Asian American and Pacific Islanders (AAH's) are the fastest growing U.S. minority group. The Chinese represent the single largest group of AAPI's. Despite the availability of early detection for breast, cervical, and colorectal cancers, Chinese women screened at significantly lower rates than Whites and other ethnic minorities. Cultural views (and acculturation) are likely to contribute to the under-utilization of screening in Chinese populations. The overall goals of this research project are to use the PRECEDE/PROCEED conceptual framework to (1) describe factors related to older Chinese women's screening behaviors; (2) refine culturally- and stage-tailored Chinese language educational materials designed to improve screening use this population; and (3) conduct a preliminary randomized trial to evaluate the feasibility, acceptability, and potential effectiveness of these culturally sensitive educational materials. A prospective longitudinal design will be used to recruit 250 Chinese American women ages 50 and older from community-based sites in the metro D.C. area for this two-phase project. In the first phase, participants will be interviewed at baseline and be followed-up for another telephone interview 18 months later. Cross-sectional analyses of baseline data will be used for refinement of educational materials tailored to stages of screening adoption. Baseline data will also be used to predict screening behaviors noted on the follow-up survey to confirm cross-sectional results and temporality of effects. In the second phase, participants will be randomized after completing the follow-up survey into two groups: receipt of standard vs. culturally- and stage- tailored Chinese language educational print materials. Women will be contacted by phone 1-2 weeks after mailing of materials to evaluate feasibility, acceptability, and effects of tailored materials on intentions to receive screening. This research program will broaden and deepen the Principle Investigator's knowledge and experiences in socio-cultural aspects of cancer control in an under-studied population, and set the stage for a larger randomized trial to assess long-term behavioral change. The training program will complement this research project by strengthening the P.I.'s background in cancer epidemiology and aging, behavioral and socio-cultural research, and health services research. With the full support of a nurturing research institution and intellectual interactions with cancer control researchers, this award will allow the P.I. to develop critical research skills to become an independent cancer control researcher.
