The Role of Cultural Health Beliefs on Health Behaviors among Chinese, Korean & Mexican American Breast Cancer Sur

1. The Role of Cultural Health Beliefs on Health Behaviors among Chinese, Korean & Mexican American Breast Cancer Survivors PI’s: Drs. Patricia Gonzalez, Jung-Wong Lim & Ming Wang Students: Ann Lee & Suirong Li Advisor: Dr. Kimlin Ashing-Giwa April 7, 2008

2. Introduction • Breast cancer is the most frequently diagnosed cancer in Asian American & Latina women. • Survival rates are increasing. • Differences in HRQOL outcomes are documented (Ashing-Giwa, 2004; 2007) • Differences in health behaviors and health beliefs may exist based on culture and ethnicity.

3. Overall Goal • Examine the relationships among health behaviors and cultural health beliefs among Chinese, Korean and Mexican BCS • Conduct secondary data analyses to examine doctor patient relationships

4. Methods – Phase I • Secondary data derived from Dr. Ashing-Giwa’s study examining QOL among a population-based, multi-ethnic and multi-lingual sample of BCS • Participants (N=237) Chinese (N=85), Korean (N=29), and Mexican (N=123) • Data Analyses: • Factor analysis: Health beliefs • ANOVAs: differences by ethnicity & language on acculturation & doctor-patient relationships • Chi-Squares: treatment-related decisions & life style changes by ethnicity

5. Demographic and Medical Characteristics

6. Results I: Reasons Causing Breast Cancer by Ethnicity ** P < 0.01; ***p<0.001

7. Reasons Causing Breast Cancer • Chinese & Mexican-Americans believed hereditary is the most reason causing breast cancer. • Korean-Americans believed stressful life to be the most important reason. • The reasons indicating significant differences in reasons causing breast cancer according to ethnicity: - first child after the age of 30 (p=0.006) - injury or trauma to the breast (p=0.000) - stressful life (p=0.000) • The perceived reasons causing breast cancer needs to be explored further with more reliable methods for statistical interpretation.

9. Results III: Health Behavior Changes by Ethnicity * P < 0.05

10. Changes in Health Behaviors by Ethnicity • All three ethnic groups were more likely to change their eating patterns after their breast cancer diagnosis and treatment. • Chinese- and Korean-Americans showed different patterns in health behavior changes ⇒ Chinese-Americans: exercise, and complementary /alternative medicine ⇒ Korean-Americans: stress management

11. Results IV: Acculturation & Patient-doctor Relationship by Ethnicity ** P < 0.01; ***p<0.001

12. Acculturation and Patient-doctor Relationship by Ethnicity • The lower acculturated level for Korean-Americans may be related to their short immigration history. • The score for patient-doctor relationship by Mexican-Americans needs further investigation for the possible contributory factors such as financial & language barriers.

13. Discussion • The perceived reasons causing breast cancer needs to be explored further with more reliable methods for statistical interpretation. • Significant differences in life style changes by ethnicity exist. ⇒ the importance of different health behavior intervention based on culture/ethnicity • Lower acculturation level and better patient-doctor relationship for Korean-Americans may be related to sample characteristics including immigration history, language, and SES. • Patient-doctor relationship for Mexican-Americans needs further investigation to explore the possible factors such as financial & language barriers.

14. Timeline & Tasks Target Schedule CompletedIn-process 17

15. What have we learned?

16. Questions?