Kagawa‐Singer 2009.

Methods	Study design: prospectively controlled cohort study Sampling frame: Eligible housing units were identified in neighborhood blocks or housing complexes with highest concentrations of Hmong women age 30 years and older. Every third apartment unit or house was approached Sampling method: cohort of Hmong women age 40 and older recruited by community health workers via door‐to‐door recruitment (n = 434) Collection method: in‐person survey Description of the community coalition: collaborative partnership between 4 community‐based organizations (in 4 cities) and 2 universities (California State University, Fullerton, and the University of California, Los Angeles). Participatory approach; project management position shared between 2 university and 3 community partners
Participants	Communities: low‐income Hmong communities in urban areas of central and southern California Country: USA Ages included in assessment: women 40+ years old Reasons provided for selection of intervention community: Needs assessment found low rates of breast cancer screening knowledge among Hmong women in these cities Intervention community (population size): Fresno and San Diego, CA (not reported) Comparison community (population size): Long Beach, CA (not reported)
Interventions	Name of intervention: Life Is Precious Theory: grounded in Social Learning Theory, behavioral skills development through modeling, and Social Support Theory Aim: to increase rates of breast cancer screening among Hmong women using a culturally and linguistically appropriate educational intervention Description of costs and resources: not reported Components of the intervention: education sessions conducted by trained Hmong health educators in culturally acceptable locations. Educational materials were prepared in Hmong language Start date: October 2000 Duration: 12 months
Outcomes	Outcomes and measures: ever had breast self examination, clinical breast examination, or mammogram Time points: assessed at baseline and 1 year post intervention
Notes	Knowledge and attitudes were also assessed and were improved between baseline and follow‐up for both intervention and control communities Funding source: government
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	Quasi‐experimental cohort study conducted in 2 intervention cities and 1 control city, no randomization
Allocation concealment (selection bias)	High risk	Allocation not concealed
Baseline outcome measurement similar	High risk	Intervention and control groups differed in baseline rates of breast self examination, clinical breast examination, and mammogram utilization
Baseline characteristics similar	High risk	Significant differences in intervention and control groups for marital status, age, ability to read Hmong, ability to speak English, health insurance status
Blinding of outcome assessment (detection bias) All outcomes	High risk	No blinding
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Follow‐up of 78.6% not reported by treatment group
Blinding of participants and personnel (performance bias) All outcomes	High risk	Blinding of participants not reported
Protection against contamination	Low risk	Communities were located in geographically distinct areas. Control community received a similar (non‐culturally tailored educational) intervention; as such, likelihood of contamination is low
Selective reporting (reporting bias)	Low risk	Questionnaire described in detail