Financial Challenges and Coping Experiences of the Korean American Immigrant Households

BACKGROUND Disparities in cervical cancer incidence and mortality signify the need for intervention efforts targeting Korean American immigrant women. OBJECTIVE The purpose of this study was to demonstrate how a culturally targeted and tailored mobile text messaging intervention, mobile screening (mScreening), was developed to promote the uptake of Papanicolaou tests and human papillomavirus vaccine among young Korean American immigrant women. METHODS Guided by the Fogg behavior model, the mScreening intervention was developed through a series of focus groups. Braun and Clarke’s thematic analysis was used to identify core themes. RESULTS Overall, 4 themes were identified: (1) tailored message content (ie, basic knowledge about cervical cancer), (2) an interactive and visual message format (ie, age-appropriate and friendly messages using emoticons), (3) brief message delivery formats to promote participant engagement, and (4) use of an incentive to motivate participation (ie, gift cards). CONCLUSIONS This study demonstrated the processes of gathering culturally relevant information to develop a mobile phone text messaging intervention and incorporating the target population’s perspectives into the development of the intervention. The findings of the study could help guide future intervention development targeting different types of cancer screening in other underserved racial or ethnic groups.

Download Full-text

Development and Evaluation of Culturally and Linguistically Tailored Mobile App to Promote Breast Cancer Screening

Journal of Clinical Medicine ◽

10.3390/jcm7080181 ◽

2018 ◽

Vol 7 (8) ◽

pp. 181 ◽

Cited By ~ 7

Author(s):

Hee Lee ◽

Mi Lee ◽

Zan Gao ◽

Karim Sadak

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Immigrant Women ◽

Mobile App ◽

Korean American ◽

Screening Behavior ◽

American Immigrant ◽

The Impact ◽

Promote Breast Cancer

Background: While a significant breast cancer burden exists for Korean American immigrant women, their cancer screening behavior is strikingly poor, and few interventions have focused on this population. To promote breast cancer screening behavior in Korean American immigrant women, a mobile phone multimedia messaging intervention (mMammogram) was developed. Objective: The current study explores the impact of mMammogram on changes to study participants’ screening behavior and proposes suggestions for how the intervention can be improved for wide dissemination and implementation in the Korean American community. Material and Methods: Data were collected through qualitative research methods. Three focus groups were conducted with 14 Korean immigrant women who completed the mMammogram. Findings: Three themes emerged: (1) better understanding of breast cancer and screening through mMammogram (e.g., increased knowledge on breast cancer and screening methods, increased understanding of the importance of regular mammography, and reduced anxiety about mammography); (2) health navigators as a trigger to promote mammography (e.g., providing resources for free or low-cost mammograms and scheduling mammogram appointments); and (3) suggestions for mMammogram (e.g., technical issues and program period). Conclusions: Mobile app intervention that is culturally tailored, along with health navigation services, can be a feasible, effective, and acceptable tool to promote breast cancer screening behaviors in underserved immigrant women. A mobile app can cover a broad range of breast cancer health topics and the health navigator can further help women overcome barriers to screening. A health navigation service is critical in overcoming language, transportation, and health accessibility barriers and triggering a positive change in their health screening behavior, especially for newly arrived immigrant populations.

Download Full-text

The Association Between Fatalism and Mammography Use in Korean American Immigrant Women

Health Education & Behavior ◽

10.1177/10901981211029253 ◽

2021 ◽

pp. 109019812110292

Author(s):

Mi Hwa Lee ◽

Saahoon Hong ◽

Joseph R. Merighi

Keyword(s):

Latent Class Analysis ◽

Latent Class ◽

Immigrant Women ◽

Cultural Beliefs ◽

Korean American ◽

Class Analysis ◽

Cancer Fatalism ◽

Convenience Sample ◽

American Immigrant ◽

Mammography Use

Fatalism is reported as a salient cultural belief that influences cancer screening disparities in racial and ethnic minority groups. Previous studies provide a range of measures and descriptions of cancer fatalism, but no studies to our knowledge have analyzed how fatalistic views cluster together within subgroups to form distinct profiles, and how these profiles can be predicted. This study identified subgroups of Korean American immigrants with similar fatalistic beliefs toward cancer and examined the influence of fatalism, health belief variables, and health literacy on mammography use. A cross-sectional survey design was used to obtain a convenience sample of 240 Korean American immigrant women in Los Angeles, California. Latent class analysis was used to identify unobserved subgroups of fatalism. Hierarchical logistic regression models were used to identify predisposing, enabling, and need factors associated with recent mammography use. The latent class analysis model identified three cancer fatalism subgroups: high fatalism (17.8%), moderate fatalism (36.7%), and low fatalism (45.5%). Women in the high fatalism subgroup were more likely to have had a mammogram within the past 2 years than women in the low fatalism subgroup. Regression analysis revealed three facilitators of recent mammogram use: level of fatalism, perceived barriers to mammogram, and family history of cancer. Although cultural beliefs can have a powerful influence on health-seeking behavior, it is important to weigh individual and contextual factors that may weaken or mediate the relationship between fatalism and engaging in preventive care such as having a mammogram.

Download Full-text

Factors Associated with Mammogram Use in Korean American Immigrant Women

American Journal of Health Behavior ◽

10.5993/ajhb.43.6.6 ◽

2019 ◽

Vol 43 (6) ◽

pp. 1075-1085 ◽

Cited By ~ 2

Author(s):

Mi Hwa Lee ◽

Joseph R. Merighi ◽

Hee Yun Lee

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Los Angeles ◽

Breast Cancer Screening ◽

Immigrant Women ◽

Korean American ◽

Health Services Use ◽

Cross Sectional Survey ◽

Factors Associated ◽

American Immigrant

Objectives: In this study, we assessed breast cancer screening in Korean American immigrant women and identified factors associated with adherence to American Cancer Society mammography screening guidelines. Methods: We carried out a cross-sectional survey with 182 Korean American immigrant women in Los Angeles County, California. Andersen's Behavioral Model of Health Services Use guided this study's design and analysis. We used hierarchical logistic regression to identify predisposing, enabling, and need factors associated with mammography adherence. Results: Nearly all respondents (95.1%) had a mammogram at some point in their lifetime. Mammography adherence based on age was 22.2% (45-49 years), 29.0% (50-54 years), and 67.7% (55 years and older). The strongest correlates of mammogram adherence were having a regular primary care check-up and hearing about a mammogram experience from family members, friends, or neighbors. Awareness of free or low-cost mammogram service, family cancer history, and having fatalistic beliefs also were associated with mammogram adherence. Conclusions: The findings highlight the primacy of health education messages that emphasize the importance of regular check-ups and personal screening experiences to promote mammography use in this population. Additional research is needed to understand Korean American immigrant women's perspectives on breast cancer and breast cancer screening in relation to fatalism.

Download Full-text

Acculturative Stress and Coping: Gender Differences Among Korean and Korean American University Students

Journal of College Student Development ◽

10.1353/csd.2014.0025 ◽

2014 ◽

Vol 55 (3) ◽

pp. 243-262 ◽

Cited By ~ 11

Author(s):

Diane Sookyoung Lee ◽

Amado M. Padilla

Keyword(s):

Gender Differences ◽

University Students ◽

Acculturative Stress ◽

Stress And Coping ◽

Korean American ◽

American University ◽

And Coping

Download Full-text

Barriers to Breast Cancer Screening and Coping Strategies in Korean American Women

Journal of Transcultural Nursing ◽

10.1177/1043659619881482 ◽

2019 ◽

Vol 32 (1) ◽

pp. 6-13

Author(s):

Mi Hwa Lee ◽

Abby J. Schwartz

Keyword(s):

Coping Strategies ◽

Home Country ◽

Korean American ◽

Sociocultural Context ◽

Culturally Appropriate ◽

Korean American Women ◽

American Women ◽

Individual Interviews ◽

Psychosocial Concerns ◽

And Coping

Introduction: To develop more culturally appropriate and effective intervention strategies, this qualitative study explored Korean American women’s barriers to mammography and their coping strategies within their sociocultural context. Methodology: Semistructured individual interviews were conducted with 30 Korean American women in 2016. Thematic analysis was used to analyze the data and identify themes. Results: Four themes and their associated subthemes emerged from the data: (1) barriers to accessing mammography (cost, time consuming and complicated procedure, and language barriers), (2) psychosocial concerns related to mammography (pain, discomfort and embarrassment, and exposure to radiation), (3) strategies to access mammography (identifying ways to get a cost-free mammogram and having procedure done in home country), and (4) ways to deal with psychosocial concerns (being positive and avoiding or postponing the procedures). Discussion: Health professionals should account for cultural differences including, but not limited to, patients’ concerns, access to care, and beliefs surrounding screening processes.

Download Full-text