Erica Woodall

Hepatitis B and liver cancer beliefs among Korean immigrants in Western Washington

Hepatocellular cancer occurs more frequently among Koreans, Vietnamese, and Chinese than other racial/ethnic groups in the U.S. This excess risk can be attributed to high rates of chronic hepatitis B viral (HBV) infection and low rates of HBV vaccination among Asian immigrants. However, there is little available information regarding the hepatitis B knowledge, beliefs, and practices among Koreans, the fifth‐largest Asian population in the U.S. This brief report summarizes results from 30 qualitative interviews and two focus groups investigating hepatitis and liver cancer prevention, behavior, and beliefs among first‐generation Korean immigrant adults ages 18–64 years residing in the Seattle–Tacoma metropolitan area of Washington State. The report concludes with suggestions for future investigations to address the high rates of chronic HBV infection and hepatocellular cancer in this vulnerable population. Cancer 2005.

Evaluation of a Cervical Cancer Control Intervention Using Lay Health Workers for Vietnamese American Women

OBJECTIVES We conducted a trial to evaluate the effectiveness of a cervical cancer control intervention for Vietnamese American women that used lay health workers. METHODS 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 womens 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. RESULTS 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. CONCLUSIONS 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.

Pap smear receipt among Vietnamese immigrants: the importance of health care factors

Objective. Recent US data indicate that women of Vietnamese descent have higher cervical cancer incidence rates than women of any other race/ethnicity, and lower levels of Pap testing than white, black, and Latina women. Our objective was to provide information about Pap testing barriers and facilitators that could be used to develop cervical cancer control intervention programs for Vietnamese American women. Design. We conducted a cross-sectional, community-based survey of Vietnamese immigrants. Our study was conducted in metropolitan Seattle, Washington, DC. A total of 1532 Vietnamese American women participated in the study. Demographic, health care, and knowledge/belief items associated with previous cervical cancer screening participation (ever screened and screened according to interval screening guidelines) were examined. Results. Eighty-one percentage of the respondents had been screened for cervical cancer in the previous three years. Recent Pap testing was strongly associated (p<0.001) with having a regular doctor, having a physical in the last year, previous physician recommendation for testing, and having asked a physician for testing. Women whose regular doctor was a Vietnamese man were no more likely to have received a recent Pap smear than those with no regular doctor. Conclusion. Our findings indicate that cervical cancer screening disparities between Vietnamese and other racial/ethnic groups are decreasing. Efforts to further increase Pap smear receipt in Vietnamese American communities should enable women without a source of health care to find a regular provider. Additionally, intervention programs should improve patient–provider communication by encouraging health care providers (especially male Vietnamese physicians serving women living in ethnic enclaves) to recommend Pap testing, as well as by empowering Vietnamese women to specifically ask their physicians for Pap testing.

Sources of health information among Vietnamese American men

Vietnamese American men face multiple health disparities compared to white men. Our study objective was to determine the sources of health information used by Vietnamese men in the United States. A population-based, in-person survey was conducted among Vietnamese men in Seattle during 2002. Our survey was completed by 509 Vietnamese men (79% response rate). The most commonly reported sources of health information included Vietnamese newspapers/magazines (73%), Vietnamese and English language television (64% and 67%, respectively), Vietnamese radio (51%), and friends and family members (51% and 63%, respectively). We found that sources of health information varied significantly among sociodemographic subgroups of the Vietnamese male population. Sources of health information among Vietnamese American men differ considerably from other racial/ethnic groups. Research findings should be used to guide the development of health education interventions for Vietnamese men and subgroups within the Vietnamese male population.

Development of an ESL Curriculum to Educate Chinese Immigrants about Physical Activity

Regular physical activity reduces the risk of many chronic conditions. Multiple studies have shown that Asians in North America engage in less physical activity than the general population. One area for strategic development in the area of health education is the design and evaluation of English as a second language (ESL) curricula. The PRECEDE model and findings from focus groups were used to develop a physical activity ESL curriculum for Chinese immigrants. In general, focus group participants recognized that physical activity contributes to physical and mental wellbeing. However, the benefits of physical activity were most commonly described in terms of improved blood circulation, immune responses, digestion, and reflexes. The importance of peer pressure and the encouragement of friends in adhering to regular physical activity regimens were mentioned frequently. Reported barriers to regular physical activity included lack of time, weather conditions, and financial costs. The ESL curriculum aims to both promote physical activity and improve knowledge, and includes seven different ESL exercises. Our curriculum development methods could be replicated for other health education topics and in other limited English-speaking populations.

Heart Disease Prevention Practices among Immigrant Vietnamese Women

BACKGROUND Cardiovascular disease is a leading cause of death in the United States as well as in many countries around the world, including Vietnam. METHODS Using data from a household survey of Vietnamese American women aged 20-79 years in Seattle, Washington, collected in 2006 and 2007, we examined heart disease prevention practices. Multivariable analyses were conducted to examine the relationship between demographic factors and preventive behaviors. RESULTS A total of 1523 immigrant women completed interviews. The average daily consumption of fruits and vegetables was 3.5 servings, and 31% of our sample reported being physically active (engaging in at least 30 minutes of physical activity 5 or more days per week). Few respondents reported being current smokers (1.5%). Over three quarters of women had received a recent blood pressure check and a recent cholesterol check. Age and length of time in the United States were strongly associated with several cardiovascular prevention behaviors. CONCLUSIONS Our findings confirm the need for continued efforts to develop and implement targeted educational campaigns to reduce the risk of cardiovascular disease among Vietnamese American women.