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Culturally Competent Training Program: A Key to Training Lay Health Advisors for Promoting Breast Cancer Screening

Healthy Asian Americans Project, University of Michigan, School of Nursing, Ann Arbor

Lixin Song, MS, RN

Healthy Asian Americans Project, University of Michigan, School of Nursing, Ann Arbor

Amy Seetoo, MBA, MLS, MA

Healthy Asian Americans Project, University of Michigan, School of Nursing, Ann Arbor

Cuijuan Cai, PhD, MS

Healthy Asian Americans Project, University of Michigan, School of Nursing, Ann Arbor

Gary Smith, MA

Department of Chemistry, University of Michigan, Ann Arbor

Deborah Oakley, PhD

Healthy Asian Americans Project, University of Michigan, School of Nursing, Ann Arbor, doakley{at}umich.edu

The lay health advisor (LHA) training program for breast cancer screening was conducted among Chinese– English bilingual trainees residing in Southeast Michigan. Guided by Bandura's Social Learning Theory, the development of the training curriculum followed the health communication process recommended by the National Cancer Institute. Data analysis based on questionnaires completed by 79 LHAs indicated that the breast cancer screening training program significantly increased LHAs' knowledge and self-efficacy (p < .01, t test, two-tailed) and LHAs had a positive perception with regard to the training manual. Regression analysis found that LHAs who were younger, employed, and demonstrated a positive perception of the training manual tended to have higher self-efficacy in promoting breast cancer screening (R ² = .30). This study suggests that a culturally competent training program effectively increases LHAs' self-efficacy. The findings have implications for developing effective LHA training programs in Asian American communities where LHA interventions are rarely implemented.

Key Words: lay health advisor • training program • breast cancer screening • Chinese American • self-efficacy

References

• Agency for Health Care Reform. (2005). National healthcare disparities report. Washington, DC: Department of Health and Human Services .
• American Cancer Society. (2005). Cancer prevention & early detection facts & figures 2005. Atlanta, GA: Author .
• American Cancer Society. (2006). Cancer facts & figures 2006. Atlanta, GA: Author .
• Bandura, A. (1997). Self-efficacy: The exercise of control. New York: W. H. Freeman & Company .
• Bandura, A. (1999). Self-efficacy: Toward a unifying theory of behavioral change. In R. F. Baumeister (Ed.), The self in social psychology (pp. 285-298). Philadelphia: Psychology Press / Taylor & Francis .
• Bandura, A., & Adams, N.E. (1997). Analysis of self-efficacy theory of behavior change . Cognitive Therapy and Research, 4, 287-310 .
• Beijing Foreign Language University. (1997 ). A Chinese-English dictionary. Beijing: Beijing Language Teaching and Research Press .
• Davis, D.T., Bustamante, A., Brown, C.P., Wolde-Tsadik, G., Savage, E.W., Cheng, X.G., et al. (1994). The urban church and cancer control: A source of social influence in minority communities . Public Health Reports, 109, 501-506 .
• Earp, J.A., Eng, E., O'Malley, M.S., Altpeter, M., Rauscher, G., Mayne, L., et al. (2002). Increasing use of mammography among older, rural African American women: Results from a community trial . American Journal of Public Health, 92, 646-654 .[Abstract/Free Full Text]
• Earp, J.A., Viadro, C.I., Vincus, A.A., Altpeter, M., Flax, V., Mayne, L., et al. (1997). Lay health advisor: A strategy for getting the word out about breast cancer . Health Education & Behavior, 24, 432-451 .[Abstract/Free Full Text]
• Eng, E., & Smith, J. (1995). Natural helping functions of lay health advisors in breast cancer education . Breast Cancer Research and Treatment, 35, 23-29 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Eng, G., & Young, R. (1992). Lay health advisors as community change agents . Family & Community Health, 15, 24-40 .
• Flax, V.L., & Earp, J.L. (1999). Counseled women's perspective on their interactions with lay health advisors: A feasibility study . Health Education Research, 14, 15-24 .[Abstract/Free Full Text]
• Ham, O.K. (2006). Factors affecting mammography behavior and intention among Korean women . Oncology Nursing Forum, 33, 113-119 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Hirschman, C. (2005). Immigration and the American century . Demography, 42, 595-620 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Huang, Z.T., & Action, G.J. (2004). Effectiveness of home visit falls prevention strategy for Taiwanese community-dwelling elders: Randomized trial . Public Health Nursing, 21, 247-256 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Jackson, E.J., & Parks, C.P. (1997). Recruitment and training issues from selected lay health advisor programs among African Americans: A 20-year perspective . Health Education & Behavior, 24, 418-431 .[Abstract/Free Full Text]
• 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 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Liang, W., Yuan, E., Mandelblatt, J.S., & Pasick, R.J. (2004). How do older Chinese women view health and cancer screening? Results from focus groups and implications for interventions. Ethnicity & Health, 9, 283-304 .
• Minnesota Public Health Association Immigrant Health Task Force. (1996). Six steps toward cultural competence. Minneapolis: Minnesota Department of Health .
• National Cancer Institute. (2002). Making health communication programs work (NCI Publication No. 02-5145). Bethesda, MD: Author .
• National Center for Health Statistics. (2006 ). Health, United States, 2006 with chartbook on trends in the health of Americans (Publication No. 2006-1232). Washington, DC: Department of Health and Human Services .
• National Institutes of Health. (2002). Women of color health data book (Publication No. 02-4247). Bethesda, MD: Author .
• Navarro, A.M., Senn, K.L., McNicholas, L.J., Kaplan, R.M., Roppe, B., & Campo, M.C. (1998). Por La Vida model intervention enhances use of cancer screening tests among Latinas . American Journal of Preventive Medicine, 15, 21-41 .[Medline] [Order article via Infotrieve]
• NAWHO's Asian American Women's Breast and Cervical Cancer Program. (2001). What is cultural competency? Unit 1. San Francisco: NAWHO .
• The Robert Graham Center. (2000a, January). The importance of having a usual source of health care. Policy Studies in Family Practice and Primary Care. Retrieved October 2006 from http://www.graham-center.org/x149.xml
• The Robert Graham Center. (2000b, February). The importance of primary care physicians as the usual source of healthcare in the achievement of prevention goals. Policy Studies in Family Practice and Primary Care. Retrieved October 2006 from http://www.graham-center.org/x159.xml
• Schrefer, S. (Ed.). (1994). Bloch's ethnic/cultural assessment guide. In Quick reference to cultural assessment (pp. 40-56). St. Louis, MO: Mosby .
• Schwarzer, R. (Ed.). (1992). Self-efficacy: Thought control of action. Washington, DC: Hemisphere .
• Shanghai College of Traditional Medicine. ( 1981). Acupuncture: A comprehensive text. Seattle: Eastland Press .
• Smith, R.A., Cokkinides, V., & Eyre, H.J. (2006). American Cancer Society guidelines for the early detection of cancer . CA-A Cancer Journal for Clinicians, 56, 11-25 .
• Su, X.F., Ma, G.X., Seals, B., Tan, Y., & Hausman, A. (2006). Breast cancer early detection among Chinese women in the Philadelphia area . Journal of Women's Health, 15, 507-519 .[CrossRef][Web of Science]
• Sutton, M. (2000). Cultural competence: It's not just political correctness. It's good medicine. Retrieved November 2004 from http://www.aafp.org/fpm/20001000/58cult.html
• Texas Cancer Council & Texas A&M University. (2003). Cancer prevention materials for African Americans: Cultural sensitivity assessment tool manual, 1996. Retrieved February 2003 from www.texascancercouncil.org
• Tsay, S.L. (2003). Self-efficacy training for patients with end-stage renal disease . Journal of Advanced Nursing, 43, 370-375 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• U.S. Census Bureau. (2000). Table DP-1. Profile of general demographic characteristics: 2000. Washington, DC: Author .
• Yu, M.Y., Hong, O.S., & Seetoo, A.D. (2003). Uncovering factors contributing to under-utilization of breast cancer screening by Chinese and Korean women living in the United States . Ethnicity & Disease, 13, 213-219 .[Web of Science][Medline] [Order article via Infotrieve]
• Yu, M.Y., Seetoo, A.D., Hong, O.S., Song, L.X., Raizada, R., & Weller, A.D.L.A. (2002). Cancer screening promotion among medically underserved Asian American women: Integration of research and practice . Research and Theory for Nursing Practice, 16, 237-248 .[Medline] [Order article via Infotrieve]
• Yu, M.Y., Seetoo, A.D., Tsai, C.K., & Sun, C. (1998). Sociodemographic predictors of Papanicolaou smear test and mammography use among women of Chinese descent in Southeastern Michigan . Women's Health Issues, 8, 372-381 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Yu, M.Y., & Wu, T.Y. (2005). Factors influencing mammography screening of Chinese American women . Journal of Obstetric, Gynecologic, and Neonatal Nursing, 34, 385-394 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Yu, M.Y., Wu, T.Y., & Mood, D.W. (2005). Cultural affiliation and mammography screening of Chinese women in an urban county of Michigan. Journal of Transcultural Nursing, 16, 107-116 .

This version was published on December 1, 2007

Health Education & Behavior, Vol. 34, No. 6, 928-941 (2007)
DOI: 10.1177/1090198107304577


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Yu, M.-y. Articles by Oakley, D. Search for Related Content PubMed PubMed Citation Articles by Yu, M.-y. Articles by Oakley, D. Pubmed/NCBI databases Medline Plus Health Information Asian-American Health Breast Cancer Social Bookmarking                         What's this?