korean outreach workers reducing screening barriers for korean women
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Korean Outreach Workers Reducing Screening Barriers for Korean WomenMaryland Breast & Cervical Cancer ProgramCourtney Lewis MPH, CHESPublic Education Coordinator
Maryland Breast & Cervical Cancer Program (BCCP)
• National program screening for eligible, low income, un/under insured women for breast and cervical cancer
• Priority populations for screening described as women who are racial, ethnic and/or cultural minorities
• Program is operated through the 22 Local Health Departments and 2 hospitals in Maryland
Korean Population in Baltimore County and Howard County
• Baltimore and Howard Counties both have significant Korean populations
• From 1990 to 2000 Howard County’s Korean population increased from 2,369 to 6,188, or 161%
• From 1990 to 2000 Baltimore County’s Korean population increased from 4,893 to 5,249 or 7.2%
• Source: www.census.gov
Korean Language MapSource: Modern Language Association www.mla.org
Barriers to Screening for Korean Women
• Language• Lack of familiarity of with preventative health
services• Fatalistic attitude• Embarrassment and/or dislike of Pap test• Misperceptions about cancer risk• Procrastination• Fear of having cancer or other disease• Source: http://www.cdc.gov/cancer/nbccedp/publications/cc-strategies/korean.htm
Korean Outreach Workers
• Are trusted, natural helpers from within the community
• Provide emotional support, advice, and tangible aid to members in their network
• Provide language interpretation during screening appointments, case management and recall
Korean Outreach Strategies
• One-to-one recruitment• PSAs in a local Korean newspapers• Outreach to Korean grocery stores • Word of mouth within the Korean
community• Korean faith-based organizations and
community centers• Program brochures translated in Korean
Howard County Korean Outreach Program Results
• Implemented in 1998 in Howard County • 2.5 times increase in percentage of
Asian/Korean clients in the first two fiscal years following implementation
Howard County Korean Outreach Program Results
12%
31%
35%
0%5%
10%15%20%25%30%35%
FiscalYear1997
FiscalYear2001
FiscalYear2006
Percentage of Asian/Korean Clients in Howard County Breast & Cervical Cancer Program
Asian/Korean Clients
Baltimore County Korean Outreach Program Results
• Implemented in 2000 in Baltimore County
• 3.2 times increase in percentage of Asian/Korean clients in the first two fiscal years following implementation
Baltimore County Korean Outreach Program Results
4%
13%
4%
0%
5%
10%
15%
FiscalYear2000
FiscalYear2002
*FiscalYear2006
Percentage of Asian/Korean Clients in Baltimore County Breast & Cervical Cancer Program
Asian/Korean Clients
*Korean Outreach Worker took leave of absence from program for 5 months in Fiscal Year 2006, resulting in lower Asian/Korean women enrolled in program
Implications
• The use of bi-lingual Korean outreach workers has demonstrated success in decreasing access barriers and enabled many high-risk Asian/Korean women to obtain breast and cervical cancer screening that they may not have received otherwise.
Sustainability
• Continued funding and employment of culturally relevant outreach workers is needed. This concept is illustrated in the significant decrease in percentage of Asian/Korean women served during the period without a Korean Outreach Worker in Baltimore County.
• Culturally relevant outreach produces meaningful health communication and progress eliminating related disparities by bridging the health care divide.
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