Asian American and Pacific Islander journal of health最新文献

Purpose: The purpose of this paper is to describe 'Imi Hale, a program developed and managed by Native Hawaiians to increase cancer awareness and research capacity among Native Hawaiians. This US subgroup of indigenous people of the Hawaiian islands has disproportionately high rates of cancer mortality and low rates of participation in health and research careers.

Methods: As a community-based research project, 'Imi Hale spent its first year gathering data from Native Hawaiians about their cancer awareness and research priorities. These findings guide 'Imi Hale's community and scientific advisors, a community-based Institutional Review Board, Na Liko Noelo (budding researchers), and staff in developing and carrying out projects that address these priority areas. Emphasis is placed on transferring skills and resources to Native Hawaiians through training, technical assistance, and mentorship. A biennial survey assesses the extent to which community-based participatory research principles are being followed.

Principal findings: By the end of the school year, statewide and island-specific awareness plans were produced, and 9 funded awareness projects are supporting the development and dissemination of Hawaiian health education materials. Research accomplishments include the enrollment of 42 Native Hawaiian Na Liko Noelo (budding researchers), 22 of which are involved in 14 funded research projects. The biennial evaluation survey found that 92% of our advisors felt that 'Imi Hale was promoting scientifically rigorous research that was culturally appropriate and respectful of Native Hawaiian beliefs, and 96% felt that 'Imi Hale was following its own principles of community-based participatory research.

Conclusion: 'Imi Hale's community-based approach to promoting cancer awareness will result in a sustainable infrastructure for reducing the cancer burden on Native Hawaiians.

Purpose: The Pacific Islander Cancer Control Network (PICCN) is one of the 18 Special Populations Networks recently established by the National Cancer Institute (NCI) to address the cancer control needs of America's medically under-served populations. The PICCN focuses on three Pacific Islander groups: Samoans, Guamanians/Chamorros, and Tongan Americans. The program provides an infrastructure for collaboration between an academic institution, the University of California, Irvine; an NCI designated cancer center, the Chao Family Comprehensive Cancer Center; community-based organizations; and other agencies concerned with the health of Pacific Islanders.

Methods: The PICCN's objectives include improving cancer awareness, enhancing recruitment to clinical trials, increasing the number of cancer control investigators, and encouraging more research among these Pacific Islanders. The activities that increase cancer awareness include assessing existing cancer education materials aimed at Pacific Islanders, working with the NCI's Cancer Information Service to modify existing materials, developing new culturally-sensitive materials, and distributing the materials in a culturally-sensitive manner.

Principal findings: The PICCN enhances recruitment of Pacific Islanders to clinical trials by establishing relationships with cancer centers, making them aware of existing cancer center studies, and developing culturally appropriate recruitment materials when necessary. The network plans to increase the number of Pacific Islander investigators and encourage more research among Pacific Islanders by identifying potential investigators, informing them about existing cancer control training opportunities, developing a new training opportunity, and providing mentors to help with the development of pilot projects and RO1 applications.

Conclusion: Through these efforts, the PICCN is addressing the goal of eliminating health disparities among ethnic and racial minorities in this country.

Purpose: The purpose of this paper is to describe the content for the Asian American Network for Cancer Awareness Research and Training (AANCART) with respect to Asian American demographic characteristics and their cancer burden, highlights of accomplishments in various AANCART regions, aspirations for AANCART, and an interim assessment of AANCART's activities to date.

Methods: The author compiled literature and other data references to describe the context for Asian American demographic characteristics and their cancer burden. As the AANCART Principal Investigator, he collected data from internal AANCART reports to depict highlights of accomplishments in various AANCART regions and offer evidence that AANCART's first two specific aims have been attained.

Principal findings: With respect to our first specific aim, we have built an infrastructure for cancer awareness, research and training operationally at a Network-wide basis through program directors for biostatistics, community, clinical, and research and in our four original AANCART regions: New York, Seattle, San Francisco, and Los Angeles. With respect to our second specific aim, we have established partnerships as exemplified by working collaboratively with New York's Charles B. Wang Community Health Center in securing external funding with them for a tobacco control initiative and nationally with the American Cancer Society. With respect to our third specific aim, we have been fortunate to assist at least eight junior investigators in receiving NCI-funded pilot studies. The most notable change was the transfer of AANCART's national headquarters from Columbus, Ohio to Sacramento, California along with potentially an increased diversification of Asian American ethnic groups as well as an expansion to Hawaii and Houston.

Conclusion: As of the end of year 2 of AANCART, AANCART's two specific aims have been achieved. We are focusing on our third specific aim.

Purpose: This article identifies the urgent needs for tobacco and cancer control in Asian American communities and the barriers that have historically prevented the development and implementation of tobacco and cancer prevention and intervention research programs among Asian Americans residing in Delaware Valley region of Pennsylvania and New Jersey. This article also presents ATECAR, the first long-term federal effort in tobacco and cancer control targeting the multi-ethnic Asian American communities in this area.

Methods: ATECAR uses a three-pronged approach: the development of community and university infrastructure, the development of training programs for minority and underserved students so that they will pursue cancer research careers, and community-based intervention research projects.

Principal findings: ATECAR's pioneering work redefined our understanding of Asian Americans' smoking habits and the important role of smoking, especially in newly immigrated communities.

Conclusion: The advent of ATECAR marks the building of a viable infrastructure that can ensure sustainability of current and future efforts in tobacco control and use.

Purpose: This study examines the relationship between perinatal substance use and adverse pregnancy outcomes among a select group of high risk women residing in the state of Hawaii.

Methods: Participants were the 2,750 women who had live births during 1994 and 1995 and were enrolled in Hawaii's Perinatal Support Services (PSS) program. Demographic and behavioral risk factors associated with selection for participation in the PSS program were examined along with patterns of substance use and adverse perinatal outcomes.

Principal findings: After adjustment for demographic factors, Hawaiian/part Hawaiian women compared to non-Hawaiian women were 1.5 times as likely to drink alcohol (p<0.01) and 1.8 times as likely to smoke (p<0.001). Among these women, the relative risk (RR) for preterm delivery was significantly higher for those who used alcohol (RR=1.7, p=0.027), tobacco (RR=1.6, p=0.027), or illicit drugs (RR=1.8, 0.029). Among the same women, the relative risk for low birth weight was significantly higher for those who smoked (RR=1.6, p=0.010) or used illicit drugs (RR=1.7, p=0.046).

Conclusion: Hawaiian/part Hawaiian PSS women had a higher prevalence of substance use than non-Hawaiian PSS women, even after adjusting for age, education, and marital status. RELEVANCE TO ASIAN AMERICAN AND PACIFIC ISLANDER POPULATIONS: Special attention must be paid to the reasons why Hawaiian/part Hawaiian pregnant women use tobacco and alcohol at higher rates than women of other ethnic groups enrolled in Hawaii's PSS Program. Furthermore, services to assist pregnant women refraining from using illicit drugs should be supported.

Purpose: Translation of cross-cultural surveys and programs pose unique challenges. This paper identifies potential pitfalls of current translation guidelines and presents solutions employed for one project.

Methods: We followed current guidelines for translation of survey instruments including forward and back translation, and also utilized qualitative methods to decenter survey questions. In addition, our project adapted translation by committee with a core translation team of bilingual/trilingual investigators and staff members with diverse skills and complementary degrees of proficiency in the languages and dialects of interest.

Principal findings: This approach resulted with a mechanism for emic equivalence, identifying and resolving dialectic and sociolinguistic concerns, selecting appropriate written Chinese styles, and providing appropriate linguistic training to interviewers.

Conclusions: An understanding of the history of a people and its ramifications for the language are important components of the translation process. Allocation of appropriate time, resources, and skills are critical to the successful development of valid cross-cultural survey instruments and effective programs.

Objectives: We determined the most common diseases among adult Vietnamese men and women in Hawaii.

Methods: A chart review of 952 adult Vietnamese patients was conducted between January and February 2000. A data collection form with 39 categories of diagnosed chronic illnesses or problems was used. The study was conducted at a Vietnamese internist's private medical office in Honolulu, HI.

Results: Chart review revealed that the five most prevalent diagnostic conditions seen in Vietnamese men, from the highest to lowest frequency, were gastrointestinal disorders (39%), cutaneous conditions (31%), lower back pain (23%), headache (18%), and allergies (18%). In women, gastrointestinal disorders (38%), cutaneous conditions (34%), headache (32%), gynecologic conditions (30%), and arthritic diseases (24%) were most common. Gender, years of U.S. arrival, and types of occupation were significantly correlated with certain diseases (p< or =0.05).

Conclusions: This is the first study to examine frequency of diseases diagnosed in an ambulatory care setting in a cohort of Vietnamese patients in Hawaii.

Objectives: The objective of this paper is to discuss the epidemiology, etiology, and cultural phenomena that characterize cancers specific to Asian American males.

Methods: The author reviewed various published literature concerning the health of Asian American males.

Results: Data show an epidemiological dichotomy in cancer incidences between Asian American males and the general U.S. male population. First, lung and colorectal cancers are among the top three cancers for most Asian groups, similar to the situation in the White population. Second, prostate cancer is the leading, or second leading, cause of cancer for Chinese, Japanese, and Filipino males -- all groups considered, in U.S. terms, to be more established in their migration patterns. Third, liver and stomach cancer are in the top five cancers for most Asian groups, an incidence not shared by the White population.

Conclusions: The most common cancers in Asian American males involve the interplay of host genetic and environmental factors, and both primary and secondary prevention strategies are necessary to decrease the morbidity and mortality rates of this uniquely diverse population.

Objectives: In this paper, we assess the state of scientific study of cancer among Thais, one of the most underserved AAPI populations.

Methods: We reviewed published literature and a database of Federally-funded research in the United States.

Results: We found virtually no cancer-related research on the Thai population in the U.S. A review of the international literature, including studies conducted in Thailand, shows that Thais are at significant risk for developing lung, liver, colorectal, breast, and cervical cancers.

Conclusions: Given the sizable Thai population in the U.S. and the high likelihood that this population has been suffering from cancer, we recommend that Thais be classified separately in cancer registries and that they receive culturally meaningful outreach and support.