An Intervention to Increase Mammography Use by Korean American Women

Young H. Kim

Linda Sarna

ONF 2004, 31(1), 105-110. DOI: 10.1188/04.ONF.105-110

Purpose/Objectives: To test the effectiveness of a community-based intervention to increase mammography screening for Korean American women.

Design: Quasi-experimental, pre-/post-test, three-group design.

Setting: Urban Korean American communities in Southern California.

Sample: 141 Korean American women, aged 40-75, who had not had a mammogram in the previous 12 months.

Method: Two Korean churches were selected randomly to be study sites that would provide health screening programs. The study included an experimental group that would have access to a peer-group educational program and low-cost mammography, a group that would have access to low-cost mammography alone, and a control group. Participant-focused strategies were used to involve Korean American women from the community.

Main Research Variables: Mammography use, breast cancer screening attitudes, and knowledge.

Findings: Women in the experimental program had significantly improved attitudes and knowledge about breast cancer screening. Mammography use in the experimental group (87%) was not significantly different from that in the mammography-access-only group (72%). Both interventions proved to be more effective than no intervention at all (control group = 47%).

Conclusions: An educational program that includes participant-focused research strategies and access to low-cost mammograms resulted in higher levels of screening.

Implications for Nursing: Community-focused interventions can increase rates of cancer screening among Korean American women.

Jump to a section


    American Cancer Society. (2003). Breast cancer facts and figures, 2003-2004. Atlanta, GA: Author.

    Anderson, R., Moeschberger, M., Chen, M.S., Kunn, P., Wewers, M., & Guthrie, R. (1993). An acculturation scale for Southeast Asians. Society of Psychiatry and Psychiatric Epidemiology, 28, 134-141.

    Centers for Disease Control and Prevention. (1997). Behavioral risk factor survey of Korean-American-Alameda County, California 1994. Morbidity and Mortality Weekly Report, 46, 774-777.

    Champion, V. (1993). Instrument refinement for breast cancer screening behaviors. Nursing Research, 42, 139-143.

    Davis, B.D. (1996). Utilization of screening mammography, 1987-1994. In C.R. Morris & W.E. Wright (Eds.)Breast cancer in California. Sacramento, CA: California Department of Health Services, Cancer Surveillance Section. Retrieved December 15, 2003, from

    Green, L.W., & Kreuter, M.W. (1991). Healthy promotion planning: An educational and environmental approach (2nd ed.). Mountain View, CA: Mayfield Publishing.

    Han, Y., Williams, R.D., & Harrison, R. (2000). Breast cancer screening knowledge, attitudes, and practices among Korean American women. Oncology Nursing Forum, 27, 1585-1591.

    Isarel, B.A., Schulz, A.J., Parker, E.A., & Becker, A.B. (1998). Review of community-based research: Assessing partnership approaches to improve health. Annual Review of Public Health, 19, 173-202.

    Kagawa-Singer, M. (1997). Addressing issues for early detection and screening in ethnic populations. Oncology Nursing Forum, 24, 1705-1711.

    Kagawa-Singer, M., & Pourat, N. (2000). Asian American and Pacific Islander breast and cervical carcinoma screening rates and Healthy People 2000 objectives. Cancer, 89, 696-705.

    Kim, K., Yu, E., Chen, E., Kim, J., & Brintnall, R. (1998a). Breast cancer screening knowledge and practices among Korean American women. Asian American and Pacific Islander Journal of Health, 6, 263-275.

    Kim, K., Yu, E., Chen, E., Kim, J., & Brintnall, R. (1998b). Colorectal cancer screening. Cancer Practice, 6, 167-175.

    Levin, J.R., Hirsch, S.H., Bastani, R., Granz, P.A., Lovett, M.L., & Reuben, D.B. (1997). Acceptability of mobile mammography among community-dwelling older women. Journal of the American Geriatric Society, 45, 1365-1370.

    Maxwell, A.E., Bastani, R., & Warda, U. (1998). Women and Health, 27, 89-105.

    Miller, A., & Champion, V. (1993). Mammography in women > 50 years of age: Predisposing and enabling characteristics. Cancer Nursing, 16, 260-269.

    Miller, A., & Champion, V. (1996). Mammography in older women: One time and three-year adherence to guidelines. Nursing Research, 45, 239-245.

    Powe, B.D. (1995). Cancer fatalism among elderly Caucasians and African Americans. Oncology Nursing Forum, 22, 1355-1358.

    Sarna, L., Tae, Y.S., Kim, Y.H., Brecht, M.L., & Maxwell, A. (2001). Cancer screening among Korean Americans. Cancer Practice, 9, 134-140.

    U.S. Department of Commerce. (1997). Resident population of the United States by race and Hispanic origin, September 1997. Washington, DC: Bureau of the Census.

    U.S. Department of Health and Human Services. (2001). Healthy People 2000: National health promotion and disease prevention objectives (DHHS Publication No. 91-50212). Washington, DC: Public Health Service.

    Waltz, C.F., Strickland, O.L., & Lenz, E.R. (1991). Measurement in nursing research. Philadelphia: F.A. Davis.

    Wismer, B.A., Moskowitz, J.M. Chen, A.M., Kang, S.H., Novotny, T.E., Lew, R., et al. (1998). Mammography and clinical breast examination among Korean American women in two California counties. Preventive Medicine, 27, 144-151.

    Zapka, J.G., Bigelow, C., Hurley, T., Ford, L.D., Egelhofer, J., Cloud, W.M., et al. (1996). Mammography use among sociodemographically diverse women: The accuracy of self-report. American Journal of Public Health, 86, 1016-1021.

    Ziegler, R.G., Hoover, R.N., Pike, M.C., Hildesheim, A., Nomura, A.M., West, D.W., et al. (1993). Migration pattern and breast cancer risk in Asian American women. Journal of the National Cancer Institute, 85, 1819-1827.