Janice Tsoh - Academia.edu (original) (raw)
Papers by Janice Tsoh
Nicotine & Tobacco Research, 2015
Smoking prevalence is high among limited English-proficient Chinese and Vietnamese American men, ... more Smoking prevalence is high among limited English-proficient Chinese and Vietnamese American men, who are frequently unmotivated to quit and who underutilize smoking cessation resources. This study applied lay health worker outreach to leverage peer and family networks to promote smoking cessation among these men. We integrated qualitative formative research findings and Social Network Theory to develop a social-network family-focused intervention. In a pilot single-group trial, 15 lay health workers recruited 96 dyads (N = 192, 75% Vietnamese) of Chinese or Vietnamese male daily smokers and their family members and delivered the intervention consisting of two small group education sessions and two individual telephone calls over 2 months. At baseline, 42% of smokers were at precontemplation. At 3 months following the initiation of the intervention, 7-day and 30-day point prevalence smoking abstinence rates as reported by smokers and independently corroborated by family members were 30% and 24%, respectively. Utilization of smoking cessation resources (medication, quitline, physician's advice) increased from 2% to 60% (P < .001). Findings showed high acceptability of the intervention as it facilitated learning about tobacco-related health risks and cessation resources, and communications between smokers and their families. This novel social network family-focused intervention to promote smoking cessation among Chinese and Vietnamese smokers appears to be acceptable, feasible, and potentially efficacious. Findings warrant evaluation of long-term efficacy of the intervention in a larger scale randomized controlled trial.
MMWR. Surveillance summaries: Morbidity and mortality weekly report. Surveillance summaries / CDC
Since 1964, smoking prevalence in the United States has declined because of nationwide interventi... more Since 1964, smoking prevalence in the United States has declined because of nationwide intervention efforts. However, smoking interventions have not been implemented uniformly throughout all communities. Some of the highest smoking rates in the United States have been reported among Southeast Asian men, and socioeconomic status has been strongly associated with smoking. To compare the effect in reducing racial and ethnic disparities between men in Southeast Asian (Vietnamese and Cambodian) communities and men residing in the same states, CDC analyzed 2002-2006 data from The Racial and Ethnic Approaches to Community Health (REACH) project. The prevalence of current smoking significantly decreased and the quit ratio (percentage of ever smokers who have quit) significantly increased in REACH Vietnamese and Cambodian communities, but changes were minimal among all men in California or all men in Massachusetts (where these communities were located). The smoking rate also declined signifi...
Nicotine & Tobacco Research, 2015
Smoking prevalence is high among limited English-proficient Chinese and Vietnamese American men, ... more Smoking prevalence is high among limited English-proficient Chinese and Vietnamese American men, who are frequently unmotivated to quit and who underutilize smoking cessation resources. This study applied lay health worker outreach to leverage peer and family networks to promote smoking cessation among these men. We integrated qualitative formative research findings and Social Network Theory to develop a social-network family-focused intervention. In a pilot single-group trial, 15 lay health workers recruited 96 dyads (N = 192, 75% Vietnamese) of Chinese or Vietnamese male daily smokers and their family members and delivered the intervention consisting of two small group education sessions and two individual telephone calls over 2 months. At baseline, 42% of smokers were at precontemplation. At 3 months following the initiation of the intervention, 7-day and 30-day point prevalence smoking abstinence rates as reported by smokers and independently corroborated by family members were 30% and 24%, respectively. Utilization of smoking cessation resources (medication, quitline, physician's advice) increased from 2% to 60% (P < .001). Findings showed high acceptability of the intervention as it facilitated learning about tobacco-related health risks and cessation resources, and communications between smokers and their families. This novel social network family-focused intervention to promote smoking cessation among Chinese and Vietnamese smokers appears to be acceptable, feasible, and potentially efficacious. Findings warrant evaluation of long-term efficacy of the intervention in a larger scale randomized controlled trial.
Background/Significance: Chinese Americans have low levels of knowledge and adherence with recomm... more Background/Significance: Chinese Americans have low levels of knowledge and adherence with recommendations for healthy nutrition and physical activity (NPA). Objective: To evaluate a health educator intervention to teach NPA in a randomized controlled trial. Methods: Chinese Americans aged 50-75 in San Francisco were recruited by lay health workers (LHW) and randomized. A health educator delivered two NPA lectures in English, Cantonese or Mandarin to the intervention group, who also received lecture handouts and a brochure. The comparison group received the handouts and the brochure. NPA knowledge and self-reported behaviors were assessed by pre- and post- intervention surveys 6 months apart. T-tests for continuous measures and chi-square tests for categorical measures were used to calculate statistical significance for pre-post changes within each group. Results: Out of 541 participants, 82% were female, 99% foreign-born, 96% limited English speakers, and 58.4% were overweight or o...
Background: Colorectal cancer (CRC) screening rates are low among Chinese Americans, the largest ... more Background: Colorectal cancer (CRC) screening rates are low among Chinese Americans, the largest Asian ethnic group in the United States. Although physician recommendation for CRC screening is known to be associated with increased screening rates in the general population, little is known about its impact in Chinese American immigrants. Methods: We analyzed baseline data from 319 Chinese Americans aged 50-75 enrolled in an ongoing trial to promote CRC screening. Participants reported on receipt of fecal occult blood testing (FOBT) and endoscopy (sigmoidoscopy or colonoscopy). Results: Among participants, 22% were male, 95% were limited English proficient, and 11% were uninsured. Only 62.1% reported ever receiving a FOBT, while 37.3% received an endoscopy. Only 52.0% reported receiving a physician recommendation for FOBT and 28.8%, for endoscopy. In multivariate analyses, age >60 was associated with FOBT receipt (OR=2.1, 95% CI: 1.1-4.3), while >10 years in the U.S. was associa...
Colorectal cancer (CRC) is the second most common cancer among Chinese Americans. Although effect... more Colorectal cancer (CRC) is the second most common cancer among Chinese Americans. Although effective prevention exists through CRC screening, rates of screening in this population are low. Prior studies indicate that Chinese Americans frequently utilize Traditional Chinese Medicine (TCM) providers. The goal is to explore whether these providers can serve as a useful addition to a community-based lay health educator strategy, given their unique role and accessibility within the community. As a result, we have begun a collaboration with them. As part of a community-based participatory research (CBPR) trial to increase CRC screening among Chinese American age 50 to 75 in San Francisco, our community-academic research team conducted 2 focus groups with TCM providers and 2 focus groups with their patients. The purpose was to assess the feasibility of working with TCM providers as complementary health educators to promote CRC screening with their patients. We found that traditional medici...
Background: Health literacy plays an important role in health care outcomes. This study assessed ... more Background: Health literacy plays an important role in health care outcomes. This study assessed health literacy among older Chinese American adults. Methods: In a convenience sample of 312 Chinese American immigrants aged 50 to 75, we used the Single Item Literacy Screener to assess health literacy. We defined respondents as having a health literacy need' when they indicated sometimes, often, or always needing assistance in reading health materials from their doctor or pharmacy. Results: The sample included 23% men, 94% limited English proficient, and 72% not high school graduates. Two-thirds (68%) were found to have a health literacy need. Individuals with limited English proficiency and less than college education were more likely to have this need, 71% and 73%, respectively (p < 0.01). Need was higher among those rating their own health as poor or fair compared to those rating it good or excellent (74% vs. 56%, p<0.01). Respondents needing a medical interpreter were mo...
Colorectal cancer (CRC) is the second most common cancer among Chinese Americans. Although CRC sc... more Colorectal cancer (CRC) is the second most common cancer among Chinese Americans. Although CRC screening is effective, screening rates in this population are low. Given the high use of Traditional Chinese Medicine (TCM) among Chinese Americans, a study was conducted to explore the involvement of TCM providers in CRC prevention. Methods: Phase I was the creation of educational materials acceptable to TCM providers. A graphically rich 32-page Chinese language TCM-provider CRC prevention flipchart was developed, based on a previously tested biomedical-oriented lay health worker outreach CRC flipchart. The TCM provider version included traditional theories on disease causation and prevention, health proverbs, and culturally appropriate images. Design of the TCM provider flipchart was an iterative process involving the research team and community members, including input from four TCM providers, cognitive testing with 2 additional providers, and final evaluation by 2 focus groups compris...
BACKGROUND: Older age and limited English proficiency (LEP) are associated with poor health. This... more BACKGROUND: Older age and limited English proficiency (LEP) are associated with poor health. This study examined the association between health literacy (HL) and perceived health status in a sample of older Chinese immigrant adults with LEP. METHODS: Cross-sectional survey data from a convenience sample of 525 Chinese American immigrants aged 50 to 75 were analyzed. A validated instrument, the Single Item Literacy Screener, which asked if respondents needed assistance in reading health materials from their doctor or pharmacy, was used to assess HL. Response options “never or rarely”, “sometimes”, and “often or always” defined “adequate,” “low,” and “poor” HL, respectively. A single item was used to assess self-rated health. RESULTS: In the sample, 18% were males, 71% were non-high school graduates, 96% had LEP and 65% perceived their health as fair or poor. Prevalence of low HL was 34% and poor HL was 37%. On multivariate logistic regression analysis, compared to those with adequate...
Nicotine & Tobacco Research, 2015
In 2005, the National Cancer Institute funded the Community Networks Program (CNP), which aimed t... more In 2005, the National Cancer Institute funded the Community Networks Program (CNP), which aimed to reduce cancer health disparities in minority racial/ethnic and underserved groups through community-based participatory research, education, and training. The purpose of this study was to describe the CNP model and their tobacco-related work in community-based research, education, and training using a tobacco disparities research framework. We conducted a comprehensive review of the CNP tobacco-related activities including publications, published abstracts, research activities, trainee pilot studies, policy-related activities, educational outreach, and reports produced from 2005-2009. Two authors categorized the tobacco-related activities and publications within the framework. Although there was no mandate to address tobacco, the CNPs produced 103 tobacco-related peer-reviewed publications, which reflects the largest proportion (12%) of all CNP cancer-related publications. Selected publications and research activities were most numerous under the framework areas &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Psychosocial Research,&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Surveillance,&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Epidemiology,&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Treatment of Nicotine…
Breast cancer is the most common cancer among Chinese American women in California, and previous ... more Breast cancer is the most common cancer among Chinese American women in California, and previous data suggested nearly 40% of the Chinese American women over 40 years old had not have a mammogram in the past year. Studies revealed that underutilization of cancer screening services among ethnic minorities are often attributed to factors such as language difficulties, cultural values and beliefs, and fear of cancer. The study was designed to investigate if young children's theatrical performance is an effective venue in delivering health messages to the Chinese immigrant community. The Health Belief Model was employed as the theoretical framework for the intervention. A total of 177 pre- and post-performance surveys were collected at four San Francisco preschools. The participant's age ranged from 25-77 years. Approximately 70% of participants' relationships to preschoolers were mothers. Participant's length of stay in the United States ranged from 3 days 68 years. Abo...
Few studies have examined completion of advance directives (AD) in Asian Americans. Little is kno... more Few studies have examined completion of advance directives (AD) in Asian Americans. Little is known about advance care planning (ACP) among Asian Americans who attend churches. We describe AD completion and associated attitudes and beliefs among church-going older Chinese and Vietnamese American adults age 50 and older. A convenience sample of 140 Chinese (79% female, 96% immigrants) and 131 Vietnamese (27% female, 99% immigrants) adults age 50 and older who attended 2 Chinese and 2 Vietnamese Christian churches in Northern California answered a self-administered, paper survey. The survey assessed awareness and completion of AD (Living Will or Durable Power of Attorney for Health Care [DPOA]) and associated attitudes, beliefs, influences, and norms. Most respondents had never heard of a Living Will (50% Chinese, 78.6% Vietnamese) or DPOA (56.1% Chinese, 79% Vietnamese). Few (20.7% Chinese, 13.5% Vietnamese) had completed an AD. The most commonly reported influence on AD completion w...
Journal of Health Care for the Poor and Underserved, 2015
The nail salon sector is booming, predominantly with Vietnamese immigrant workers who regularly h... more The nail salon sector is booming, predominantly with Vietnamese immigrant workers who regularly handle nail care products containing harmful chemicals. Based on lessons learned from an ongoing randomized controlled trial, occupational interventions need to incorporate inputs from different stakeholders, including salon owners, workers, and customers as well as governmental regulatory agencies.
Women's Health Issues, 2011
Purpose-To report the effectiveness of a prenatal intervention and to provide evidence that prena... more Purpose-To report the effectiveness of a prenatal intervention and to provide evidence that prenatal visits provide an opportune time for health assessment and counseling with abused women.
Journal of Pediatric Dentistry, 2015
Journal of the American Dental Association (1939), 2014
The authors conducted a study of tweets posted on Twitter to compare self-reported toothache expe... more The authors conducted a study of tweets posted on Twitter to compare self-reported toothache experiences with those of backache, earache and headache in regard to pain intensity, action taken, perceived cause and effect of pain. From a total of 508,591 relevant tweets collected on seven nonconsecutive days, the authors randomly selected 1,204 tweets (301 per pain type) and conducted content analyses of each tweet. Toothaches were described as having higher pain intensity than were earaches or headaches but pain intensity comparable with that of backaches. Despite people who experience toothache being more likely to seek health care than those experiencing backaches (odds ratio [OR], 3.91; 95 percent confidence interval [CI], 1.57-9.71) or headaches (OR, 6.11; 95 percent CI, 2.16-17.25), only one in 10 people with toothaches mentioned seeking health care for their pain. People with toothaches were less likely to report an effect on daily functioning compared with those with backaches...
Nicotine & Tobacco Research, 2015
Smoking prevalence is high among limited English-proficient Chinese and Vietnamese American men, ... more Smoking prevalence is high among limited English-proficient Chinese and Vietnamese American men, who are frequently unmotivated to quit and who underutilize smoking cessation resources. This study applied lay health worker outreach to leverage peer and family networks to promote smoking cessation among these men. We integrated qualitative formative research findings and Social Network Theory to develop a social-network family-focused intervention. In a pilot single-group trial, 15 lay health workers recruited 96 dyads (N = 192, 75% Vietnamese) of Chinese or Vietnamese male daily smokers and their family members and delivered the intervention consisting of two small group education sessions and two individual telephone calls over 2 months. At baseline, 42% of smokers were at precontemplation. At 3 months following the initiation of the intervention, 7-day and 30-day point prevalence smoking abstinence rates as reported by smokers and independently corroborated by family members were 30% and 24%, respectively. Utilization of smoking cessation resources (medication, quitline, physician&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s advice) increased from 2% to 60% (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). Findings showed high acceptability of the intervention as it facilitated learning about tobacco-related health risks and cessation resources, and communications between smokers and their families. This novel social network family-focused intervention to promote smoking cessation among Chinese and Vietnamese smokers appears to be acceptable, feasible, and potentially efficacious. Findings warrant evaluation of long-term efficacy of the intervention in a larger scale randomized controlled trial.
MMWR. Surveillance summaries: Morbidity and mortality weekly report. Surveillance summaries / CDC
Since 1964, smoking prevalence in the United States has declined because of nationwide interventi... more Since 1964, smoking prevalence in the United States has declined because of nationwide intervention efforts. However, smoking interventions have not been implemented uniformly throughout all communities. Some of the highest smoking rates in the United States have been reported among Southeast Asian men, and socioeconomic status has been strongly associated with smoking. To compare the effect in reducing racial and ethnic disparities between men in Southeast Asian (Vietnamese and Cambodian) communities and men residing in the same states, CDC analyzed 2002-2006 data from The Racial and Ethnic Approaches to Community Health (REACH) project. The prevalence of current smoking significantly decreased and the quit ratio (percentage of ever smokers who have quit) significantly increased in REACH Vietnamese and Cambodian communities, but changes were minimal among all men in California or all men in Massachusetts (where these communities were located). The smoking rate also declined signifi...
Nicotine & Tobacco Research, 2015
Smoking prevalence is high among limited English-proficient Chinese and Vietnamese American men, ... more Smoking prevalence is high among limited English-proficient Chinese and Vietnamese American men, who are frequently unmotivated to quit and who underutilize smoking cessation resources. This study applied lay health worker outreach to leverage peer and family networks to promote smoking cessation among these men. We integrated qualitative formative research findings and Social Network Theory to develop a social-network family-focused intervention. In a pilot single-group trial, 15 lay health workers recruited 96 dyads (N = 192, 75% Vietnamese) of Chinese or Vietnamese male daily smokers and their family members and delivered the intervention consisting of two small group education sessions and two individual telephone calls over 2 months. At baseline, 42% of smokers were at precontemplation. At 3 months following the initiation of the intervention, 7-day and 30-day point prevalence smoking abstinence rates as reported by smokers and independently corroborated by family members were 30% and 24%, respectively. Utilization of smoking cessation resources (medication, quitline, physician&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s advice) increased from 2% to 60% (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). Findings showed high acceptability of the intervention as it facilitated learning about tobacco-related health risks and cessation resources, and communications between smokers and their families. This novel social network family-focused intervention to promote smoking cessation among Chinese and Vietnamese smokers appears to be acceptable, feasible, and potentially efficacious. Findings warrant evaluation of long-term efficacy of the intervention in a larger scale randomized controlled trial.
Background/Significance: Chinese Americans have low levels of knowledge and adherence with recomm... more Background/Significance: Chinese Americans have low levels of knowledge and adherence with recommendations for healthy nutrition and physical activity (NPA). Objective: To evaluate a health educator intervention to teach NPA in a randomized controlled trial. Methods: Chinese Americans aged 50-75 in San Francisco were recruited by lay health workers (LHW) and randomized. A health educator delivered two NPA lectures in English, Cantonese or Mandarin to the intervention group, who also received lecture handouts and a brochure. The comparison group received the handouts and the brochure. NPA knowledge and self-reported behaviors were assessed by pre- and post- intervention surveys 6 months apart. T-tests for continuous measures and chi-square tests for categorical measures were used to calculate statistical significance for pre-post changes within each group. Results: Out of 541 participants, 82% were female, 99% foreign-born, 96% limited English speakers, and 58.4% were overweight or o...
Background: Colorectal cancer (CRC) screening rates are low among Chinese Americans, the largest ... more Background: Colorectal cancer (CRC) screening rates are low among Chinese Americans, the largest Asian ethnic group in the United States. Although physician recommendation for CRC screening is known to be associated with increased screening rates in the general population, little is known about its impact in Chinese American immigrants. Methods: We analyzed baseline data from 319 Chinese Americans aged 50-75 enrolled in an ongoing trial to promote CRC screening. Participants reported on receipt of fecal occult blood testing (FOBT) and endoscopy (sigmoidoscopy or colonoscopy). Results: Among participants, 22% were male, 95% were limited English proficient, and 11% were uninsured. Only 62.1% reported ever receiving a FOBT, while 37.3% received an endoscopy. Only 52.0% reported receiving a physician recommendation for FOBT and 28.8%, for endoscopy. In multivariate analyses, age >60 was associated with FOBT receipt (OR=2.1, 95% CI: 1.1-4.3), while >10 years in the U.S. was associa...
Colorectal cancer (CRC) is the second most common cancer among Chinese Americans. Although effect... more Colorectal cancer (CRC) is the second most common cancer among Chinese Americans. Although effective prevention exists through CRC screening, rates of screening in this population are low. Prior studies indicate that Chinese Americans frequently utilize Traditional Chinese Medicine (TCM) providers. The goal is to explore whether these providers can serve as a useful addition to a community-based lay health educator strategy, given their unique role and accessibility within the community. As a result, we have begun a collaboration with them. As part of a community-based participatory research (CBPR) trial to increase CRC screening among Chinese American age 50 to 75 in San Francisco, our community-academic research team conducted 2 focus groups with TCM providers and 2 focus groups with their patients. The purpose was to assess the feasibility of working with TCM providers as complementary health educators to promote CRC screening with their patients. We found that traditional medici...
Background: Health literacy plays an important role in health care outcomes. This study assessed ... more Background: Health literacy plays an important role in health care outcomes. This study assessed health literacy among older Chinese American adults. Methods: In a convenience sample of 312 Chinese American immigrants aged 50 to 75, we used the Single Item Literacy Screener to assess health literacy. We defined respondents as having a health literacy need' when they indicated sometimes, often, or always needing assistance in reading health materials from their doctor or pharmacy. Results: The sample included 23% men, 94% limited English proficient, and 72% not high school graduates. Two-thirds (68%) were found to have a health literacy need. Individuals with limited English proficiency and less than college education were more likely to have this need, 71% and 73%, respectively (p < 0.01). Need was higher among those rating their own health as poor or fair compared to those rating it good or excellent (74% vs. 56%, p<0.01). Respondents needing a medical interpreter were mo...
Colorectal cancer (CRC) is the second most common cancer among Chinese Americans. Although CRC sc... more Colorectal cancer (CRC) is the second most common cancer among Chinese Americans. Although CRC screening is effective, screening rates in this population are low. Given the high use of Traditional Chinese Medicine (TCM) among Chinese Americans, a study was conducted to explore the involvement of TCM providers in CRC prevention. Methods: Phase I was the creation of educational materials acceptable to TCM providers. A graphically rich 32-page Chinese language TCM-provider CRC prevention flipchart was developed, based on a previously tested biomedical-oriented lay health worker outreach CRC flipchart. The TCM provider version included traditional theories on disease causation and prevention, health proverbs, and culturally appropriate images. Design of the TCM provider flipchart was an iterative process involving the research team and community members, including input from four TCM providers, cognitive testing with 2 additional providers, and final evaluation by 2 focus groups compris...
BACKGROUND: Older age and limited English proficiency (LEP) are associated with poor health. This... more BACKGROUND: Older age and limited English proficiency (LEP) are associated with poor health. This study examined the association between health literacy (HL) and perceived health status in a sample of older Chinese immigrant adults with LEP. METHODS: Cross-sectional survey data from a convenience sample of 525 Chinese American immigrants aged 50 to 75 were analyzed. A validated instrument, the Single Item Literacy Screener, which asked if respondents needed assistance in reading health materials from their doctor or pharmacy, was used to assess HL. Response options “never or rarely”, “sometimes”, and “often or always” defined “adequate,” “low,” and “poor” HL, respectively. A single item was used to assess self-rated health. RESULTS: In the sample, 18% were males, 71% were non-high school graduates, 96% had LEP and 65% perceived their health as fair or poor. Prevalence of low HL was 34% and poor HL was 37%. On multivariate logistic regression analysis, compared to those with adequate...
Nicotine & Tobacco Research, 2015
In 2005, the National Cancer Institute funded the Community Networks Program (CNP), which aimed t... more In 2005, the National Cancer Institute funded the Community Networks Program (CNP), which aimed to reduce cancer health disparities in minority racial/ethnic and underserved groups through community-based participatory research, education, and training. The purpose of this study was to describe the CNP model and their tobacco-related work in community-based research, education, and training using a tobacco disparities research framework. We conducted a comprehensive review of the CNP tobacco-related activities including publications, published abstracts, research activities, trainee pilot studies, policy-related activities, educational outreach, and reports produced from 2005-2009. Two authors categorized the tobacco-related activities and publications within the framework. Although there was no mandate to address tobacco, the CNPs produced 103 tobacco-related peer-reviewed publications, which reflects the largest proportion (12%) of all CNP cancer-related publications. Selected publications and research activities were most numerous under the framework areas &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Psychosocial Research,&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Surveillance,&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Epidemiology,&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Treatment of Nicotine…
Breast cancer is the most common cancer among Chinese American women in California, and previous ... more Breast cancer is the most common cancer among Chinese American women in California, and previous data suggested nearly 40% of the Chinese American women over 40 years old had not have a mammogram in the past year. Studies revealed that underutilization of cancer screening services among ethnic minorities are often attributed to factors such as language difficulties, cultural values and beliefs, and fear of cancer. The study was designed to investigate if young children's theatrical performance is an effective venue in delivering health messages to the Chinese immigrant community. The Health Belief Model was employed as the theoretical framework for the intervention. A total of 177 pre- and post-performance surveys were collected at four San Francisco preschools. The participant's age ranged from 25-77 years. Approximately 70% of participants' relationships to preschoolers were mothers. Participant's length of stay in the United States ranged from 3 days 68 years. Abo...
Few studies have examined completion of advance directives (AD) in Asian Americans. Little is kno... more Few studies have examined completion of advance directives (AD) in Asian Americans. Little is known about advance care planning (ACP) among Asian Americans who attend churches. We describe AD completion and associated attitudes and beliefs among church-going older Chinese and Vietnamese American adults age 50 and older. A convenience sample of 140 Chinese (79% female, 96% immigrants) and 131 Vietnamese (27% female, 99% immigrants) adults age 50 and older who attended 2 Chinese and 2 Vietnamese Christian churches in Northern California answered a self-administered, paper survey. The survey assessed awareness and completion of AD (Living Will or Durable Power of Attorney for Health Care [DPOA]) and associated attitudes, beliefs, influences, and norms. Most respondents had never heard of a Living Will (50% Chinese, 78.6% Vietnamese) or DPOA (56.1% Chinese, 79% Vietnamese). Few (20.7% Chinese, 13.5% Vietnamese) had completed an AD. The most commonly reported influence on AD completion w...
Journal of Health Care for the Poor and Underserved, 2015
The nail salon sector is booming, predominantly with Vietnamese immigrant workers who regularly h... more The nail salon sector is booming, predominantly with Vietnamese immigrant workers who regularly handle nail care products containing harmful chemicals. Based on lessons learned from an ongoing randomized controlled trial, occupational interventions need to incorporate inputs from different stakeholders, including salon owners, workers, and customers as well as governmental regulatory agencies.
Women's Health Issues, 2011
Purpose-To report the effectiveness of a prenatal intervention and to provide evidence that prena... more Purpose-To report the effectiveness of a prenatal intervention and to provide evidence that prenatal visits provide an opportune time for health assessment and counseling with abused women.
Journal of Pediatric Dentistry, 2015
Journal of the American Dental Association (1939), 2014
The authors conducted a study of tweets posted on Twitter to compare self-reported toothache expe... more The authors conducted a study of tweets posted on Twitter to compare self-reported toothache experiences with those of backache, earache and headache in regard to pain intensity, action taken, perceived cause and effect of pain. From a total of 508,591 relevant tweets collected on seven nonconsecutive days, the authors randomly selected 1,204 tweets (301 per pain type) and conducted content analyses of each tweet. Toothaches were described as having higher pain intensity than were earaches or headaches but pain intensity comparable with that of backaches. Despite people who experience toothache being more likely to seek health care than those experiencing backaches (odds ratio [OR], 3.91; 95 percent confidence interval [CI], 1.57-9.71) or headaches (OR, 6.11; 95 percent CI, 2.16-17.25), only one in 10 people with toothaches mentioned seeking health care for their pain. People with toothaches were less likely to report an effect on daily functioning compared with those with backaches...