Steven E. Shive

Knowledge, Attitudes, and Behaviors of Hepatitis B Screening and Vaccination and Liver Cancer Risks Among Vietnamese Americans

Hepatitis B Virus (HBV) infection is a serious health problem among Asian Americans. Vietnamese Americans are disproportionately affected by liver cancer compared with other racial and ethnic groups. Vietnamese males have the highest incidence of liver cancer of any racial group; incidence of liver cancer among Vietnamese males is 11 times higher than among White males. Nearly 80% of liver cancer is attributed to HBV. This study measured knowledge, attitudes, and behaviors related to HBV screening and vaccination. The study was conducted among 256 Vietnamese Americans in the greater Philadelphia and New Jersey area, with a large number of underserved, recent immigrants with low socioeconomic status and limited English proficiency. Participants were recruited from Vietnamese community-based organizations. Overall, 46.3% of the sample had heard of HBV or knew about the availability of screening (32.6%) or vaccination (35.5%) while 7.5% were ever screened and 6.3% had been vaccinated. Community-based, culturally appropriate interventions for Vietnamese Americans and health care providers should increase screening and vaccination rates.

Evaluation of the Energize Your Life! Social Marketing Campaign Pilot Study to Increase Fruit Intake Among Community College Students

In this study, the authors evaluated the effectiveness of the Energize Your Life! social-marketing campaign pilot study to improve knowledge, attitudes, and fruit intake among community college students. The authors used a cross-sectional, quasi-experimental, pre- and posttest design. They randomly selected community college students (N = 1,367) and exposed the intervention campus to fruit fairs to distribute fresh fruit, 100% fruit juice, and fruit smoothie samples and information about fruit to students. The authors also addressed policy change to increase the accessibility of fruit on campus. There was a significant increase in fruit intake between pre- and posttest at the intervention campus. Although students had positive attitudes toward intake, most did not achieve the minimum recommended daily 2 servings of fruit. Approximately 25% of the students had insufficient funds, which affected their food intake. Longer-term social marketing interventions may be an effective means of improving the dietary quality of community college students.

Factors Associated With Cervical Cancer Screening Compliance and Noncompliance among Chinese, Korean, Vietnamese, and Cambodian Women

OBJECTIVE The purpose of this study was to determine factors associated with cervical cancer screening compliance and noncompliance among Chinese, Korean, Vietnamese, and Cambodian women aged 18 years and older. METHODS A cross-sectional design was used. The sample consisted of 1049 women aged 18 or older, of whom 37.94% reported never having been screened for cervical cancer, 23.55% reported noncompliance, and 38.51% were in compliance with screening guidelines. The sample was comprised of Chinese, 50.58%; Koreans, 17.50%; Vietnamese, 16.15%; and Cambodians, 15.77%. RESULTS Education was significantly associated with never having been screened for cervical cancer for Cambodians. Low income (<

The Impact of Acculturation on Smoking in Asian American Homes

10000) was significantly associated with never having been screened for Cambodian and Chinese women. Not having health insurance was significantly correlated with not getting screened for all ethnic groups. Age and living in the United States less than 15 years were significantly correlated with never having been screened for Vietnamese, Korean, and Chinese women. Marital status was significantly correlated with not getting screened for Korean and Chinese women. English fluency was significantly associated with screening for Cambodians, Koreans, and Chinese. Barriers associated with women who were never screened compared to those barriers for women who were screened and were compliant included lack of knowledge, psychosocial, no insurance, language, transportation, and lack of time, but these barriers were different among the 4 ethnic groups. CONCLUSION Compliance with cervical cancer screening guidelines among Asian American women can be enhanced significantly by providing culturally and linguistically appropriate educational and early intervention programs.

Asian Tobacco Education and Cancer Awareness Research Special Population Network. A model for reducing Asian American cancer health disparities.

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Health seeking behavioral analysis associated with breast cancer screening among Asian American women

Asian Americans are the fastest growing and the second largest foreign‐born ethnic group in the United States. Cancer is a leading cause of death among Asian Americans. The Asian Tobacco Education and Cancer Awareness Research (ATECAR) Special Population Network, Center for Asian Health, aimed to reduce or eliminate cancer health disparities in these diverse, underserved populations in Pennsylvania, New Jersey, Delaware, and New York. The ATECAR logic model was adapted from a variety of conceptual frameworks to develop and implement the networks multifaceted cancer health disparities research, training, awareness, and outreach programs. The model was the basis for the developmental phases of the network that included (1) needs assessment, infrastructure, and partnership building; (2) intervention research, training, and mentorship; and (3) evaluation, dissemination, and diffusion. Community involvement occurred at every operational level to ensure program and network sustainability. Between 2000 and 2005, the ATECAR network consisted of 88 partners, representing a cross‐section of Asian communities, academia, cancer centers, and health service agencies, ensuring a viable infrastructure for the networks multidimensional cancer health disparities programs. ATECARs research covered tobacco control, cancer prevention and intervention, and clinical trials. More than 22 research projects were conducted and their results disseminated in peer‐reviewed journals. ATECAR also trained 76 junior researchers and special population investigators and 1014 community professionals in disparity issues. ATECARs multimedia cancer awareness education program reached over 116,000 Asians. The ATECAR networks achievements have had a profound impact on Asian Americans and established a trend toward reducing cancer health disparities, especially among underserved Asian Americans. Cancer 2006.

Prostate cancer screening among chinese american men: a structural model.

Objective The purpose of this community-based study was to apply a Sociocultural Health Behavior Model to determine the association of factors proposed in the model with breast cancer screening behaviors among Asian American women. Methods A cross-sectional design included a sample of 682 Chinese, Korean, and Vietnamese women aged 40 years and older. The frequency distribution analysis and Chi-square analysis were used for the initial screening of the following variables: sociodemographic, cultural, enabling, environmental, and social support. Univariate and multivariate analyses were conducted on factors for breast cancer screening using multinomial logistic regression analysis. Results Correlates to positive breast cancer screening included demographics (ethnicity), cultural factors (living in the United States for 15 years or more, speaking English well), enabling factors (having a regular physician to visit, health insurance covering the screening), and family/social support factors (those who had a family/friend receiving a mammogram). Conclusions The results of this study suggest that breast cancer screening programs will be more effective if they include the cultural and health beliefs, enabling, and social support factors associated with breast cancer screening. The use of community organizations may play a role in helping to increase breast cancer screening rates among Asian American women.

Pathways of cervical cancer screening among Chinese women.

OBJECTIVE To test the Sociocultural Health Behavior Model in relation to the health behavior of prostate cancer (PCa) screening among Chinese American men. METHODS Confirmatory factor analysis and structural equation model analyses were conducted among Chinese American men. RESULTS The path analysis supported the components of the sociocultural model and indicated a positive and significant relationship between PCa screening and the enabling factors; between cultural factors and predisposing, enabling, and access/satisfaction with health care factors; and between enabling factors and access/satisfaction with health care. CONCLUSIONS The model highlights the significance that sociocultural factors play in relation to PCa screening.

Improving Our Application of the Health Education Code of Ethics

Background The purpose of this community-based study was to develop a structural equation model for factors contributing to cervical cancer screening among Chinese American women. Methods A cross-sectional design included a sample of 573 Chinese American women aged 18 years and older. The initial step involved use of confirmatory factor analysis, that included the following variables: access to and satisfaction with health care, and enabling and predisposing cultural and health beliefs. Structural equation model analyses were conducted on factors related to cervical cancer screening. Results Age, marital status, employment, household income, and having health insurance, but not educational level, were significantly related to cervical screening status. Predisposing and enabling factors were positively associated with cervical cancer screening. The cultural factor was significantly related to the enabling factor or the satisfaction with health care factor. Conclusion This model highlights the significance of sociocultural factors in relation to cervical cancer screening. These factors were significant, with cultural, predisposing, enabling, and health belief factors and access to and satisfaction with health care reinforcing the need to assist Chinese American women with poor English fluency in translation and awareness of the importance of cervical cancer screening. Community organizations may play a role in assisting Chinese American women, which could enhance cervical cancer screening rates.

Pathways of Breast Cancer Screening Among Chinese American Women

The Health Education Code of Ethics was designed to provide a framework of shared values within which health education might be practiced. However, an informal survey conducted on a limited sample in November 2004 indicated that ethics and how to apply the code are topics not readily taught formally within all health education programs. There is, however, an expressed interest among health educators in understanding the code and its application. Because of the immense import of ethics, affecting responsible professional conduct at all levels, this article is designed to introduce the topic to health education practitioners who have had little formal exposure to ethics curricula, as well as to faculty who would like to teach this subject. The authors specifically review several resources that might be especially helpful in fostering a better understanding of this essential but often underestimated aspect of health education practice and research, namely, its ethical application.