Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Kathy Shadle James, DNSc, FNP, FAAN, Chairperson; Lois Chandler Howland, DrPH, MSN, RN; Eunice Lee, PhD, GNP


Acculturation, American identity, bicultural, Breast Cancer, Korean Americans, Korean identity, Los Angeles county (California), Mammography, marginality, nursing, women


The purpose of this study was to examine the relationship between acculturation and mammography utilization among Korean American (KA) women. The specific aims of this study were to determine the differences in demographic characteristics, perceived health beliefs, self-efficacy, and knowledge of breast cancer, and mammogram history among the four cultural groups (American identity, Bicultural, Korean identity, and Marginality) of KA women, and to examine the effects of the level of acculturation on the likelihood of getting a mammogram. Breast cancer remains the most commonly diagnosed cancer among KA women. However, KA women consistently have lower screening rates for breast cancer. Although the overall rate of mammogram utilization by KA women in the United States is low, it is relatively higher when compared with that of women in Korea. This comparatively higher screening rate in KA women may be an indication of sociocultural influences from the host country. A descriptive correlational study using a cross sectional design was conducted. A convenience of sample of 215 KA women was recruited from local Korean churches in LA County. The participants completed several self-administered questionnaires and they were divided into four cultural groups according to their scores on the acculturation scale. The perceived barriers played as the most significant factor for receiving a mammogram. The American identity group scored the highest in the self-efficacy scale while the Marginality group scored the lowest. No relationship was identified between knowledge and mammography utilization. The American identity group had the highest rate (57.1%) of recent mammograms while the Marginality group had the lowest rate (26.1%). The Bicultural group had the highest rate (21.7%) of regular mammograms while the Korean identity and Marginality groups demonstrated lower rates. Logistic Regressions demonstrated that the Bicultural group would be significantly more likely to receive regular mammograms than the Korean identity group (OR = 0.340). Therefore, acculturation was an important predictor for mammography utilization among KA women in this study. Developing culturally appropriate interventions with specific emphasis on targeting different acculturation levels would be an important factor for increasing breast cancer screening practices of KA women. Keywords: acculturation, mammography, Korean American women.

Document Type

Dissertation: Open Access



Included in

Nursing Commons