153177 Effectiveness of Lay Health Workers to Increase Breast Cancer Screening Among Vietnamese American Women: A Randomized Controlled Trial

Monday, November 5, 2007

Gem Le, MHS , Department of Epidemiology, University of California, Berkeley, Berkeley, CA
Ky Quoc Lai, MD, MPH , Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Jose, CA
Khanh Quoc Le, MD, MPH , Research Department, Cancer Prevention Institute of California, Fremont, CA
Ginny Gildengorin, PhD , Department of Medicine, University of California, San Francisco, San Francisco, CA
Tung Nguyen, MD , Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
Thoa Nguyen , Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
Steve McPhee, MD , Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
Background: Breast cancer is the leading cancer among Vietnamese American women in California, yet rates of breast cancer screening tests (annual clinical breast examinations [CBE] and mammograms) in these women are low.

Methods: A coalition of researchers and community-based organizations (CBOs) designed and implemented a Lay Health Worker Outreach (LHWO) program for Vietnamese women in Santa Clara County, California. The program trained 50 LHWs about research, outreach strategies, and breast cancer. LHWs recruited 1100 women aged 40 and older, who were randomized into intervention and control groups. Intervention participants attended 2 discussion groups organized by LHWs, who used culturally tailored materials to teach about breast cancer, CBE, and mammograms. Researchers administered pre- and post-intervention telephone surveys separated by 6 months to participants.

Results: Analyses of the first 437 intervention and 440 control participants showed that the intervention increased mammography receipt within the last 2 years from 66.4% at pre- to 82.4% at post- for intervention participants (versus 74.3% to 75.7% for controls)(p=0.012 for change). Similarly, the increase in CBE receipt within the last 2 years was greater among intervention (47.9% to 72.8%) than control women (54.1% to 58.6%)(p<0.0001). Intervention participants were significantly more likely to know more about breast cancer and to plan to obtain future screening. The program had a multiplier effect as participants on average informed approximately 11 other women about breast cancer screening.

Conclusion: Based on cultural concordance and existing social networks, LHWO is effective in improving breast cancer screening rates among Vietnamese American women.

Learning Objectives:
1. Recognize breast cancer as the leading cancer among Vietnamese women. 2. Describe the design of a Lay Health Worker Outreach (LHWO) program. 3. Evaluate the impact of LHWO to promote breast cancer screening among Vietnamese American women.

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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