15 observational studies with two case-control studies and 13 cohort studies involving 31 893 cancer patients among a total of 1 915 179 participants in the final analysis. In the random-effects meta-analysis of all studies, patients with type 1 diabetes had an increased risk of cancer (OR or RR, 1.29; 95% CI, 1.09-1.52; n = 15; I2 = 95.2%). In the subgroup meta-analysis by type of cancer, type 1 diabetes significantly increased the risk of cancers of stomach, lung, pancreas, liver, ovary and kidney, whereas it significantly decreased the risk of breast cancer (OR or RR, 0.91; 95% CI, 0.86-0.95; n = 9; I2 = 0%). CONCLUSION: This meta-analysis suggests that type 1 diabetes is associated with the increased risk of several types of cancer and the decreased risk of breast cancer. However, the plausible mechanisms for the decreased risk of breast cancer remain unclear. Further prospective studies with proper adjustment for possible confounding factors are warranted.

Cancer cost communication: experiences and preferences of patients, caregivers, and oncologists-a nationwide triad study.

PURPOSE: We assessed cost communication between cancer patients, caregivers, and oncologists and identified factors associated with communication concordance. METHODS: A national, multicenter, cross-sectional survey of patient-caregiver-oncologist triads was performed, and 725 patient-caregiver pairs, recruited by 134 oncologists in 13 cancer centers, were studied. Discordance in preferences and experiences regarding cost communication between patients, caregivers, and oncologists were assessed. Hierarchical generalized linear models were used to identify predictors of concordance and to identity the possible association of concordance with patient satisfaction and degree of trust in the physician. RESULTS: Although the oncologists thought that patients would be affected by the cost of care, only half of them were aware of the subjective burden experienced by their patients, and the degree of concordance for this parameter was very low (weighted kappa coefficient = 0.06). Caregivers consistently showed similar preferences to those of the patients. After controlling for covariates, the education level of patients [adjusted odds ratio (aOR) for > 12 vs. < 9 years, 2.92; 95% confidence interval (CI), 1.87-4.56], actual out-of-pocket costs [aOR for ≥ 8 million vs. < 2 million Korean Won, 0.56; 95% CI, 0.34-0.89], and physician age (aOR for ≥ 55 vs. < 45 years, 1.83; 95% CI, 1.04-3.21) were significant. CONCLUSIONS: The results show underestimation by oncologists regarding the subjective financial burden on a patient, and poor patient-physician concordance in cost communication. Oncologists should be more cognizant of patient OOP costs that are not indexed by objective criteria, but instead involve individual patient perceptions.

Income Difference in Attitudes towards Cancer in General Population: Findings from a National Survey.

BACKGROUND: To better understand cancer-related health behaviors, it is critical to know how general populations with different socioeconomic and demographic backgrounds perceive cancer. The current paper explored differences in general attitudes and beliefs towards cancer among Koreans. METHODS: A cross-sectional national survey was conducted for 1,000 Korean participants who were not cancer patients and did not have immediate family members with cancer via proportional quota random sampling. General attitudes and beliefs about cancer were measured by face-to-face interview using the awareness and beliefs about cancer (ABC) measure. RESULTS: Most respondents (84.8%-88.5%) had optimistic attitudes towards cancer. However, 35.6% to 87.7% agreed with negative cancer beliefs across all age groups simultaneously. Socioeconomic disparity of positive cancer beliefs was not evident. Unexpectedly, the highest income group agreed more strongly with the negatively framed statements that cancer treatment is worse than the cancer itself (odds ratio [OR], 2.68; 95% confidence interval [CI], 1.31-5.53), that they would not want to know if they have cancer (OR, 1.61; 95% CI, 0.94-2.75), and that a cancer diagnosis is a death sentence (OR, 2.32; 95% CI, 1.34-4.01), than the lowest income group. CONCLUSION: The present results imply a complicated context of cancer beliefs in Korea, unlike those shown in the studies of western populations. While the contradictory attitudes toward cancer can be attributable to the dual nature of information processing, social environment might have played a role. The association between socioeconomic status and negative attitudes toward cancer may vary depending on the diversity of the contexts.

What cancer means to the patients and their primary caregivers in the family-accounted Korean context: A dyadic interpretation.

OBJECTIVE: When cancer hits a family, the entire family members start to adapt to the new status. This study aimed to investigate the main issue of the family with cancer patient and their way of solving it. METHODS: In-depth interviews were conducted as a qualitative research. Thirty-three participants described their experience either as cancer patients or as family caregivers. RESULTS: Guided by the grounded theory, we identified the main concern of the families being primary caregiver selection. The primary caregiver was determined by the conditions of the patient and the family, but the primary caregiver accepted his/her role believing no alternative was plausible in the family. The processes of the entire family have change since cancer showed their "adapting living," which was identified as the core variable. CONCLUSIONS: On the basis of the current study's limitations, suggestions were made for future studies in which cultural attributes are distinguished from the medical system attributes.

Attitudes Toward Family Involvement in Cancer Treatment Decision Making: The Perspectives of Patients, Family Caregivers, and Their Oncologists.

BACKGROUND: To investigate how cancer patients, family caregiver, and their treating oncologist view the risks and benefits of family involvement in cancer treatment decision making (TDM) or the degree to which these perceptions may differ. PATIENTS AND METHODS: A nationwide, multicenter survey was conducted with 134 oncologists and 725 of their patients and accompanying caregivers. Participant answered to modified Control Preferences Scale and investigator-developed questionnaire regarding family involvement in cancer TDM. RESULTS: Most participants (>90%) thought that family should be involved in cancer TDM. When asked if the oncologist should allow family involvement if the patient did not want them involved, most patients and caregivers (>85%) thought they should. However, under this circumstance, only 56.0% of oncologists supported family involvement. Patients were significantly more likely to skew their responses toward patient rather than family decisional control than were their caregivers (P < .003); oncologists were more likely to skew their responses toward patient rather than family decisional control than caregivers (P < .001). Most respondents thought that family involvement is helpful and neither hamper patient autonomy nor complicate cancer TDM process. Oncologists were largely positive, but less so in these ratings than either patients or caregivers (P < .002). CONCLUSIONS: Patients, family caregivers, and, to a lesser degree, oncologists expect and valued family involvement in cancer TDM. These findings support a reconsideration of traditional models focused on protection of patient autonomy to a more contextualized form of relational autonomy, whereby the patient and family caregivers can be seen as a unit for autonomous decision.

Perceived social support and its impact on depression and health-related quality of life: a comparison between cancer patients and general population.

OBJECTIVE: It is well known that cancer patients' perception of social support is associated with their depressive symptoms and health-related quality of life. However, there have been little studies that compared the variates of cancer patients with the general population. We sought to compare differences in the level of perceived social support and the impact of perceived social support on depressive symptoms and health-related quality of life between cancer survivors and the general population. METHODS: Data were collected from 1818 cancer patients treated at the National Cancer Center and regional cancer centers in South Korea. The control group of the general population was composed of 2000 individuals without cancer from community. RESULTS: Cancer patients reported significantly higher level of perceived social support than the general population, while they reported lower health-related quality of life and were more susceptible to depression. The positive associations of higher perceived social support with lower depressive symptoms, as well as with higher health-related quality of life, were stronger among cancer patients than among the general population. CONCLUSIONS: The interaction effect suggests that the impact of social support would be stronger among cancer patients than the general public. Thus, it would be beneficial to pay attention to providing social support to cancer patients, particularly to those who are more vulnerable. Furthermore, investigation of the most effective and efficient methods to deliver social support interventions would be worthwhile.

Suicidal ideation and suicidal attempts among adults with chronic diseases: A cross-sectional study.

INTRODUCTION: About 14% of the global burden of disease has been attributed to neuropsychiatric disorders. The aim of this study was to show the general picture of suicidal ideation and behavior among Korean, and to test the hypothesis that there is a positive association between diseases and suicidality. METHOD: A total of 19,599 individuals were asked if they had any chronic diseases, suicidal ideation and attempts. The data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V, 2010-2012) conducted by Korea Centers for Disease Control and Prevention (KCDC) were examined. RESULTS: Stroke and osteoarthritis were associated with a 1.81 and 1.27 times increase in the odds of suicidal ideation, respectively (95% CI=1.24-2.65; 95% CI=1.09-1.48). Angina pectoris and osteoarthritis were associated with a 3.88 and 2.09 times increase in the odds of suicide attempts (95% CI=1.78-8.43; 95% CI=1.24-3.55). Having pulmonary tuberculosis increased the odds of a suicide attempt 12-fold (OR=12.47, 95% CI=1.12-138.66). Having renal failure was associated with a 4.92 times increase in the odds of suicide attempts (95% CI=1.25-19.30). Having lung cancer or cervical cancer increased the odds of suicide attempts more than 10-fold (OR=11.53, 95% CI=1.03-128.80; OR=17.66, 95% CI=1.58-197.01). CONCLUSIONS: Various diseases were risk factors for suicidality. Physicians' communication skills for frank and clear discussions about suicidality should be developed through various training courses.

The effects on caregivers of cancer patients' needs and family hardiness.

OBJECTIVES: Family caregivers of cancer patients are anticipated to serve multiple roles but the factors that influence their reaction to caregiving have not gotten much attention. The current study aimed to investigate the effects of cancer patient's needs level and the family hardiness on the caregivers' reaction. METHODS: A national survey was conducted through regional branches of the National Cancer Center of South Korea, yielding 990 patient-caregiver dyads. Patients and caregivers provided self-report questionnaires. Patient's medical records complemented the self-report survey data. RESULTS: On all five domains of caregiver reaction, which were schedule, esteem, support, health, and finance, family hardiness was a significant predictor. Male, older, low-income caregivers reported more burden in caregiving with some. The interaction effect of patient's needs and family hardiness was found only on esteem. CONCLUSIONS: The implications based on the findings are discussed in terms of the psycho-oncological and psycho-social interventions for the cancer patients and their family caregivers.

Underweight and mortality.

OBJECTIVE: According to most prospective studies, being underweight (BMI<18·5 kg/m2) is associated with significantly higher mortality than being of normal weight, especially among smokers. We aimed to explore in a generally lean population whether being underweight is significantly associated with increased all-cause mortality. DESIGN: Prospective cohort study. SETTING: Korea Medical Insurance Corporation study with 14 years of follow-up. SUBJECTS: After excluding deaths within the first 5 years of follow-up (1993-1997) to minimize reverse causation and excluding participants without information about smoking and health status, 94 133 men and 48 496 women aged 35-59 years in 1990 were included. RESULTS: We documented 5411 (5·7 %) deaths in men and 762 (1·6 %) in women. Among never smokers, hazard ratios (HR) for underweight individuals were not significantly higher than those for normal-weight individuals (BMI=18·5-22·9 kg/m2): HR=0·87 (95 % CI 0·41, 1·84, P=0·72) for underweight men and HR=1·12 (95 % CI 0·76, 1·65, P=0·58) for underweight women. Among ex-smokers, HR=0·86 (95 % CI 0·38, 1·93, P=0·72) for underweight men and HR=3·77 (95 % CI 0·42, 32·29, P=0·24) for underweight women. Among current smokers, HR=1·60 (95 % CI 1·28, 2·01, P<0·001) for underweight men and HR=2·07 (95 % CI 0·43, 9·94, P=0·36) for underweight women. CONCLUSIONS: The present study does not support that being underweight per se is associated with increased all-cause mortality in Korean men and women.

News Portrayal of Cancer: Content Analysis of Threat and Efficacy by Cancer Type and Comparison with Incidence and Mortality in Korea.

How the news media cover cancer may have profound significance for cancer prevention and control; however, little is known about the actual content of cancer news coverage in Korea. This research thus aimed to examine news portrayal of specific cancer types with respect to threat and efficacy, and to investigate whether news portrayal corresponds to actual cancer statistics. A content analysis of 1,138 cancer news stories was conducted, using a representative sample from 23 news outlets (television, newspapers, and other news media) in Korea over a 5-year period from 2008 to 2012. Cancer incidence and mortality rates were obtained from the Korean Statistical Information Service. Results suggest that threat was most prominent in news stories on pancreatic cancer (with 87% of the articles containing threat information with specific details), followed by liver (80%) and lung cancers (70%), and least in stomach cancer (41%). Efficacy information with details was conveyed most often in articles on colorectal (54%), skin (54%), and liver (50%) cancers, and least in thyroid cancer (17%). In terms of discrepancies between news portrayal and actual statistics, the threat of pancreatic and liver cancers was overreported, whereas the threat of stomach and prostate cancers was underreported. Efficacy information regarding cervical and colorectal cancers was overrepresented in the news relative to cancer statistics; efficacy of lung and thyroid cancers was underreported. Findings provide important implications for medical professionals to understand news information about particular cancers as a basis for public (mis)perception, and to communicate effectively about cancer risk with the public and patients.

Caregiver burden, patients' self-perceived burden, and preference for palliative care among cancer patients and caregivers.

OBJECTIVE: Recently, caregiver burden (CB) has emerged as an important issue in the area of palliative medicine. However, patients' feelings related to being a burden to their families (i.e., self-perceived burden [SPB]) is also a significant issue. We evaluated the relation of CB and SPB as preference for palliative care. METHODS: A national, multicenter, cross-sectional survey of 326 patient-caregiver dyads was performed. A set of paired questionnaires evaluating CB and SPB (five domain items assessed on a four-point Likert scale) were independently administered to patients and their caregivers. Among the respondents, only the patients with distant stage cancer and their caregivers were included. Multivariate analyses were conducted to identify the associations between CB and SPB and preference for palliative care. RESULTS: Caregivers and patients who preferred palliative care to life sustaining treatment reported higher CB and SPB scores, respectively. Caregivers who felt more of a burden were more likely to prefer palliative care over life sustaining treatment for their patients (adjusted odds ratio [aOR] = 1.67, 95% CI: 1.21-2.31). In addition, patients who perceived their caregivers' burden as large tended to prefer palliative care (aOR = 1.61, 95% CI: 1.16-2.22). CONCLUSIONS: Both CB and SPB increased preference for palliative care. This could be interpreted that high CB can lead to preference for palliative care in both patients and their caregivers, potentially threatening patient autonomy. Efforts to relieve CB and SPB are needed.

Effects of Health Literacy and Social Capital on Health Information Behavior.

This study aimed to examine whether social capital (bonding and bridging social capital) attenuate the effect of low functional health literacy on health information resources, efficacy, and behaviors. In-person interviews were conducted with 1,000 residents in Seoul, Korea, in 2011. The authors found that respondents' functional health literacy had positive effects on the scope of health information sources and health information self-efficacy but not health information-seeking intention. Respondents' social capital had positive effects on the scope of health information sources, health information efficacy, and health information-seeking intention. The authors found (a) a significant moderation effect of bridging social capital on the relation between health literacy and health information self-efficacy and (b) a moderation effect of bonding social capital on the relation between health literacy and health information-seeking intention.

Psychosocial predictors of four health-promoting behaviors for cancer prevention using the stage of change of Transtheoretical Model.

OBJECTIVES: The present study aimed to examine whether demographic as well as psychosocial variables related to the five stages of change of the Transtheoretical Model can predict non-clinical adults' cancer preventive and health-promoting behaviors. This study specifically focused on cancer, one of the major chronic diseases, which is a serious threat of national health. METHODS: A total of 1530 adults participated in the study and completed questionnaires. Collected data were analyzed by using multinominal logistic regression. RESULTS: The significant predictors of later stages varied among the types of health-promoting behaviors. Certain cancer preventive health-promoting behaviors such as well-balanced diet and exercise were significantly associated with psychosocial variables including cancer prevention-related self-efficacy, personality traits, psychosocial stress, and social support. On the other hand, smoking cessation and moderate or abstinence from drinking were more likely to be predicted by demographic variables including sex and age. CONCLUSIONS: The present study found that in addition to self-efficacy-a relatively well-studied psychological variable-other personality traits and psychological factors including introversion, neuroticism, psychosocial stress, and social support also significantly predicted later stages of change with respect to cancer preventive health-promoting behaviors. The implications of this study are also discussed.

Attitude and knowledge of physicians about cancer pain management: young doctors of South Korea in their early career.

OBJECTIVE: This study is aimed at evaluating the attitude and knowledge about the optimal use of opioids and finding out the barriers to cancer pain management especially for young doctors in South Korea. METHODS: A survey through questionnaire form was conducted on 1204 physicians. Physicians were grouped by their medical specialties and personal characteristics. Specialties were grouped into internal medicine and family medicine doctors, surgeons, anesthesiologists, pediatricians, other board holders and general physicians. Personal characteristics were grouped by their past experiences and current surroundings. RESULTS: Though many doctors thought that they were fairly well educated for pain management strategy, a large population of physicians showed a negative attitude and inadequate knowledge status about cancer pain management. The degree of attitude and knowledge status was different as their specialties and personal experiences. The factors that affected doctors' attitude and knowledge were: (i) medical specialty, (ii) past history of using practical pain assessment tool, (iii) self-perception of knowledge status about pain management, (iv) experience of prescribing opioids, (v) experience of education for cancer pain management. Although many physicians had a passive attitude in prescribing opioid analgesics, they are willingly open to use opioids for cancer pain management in the future. The most important perceived barriers to optimal cancer pain management were the fear for risk of tolerance, drug addiction, side effects of opioid analgesics and knowledge deficit about opioid analgesics. CONCLUSIONS: From this study, we found that further education and practical training will be needed for adequate cancer pain management for young physicians in their early career.

Community-based intervention to promote breast cancer awareness and screening: the Korean experience.

BACKGROUND: There are many differences in culture, community identity, community participation, and ownership between communities in Western and Asian countries; thus, it is difficult to adopt the results of community intervention studies from Western countries. In this study, we conducted a multicity, multicomponent community intervention trial to correct breast cancer myths and promote screening mammography for women living in an urban community in Korea. METHODS: A 6-month, 2-city community intervention trial was conducted. In the intervention city, 480 women were surveyed at baseline and 7 months later to evaluate the effects of the intervention program. Strategies implemented in the intervention city included community outreach and clinic and pharmacy-based in-reach strategies. RESULTS: This study showed a 20.4-percentage-point decrease in myths about the link between cancer and breast size, a 19.2-percentage-point decrease in myths concerning mammography costs, and a 14.1-percentage-point increase in intention to undergo screening mammography. We also saw a 23.4-percentage-point increase in the proportion of women at the action stage of the transtheoretical model in the intervention city. In the comparison city, smaller decreases and increases were observed. CONCLUSIONS: Our study showed the value of an intervention study aimed at reducing belief in breast cancer myths in an urban community in Korea. The invention also made women more likely to undergo mammography in future.