Breast cancer screening among Vietnamese Americans: a randomized controlled trial of lay health worker outreach.
BACKGROUND
Vietnamese-American women underutilize breast cancer screening.


METHODS
An RCT was conducted comparing the effect of lay health workers (LHWs) and media education (ME) to ME alone on breast cancer screening among these women.


METHODS
Conducted in California from 2004 to 2007, the study included 1100 Vietnamese-American women aged > or = 40 years who were recruited through LHW social networks. Data were analyzed from 2007 to 2009.


METHODS
Both groups received targeted ME. The intervention group received two LHW educational sessions and two telephone calls.


METHODS
Change in self-reported receipt of mammography ever, mammography within 2 years, clinical breast examination (CBE) ever, or CBE within 2 years.


RESULTS
The LHW+ME group increased receipt of mammography ever and mammography in the past 2 years (84.1% to 91.6% and 64.7% to 82.1%, p<0.001) while the ME group did not. Both ME (73.1% to 79.0%, p<0.001) and LHW+ME (68.1% to 85.5%, p<0.001) groups increased receipt of CBE ever, but the LHW+ME group had a significantly greater increase. The results were similar for CBE within 2 years. In multivariate analyses, LHW+ME was significantly more effective than ME for all four outcomes, with ORs of 3.62 (95% CI=1.35, 9.76) for mammography ever; 3.14 (95% CI=1.98, 5.01) for mammography within 2 years; 2.94 (95% CI=1.63, 5.30) for CBE ever; and 3.04 (95% CI=2.11, 4.37) for CBE within 2 years.


CONCLUSIONS
Lay health workers increased breast cancer screening among Vietnamese-American women.Future research should focus on how LHWs work and whether LHW outreach can be disseminated to other ethnic groups [corrected].
Nguyen
Tung T
TT
Vietnamese Community Health Promotion Project, University of California, San Francisco, San Francisco, CA 94143, USA. Tung.Nguyen@ucsf.edu
Le
Gem
G
Nguyen
Thoa
T
Le
Khanh
K
Lai
Ky
K
Gildengorin
Ginny
G
Tsoh
Janice
J
Bui-Tong
Ngoc
N
McPhee
Stephen J
SJ
D000328:Adult; D000368:Aged; D001213:Asian / Q000523:psychology / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000517:prevention & control*; D003146:Communications Media; D018672:Community Health Planning / Q000379:methods / Q000458:organization & administration; D003150:Community Health Workers / Q000458:organization & administration* / Q000523:psychology; D005260:Female; D006266:Health Education / Q000379:methods* / Q000458:organization & administration; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D014481:United States; D014744:Vietnam / Q000208:ethnology