Breast Health Education

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parents hear their children ------ penetrate the cultural boundary

Successful interventions on promotion of breast health

Studies have indicated that the use of media in promotion of Breast Health Guidelines has increased awareness of cancer and promoted the importance of early detection among the general population (Rimer, 2000; Agha, 2003: Hornik, 2002).

Culturally appropriateness

If health promotion campaigns are to impact the intended population, they must be designed culturally and linguistically appropriate (Williams et al., 2001).

Barriers to breast health practice

Knowledge:

Finding from a study conducted among Chinese women in Hong Kong suggested that women who had knowledge of breast health and screen methods were more likely to practice breast health (Chan et. al, 2007).

A study involved 332 random sample of Chinese American women age ranged from 40 to 69 years of age, from the Chinatown area of Chicago, revealed a low level of knowledge of cancer screening tests and low screening tests use rates.

Cultural believe:

Kwok & Sullivan (2006) from their quality study of Chinese-Australian women indicated that cultural believes could impact women on cancer screening behavior. Their finding revealed Chinese women associate cancer with fear, mystery, contagion, and stigma.

Propaganda aimed at children

In the Progressive-era, many of the health propaganda targeted at children because it was believed that children were more amenable to persuade and they would influence their parents more than an outsider could. For example, the Modern Health Crusade organized by the National Tuberculosis Association to deliver educational message on tuberculosis involved a nationwide organization of millions of school children (Pernick, 1978).

Adult Respond to Child Communication

Teyber, Messe and Stollak (1977) found in their study of adult responses to child communication that adults exhibited a strong tendency to respond to their children’s messages delivered in a loving tone.

Persuasive Effects of Emotive Message

Rosselli, Skelly & Mackie (1995) suggested that emotional appeals could generate attitude change through both cognitive and affective mediation of persuasion.

Similar Studies Involving Young Children

Although, no study has been done involving young children to influence adults’ attitude and health practices related to cancer, previous studies have shown that children’s knowledge about nutrition can affect their parents’ dietary behavior, which was published in Polish (Kozlowska-Wojciechowska, et. al, 2002). Another study in India demonstrated that children’s knowledge about leprosy influenced their parents’ attitude toward leprosy (Bhore et. al, 1992;Jacob et. al 1994). In 1994, a pediatrician, Peter Ng, MD who worked in the San Francisco Chinatown community, engaged Chinese children of smoking parents to encourage the parents to quit smoking by simply including the children’s signature (or palm print of infants) on a prescription he wrote to the smoking parents urging them to quit. Dr. Ng observed approximately 50 parents who stopped smoking as a result of this intervention.

Numerous of studies involving older children to improve knowledge and practice of the parents related to health (Crockett, Mullis & Perry, 1988; Ballantyne, Fien & Packer, 2001& Shi-Chang et al 2004). Vaughan et al (1999) involved third and fourth graders learning conservation principles in school environment and transferring to their parents. The results of the study detected a high level of information transfer from children to their parents concerning conservation of environment.

Prior studies involving children and Dr. Ng’s work provide supporting evidence that preschool children may influence adults’ attitude and health practices.

Background on cancer

Traditionally, cancer has been a taboo topic that Chinese avoid. To date, some Chinese Americans still hold myths about cancer. In a 1999 cancer attitude survey conducted by Sun et. al, 25.7% of the 772 Chinese respondents in San Francisco believed that cancer was contagious. In a recent study conducted by Chinese Community Health Resource Center on Quality of Life in Chinese Patients with Breast Cancer, one of the Chinese breast cancer patients described the discrimination she faced because of her diagnosis that she was forced to move out when her landlady found out that she was being treated for cancer. Less extreme example of misinformation about cancer was an elderly woman asking whether one could contract cancer by having a meal with someone with cancer. The apprehension associated with cancer is one of the reasons some Chinese shun and/or delay cancer screenings (Wong-Kim, 2005).

Cancer is the leading cause of death for female Asian Americans, and breast cancer is the most common cancer among Chinese American women in California. The Asian American and Pacific Islander (AAPI) are the only group with a statistically significant increase in the incidence rate of invasive breast cancer by approximately 20% between 1988 and 1998 in California (2002 California Cancer Facts & Figures, Kwong, et. al, 2001). The rise in invasive breast cancer rate is possible due the unfamiliarity with the Breast Health Guidelines among AAPI women (Sadler et. al., 2001 ). A breast health media campaign conducted by Sun et. al in 2000 found that more than 50% of the 710 Chinese participants in San Francisco were not able to identify all of the Breast Health Guidelines (Sun et. al., 2007). The Women’s Health Survey conducted in 2001 revealed that less only 49% of AAPI women 40 years and older had an annual mammogram, the lowest breast cancer-screening rate of all ethnic/racial groups in the United States (2001 Women’s Health Survey).

Chapter 3

Rational for involving children in the study

Prior studies involving children and Dr. Ng’s work provide supporting evidence for the proposed project to incorporate breast health messages in the performance at preschool graduation ceremonies as a means to reach out to adults in Chinese American families. The rationales for the project are as

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