Term of Award

Summer 2020

Degree Name

Doctor of Public Health (Dr.P.H.)

Document Type and Release Option

Dissertation (restricted to Georgia Southern)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


College of Public Health

Committee Chair

Kelly Sullivan

Committee Member 1

Jingjing Yin

Committee Member 2

Logan Cowan


Asian American women disproportionally bear the breast cancer burden, and yet their cancer disparities have long been overlooked. To appeal to the public to recognize the existing cancer disparities in this fastest-growing minority group in the US, this study utilized three approaches through performing 1) a meta-analysis to examine the effectiveness of current educational interventions on mammography uptake, 2) a secondary data analysis to evaluate how a culturally tailored video in conjunction with a small group discussion improved the receipt of mammography in Chinese American older women, and 3) a mixed-methods study to understand how health care providers utilized the shared decision-making process to exert their impacts on helping Chinese American women make a collective decision for their breast cancer treatment. Overall, the findings of the meta-analysis revealed that the access-enhancing approach was the most effective teaching strategy (OR = 7.46, 95%CI [5.31, 10.38]) followed by interventions using an individually tailored approach (OR = 4.81, 95%CI [2.05, 11.13]). Although the efficacy of adding a discussion group to the culturally targeted video resulted in similar effects as using the culturally tailored video alone, participants’ knowledge on breast cancer prevention (|∆| = 1.76, SD = 2.01, p < .01), perceptions on self-care (|∆| = 0.63, SD = 3.15, p < .01), and perceived barriers (|∆| = 2.92, SD = 10.68, p < .01) were significantly improved at postintervention across the intervention (i.e. culturally tailored video + a group discussion) and control groups (i.e. culturally tailored video). The mixed-methods approach identified that health care providers did not fully adopt shared-decision making despite its proven positive impact on patients’ health outcomes. Specifically, health care providers seldom encouraged nor reminded Chinese American women to participate in the decision-making process. Reducing cancer disparities is of importance to minimize the economic and societal cancer burden in the US. Thus, public health professionals should be on the front line to ameliorate the impact of cancer disparities on this minority group by being aware of Asian Americans’ heterogeneity and debunking the stereotype of minimal cancer disparities in Asian Americans.

Research Data and Supplementary Material


Available for download on Monday, June 23, 2025