Jenny K. Yi

FACTORS ASSOCIATED WITH CERVICAL CANCER SCREENING BEHAVIOR AMONG VIETNAMESE WOMEN

The purpose of this study was to gather information on the prevalence of pap smear testing among Vietnamese women and to identify predictive factors that influence women to engage in early cervical cancer detection behavior. One hundred and forty-one (141) Vietnamese women ages 18 years and older and living in Western Massachusetts were surveyed by telephone. The overall socioeconomic status of these women was low. Survey results showed that among these women, the use of pap tests was lower than for the U.S. female population in general. Approximately one-half of the respondents reported having had a pap smear. Bivariate and multivariate methods, including logistic regression, were used to analyze the differences between users and nonusers. Bivariate analysis revealed that age, marital status, number of children, religion, regular physician care, and income were significantly related to a prior pap smear experience. The multivariate model for pap test included: age, income, length of residence in the U.S., and marital status. Compared to women who had never had a pap test, women who had were older, married, had higher incomes, and lived in the U.S. longer. It was concluded that this model is useful for screening cancer behavior in Vietnamese women 18 years and older and living in Western Massachusetts, but, in general, should not be used as a cancer screening tool in other populations, at least until similar assessments have been done for these populations.The purpose of this study was to gather information on the prevalence of pap smear testing among Vietnamese women and to identify predictive factors that influence women to engage in early cervical cancer detection behavior. One hundred and forty-one (141) Vietnamese women ages 18 years and older and living in Western Massachusetts were surveyed by telephone. The overall socioeconomic status of these women was low. Survey results showed that among these women, the use of pap tests was lower than for the U.S. female population in general. Approximately one-half of the respondents reported having had a pap smear. Bivariate and multivariate methods, including logistic regression, were used to analyze the differences between users and nonusers. Bivariate analysis revealed that age, marital status, number of children, religion, regular physician care, and income were significantly related to a prior pap smear experience. The multivariate model for pap test included: age, income, length of residence in the U.S., and marital status. Compared to women who had never had a pap test, women who had were older, married, had higher incomes, and lived in the U.S. longer. It was concluded that this model is useful for screening cancer behavior in Vietnamese women 18 years and older and living in Western Massachusetts, but, in general, should not be used as a cancer screening tool in other populations, at least until similar assessments have been done for these populations.

Vietnamese American College Students' Knowledge and Attitudes Toward HIV/AIDS

Mail and telephone surveys were used to investigate the extent of HIV-related knowledge and attitudes among Vietnamese-American college students. Findings indicated that the 412 respondents who completed the survey were aware of the major modes of HIV transmission but had many misconceptions about HIV. Female students were more knowledgeable than male students, but sexually active participants were less knowledgeable than those who were not sexually active. The findings also suggest that respondents were not comfortable discussing their HIV and safe sex concerns with their sexual partners. The results of the study underscore the need for culturally sensitive HIV/AIDS education for Vietnamese students, especially for those who are sexually active. HIV prevention interventions should be directed toward this minority ethnic group to maintain the currently low rates of HIV infection.

English Proficiency, Symptoms, and Quality of Life in Vietnamese- and Chinese-American Breast Cancer Survivors

CONTEXT In the United States, limited English proficiency has been shown to have a negative influence on effective functioning in the health care environment. Minority immigrant populations, therefore, may be especially vulnerable to poorer symptom management and quality of life (QOL) during and after cancer treatment, given their limited language skills. Breast cancer is the most prevalent cancer in Asian-American women but little is known about its adverse consequences in this population. OBJECTIVES We examined the extent to which English proficiency was associated with symptoms and QOL in Chinese- (n = 72) and Vietnamese-American (n = 25) breast cancer survivors in Houston, Texas. METHODS Data were collected through face-to-face interviews. Symptoms and QOL were assessed using the Edmonton Symptom Assessment Scale and the Quality of Life Instrument-Breast Cancer Patient Version (QOL-BC), respectively. RESULTS The most commonly reported severe symptoms (≥ 7 on a 0-10 scale) were lack of well-being (38%), fatigue (26%), pain (18%), lack of appetite (14%), anxiety (14%), and feeling depressed (14%). For the QOL-BC, the physical (mean = 6.78; standard deviation [SD] = 1.28) and spiritual subscales (mean = 6.01; SD = 2.18) had the highest and lowest mean scores, respectively. Of the whole sample, 33% reported having the ability to understand, read, speak, and write in English very well. English proficiency was significantly associated with symptom distress (coefficient = -0.257; P = 0.011) and QOL (coefficient = -0.390; P = 0.002). CONCLUSION English proficiency has a significant impact on symptom distress and QOL. These findings may help the development of services to meet the unique needs of Vietnamese- and Chinese-American breast cancer survivors.

Breast cancer screening practices among low-income Vietnamese women.

Cancer is the leading cause of death among Asian-American women in the United States and breast cancer is the most commonly diagnosed cancer among Asian-American women. Early detection through breast cancer screening has been found to improve the rate of survival for breast cancer. This study examined factors associated with breast cancer screening among 345 Vietnamese women ≥40 years old residing in a low-income Houston area. Data were collected through a self-administered questionnaire assessing socio-demographic characteristics, access to care factors, acculturation, and perceived susceptibility and severity of risks. Results showed 38 percent, 49 percent, and 33 percent of the respondents reporting having had a breast self-exam, a clinical breast exam, and a mammogram, respectively. Predictors of breast cancer screening include education, employment, ability to speak English, having lived in the United States for more than five years, and having a regular place of care. Implications of this study include the need for a culturally-relevant educational program for this understudied population.

Development of a Health Risk Factors Questionnaire for Chinese and Vietnamese Residents of the Houston, Texas Area

The purpose of the Asian American Health Needs Assessment (AsANA) project was to collect information on the health risks, behaviors, and beliefs among Chinese and Vietnamese residents in the Houston area, two of the largest Asian American subgroups in Texas. The first phase of the project was to develop the AsANA survey instrument, which was adapted from the Texas Community Health Survey, a condensed version of the Behavioral Risk Factors Surveillance System. This report describes the steps used in adapting, modifying and developing the survey instrument, and provides insights, which may assist other investigators conducting similar research.

Apartment-Based Breast Cancer Education Program for Low Income Vietnamese American Women

The purpose of the project was to develop and implement an apartment-based intervention that would improve the knowledge and preventive health habits of hard to reach low income Vietnamese women regarding breast cancer. The targets were Vietnamese women aged 40 and older who resided in apartments in low-income communities in Houston. Twenty apartments were identified and randomly assigned to intervention and control groups. A total of 345 Vietnamese women participated in the project. Follow-up telephone interviews were conducted at five months. Results showed that the intervention group demonstrated significant changes in knowledge and attitudes about breast cancer. Implications of this study include support for culturally appropriate education offered at convenient locations that emphasizes the benefits of early detection of breast cancer for low-income Vietnamese women.

Internet Use among Chinese-American breast Cancer survivors

This study describes information seeking behaviors and patient characteristics associated with Internet use by 72 Chinese-American breast cancer survivors diagnosed in the past 5 years and living in Houston, Texas. Face-to-face interviews showed that only 56% used the Internet for health information; only 9% used e-mail or visited a website to communicate with a doctors office or get online provider advice. Results indicate that health providers who want to reach breast cancer patients with limited English skills need to take into account this low use of Internet resources and web-based information. Particularly important is the need to develop and make available culturally effective and appropriate health information in the native languages of the patients to promote greater health literacy.