Moon S. Chen, Jr., Tung Nguyen, Susan Stewart, Edward Chow, Reginald Ho, May Ying Ly, Marjorie Kagawa-Singer, Vicky Taylor

Transcription

1 How the Asian American Network for Cancer Awareness Research and Training (AANCART) evaluates the reduction of cancer health disparities among Asian Americans Moon S. Chen, Jr., Tung Nguyen, Susan Stewart, Edward Chow, Reginald Ho, May Ying Ly, Marjorie Kagawa-Singer, Vicky Taylor

2 ACKNOWLEDGMENTS & APPRECIATION AANCART is funded by the NCI Center to Reduce Cancer Health Disparities, U01 CA Appreciation to AANCART colleagues, Khanh Le, AANCART Program Manager, and Gina Dayton, Population Research & Cancer Disparities Manager for their work.

3 The Asian American cancer burden is Unique: only group to have cancer as the leading cause of death. Unusual Unnecessary

4 AANCART Regions

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7 Objectives for Presentation Challenges: what we face Conduct: what we did or are doing Conclusions: what we accomplish

8 Challenge #1: what we face Rigorous evaluation designs are Resource-intensive

9 Challenge #2 Needing locally-specific baseline data

10 Challenge #3 Cultural, ethnic & linguistic heterogeneity

11 Lands of origin for Asian Americans

12 Conduct: what we did or are doing

13 City Population Cancer Risk Vietnamese in San Francisco Chinese in San Francisco Koreans in Los Angeles Korean

14 City Population Cancer Risk Filipinos in Hawaii Hmong in Sacramento Cambodians in Seattle

15 Healthy Colon, Healthy Life Intervention 1: Culturally Tailored Brochure, FOBT Kit, n = 385 Vietnamese n = 900 Intervention 2: Culturally Tailored Brochure, FOBT Kit, PLUS Telephone Counseling, n = 385 Control: Usual Care, n = 130 Baseline Survey Intervention Brochure plus FOBT Kit Telephone Counseling Follow-up Survey Walsh J. et al. Healthy Colon, Healthy Life. ACS

16 Effects of Intervention in Vietnamese Baseline Follow up Change P* P** N (%) N (%) N (%) FOBT Control Group 1 43 (46.2) 149 (55.6) 54 (58.1) 175 (65.3) <0.001 Group (53.0) 219 (78.5) SIG/COL Control 35 (37.6) 46 (49.5) Group (43.3) 149 (55.6) Group (44.1) 151 (54.1) ANY CRC Control Group 1 62 (61.4) 208 (77.6) 71 (76.3) 231 (86.2) Group (73.5) 255 (91.4) Walsh J. et al. Healthy Colon, Healthy Life. ACS

17 Chinese Community Colorectal Initiative San Francisco, CA

18 Chinese Community Colorectal Initiative San Francisco, CA Annual CME ( )with Screening Guidelines each session Understanding colorectal cancer & Screening(2005) Surgical Treatment (2006) Chemotherapy (2007) Medical group adds colorectal screening for pay-forperformance Pre-post tests showed statistically significant increase in awareness of screening guidelines , shows 10% increase in colonoscopies (to 60/1000)

19 Korean Colorectal Cancer Screening Efforts Angela M. Jo, MD, MSHS Koy Parada, PhD(c), MPH Marjorie Kagawa-Singer, PhD, RN, MN Roshan Bastani, PhD Paul Murata, MD, MPH Annette Maxwell, DrPH Collaborating community based organizations Korean Resource Center Koryo Health Foundation Community Clinic

20 FOBT sample return rates Event Format Number participated Number of kits Number returned Return rate Festival One-one % KRC HF Small grp % KRC HS Large grp % Total % Small group = participants / session x 4 sessions Large group = 124 participants x 1 session

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23 Have you ever had a Pap test? N = 421 Never had 117 (28%) Ever had 304 (72%) Current 225 (74%) No Response 2 (1%) Not Current 77 (25%)

24 Hepatitis B Knowledge and Practices among Cambodian Immigrants

25 Funded by the National Cancer Institute & National Center on Minority Health & Health Disparities (P01CA A1)

26 Utilize list of Hmong households Determine eligibility Interview to: 1. Collect baseline data 2. Verify eligibility CBO #1: HBV intervention with LHW/Navigator Random Assignment CBO #2: Dietary Control With LHW Follow-up interview: self-reported testing Verification of testing by checking medical records (on random sample)

27 Conclusions 1. Conductor of research, e.g., Vietnamese Healthy Colon study 2. Capacity-builder, e.g., CME in SF; Angela Jo; Hmong 3. Convener/Catalyst, e.g., P01: Liver Cancer Control Interventions for Asian Americans; Cambodians 4. Considerable & count-able impact in each of populations 5. Conveyer/Communicator/Connections

28 The longest journey begins with a single step. Ancient Chinese Proverb