Cervical Cancer Control Research in Vietnamese American Communities

ArticleinCancer Epidemiology Biomarkers & Prevention 17(11):2924-30 · December 2008with14 Reads
DOI: 10.1158/1055-9965.EPI-08-0386 · Source: PubMed
Abstract
Census data show that the U.S. Vietnamese population now exceeds 1,250,000. Cervical cancer among Vietnamese American women has been identified as an important health disparity. Available data indicate the cervical cancer disparity may be due to low Papanicolaou (Pap) testing rates rather than variations in human papillomavirus infection rates and/or types. The cervical cancer incidence rates among Vietnamese and non-Latina White women in California during 2000 to 2002 were 14.0 and 7.3 per 100,000, respectively. Only 70% of Vietnamese women who participated in the 2003 California Health Interview Survey reported a recent Pap smear compared with 84% of non-Latina White women. Higher levels of cervical cancer screening participation among Vietnamese women are strongly associated with current/previous marriage, having a usual source of care/doctor, and previous physician recommendation. Vietnamese language media campaigns and lay health worker intervention programs have been effective in increasing Pap smear use in Vietnamese American communities. Cervical cancer control programs for Vietnamese women should address knowledge deficits, enable women who are without a usual source of care to find a primary care doctor, and improve patient-provider communication by encouraging health-care providers to recommend Pap testing as well as by empowering women to ask for testing.
    • "Additionally, experimental group participants had significantly higher levels of knowledge about HBV than control group participants at follow-up. Research has shown that CHW interventions can improve adherence to breast and cervical cancer screening guidelines in Asian American, as well as other racial/ethnic minority communities (Taylor et al., 2008; Viswanathan et al., 2010; Hou et al., 2011; Wells et al., 2011). However, there is very limited information about the utility of CHW approaches to cancer education for Asian American or other minority men. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Cambodian Americans have high rates of chronic hepatitis B virus (HBV) infection and liver cancer. There is very limited information about the utility of community health worker (CHW) approaches to cancer education for Asian American men. We have previously reported our positive findings from a trial of CHW education about HBV for Cambodian Americans who had never been tested for HBV. This report describes similarities and differences between the outcomes of our CHW HBV educational intervention among Cambodian American men and women. Methods: The study group for this analysis included 87 individuals (39 men and 48 women) who were randomized to the experimental (HBV education) arm of our trial, participated in the CHW educational intervention, and provided follow-up data six months post-intervention. We examined HBV testing rates at follow-up, changes in HBV-related knowledge between baseline and follow-up, and barriers to HBV testing (that were reported to CHWs) by gender. Results: At follow-up, 15% of men and 31% of women reported they had received a HBV test (p=0.09). HBV-related knowledge levels increased significantly among both men and women. With respect to HBV testing barriers, women were more likely than men to cite knowledge deficits, and men were more likely than women to cite logistic issues. Discussion: Our study findings indicate that CHW interventions can positively impact knowledge among Cambodian American men, as well as women. They also suggest CHW interventions may be less effective in promoting the use of preventive procedures by Cambodian American men than women. Future CHW research initiatives should consider contextual factors that may differ by gender and, therefore, potentially influence the relative effectiveness of CHW interventions for men versus women.
    Article · Aug 2013
    • "Findings from this population suggest that younger Vietnamese women are less likely to have ever had a Pap smear compared to their older (>60 years) counterparts. This finding is in contrast to a number of studies [16, 28– 30], which have been summarized in several recent reviews [31, 32]. But a recent study of young Asian American women [33] also reported that younger age was associated with lower likelihood of obtaining screening. "
    [Show abstract] [Hide abstract] ABSTRACT: Objective: Vietnamese American women are at the greatest risk for cervical cancer but have the lowest cervical cancer screening rates. This study was to determine whether demographic and acculturation, healthcare access, and knowledge and beliefs are associated with a prior history of cervical cancer screening among Vietnamese women. Methods: Vietnamese women (n = 1450) from 30 Vietnamese community-based organizations located in Pennsylvania and New Jersey participated in the study and completed baseline assessments. Logistic regression analyses were performed. Results: Overall levels of knowledge about cervical cancer screening and human papillomavirus (HPV) are low. Factors in knowledge, attitude, and beliefs domains were significantly associated with Pap test behavior. In multivariate analyses, physician recommendation for screening and having health insurance were positively associated with prior screening. Conclusion: Understanding the factors that are associated with cervical cancer screening will inform the development of culturally appropriate intervention strategies that would potentially lead to increasing cervical cancer screening rates among Vietnamese women.
    Full-text · Article · Sep 2012
    • "Similar to our findings, only 25% of 98 Chinese participants and 24% of 66 Korean participants reported their daughters had initiated the HPV vaccination series [11]. Previous research has shown that provider-patient communication variables are the most important correlates of Pap testing in Southeast Asian communities [13,14]. For example, Nguyen and colleagues found that Vietnamese women who had requested a Pap test were nine times more likely to have been screened than women who had never requested the test, and women who had received a physician recommendation were eight times more likely to have been screened than those who had not received a recommendation [14]. "
    [Show abstract] [Hide abstract] ABSTRACT: Women of Southeast Asian descent have higher cervical cancer incidence rates than any other group. Widespread use of HPV vaccination could prevent up to 70% of cervical cancers. There is little published information addressing HPV vaccination uptake among Asian Americans. We conducted a survey of Cambodian women with daughters who were age-eligible for HPV vaccination. Survey items addressed HPV vaccination barriers, facilitators, and uptake. Only 26% of the survey participants reported any of their age-eligible daughters had received vaccination, and only 40% reported a previous physician recommendation for vaccination. Higher levels of vaccine uptake were strongly associated with having received a doctor's recommendation for vaccination (p < 0.001) and having asked a doctor for vaccination (p = 0.002). HPV vaccine uptake was relatively low in our Cambodian study group. Educational initiatives should encourage health care providers who serve Cambodian families to recommend HPV vaccination and empower Cambodian mothers to ask their daughters' doctors for vaccination.
    Article · Aug 2011
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