A comparative case study of resource structures (information and service) for Korean American women's breast cancer screenings in Atlanta and Chicago metropolitan areas

Abstract

The purpose of the three studies in this dissertation is to provide the foundation of the research study “A Comparative Case Study of Resource Structures for Korean American Women’s Breast Cancer Screenings in Atlanta and Chicago Metropolitan Areas” for further analysis on the current information and service systems for Korean American women’s breast cancer screenings and their screening status in Atlanta and Chicago metropolitan areas. In Study One, through reviewing previous research studies on Korean American women’s breast cancer screening, it was found that theoretical approaches were biased toward the Health Belief Model. This study attempts to bridge the gap between micro and macro perspectives by extending HBM with habitus, a concept of Pierre Bourdieu. In Study Two, exploratory statistical analysis was performed to examine the factors influencing Korean American women’s breast cancer screening practice, with a sample of 274 Korean American women, from 40 to 65 years of age. Data were collected through a self-administrated survey in Atlanta and Chicago metropolitan areas to confirm the revised framework of Study One. In addition to that, the functionality of two different types of response items about the status of breast cancer screening is examined using binary and Likert five-point scales. Compared with the findings of research studies before 2014, the rate of Korean American women with health insurance in both regions has increased but the rate of Korean American women having a mammogram in the past two years was still low, especially in Chicago. The response items using a Likert five-point scale had significant relations with more factors than binary response items. In Study Three, the scale of information and service resources, medical dependency on S. Korea, social barriers, and breast cancer screening behavior pattern was developed to explain the Korean American women’s breast cancer screening practice through the extended Health Belief Model within the social structures, and their reliability and construct validity were tested. After the deleting, summating, and redefining process, the sensitivity of the new variables was checked through logistic regression, resulting in significant results. Eventually, the findings will provide a critical foundation for future research studies.