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Research paper thumbnail of Breast and Cervical Cancer Control Among Pacific Islander and Southeast Asian Women: Participatory Action Research Strategies for Baseline Data Collection in California

Journal of Cancer Education, 2006

A core ideal of health promotion is to foster concerted community efforts for the improvement of ... more A core ideal of health promotion is to foster concerted community efforts for the improvement of their own health status. This is not a new concept. More than 30 years ago, Dorothy Nyswander (1967) called for health education to "go beyond the goal that attaining physical and mental health are sufficient for a great nation" and to commit to an open society that fosters "a social climate of democracy, freedom, equality and justice" (p. 10). Thirty years later, President Clinton unveiled his "Initiative on Race" to reduce health disparities experienced by non-White ethnic and racial groups by identifying and addressing the underlying causes of higher levels of disease and disability in racial and ethnic minority communities. Such root causes include 147

Research paper thumbnail of The Role of Legislation and Practitioner Perceptions on the Availability of Patient Navigation Programs

Research paper thumbnail of The Role of Medical Interpretation on Breast and Cervical Cancer Screening Among Asian American and Pacific Islander Women

Journal of Cancer Education, 2010

We examined whether the impact of medical interpretation services was associated with the receipt... more We examined whether the impact of medical interpretation services was associated with the receipt of a mammogram, clinical breast exam, and Pap smear. We conducted a large cross-sectional study involving four Asian American and Pacific Islander (AAPI) communities with high proportions of individuals with limited English proficiency (LEP). Participants were recruited from community clinics, churches and temples, supermarkets, and other community gathering sites in Northern and Southern California. Among those that responded, 98% completed the survey rendering a total of 1,708 AAPI women. In a series of multivariate logistic regression models, it was found that women who typically used a medical interpreter had a greater odds of having received a mammogram (odds ratio [OR]=1.85; 95% confidence interval [CI]=1.21, 2.83), clinical breast exam (OR= 3.03; 95% CI=1.82, 5.03), and a Pap smear (OR=2.34; 95% CI=1.38, 3.97) than those who did not usually use an interpreter. The study provides support for increasing language access in healthcare settings. In particular, medical interpreters may help increase the utilization of breast and cervical cancer screening among LEP AAPI women.

Research paper thumbnail of Cancer, Culture, and Health Disparities: Time to Chart a New Course?

CA: A Cancer Journal for Clinicians, 2010

Little progress has been made over the last 40 years to eliminate the racial/ethnic differences i... more Little progress has been made over the last 40 years to eliminate the racial/ethnic differences in incidence, morbidity, avoidable suffering, and mortality from cancer that result from factors beyond genetic differences. More effective strategies to promote equity in access and quality care are urgently needed because the changing demographics of the United States portend that this disparity will not only persist but significantly increase. Such suffering is avoidable. The authors posit that culture is a prime factor in the persistence of health disparities. However, this concept of culture is still poorly understood, inconsistently defined, and ineffectively used in practice and research. The role of culture in the causal pathway of disparities and the potential impact of culturally competent cancer care on improving cancer outcomes in ethnic minorities has, thus, been underestimated. In this article, the authors provide a comprehensive definition of culture and demonstrate how it can be used at each stage of the cancer care continuum to help reduce the unequal burden of cancer. The authors conclude with suggestions for clinical practice to eliminate the disconnection between evidence-based, quality, cancer care and its delivery to diverse population groups.

Research paper thumbnail of Breast and Cervical Cancer Control Among Pacific Islander and Southeast Asian Women: Participatory Action Research Strategies for Baseline Data Collection in California

Journal of Cancer Education, 2006

A core ideal of health promotion is to foster concerted community efforts for the improvement of ... more A core ideal of health promotion is to foster concerted community efforts for the improvement of their own health status. This is not a new concept. More than 30 years ago, Dorothy Nyswander (1967) called for health education to "go beyond the goal that attaining physical and mental health are sufficient for a great nation" and to commit to an open society that fosters "a social climate of democracy, freedom, equality and justice" (p. 10). Thirty years later, President Clinton unveiled his "Initiative on Race" to reduce health disparities experienced by non-White ethnic and racial groups by identifying and addressing the underlying causes of higher levels of disease and disability in racial and ethnic minority communities. Such root causes include 147

Research paper thumbnail of Designing Culturally and Linguistically Appropriate Health Interventions: The "Life Is Precious" Hmong Breast Cancer Study

Health Education & Behavior, 2006

A culturally and linguistically appropriate intervention to improve the breast cancer screening r... more A culturally and linguistically appropriate intervention to improve the breast cancer screening rates among Hmong women. A 1 to 1 1/2 hour workshop was scheduled with small groups of women age 40 years and older. Intervention elements included the development of a flipchart, brochure, and video that presented basic breast health and screening information, along with the targeting of not only women but men to support their wives' breast cancer screening.

Research paper thumbnail of Outcomes of a Breast Health Project for Hmong Women and Men in California

American Journal of Public Health, 2009

Research paper thumbnail of Progress in the Pipeline: Replication of the Minority Training Program in Cancer Control Research

Journal of Cancer Education, 2007

Background. This paper evaluates the replicability of an NCI-funded didactic/experiential program... more Background. This paper evaluates the replicability of an NCI-funded didactic/experiential program to increase the diversity of doctorally-prepared cancer disparities investigators. Methods. The program was developed and operated successfully for three years in Northern California when a replication was established at UCLA. Feasibility, process, impact, and outcome measures on UCSF and UCLA summer-institute participants were compared. Results. Average participant rankings of the influence of the program on intention to apply for a doctorate were 9.1/10 (UCSF) and 8.6/10 (UCLA). A total of 22.5% of UCSF and 10% of UCLA participants have enrolled in, been accepted by, or completed doctoral programs. Among these alumni, 68% (21/31) of UCSF and 60% (3/5) of UCLA participants plan to conduct their doctoral research in cancer control. Conclusions. This program has been successfully replicated and has met its objective to increase the pipeline of ethnically diverse doctoral-level public health researchers. Expansion of the program to other regions of the US is feasible and indicated. J Cancer Educ. 2006; 21:230-236. here is extensive documentation of the disproportionate burden borne by minority and underserved populations in morbidity and mortality due to cancer. 1-7 The body of research aimed at redressing these disparities is large and cuts across disciplines including epidemiology, genetics, health education/behavioral science, health psychology, clinical medicine, health economics, nutrition, communications, and many more. It is indisputable that there is much more to be learned from these fields so that all populations may benefit equally from prevention, early detection, cancer treatment modalities and survivorship interventions.

Research paper thumbnail of Breast and Cervical Cancer Control Among Pacific Islander and Southeast Asian Women: Participatory Action Research Strategies for Baseline Data Collection in California

Journal of Cancer Education, 2006

A core ideal of health promotion is to foster concerted community efforts for the improvement of ... more A core ideal of health promotion is to foster concerted community efforts for the improvement of their own health status. This is not a new concept. More than 30 years ago, Dorothy Nyswander (1967) called for health education to "go beyond the goal that attaining physical and mental health are sufficient for a great nation" and to commit to an open society that fosters "a social climate of democracy, freedom, equality and justice" (p. 10). Thirty years later, President Clinton unveiled his "Initiative on Race" to reduce health disparities experienced by non-White ethnic and racial groups by identifying and addressing the underlying causes of higher levels of disease and disability in racial and ethnic minority communities. Such root causes include 147

Research paper thumbnail of The Role of Legislation and Practitioner Perceptions on the Availability of Patient Navigation Programs

Research paper thumbnail of The Role of Medical Interpretation on Breast and Cervical Cancer Screening Among Asian American and Pacific Islander Women

Journal of Cancer Education, 2010

We examined whether the impact of medical interpretation services was associated with the receipt... more We examined whether the impact of medical interpretation services was associated with the receipt of a mammogram, clinical breast exam, and Pap smear. We conducted a large cross-sectional study involving four Asian American and Pacific Islander (AAPI) communities with high proportions of individuals with limited English proficiency (LEP). Participants were recruited from community clinics, churches and temples, supermarkets, and other community gathering sites in Northern and Southern California. Among those that responded, 98% completed the survey rendering a total of 1,708 AAPI women. In a series of multivariate logistic regression models, it was found that women who typically used a medical interpreter had a greater odds of having received a mammogram (odds ratio [OR]=1.85; 95% confidence interval [CI]=1.21, 2.83), clinical breast exam (OR= 3.03; 95% CI=1.82, 5.03), and a Pap smear (OR=2.34; 95% CI=1.38, 3.97) than those who did not usually use an interpreter. The study provides support for increasing language access in healthcare settings. In particular, medical interpreters may help increase the utilization of breast and cervical cancer screening among LEP AAPI women.

Research paper thumbnail of Cancer, Culture, and Health Disparities: Time to Chart a New Course?

CA: A Cancer Journal for Clinicians, 2010

Little progress has been made over the last 40 years to eliminate the racial/ethnic differences i... more Little progress has been made over the last 40 years to eliminate the racial/ethnic differences in incidence, morbidity, avoidable suffering, and mortality from cancer that result from factors beyond genetic differences. More effective strategies to promote equity in access and quality care are urgently needed because the changing demographics of the United States portend that this disparity will not only persist but significantly increase. Such suffering is avoidable. The authors posit that culture is a prime factor in the persistence of health disparities. However, this concept of culture is still poorly understood, inconsistently defined, and ineffectively used in practice and research. The role of culture in the causal pathway of disparities and the potential impact of culturally competent cancer care on improving cancer outcomes in ethnic minorities has, thus, been underestimated. In this article, the authors provide a comprehensive definition of culture and demonstrate how it can be used at each stage of the cancer care continuum to help reduce the unequal burden of cancer. The authors conclude with suggestions for clinical practice to eliminate the disconnection between evidence-based, quality, cancer care and its delivery to diverse population groups.

Research paper thumbnail of Breast and Cervical Cancer Control Among Pacific Islander and Southeast Asian Women: Participatory Action Research Strategies for Baseline Data Collection in California

Journal of Cancer Education, 2006

A core ideal of health promotion is to foster concerted community efforts for the improvement of ... more A core ideal of health promotion is to foster concerted community efforts for the improvement of their own health status. This is not a new concept. More than 30 years ago, Dorothy Nyswander (1967) called for health education to "go beyond the goal that attaining physical and mental health are sufficient for a great nation" and to commit to an open society that fosters "a social climate of democracy, freedom, equality and justice" (p. 10). Thirty years later, President Clinton unveiled his "Initiative on Race" to reduce health disparities experienced by non-White ethnic and racial groups by identifying and addressing the underlying causes of higher levels of disease and disability in racial and ethnic minority communities. Such root causes include 147

Research paper thumbnail of Designing Culturally and Linguistically Appropriate Health Interventions: The "Life Is Precious" Hmong Breast Cancer Study

Health Education & Behavior, 2006

A culturally and linguistically appropriate intervention to improve the breast cancer screening r... more A culturally and linguistically appropriate intervention to improve the breast cancer screening rates among Hmong women. A 1 to 1 1/2 hour workshop was scheduled with small groups of women age 40 years and older. Intervention elements included the development of a flipchart, brochure, and video that presented basic breast health and screening information, along with the targeting of not only women but men to support their wives' breast cancer screening.

Research paper thumbnail of Outcomes of a Breast Health Project for Hmong Women and Men in California

American Journal of Public Health, 2009

Research paper thumbnail of Progress in the Pipeline: Replication of the Minority Training Program in Cancer Control Research

Journal of Cancer Education, 2007

Background. This paper evaluates the replicability of an NCI-funded didactic/experiential program... more Background. This paper evaluates the replicability of an NCI-funded didactic/experiential program to increase the diversity of doctorally-prepared cancer disparities investigators. Methods. The program was developed and operated successfully for three years in Northern California when a replication was established at UCLA. Feasibility, process, impact, and outcome measures on UCSF and UCLA summer-institute participants were compared. Results. Average participant rankings of the influence of the program on intention to apply for a doctorate were 9.1/10 (UCSF) and 8.6/10 (UCLA). A total of 22.5% of UCSF and 10% of UCLA participants have enrolled in, been accepted by, or completed doctoral programs. Among these alumni, 68% (21/31) of UCSF and 60% (3/5) of UCLA participants plan to conduct their doctoral research in cancer control. Conclusions. This program has been successfully replicated and has met its objective to increase the pipeline of ethnically diverse doctoral-level public health researchers. Expansion of the program to other regions of the US is feasible and indicated. J Cancer Educ. 2006; 21:230-236. here is extensive documentation of the disproportionate burden borne by minority and underserved populations in morbidity and mortality due to cancer. 1-7 The body of research aimed at redressing these disparities is large and cuts across disciplines including epidemiology, genetics, health education/behavioral science, health psychology, clinical medicine, health economics, nutrition, communications, and many more. It is indisputable that there is much more to be learned from these fields so that all populations may benefit equally from prevention, early detection, cancer treatment modalities and survivorship interventions.