Objectives: Vietnamese American women are five times more likely to be diagnosed with cervical cancer than their White counterparts.
Previous research has demonstrated low levels of Papanicolaou ...(Pap) testing among Vietnamese. Our study objective was to examine
factors associated with interval Pap testing adherence. Methods: A population-based, in-person survey of Vietnamese women
aged 18–64 years was conducted. Questionnaire content was guided by the Health Behavior Framework (HBF). The study sample
was randomly selected from 1639 south Seattle households. Statistical methods included χ 2 tests and logistic regression. Results: The response rate among eligible households was 82%, and the study included 352 women.
Sixty-eight percent of the participants had been screened during the preceding 3 years. The following HBF factors were associated
( P < 0.05) with interval Pap testing in bivariate comparisons: believing Pap tests decrease the risk of cervical cancer and
believing cervical cancer is curable if detected early (perceived effectiveness); knowing testing is necessary for women who
are asymptomatic, sexually inactive, or postmenopausal (knowledge); reporting concern about pain/discomfort as a barrier to
screening (barriers); family member(s) and friend(s) had suggested testing (social support); doctor(s) had recommended testing;
and had asked doctor(s) for testing (communication with provider). In a multivariate analysis, being married, knowing Pap
testing is necessary for asymptomatic women, doctor(s) had recommended testing, and had asked doctor(s) for testing were independently
associated ( P < 0.05) with screening participation. Conclusion: Our results confirm low levels of Pap testing among Vietnamese women and
demonstrate the importance of physician-patient communication in increasing screening adherence. Health education efforts
should target unmarried women and reinforce the importance of Pap testing for all Vietnamese women.
Colorectal cancer (CRC) is a leading cause of cancer mortality in the US. Surveys reveal low CRC screening levels among Asians in the US, including Chinese Americans.
A randomized controlled trial ...was conducted with Chinese patients to evaluate a clinic-based, culturally and linguistically appropriate intervention promoting fecal occult blood test (FOBT) screening. The multifaceted intervention included a trilingual and bicultural health educator, bilingual materials (a video, a motivational pamphlet, an informational pamphlet, and FOBT instructions), and three FOBT cards. Patients in the control arm received usual care. Our primary outcome measure was FOBT screening within 6 months after randomization. The proportion of FOBT completion in the intervention and control arms was compared by using a chi-square test, and logistic regression analysis was performed to adjust for the effects of sociodemographic variables and prior screening history. Potential effect modifications were also tested by using logistic regression models.
Our intervention had a strong effect on FOBT completion (intervention group, 69.5%; control group, 27.6%), and the adjusted odds of FOBT slightly increased to over 6-fold greater in the intervention arm compared with the control arm. No effect modification by age, gender, language, insurance, or prior FOBT was found.
The authors' multifaceted, culturally appropriate intervention significantly increased FOBT screening in a group of low-income and less-acculturated minority patients. Given the large effect size, future research should determine the effective core component(s) that can increase CRC screening in both the general and minority populations.
We conducted a trial to evaluate the effectiveness of a cervical cancer control intervention for Vietnamese American women that used lay health workers.
The study group included 234 women who had not ...received a Papanicolaou (Pap) test in the last 3 years. Experimental group participants received a lay health worker home visit. Our trial endpoint was Pap test receipt within 6 months of randomization. Pap testing completion was ascertained through women's self-reports and medical record reviews. We examined intervention effects among women who had ever received a Pap test (prior to randomization) and women who had never received a Pap test.
Three quarters of the women in the experimental group completed a home visit. Ever-screened experimental group women were significantly more likely to report Pap testing (P < .02) and to have records verifying Pap testing (P < .04) than were ever-screened control group women. There were no significant differences between the trial arms for women who had never been screened.
Our findings indicate that lay health worker-based interventions for Vietnamese American women are feasible to implement and can increase levels of Pap testing use among ever-screened women but not among never-screened women.
The cervical cancer incidence rate among Cambodian American women is 15.0 per 100,000, compared to 7.7 per 100,000 among non-Latina white women. HPV infection has been identified as a universal risk ...factor for cervical cancer. The HPV vaccine was recently approved in the United States for females aged 9-26 years. There is little information about HPV vaccination knowledge and beliefs in Southeast Asian communities.
We conducted 13 key informant interviews with Cambodian community leaders, as well as four focus groups with Cambodian parents (37 participants). Two of the focus groups included fathers and two of the focus groups included mothers. Interview and focus group questions addressed HPV vaccine barriers and facilitators.
Participants had limited knowledge about HPV infection and the HPV vaccine. Barriers to HPV vaccination included a lack of information about the vaccine, as well as concerns about vaccine safety, effectiveness, and financial costs. The most important facilitators were a health care provider recommendation for vaccination and believing in the importance of disease prevention.
Future cervical cancer control educational programs for Cambodians should promote use of the HPV vaccine for age-eligible individuals. Health care providers who serve Cambodian communities should be encouraged to recommend HPV vaccination.
Background: North American Chinese women have lower levels of Papanicolaou (Pap) testing than other population subgroups. We conducted a randomized controlled trial to evaluate the effectiveness of ...two alternative cervical cancer screening interventions for Chinese women living in North America. Methods: Four hundred and eighty-two Pap testing underutilizers were identified from community-based surveys of Chinese women conducted in Seattle, Washington, and Vancouver, British Columbia. These women were randomly assigned to one of two experimental arms or control status. Several Chinese-language materials were used in both experimental arms: an education-entertainment video, a motivational pamphlet, an educational brochure, and a fact sheet. Women in the first experimental group (outreach worker intervention) received the materials, as well as tailored counseling and logistic assistance, during home visits by trilingual, bicultural outreach workers. Those in the second experimental group (direct mail intervention) received the materials by mail. The control group received usual care. Follow-up surveys were completed 6 months after randomization to ascertain participants' Pap testing behavior. All statistical tests were two-sided. Results: A total of 402 women responded to the follow-up survey (83% response rate). Of these women, 50 (39%) of the 129 women in the outreach group, 35 (25%) of the 139 women in the direct mail group, and 20 (15%) of the 134 women in the control group reported Pap testing in the interval between randomization and follow-up data collection (P<.001 for outreach worker versus control, P = .03 for direct mail versus control, and P = .02 for outreach worker versus direct mail). Intervention effects were greater in Vancouver than in Seattle. Conclusion: Culturally and linguistically appropriate interventions may improve Pap testing levels among Chinese women in North America.
Chinese immigrants to the United States experience high rates of liver cancer. Chronic carriage of hepatitis B virus (HBV) is the most common underlying cause of liver cancer among Chinese Americans. ...Our objective was to describe Chinese immigrants' hepatitis B knowledge, testing, and vaccination levels.
A community-based, in-person survey of Chinese men and women was conducted in Seattle during 2005. Our study sample included 395 individuals.
Less than one-half (48%) of our study group indicated they had received a hepatitis B blood test, and about one-third (31%) indicated they had been vaccinated against hepatitis B. The proportions of respondents who knew HBV can be spread during childbirth, during sexual intercourse, and by sharing razors were 70%, 54%, and 55%, respectively. Less than one-quarter of the study group knew that HBV cannot be spread by eating food that was prepared by an infected person (23%) and by sharing eating utensils with an infected person (16%).
Over 50% of our respondents did not recall being tested for HBV. Important knowledge deficits about routes of hepatitis B transmission were identified. Continued efforts should be made to develop and implement hepatitis B educational campaigns for Chinese immigrant communities.
Hepatitis B ESL Education for Asian Immigrants Taylor, Vicky M; Gregory Hislop, T; Bajdik, Christopher ...
Journal of community health,
02/2011, Letnik:
36, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Asian communities in North America include large numbers of immigrants with limited English proficiency. Hepatitis B virus (HBV) infection is endemic in most Asian countries and, therefore, Asian ...immigrant groups have high rates of chronic HBV infection. We conducted a group-randomized trial to evaluate the effectiveness of a hepatitis B English as a second language (ESL) educational curriculum for Asian immigrants. Eighty ESL classes were randomized to experimental (hepatitis B education) or control (physical activity education) status. Students who reported they had not received a HBV test (at baseline) completed a follow-up survey 6 months after randomization. The follow-up survey assessed recent HBV testing and HBV-related knowledge. Provider reports were used to verify self-reported HBV tests. The study group included 218 students who reported they had not been tested for HBV. Follow-up surveys were completed by 180 (83%) of these students. Provider records verified HBV testing for 6% of the experimental group students and 0% of the control group students (P = 0.02). Experimental group students were significantly (P < 0.05) more likely than control group students to know that immigrants have high HBV infection rates, HBV can be spread during sexual intercourse and by sharing razors, and HBV infection can cause liver cancer. Our ESL curriculum had a meaningful impact on HBV-related knowledge and a limited impact on HBV testing levels. Future research should evaluate the effectiveness of ESL curricula for other immigrant groups and other health topics, as well as other intervention approaches to increasing levels of HBV testing in Asian immigrant communities.
Hepatitis B testing is recommended for immigrants from countries where hepatitis B infection is endemic. However, only about one-half of Chinese in North America have received hepatitis B testing. We ...conducted a randomized controlled trial to evaluate the effectiveness of a hepatitis B lay health worker intervention for Chinese Americans/Canadians. Four hundred and sixty individuals who had never been tested for hepatitis B were identified from community-based surveys of Chinese conducted in Seattle, Washington, and Vancouver, British Columbia. These individuals were randomly assigned to receive a hepatitis B lay health worker intervention or a direct mailing of physical activity educational materials. Follow-up surveys were completed 6 months after randomization. Self-reported hepatitis B testing was verified through medical records review. A total of 319 individuals responded to the follow-up survey (69% response rate). Medical records data verified hepatitis B testing since randomization for 9 (6%) of the 142 experimental group participants and 3 (2%) of the 177 control group participants (P = 0.04). At follow-up, a higher proportion of individuals in the experimental arm than individuals in the control arm knew that hepatitis B can be spread by razors (P < 0.001) and during sexual intercourse (P = 0.07). Our findings suggest that lay health worker interventions can impact hepatitis B-related knowledge. However, our hepatitis B lay health worker intervention had a very limited impact on hepatitis B testing completion. Future research should evaluate other intervention approaches to improving hepatitis B testing rates among Chinese in North America.
Background
. Chronic hepatitis B infection is the most common cause of liver cancer among Cambodians. Our objective was to describe Cambodian Americans’ hepatitis B knowledge, testing, and ...vaccination levels.
Methods
. A community-based telephone survey was conducted in Seattle. Our study sample included 111 individuals.
Results
. Less than one half (46%) of our study group had received a hepatitis B blood test, and about one third (35%) had been vaccinated against hepatitis B. Only 43% knew that Cambodians are more likely to be infected with hepatitis B than whites.
Conclusions
. Over 50% of our respondents did not recall being tested for hepatitis B. We identified important knowledge deficits about hepatitis B. Continued efforts should be made to implement hepatitis B educational campaigns for Cambodians.
Objectives: According to recent census data, 1,216,600 Canadians are of Chinese descent, and over 80% of Chinese Canadians are foreign born. Approximately 10% of Chinese immigrants are chronic ...carriers of hepatitis B, compared with less than 0.5% of the general population. English as a second language (ESL) classes provide ready access for individuals with limited English proficiency who are not reached by English language health education materials and media campaigns. We conducted a group-randomized trial to evaluate the effectiveness of a hepatitis B ESL educational curriculum for Chinese immigrants. Methods: Five community-based organizations that provide ESL education in the greater Vancouver area participated in the study. Forty-one ESL classes (which included 325 Chinese students) were randomly assigned to experimental or control status. A follow-up survey, conducted six months after randomization, assessed knowledge about hepatitis B. Generalized estimating equations were used to analyze the data. Results: Follow-up surveys were completed by 298 (92%) of the students. At follow-up, experimental group students were significantly (p<0.05) more likely than control group students to know that immigrants have higher hepatitis B infection rates than people who were born in Canada; hepatitis B can be spread during childbirth, during sexual intercourse and by sharing razors; hepatitis B is not spread by sharing eating utensils; and hepatitis B infection can cause cirrhosis and liver cancer. Conclusion: Our findings indicate that ESL curricula can have a positive impact on health knowledge among Chinese immigrants with limited English. Future research should evaluate the effectiveness of ESL curricula for other immigrant groups, as well as other health topics. Objectif : Selon les données du dernier Recensement, 1 216 600 Canadiens sont d'ascendance chinoise, et plus de 80 % des Sino-Canadiens sont nés à l'étranger. Environ 10 % des immigrants chinois sont porteurs chroniques de l'hépatite B, contre moins de 0,5 % dans la population générale. Les classes d'anglais, langue seconde (ALS) permettraient de joindre facilement les personnes qui maîtrisent mal l'anglais et que l'on n'atteint pas par les outils d'éducation sanitaire et les campagnes de publicité-médias en anglais. Nous avons mené un essai de groupe randomisé pour évaluer l'efficacité d'un programme d'ALS pour les immigrants chinois qui comportait un cours sur l'hépatite B. Méthode : Cinq organismes communautaires qui enseignent l'ALS dans la région du Grand Vancouver ont participé à l'étude. Nous avons attribué au hasard à 41 classes d'ALS (incluant 325 étudiants chinois) le statut de groupe expérimental ou témoin. Un questionnaire de suivi administré six mois après l'étude randomisée a permis d'évaluer les connaissances des étudiants sur l'hépatite B. Les données ont été analysées à l'aide d'équations d'estimation généralisées. Résultats : Le questionnaire de suivi a été rempli par 298 étudiants (92 %). Lors du suivi, les étudiants du groupe expérimental étaient significativement (p<0,05) plus susceptibles que les étudiants du groupe témoin de savoir que les immigrants ont des taux d'infection par l'hépatite B supérieurs à ceux des personnes nées au Canada; que l'hépatite B peut se transmettre durant l'accouchement, durant les rapports sexuels et lorsqu'on partage un rasoir; que l'hépatite B ne se transmet pas par le partage d'ustensiles; et que l'infection par l'hépatite B peut causer la cirrhose et le cancer du foie. Conclusion : Les programmes d'ALS peuvent avoir un impact positif sur les connaissances sanitaires des immigrants chinois qui maîtrisent mal l'anglais. Les études futures devraient évaluer l'efficacité des programmes d'ALS auprès d'autres groupes d'immigrants et pour d'autres thématiques de santé.
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