1. Korean Outreach Workers Reducing Screening Barriers for Korean Women Maryland Breast & Cervical Cancer Program Courtney Lewis MPH, CHES Public Education Coordinator

2. Maryland Breast & Cervical Cancer Program (BCCP) National program screening for eligible, low income, un/under insured women for breast and cervical cancer Priority populations for screening described as women who are racial, ethnic and/or cultural minorities Program is operated through the 22 Local Health Departments and 2 hospitals in Maryland

3. Korean Population in Baltimore County and Howard County Baltimore and Howard Counties both have significant Korean populations From 1990 to 2000 Howard County’s Korean population increased from 2,369 to 6,188, or 161% From 1990 to 2000 Baltimore County’s Korean population increased from 4,893 to 5,249 or 7.2% Source: www.census.gov

4. Korean Language Map Source: Modern Language Association www.mla.org

5. Barriers to Screening for Korean Women Language Lack of familiarity of with preventative health services Fatalistic attitude Embarrassment and/or dislike of Pap test Misperceptions about cancer risk Procrastination Fear of having cancer or other disease Source: http://www.cdc.gov/cancer/nbccedp/publications/cc-strategies/korean.htm

6. Korean Outreach Workers Are trusted, natural helpers from within the community Provide emotional support, advice, and tangible aid to members in their network Provide language interpretation during screening appointments, case management and recall

7. Korean Outreach Strategies One-to-one recruitment PSAs in a local Korean newspapers Outreach to Korean grocery stores Word of mouth within the Korean community Korean faith-based organizations and community centers Program brochures translated in Korean

8. Howard County Korean Outreach Program Results Implemented in 1998 in Howard County 2.5 times increase in percentage of Asian/Korean clients in the first two fiscal years following implementation

9. Howard County Korean Outreach Program Results

10. Baltimore County Korean Outreach Program Results Implemented in 2000 in Baltimore County 3.2 times increase in percentage of Asian/Korean clients in the first two fiscal years following implementation

11. Baltimore County Korean Outreach Program Results *Korean Outreach Worker took leave of absence from program for 5 months in Fiscal Year 2006, resulting in lower Asian/Korean women enrolled in program

12. Implications The use of bi-lingual Korean outreach workers has demonstrated success in decreasing access barriers and enabled many high-risk Asian/Korean women to obtain breast and cervical cancer screening that they may not have received otherwise.

13. Sustainability Continued funding and employment of culturally relevant outreach workers is needed. This concept is illustrated in the significant decrease in percentage of Asian/Korean women served during the period without a Korean Outreach Worker in Baltimore County. Culturally relevant outreach produces meaningful health communication and progress eliminating related disparities by bridging the health care divide.