Understanding Impact of Cultural Perceptions on Breast Cancer Screening Behaviors Among Korean American Women

Purpose

Asian American women are reported to be less likely to use breast cancer screening services than other ethnic groups, and the rates are the lowest for Korean American women.  The Cultural Explanatory Models (Rajaram & Rashidi, 1998) suggests that this service underutilization might be due to the challenges they experience in relation to language, cultural values, socioeconomic disparity, and cultural insensitivity in health care system.  However, prior studies are limited in understanding the impact of these cultural aspects on the use of breast cancer prevention services among this population even though such understanding can yield important social work implications for the development and delivery of culturally tailored breast cancer prevention programs.  To fill in such gaps in the literature, this study explores factors that hinder or promote breast cancer screening behaviors among Korean American women, focusing on their cultural beliefs and access to health services.    

Methods 

Using a cross-sectional survey method, 111 Korean American women completed a self-administered questionnaire.  The participants’ mean age was 53.8 (SD=12.18) and the majority of them were married (70.3%).  Most of them had high school diploma or more advanced educational degrees (80.1%), and approximately one third had the household income below $25,000 (29.7%). 

The survey included items on the participants’ demography, receipt of breast cancer screening services including clinical breast examination (CBE) and mammogram, cultural perception on the use of breast cancer screening services (i.e. feelings of embarrassment), and access to health services (i.e., health insurance).  Data were analyzed using descriptive and logistic regression analyses.  In examining the factors for the receipt of mammogram, only the participants aged 40 or older were included in the analyses, following the American Cancer Society’s recommendation.   

Results

Slightly over 70% of the participants ever had CBE and more than a half of the participants aged 40 or older ever received mammogram.  It was noted that some participants obtained their screening services in Korea (11 for CBE and nine for mammogram), and the majority of them lacked health insurance (63.6% among CBE and 77.8% among mammogram recipients).  Insurance, interpretation services, and information on screening methods were listed as something that could help them to obtain screening services.  The logistic regression analysis revealed that the participants who do not feel embarrassed about receiving screening services are .24 times and .21 times more likely to have had CBE (p < .01) and mammogram (p < .01), respectively, when controlling for demographic variables.  While statistically insignificant, the participants with health insurance were 1.48 times and 1.18 times more likely to have had CBE (p=.48) and mammogram (p=.81), respectively.

Implications 

The current findings demonstrate that Korean American women’s cultural views toward breast cancer screenings affect their breast cancer screening behaviors.  This implies that social workers must pay more attention to the culture of this population in assisting them with breast cancer screening services.  Furthermore, the allocation of resources should be more actively pursued, considering the limited financial circumstances many of Korean American women experience.