Cultural and Linguistic Adaptation of an Evidence-Based Tailored Navigation Intervention to Increase Cancer Screening Uptake Among Southeast Asian Women - Article

Sep 23, 2026

Southeast Asian immigrant women in the U.S. experience high rates of breast and cervical cancer but are least likely to obtain screening. The study adapted the evidence-based Tailored Intervention Messaging System (TIMS) by culturally and linguistically matching community health advisors to address barriers. Using Stirman et al.’s adaptation framework, the team conducted focus groups and in-depth interviews to refine message content, context, and delivery for uptake improvement.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Background

Objectives

Methods

Results

Conclusion

Plain Language Summary

Keywords

Received, revised, accepted

Introduction

Cultural and Linguistic Adaptation of an Evidence-Based Tailored Navigation Intervention to Increase Cancer Screening Uptake Among Southeast Asian Women Cancer Control Volume 32: 1–9 © The Author(s) 2025 Article reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/10732748251329867](DOI: 10.1177/10732748251329867) [journals.sagepub.com/home/ccx](journals.sagepub.com/home/ccx) Jennifer Kue, PhD, FAACE 1 􀀁, Judith A. Tate, PhD, RN, ATS-F, FAAN2, Brbara Piñeiro, PhD 1, Laura A. Szalacha3, Bounthanh Phommasathit, BSW, MS4, Somany Pich, MBA4, and Usha Menon, PhD, RN, FAAN, FSBM 1 Abstract Background: Southeast Asian immigrant women in the U.S. have high rates of breast and cervical cancer, yet they are the least likely of all racial/ethnic groups to get screened. To address this disparity, we adapted the evidence-based Tailored Intervention Messaging System© (TIMS©), which uses tailored messages and navigation by culturally and linguistically matched community health advisors to overcome barriers to cancer screening. Objectives: This study describes the cultural and linguistic adaptation of TIMS© to improve breast and cervical cancer screening among Southeast Asian immigrant women in the U.S. Methods: Guided by Stirman et al.’s adaptation framework, we conducted focus groups and in-depth interviews to identify key constructs related to cancer screening (knowledge, perceived barriers, perceived risk, beneﬁts, self-efﬁcacy). Using the TIMS© and the thematic content from qualitative data, we modiﬁed messages for content and context. Messages were divided into three categories: 1) existing messages identiﬁed in thematic analyses, 2) existing messages not identiﬁed in thematic analyses, and 3) new messages that emerged from thematic analyses. Results: Contextual and content modiﬁcations were made to the TIMS© message library. Messages were translated into Lao, Khmer, and Vietnamese. Through an iterative process, the investigator, community health advisors, and cultural community advisory board members reviewed and revised the messages for translation accuracy, relevance, and clarity. Conclusion: Using relatable language and context is critical to engaging women from Southeast Asian communities in improving breast and cervical cancer screening uptake. This adaptation approach can be applied to tailor interventions for otherlanguages, cultures, and underrepresented groups. Plain Language Summary Southeast Asian women in the United States face a critical health challenge. Despite having high rates of breast and cervical cancer, they are the least likely of all groups to get screened for these cancers. To address this problem, we adapted an evidencebased program called TIMS© that uses personalized messages and community health workers to help women get cancer screenings. To make TIMS© more effective for Southeast Asian women, we needed to ensure it was culturally appropriate and available in their languages. We conducted group discussions and one-on-one interviews to understand what women knew 1 University of South Florida College of Nursing, Tampa, FL, USA 2The Ohio State University College of Nursing, Columbus, OH, USA 3University of South Florida Morsani College of Medicine, Tampa, FL, USA 4Southeast Asian Women’s Health Project Cultural Community Advisory Board, Columbus, OH, USA Corresponding Author: Jennifer Kue, University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd., MDC 22, Tampa, FL 33612, USA. Email: [jkue3@usf.edu](jkue3@usf.edu) Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)) which permits non-commercial use, reproduction and distribution of the work without further permission provided the

FAQs

Why was TIMS adapted for Southeast Asian women?

Southeast Asian immigrant women in the U.S. have high breast and cervical cancer rates yet are least likely to get screened. The adaptation targeted cultural and language barriers to improve screening uptake.

How did the study adapt the Tailored Intervention Messaging System (TIMS)?

Guided by an established adaptation framework, researchers used focus groups and in-depth interviews to identify key constructs and then modified the TIMS message library for content and context.

Which languages were used for the adapted messages?

The messages were translated into Lao, Khmer, and Vietnamese, with iterative review by investigators, community health advisors, and cultural community advisory board members.

Sep 23, 2026

Uploaded by Genevieve