Developing the Korean Immigrants & Mammography–Culture-Specific Health Intervention (KIMCHI)

The purpose of this paper is to describe the development of a culture-specific, theory-based intervention, called Korean Immigrants & Mammography–Culture-Specific Health Intervention (KIM-CHI). The intervention was designed to  improve adherence to mammography  among Korean American (KA) women. The development process which incorporated evidence from pilot studies and extant literature, consisted of three phases; concept development, intervention development, and feasibility testing: After developing major concepts of the intervention, it was pilot-tested for feasibility. Guided by a strong theoretical basis,the KIM-CHI program has a unique two-fold approach  on (1) changing beliefs about breast cancer and screening (susceptibility, seriousness, benefits, barriers, knowledge, self-efficacy, health temporal orientation, and internal and external control) and (2) enhancing spousal support (perceived support received from husband). To standardize delivery of culture-relevant health behavior change information related to breast cancer screening, the KIM-CHI program uses a Korean-language DVD with KA role models, KA breast cancer survivors, and a male physician as well as inclusion of spouses. When tested as a randomized controlled trial, the KIM-CHI was acceptable to KA women, feasible to implement and demonstrated efficacy in increasing mammogram use. The KIM-CHI group showed statistically significant increases in mammography uptake over an attention control group at both 6-months (35% vs. 20%, p = 0.0005) and 15-months post-baseline (55% vs. 41%, p = 0.004).