Reducing Breast Cancer Risk in Korean American Women
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: Introduction: Korean American women have the greatest increase of breast cancer incidence among all Asian subgroups between 1990-2008. The reasons for this disproportionate increase are not well known. However, emerging research suggests second hand smoke (SHS) may be an important modifiable risk factor for breast cancer. According to the California Health Interview Survey (CHIS 2011- 2012), non-smoking Korean Americans reported the highest rate of SHS exposure compared to all other ethnic/racial groups. Non-smoking limited English proficient (LEP) Korean women had the highest percentage (29%) of SHS exposure from home compared to other groups. Currently only one intervention (with adolescents) has been developed to reduce breast cancer risk associated with SHS. Given the vulnerability of Korean American women to high SHS exposure and breast cancer incidence, our community-scientific partnership focuses on reducing one of the environmental root causes of breast cancer risk that is highly prevalent and modifiable in Korean community, SHS exposure. 
 
 
 
 Question(s) or hypotheses: The proposed pilot study addresses this research question: Can a family-based intervention approach reduce SHS exposure among LEP Korean women living with a current smoker? 
 
 
 
 General methodology: We will recruit 24 pairs of non-smoking LEP Korean American women and a male family member who smokes for this intervention. Women will be recruited from a Breast Health workshop that also provides information on environmental/lifestyle risk factors (including SHS) related to breast cancer. Women will be invited to recruit a household smoker to join them in a family-based program to support reduction of SHS and smoking. To be eligible, women must be 18 or over, self-identified as limited English proficient, and have SHS exposure at home in the past 7 days from a smoker living in the same household. 
 
 
 
 The intervention consists of lay health worker-led (LHW) interactive psychoeducational gatherings (two 90- minute gatherings) and follow-up support calls (two 10-15 minute phone calls). The primary outcome is to reduce SHS exposure. Secondary outcomes include the smoker’s compliance to smoke-free rules, their utilization of smoking cessation resources, their quit attempts and smoking abstinence. The intervention curriculum is adapted from a family-based intervention that has been successfully used with Korean and other Asian groups in violence prevention and tobacco cessation education. The intervention curriculum will be further adapted culturally and linguistically through input from in-depth participant interviews and a community Women’s Health Action Team (WHAT). All participants will participate in a survey and saliva sample collection at baseline and at 3-months follow-up. 
 
 
 
 This pilot intervention study is a community-scientific partnership between the Korean Community Center of the East Bay (KCCEB) and the University of California San Francisco (UCSF). The process will involve mutual exchange and growth in expertise as guided by a partnership agreement, and conducting participation evaluation in multiple dimensions such as leadership, participation, conflict recognition and resolution. 
 
 
 
 Innovative elements: There is only one prior intervention study aimed at reducing breast cancer risk through lowering SHS exposure. Our intervention is the first to examine the effectiveness of a family-based intervention to lower SHS exposure among Korean American women, a group with the highest SHS exposure rate that also has an increasingly high breast cancer rate. This intervention is unique in working both with the adult non-smoker and adult smoker in the home. Prior randomized control interventions have either only focused on the smoker or the non-smoker in the family, not both. Finally, this intervention is unique in developing a supportive social network to enhance knowledge, attitude and behavior change to support SHS reduction. Participants will meet in small social groups comprised of their family member and other women who are non-smokers seeking to change their family environment.
 
 
 
 Community involvement: KCCEB will establish an advisory group (WHAT) that will engage in collaborative qualitative research to guide and inform the intervention from outreach to curriculum development to dissemination of findings. WHAT members will include Korean breast cancer survivors, women who have experienced SHS exposure in the home and those who have experiences with and understand the LEP Korean community and their challenges.
 
 
 
 Future Plans: Findings will provide a foundation for a future large-scale study to test the effectiveness of this family-based intervention approach that centers the family’s needs first and empowers women to protect themselves and their family from SHS exposure, while also facilitating smoking reduction and cessation among smokers in hard-to-reach communities.