DHS' Cancer Detection Programs: Every Woman Counts Uses Innovative Ethnic Grocer Promotion to Reach Out to California's Korean American Community
By Eric Mandell and Michelle MussutoCalifornia Department of Health Services, Cancer Detection Section
Acknowledgments: Robert Berger and Yonah Hong, Healthier Solutions, Korean American Grocers Organization (KAGRO) Los Angeles.
With its great ethnic diversity, California faces special challenges in providing culturally appropriate cancer education and outreach to low income, uninsured, and underinsured women. California's Korean community, for example, is growing rapidly. From 1980–1990 its population increased 123 percent (357,393 to 799,000). Invasive breast cancer rates have also increased by about 20 percent from 1988–1999 among Asian/Pacific Islander (API) women in California. Although API women have the lowest incidence rate of breast cancer, it is the only ethnic group with a statistically significant increase in the incidence rate. A 2001 study of the breast cancer knowledge and attitudes of Korean American women in San Diego, aged 40 years and older, showed that only 22 percent of the women surveyed had had a mammogram in the past 12 months. Viable strategies that address language and cultural barriers need to be in place to reach Korean women with early breast cancer detection information.
California Department of Health Services, Cancer Detection Section's Cancer Detection Programs: Every Woman Counts provides free clinical breast exams and mammograms to low-income, under/un-insured women age 40 and older. The program operates a toll-free 800 number that qualifies women for the program and has ample capacity to accept calls in Korean. In an effort to encourage Korean women to call the number, a first of its kind, grocery store-based promotion was piloted in partnership with the Los Angeles Korean American Grocer Association (KAGRO) during the month of June 2003. Focusing on the major supermarkets within the Korean community, a total of 30 KAGRO member stores participated. Advertising in Korean newspapers urged women to visit the specific stores to receive Korean language breast cancer information. Additionally, women received a potholder imprinted with the 800 number from Cancer Detection Programs: Every Woman Counts and a free package of tofu donated by JayOne Foods, a major Korean foods supplier.
Korean language call volume hit an all time high for the month of June 2003. Call volume is the number of calls registered by the toll-free 800 number. The 800 number tracks language, the county where the woman resides, and source from which the woman received information about the number. In the five months preceding the promotion, Los Angeles County handled on average 230 callers per month, with an average of 15 being from Korean language speakers (6 percent). During the month of the promotion, which was held June 16–27, 2003, Korean language calls from Los Angeles County rose to 27 percent (122 of 453 calls from the Los Angeles area). Korean language call volume remained higher than average through the month of July. Anecdotal evidence from Cancer Detection Programs: Every Woman Counts providers in the Los Angeles area also shows a corresponding increase in the interest in breast cancer screening among Korean women. The KAGRO promotion added additional value as it educated Korean community leaders and Korean organizations on the issue of breast cancer within their community.
Based on the successes of the 2003 KAGRO campaign, the promotion was repeated on a larger scale in 2004. Joining as a first-time sponsor was Korean cosmetics giant, Amore, who provided certificates for merchandise to women who picked up screening information. A mobile billboard with a message encouraging breast cancer screening toured shopping malls and streets throughout Los Angeles' Koreatown. During the 2004 KAGRO promotion, Korean language calls to the 800 number set all time records.
Plans are now in place to expand the KAGRO concept to Chinese and other ethnic grocers within the next two years.
When the legislation establishing the CBCRP was enacted, a sister program was also born—the Cancer Detection Program: Every Woman Counts (CDP:EWC). The CDP:EWC is funded in part by half of the cigarette tax that funds the CBCRP and is run by the Cancer Detection Section in the California Department of Health Services. The mission of the CDP:EWC is to “save lives by preventing and reducing the devastating effects of cancer for all Californians through early detection, diagnosis, and treatment, with special emphasis on the underserved.” They offer breast cancer screening, diagnostic, and treatment services through a consortium of providers in all 58 counties in California. They also collaborate with the CBCRP to develop research agendas that increase outreach and delivery of care, particularly to underserved communities.
