Analyzing factors associated with decisional stage of adopting breast cancer screening among Korean American women using precaution adoption process model

ABSTRACT

Background: Korean American (KA) women have experienced higher prevalence and lower survival rates of breast cancer (BC) than other ethnic groups in the United States. However, BC screening rates for KA women remain significantly lower than the national target (81.1%) specified by Healthy People 2020. Few studies have explained how the decision to adopt BC screening occurs and progresses and what factors contribute to this decision among KA women. This study used Weinstein’s Precaution Adoption Process Model (PAPM) as a theoretical framework to examine characteristics and factors associated with the decisional stage of mammography adoption.

Methods: A cross-sectional self-report survey was administered among KA women (N = 308) ages 50–80 from the Atlanta metropolitan area. A total of 281 KA women completed the survey, answering questions about socio-demographics, health-related information, mammography history, doctor recommendation, BC screening knowledge, self-efficacy for BC screening, decisional balance scores on attitudes and beliefs pertaining to mammography, and the seven-stage PAPM.

Results: KA women reported a low rate of mammography uptake with about 24% and 35% of the participants undergoing mammography within the last year and two years, respectively. KA women in stages 5 (decided yes), 6 (action), and 7 (maintenance) were likely to have increased screening-related knowledge, positive decisional balance, and regular medical check-up compared to those in stages 1 (unaware), 2 (unengaged), and 3 (deciding).

Conclusion: This study highlights important factors that could potentially facilitate BC screening among KA women in Georgia. The findings also provide implications for interventions and practice for increasing mammography screening among medically underserved populations.

KEYWORDS:

• Breast cancer screening
• mammography
• Korean American women
• precaution adoption process model
• decisional stage of mammography adoption

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The first author for the project was supported by the National Institute on Minority Health and Health Disparities (NIMHD) [Grant Number U54MD008173], a component of the National Institutes of Health (NIH) and its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIMHD or NIH.