A pilot randomized controlled trial of an online intervention for Hodgkin lymphoma survivors to increase knowledge about late effects and recommended screening.

BACKGROUND: Hodgkin lymphoma (HL) survivors who received chest radiotherapy are at risk for breast cancer and cardiovascular disease, but screening adherence is low. We assessed the acceptability/feasibility of a web-based educational intervention and its impact on knowledge of health risks and screening. METHODS: HL survivors were randomized to either an interactive online educational intervention or handouts only. Surveys were completed at baseline and 3 months post-intervention. We described the acceptability/feasibility of the intervention and compared knowledge between groups. RESULTS: Fifty-two HL survivors participated; 27 in the intervention group and 25 in the control group. Eighteen (66%) intervention participants completed the intervention and reported high acceptability (89-100%). At baseline, adherence to breast cancer screening was low across all participants. Post-intervention, those in the intervention group more often than controls correctly identified breast cancer and echocardiogram screening guidelines (35% vs. 28%, P = 0.02 and 82% vs. 52%, P = 0.04) and reported knowing how to address potential complications from cancer treatments (87% vs. 64%, P = 0.03). We detected no increase in screening behavior post-intervention. CONCLUSION: Online education modules for high-risk HL survivors are an acceptable method to improve knowledge of health risks and screening guidelines. Future interventions should focus on improving screening uptake in this population. IMPLICATIONS FOR CANCER SURVIVORS: Web-based learning can be useful in increasing cancer survivor knowledge of their unique risks and screening recommendations but does not necessarily change patient behavior. Involvement in a cancer survivorship program can help assess individual barriers and monitor uptake of screening.

HPV and HPV Vaccine Awareness Among African Americans in the Black Belt Region of Alabama.

This study aims to examine the factors associated with the level of HPV infection and HPV vaccine awareness among rural African Americans living in the Black Belt region of Alabama. A cross-sectional survey on cancer screening and health behaviors was conducted in the Black Belt region of Alabama. Adults (18 years or older) recruited through convenience sampling completed the self-administered survey. Binary logistic regressions were conducted to identify factors associated with HPV infection and HPV vaccine awareness among African American participants. Slightly more than half of the participants were aware of HPV (62.5%) and HPV vaccine (62.1%). Married or partnered participants had lower awareness of HPV or HPV vaccine. Family cancer history and self-reported health status were positively associated with both HPV and HPV vaccine awareness. In addition, employment was positively associated with HPV awareness, and participation in social groups was positively associated with HPV vaccine awareness. Tailored educational interventions that consider our findings might increase HPV and HPV vaccine awareness and contribute to better vaccine uptakes.

Human Papillomavirus (HPV) and HPV Vaccine Awareness among Korean American Immigrants in Alabama: Would Internet Use Improve Health Awareness?

INTRODUCTION: Although the HPV vaccine is known to prevent associated cancers, studies found a low awareness among Korean Americans (KA). This study aimed to examine the HPV and HPV vaccine awareness among KA in Alabama. METHODS: A cross-sectional survey was conducted with a convenience sample of 278 KA residing in Alabama to understand the levels of HPV and HPV vaccine awareness and associated factors. RESULTS: Those who heard of HPV were 31.7% and 29.5% for HPV vaccine. Those who were older than 50 years old and married were less likely to hear of HPV and HPV vaccine. Those who were female and had annual health check-ups were more likely to hear of both. Using the Internet for health information was positively associated with HPV vaccine awareness. DISCUSSION: HPV education tailored to sociodemographic and using the Internet might be an effective strategy in improving the HPV and HPV vaccine awareness levels.

Mobile Web App Intervention to Promote Breast Cancer Screening Among American Indian Women in the Northern Plains: Feasibility and Efficacy Study.

BACKGROUND: Breast cancer is the most common cancer in the United States and the second leading cause of death for American Indian women. American Indian women have lower rates of breast cancer screening than other racial groups, and disparities in breast cancer mortality and survival rates persist among them. To address this critical need, a culturally appropriate, accessible, and personalized intervention is necessary to promote breast cancer screening among American Indian women. This study used mobile health principles to develop a mobile web app-based mammogram intervention (wMammogram) for American Indian women in a remote, rural community in the Northern Plains. OBJECTIVE: This study aimed to assess the feasibility and efficacy of the wMammogram intervention, which was designed to motivate American Indian women to undergo breast cancer screening, as compared with the control group, who received an educational brochure. METHODS: Using community-based participatory research (CBPR) principles and a multipronged recruitment strategy in a randomized controlled trial design, we developed the wMammogram intervention. This study involved 122 American Indian women aged between 40 and 70 years, who were randomly assigned to either the intervention group (n=62) or the control group (n=60). Those in the intervention group received personalized and culturally appropriate messages through a mobile web app, while those in the control group received an educational brochure. We measured outcomes such as mammogram receipt, intention to receive breast cancer screening after the intervention, and participants' satisfaction with and acceptance of the intervention. RESULTS: A significantly higher proportion of women who received the wMammogram intervention (26/62, 42%; P=.009) completed mammograms by the 6-month follow-up than the control group (12/60, 20%). The wMammogram intervention group, compared with the control group, reported significantly higher ratings on perceived effectiveness of the intervention (t120=-5.22; P<.001), increase in knowledge (t120=-4.75; P<.001), and satisfaction with the intervention (t120=-3.61; P<.001). Moreover, compared with the brochure group, the intervention group expressed greater intention to receive a mammogram in the future when it is due (62/62, 100% vs 51/60, 85%) and were more willing to recommend the intervention they received to their friends (61/62, 98.4% vs 54/60, 90%) with statistically significant differences. CONCLUSIONS: This study shows the feasibility and efficacy of the wMammogram intervention to promote breast cancer screening for American Indian women in a remote, rural community-based setting. Findings suggest that, with advancements in technology and the ubiquity of mobile devices, mobile web apps could serve as a valuable health intervention tool that builds upon low-cost technology and enhances accessibility and sustainability of preventive care to help reduce breast health disparities experienced in hard-to-reach American Indian populations. TRIAL REGISTRATION: ClinicalTrials.gov NCT05530603; https://clinicaltrials.gov/ct2/show/NCT05530603.

Evaluating Human Papillomavirus eHealth in Hmong Adolescents to Promote Vaccinations: Pilot Feasibility Study.

BACKGROUND: Human papillomavirus (HPV) is a common sexually transmitted infection, causing multiple cancers, including cervical, penile, and anal. Infection and subsequent health risks caused by HPV can be diminished by HPV vaccination. Unfortunately, vaccination rates among Hmong Americans are substantially lower than those among other racial and ethnic groups, despite having higher cervical cancer rates than non-Hispanic White women. Such disparities and sparse literature highlight the need for innovative and culturally appropriate educational interventions to improve HPV vaccine rates in Hmong Americans. OBJECTIVE: We aimed to develop and evaluate the effectiveness and usability of an innovative web-based eHealth educational website, the Hmong Promoting Vaccines website (HmongHPV website), for Hmong-American parents and adolescents to improve their knowledge, self-efficacy, and decision-making capacities to obtain HPV vaccinations. METHODS: Through social cognitive theory and community-based participatory action research process, we created a theory-driven and culturally and linguistically appropriate website for Hmong parents and adolescents. We conducted a pre-post intervention pilot study to assess the website's effectiveness and usability. Overall, 30 Hmong-American parent and adolescent dyads responded to questions about HPV and HPV vaccine knowledge, self-efficacy, and decision-making at preintervention, 1 week after intervention, and at the 5-week follow-up. Participants responded to survey questions about website content and processes at 1 and 5 weeks, and a subset of 20 dyad participants participated in telephone interviews 6 weeks later. We used paired t tests (2-tailed) to measure the change in knowledge, self-efficacy, and decision-making processes, and used template analysis to identify a priori themes for website usability. RESULTS: Participants' HPV and HPV vaccine knowledge improved significantly from pre- to postintervention stage and follow-up. Knowledge scores increased from preintervention to 1 week after intervention for both parents (HPV knowledge, P=.01; vaccine knowledge, P=.01) and children (HPV knowledge, P=.01; vaccine knowledge, P<.001), which were sustained at the 5-week follow-up. Parents' average self-efficacy score increased from 21.6 at baseline to 23.9 (P=.007) at post intervention and 23.5 (P=.054) at follow-up. Similar improvements were observed in the teenagers' self-efficacy scores (from 30.3 at baseline to 35.6, P=.009, at post intervention and 35.9, P=.006, at follow-up). Collaborative decision-making between parents and adolescents improved immediately after using the website (P=.002) and at follow-up (P=.02). The interview data also revealed that the website's content was informative and engaging; in particular, participants enjoyed the web-based quizzes and vaccine reminders. CONCLUSIONS: This theory-driven, community-based participatory action research-designed and culturally and linguistically appropriate educational website was well received. It improved Hmong parents' and adolescents' knowledge, self-efficacy, and decision-making processes regarding HPV vaccination. Future studies should examine the website's impact on HPV vaccine uptake and its potential for broader use across various settings (eg, clinics and schools).

Andersen's Behavioral Model to Identify Correlates of Cervical Cancer Knowledge among American Indian Women.

OBJECTIVE: Using the Andersen's behavioral model of health services use as a framework, this study aims to examine factors (predisposing, needs, and enabling) related to American Indian (AI) women's cervical cancer knowledge. METHODS: Andersen's behavioral model of health services was used to examine factors predisposing, needs, and enabling related to AI women's cervical cancer knowledge. A sample of 259 AI women residing in the Northern Plains was recruited using a convenience sampling strategy. Cervical cancer knowledge was measured using guidelines from the American Cancer Society. Three predisposing factors, six enabling factors, and four need factors were observed.  Result: The mean score of knowledge was 9.11 out of 13. Higher cancer knowledge was associated with 3 enabling factors (higher education, higher HPV knowledge, and use of TV/radio to gain health literacy) and one needs factor (experience in hospitalization). CONCLUSION: Our findings indicate that culturally sensitive educational interventions, especially those using media, to increase cervical cancer knowledge are needed among AI women.

Mammogram Uptake among Korean American Women in the South: Do Health Beliefs Matter?

BACKGROUND: Breast cancer is commonly diagnosed in Korean American women (KAW), and its incidence rates continue to increase. Despite the increasing burden of breast cancer diagnosis, screening rates among KAW remain low. There is a growing body of literature on breast cancer screening behaviors in this population; however, current knowledge regarding cultural influences and KAW's mammogram use is limited, particularly in the southern part of the United States. Using the Health Belief Model, this study examined the association of culturally embedded health beliefs and mammogram use among KAW. METHODS: Cross-sectional data were obtained from 538 KAW recruited in North Carolina. A hierarchical binary logistic regression was conducted to examine cultural health beliefs associated with mammogram use. FINDINGS: Preventive health orientation (OR=1.16, CI=1.02-1.32) and perceived susceptibility (OR=1.32, CI=1.10-1.58) were positively associated with having a mammogram in the past two years, while fear (OR=0.58, CI=0.36-0.94) was negatively related to getting screened in the past two years. CONCLUSIONS: The current study findings inform future intervention strategies to promote mammogram screening among KAW in sociocultural context.

Is HPV vaccine awareness associated with HPV knowledge level? Findings from HINTS data across racial/ethnic groups in the US.

BACKGROUND AND PURPOSE: Human papillomavirus (HPV) is recognized as a leading cause of multiple types of cancer. The current study examined HPV knowledge level and its associated factors, especially its relationship with HPV vaccine awareness, across race/ethnicity, including non-Hispanic White, non-Hispanic African American, and Hispanic. METHODS: Cross-sectional data were merged from Cycles 1 (2017) and Cycle 2 (2018) of the National Cancer Institute (NCI) Health Information National Trends Survey 5 (HINTS5, total N = 3648), which was collected in the United States. A multiple linear regression was performed across the three race/ethnicity groups to determine potential associated factors with level of HPV knowledge. FINDINGS: Overall HPV knowledge level among participants was low (Mean = 1.68; SD = 1.44; range 0-4). Among three racial/ethnic groups, non-Hispanic African American had the lowest level of HPV knowledge (Mean = 1.51). Less than 30% answered correctly to each of the three items assessing knowledge of HPV-associated (HPVa) cancers other than cervical (e.g. if HPV can cause penile, anal, and/or oral cancer). The HPV vaccine awareness was significantly associated with HPV knowledge across all three racial/ethnic groups. CONCLUSIONS AND IMPLICATIONS: The lowest level of HPV knowledge among non-Hispanic African American suggests that HPV education is urgently needed for this population. Specific interventions should emphasize information regarding HPVa cancers other than cervical cancer. Additionally, promoting awareness of the HPV vaccine will help to improve HPV knowledge among general population. Lastly, various factors associated with HPV knowledge across different racial/ethnic groups need to be addressed when implementing HPV education programs.

"We will do whatever it takes": Understanding Socioecological Level Influences on Hmong-American Adolescents and Parents' Perceptions of the Human Papillomavirus Vaccine.

Human papillomavirus (HPV) vaccination completion rates in Asian-American populations are substantially lower than most White Americans. Our objective was to identify the knowledge, perceptions, and decision-making processes about HPV vaccinations in the Hmong population, an Asian-American group with increased risks of HPV-related cancers. We conducted eight focus groups with Hmong adolescents (n = 12) and parents (n = 13) to learn about barriers, facilitators, and decision-making processes regarding general vaccinations and the HPV vaccine. The focus group results were analyzed using thematic analysis, informed by the socioecological model and asset lens. Findings showed that at the individual level, Hmong adolescents and parents had low HPV and HPV vaccine awareness levels (barrier) and strong desires to learn about HPV and the HPV vaccine (facilitator). Community-level barriers included salient narratives about traumatic experiences with vaccines and vaccine research, while facilitators included strong community connections. At the institutional level, barriers included structural constraints in health care settings, while facilitators included ease of obtaining vaccines at school-based clinics and provider authoritative decision-making. Additionally, a range of decision-making processes between parents, adolescents, and providers were present, with parents expressing a strong appeal to engage in more shared decision-making with providers. A linguistically and culturally specific HPV educational program for Hmong adolescents and parents could address the barriers and build on facilitators and assets to promote HPV vaccine uptake in this growing Asian-American community.

Social participation and depressive symptoms in older African American cancer survivors: a comparison with non-cancer subjects.

OBJECTIVES: African Americans are differentially affected by most cancers compared to other racial groups. Social participation has demonstrated beneficial effects on mental health in older adults with a history of cancer. The purpose of the present study is to examine and compare the effects of specific social participation activities on depressive symptoms among older African Americans with and without a history of cancer. METHOD: The study sample included 2,000 older African Americans selected from the National Health and Aging Trends Study. Waves from 2011 to 2018 were used. Mixed-effects logistic regressions were applied to examine the effects of four social participation activities on depressive symptoms among older African Americans with or without a history of cancer. RESULTS: Among older African American who had a history of cancer, visiting family and friends and attending religious services were related to lower odds of depressive symptoms. However, among older African Americans without a history of cancer, joining organized activities and going out for enjoyment predicted lower odds of depressive symptoms. CONCLUSION: Older African Americans with a history of cancer tend to benefit from visiting family and friends and attending religious services in coping with depressive symptoms. Mental health services for this group could focus interventions on promoting social participation activities with family, friends, and religious congregants.

Perceived Barriers and Facilitators in Accessing Cervical Cancer Screening: The Voices of Women in a Low-Income Urban Community.

Although advancements in cervical cancer prevention have helped reduce the incidence, mortality, and prevalence, access to these preventive services has not been experienced equally by all women in the United States. The purpose of this study was to learn about the factors that affect access to preventive services in a low-income, primarily Black community. Using a community-based participatory research approach, women were recruited to participate in 7 focus groups, with 6 to 8 women per group (N = 45). Participants were mainly Black (64%), with a mean age of 46 years, and 60% reporting completing at least some college. The discussions were transcribed, and text data were organized using Dedoose software. Guided by qualitative content analysis, the data were analyzed through an iterative process of coding and condensing the codes into themes. Ten types of barriers and 11 facilitators relating to cervical cancer screening access were identified and grouped into 7 themes. Participants provided suggestions for promoting cervical cancer screening in their community. On the basis of the findings of the data, the researchers conceptualized and mapped culturally and geographically appropriate interventions to promote cervical cancer screening within the community of interest.

Disparities in Cervical Cancer Screening with HPV Test among Females with Diabetes in the Deep South.

BACKGROUND: Due to diabetes being linked with poorer cervical cancer prognosis, this study aimed to evaluate HPV testing behaviors among females with and without diabetes across the U.S. by geographic area in 2016, 2018, and 2020. METHODS: This cross-sectional study used the Behavioral Risk Factor Surveillance System (BRFSS) from 2016, 2018, and 2020. The study population included females aged 25-69 years old, stratified by self-reported diabetes status. The primary outcome measure was cervical cancer screening behavior, which was evaluated by self-reported HPV test uptake/receipt (yes/no). RESULTS: A total of 361,546 females from across the U.S. were sampled. Within the study population combined from all study years, the overall likelihood of receiving an HPV test was significantly lower among females with diabetes [37.95% (95% CI: 36.87-39.04)] compared to those without diabetes [46.21% (95% CI: 45.84-46.58)] (p < 0.001). Screening rates with HPV tests were lowest among females with diabetes in the South in 2016 (29.32% (95% CI: 26.82-31.83)), 2018 (39.63% (95% CI: 36.30-42.96)), and 2020 (41.02% (95% CI: 37.60-44.45)). CONCLUSIONS: Females with diabetes are screening with HPV tests less frequently than females without diabetes, and females living in the South, particularly states in the Deep South, report the lowest rates of HPV testing.

Is Pap Test Awareness Critical to Pap Test Uptake in Women Living in Rural Vietnam?

INTRODUCTION: Cervical cancer is the second leading cause of cancer death among Vietnamese females. By detecting precancerous cells, Pap test screening plays a critical role in the fight against cervical cancer. The present study aims to investigate health-related factors associated with receipt of Pap test among Vietnamese females living in rural Vietnam, particularly examining the correlation between awareness level of the Pap test and the receiving of Pap test. METHODS: Anderson's Behavioral Model of Health Services Use was utilized as the present study's theoretical framework. A self-administrated questionnaire was completed among 193 females residing in Quantri City, Vietnam. RESULTS: Only 15.5% (N=30) of participants in our sample have had a Pap test. Pap test awareness (OR = 18.38, p <.001) was a strong predictor of Pap test receipt. Participants who had heard about Pap test were 18.38 times more likely to take a Pap test compared to those who had no prior knowledge. Besides the awareness, variables including employment (OR = .18, p <.05), and health insurance coverage (OR = 10.75, p <.05) were significantly associated with Pap test uptake. CONCLUSION: Findings from the present study suggests interventions should be provided through public health efforts to enhance awareness of Pap test by aiming at increasing primary prevention of cervical cancer, especially among Vietnamese women living in rural areas, in order to reduce cancer health disparities.

The Role of English Proficiency in HPV and HPV Vaccine Awareness: A Cross-Sectional Study Across Race/Ethnicity.

OBJECTIVE: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and associated with over 90% of cervical cancer cases.  The present study aimed to examine levels of HPV and HPV vaccine awareness and associated factors, particularly English proficiency, across various racial/ethnic groups. METHODS: Two cross-sectional datasets, 2017 and 2018 Health Information National Trends Survey (HINTs), were analyzed for the current study. Binary logistic regression analyses were conducted. FINDINGS: Non-Hispanic Whites had the highest levels while non-Hispanic Asians had the lowest levels of awareness regarding HPV and the HPV vaccine. English proficiency was significantly associated with increased HPV awareness among all groups except non-Hispanic Asian, and was significantly associated with greater HPV vaccine awareness in all groups. DISCUSSION: In order to promote health equity across race/ethnicity, language barriers among minorities should be addressed when implementing health education on HPV and the HPV vaccine.

Adherence to Cervical Cancer Screening in Korean American Immigrant Women: Identifying Malleable Variables for Intervention Development.

Introduction. Despite Korean American women having a high incidence rate of cervical cancer, many are unaware of the significance of Pap test. The purpose of this research was to examine the rates of Pap test receipt and factors associated with the uptake. Method. The study was guided by Andersen's Model of Health Service Use and used a cross-sectional research design. A sample of 230 women residing in metro-Atlanta, Georgia, participated in this study. Results. Slightly more than half (55.7%) had lifetime Pap tests while less than half (45.7%) had it within the last 3 years. Binary logistic regression indicated that marital status, monthly income, and annual checkups were significantly correlated with receiving Pap tests. Discussion. Special attention is needed for women who are unmarried and have low income to increase Pap test receipt. Suggested intervention programs include better communication strategies, extended Medicare coverage, and outreach programs within Korean American community.

Persistent racial disparities in cervical cancer screening with Pap test.

Given the racial disparities in cervical cancer screening, incidence, and mortality, the purpose of this study was to estimate cervical cancer screening behaviors through self-reported Pap testing among racial groups in the U.S. This cross-sectional study utilized the Behavioral Risk Factor Surveillance System (BRFSS) data to compare Pap testing behaviors among women of different racial groups. The BRFSS data from 2014, 2016, and 2018 were chosen because these were the most recent years of data capturing cervical cancer screening information. The primary outcome was self-reported Pap testing behavior (yes/no). Racial groups were analyzed with the original categorical responses for the race/ethnicity variable to investigate Pap testing behaviors across all racial groups. Statistical analyses included descriptive statistics and a multivariable binomial logistic regression model to assess differences of Pap testing by race after adjusting for covariates. Among the 538,218 females included, 88.81% (95% CI: 88.60-89.03) reported receiving a Pap test. Pap testing behaviors differed significantly between racial groups in 2014, 2016, and 2018 (p < 0.001 for all years). Compared to White women, Asians (OR: 0.169, 95% CI: 0.149-0.191), Native Hawaiians/other Pacific Islanders (OR: 0.339, 95% CI: 0.249-0.462), American Indians or Alaskan Natives (OR: 0.664, 95% CI: 0.532-0.829), Hispanics (OR: 0.726, 95% CI: 0.670-0.786), and other non-Hispanic races (OR: 0.439, 95% CI: 0.323-0.598) were significantly less likely to receive Pap test. Racial disparities in cervical cancer screening with Pap tests exist for Asians, Native Hawaiians/other Pacific Islanders, American Indians or Alaskan Natives, Hispanics, and other non-Hispanics.

Factors associated with receipt of mammogram among caregivers: a comparison with non-caregivers.

BACKGROUND: caregiving responsibilities significantly impact females' decisions on adhering to preventive mammography. The purpose of this study is to examine (1) the levels of mammogram receipt, (2) the role of caregiving factors on the receipt of mammogram in caregiving group, and (3) the role of cancer beliefs on mammogram screening in caregivers and non-caregivers. METHODS: the 2017 Health Information National Trends Survey (HINTS) provides samples of 1228 women aged 40 to 75 years old for this secondary analysis. By using Andersen's Behavioral Model of Health Services Use, a binomial logistic regression model was used to analyze associations between mammography and socioeconomic factors, caregiving factors, and cancer belief factors. RESULTS: caregivers who provided more caregiving hours per week (OR = 0.749, 95% CI = 0.564-0.94) and caregivers who had the belief of rather not knowing the likelihood of getting cancer (OR = 0.673, 95% CI = 0.496-0.914) were less likely to use mammogram. However, caregivers who believed cancer is more common than heart disease (OR = 1.490, 95% CI = 1.302-2.151) were more likely to use a mammogram. Non-caregivers who worried about getting cancer (OR = 1.158, 95% CI = 0.793-1.691) were more likely to use mammogram, but non-caregivers who had the belief of rather not know the likelihood of getting cancer (OR = 0.825, 95% CI = 0.713-0.955) were less likely to use mammogram. CONCLUSIONS: to support caregivers' breast cancer prevention, caregiving-related policies based on caregiving hours should be developed. Particularly, effort to promote breast cancer screening education and care support among older primary caregivers will likely increase their adherence to preventive mammography uptake. The development of targeted cancer prevention interventions on specific cancer beliefs held by both groups are also urgently needed to promote mammography.

Literacy of Breast Cancer and Screening Guideline in an Immigrant Group: Importance of Health Accessibility.

Little is known about predictors of breast cancer literacy among immigrant women. A cross-sectional survey investigated predisposing, enabling, and need factors of breast cancer literacy among 233 Korean American women living in a southeastern U.S. city. Breast cancer literacy was measured by questions that asked awareness of cancer screening methods and a 5-item questionnaire derived from the American Cancer Society's breast cancer screening guidelines and risk factors. Annual checkup was an enabling factor of awareness of Clinical Breast Exam (CBE) and mammogram, and also for breast cancer literacy covering the knowledge of breast cancer screening guidelines and risk factors. Health status was a need factor of CBE awareness. Marital status was a predisposing factor of mammogram awareness, and age and years of residence in the US were predisposing factors of breast cancer literacy. The findings of the study illuminate probable avenues of intervention to promote breast health knowledge for Korean American women.

Factors Associated with Reported Colorectal Cancer Screening Among Lao-American Immigrants in Minnesota.

Colorectal Cancer (CRC) is common in Lao Americans, but screening is suboptimal. To investigate CRC screening rates of Lao Americans in Minnesota, and how predisposing characteristics, enabling resources, and perceived need are associated with screening. We conducted a convenience-sample cross-sectional survey of 50-75-year-old Lao Americans, using step-wise multivariate logistic regression to identify factors associated with ever being screened. Of the 118 survey participants, 45% ever received CRC screening. In univariate regression, some enabling resources (having a primary care provider, higher self-efficacy in pursuing screening) and perceived needs (knowledge of who should be screened, higher number of chronic illnesses) were associated with screening. In multivariate logistic regression, the odds of ever being screened was 12.4 times higher for those with a primary care provider than for those without (p = 0.045). The findings reinforce a need for developing culturally tailored interventions focused on Lao-American immigrants to promote CRC screening.

Predictors of Cervical Cancer Screening Awareness and Literacy Among Korean-American Women.

BACKGROUND: Korean-American women experience a higher incidence of cervical cancer than non-Hispanic White women as well as other Asian-American women. A prominent cause of such a disproportional health risk among Korean-American women is a lack of awareness and knowledge of cervical cancer screening. Identifying factors related to cervical cancer screening awareness and literacy is critical for increasing cervical cancer screening among this population. METHODS: Researchers surveyed 230 Korean-American women in a metro area in a Southeastern state, USA. Based on Anderson's Behavioral Model of Health Services Use, predisposing, enabling, and need factors were explored to predict cervical cancer screening awareness and literacy. RESULTS: Monthly income, education, English proficiency, and annual checkups had significantly positive associations with cervical cancer screening awareness. Having an acquaintance giving support and receiving an annual checkup had significantly positive relationships with cervical cancer screening literacy. DISCUSSION: This study recommends culture specific guidelines to promote annual checkups through primary care physicians and the transfer of information about cervical cancer screening through acquaintances giving support.