Encouraging Vietnamese-American women to obtain Pap tests through lay health worker outreach and media education Authors
Cite this article as: Lam, T.K., McPhee, S.J., Mock, J. et al. J GEN INTERN MED (2003) 18: 516. doi:10.1046/j.1525-1497.2003.21043.x Abstract BACKGROUND: Five times more Vietnamese-American women develop cervical cancer than white women. Few studies have examined whether community-based participatory research can effectively address Asian immigrants’ health problems. This article reports the preliminary evaluation of 1 such project. METHODS: A coalition of 11 organizations in Santa Clara County, California worked with university researchers to design and simultaneously implement a media education (ME) campaign and a lay health worker outreach (LHWO) program to increase Vietnamese-American women’s cervical cancer awareness, knowledge, and screening. Two agencies each recruited 10 lay health workers (LHWs), who, in turn, each recruited 20 women who were then randomized into 2 groups: 10 to LHWO+ME ( n=200) and 10 to ME alone ( n=200). LHWs organized meetings with women to increase their knowledge and to motivate them to obtain Pap tests. Participants completed pre- and post-intervention questionnaires. RESULTS: At post-intervention, significantly more LHWO+ME women understood that human papillomavirus and smoking cause cervical cancer. The number of women who had obtained a Pap test increased significantly among women in both LHWO+ME and ME groups, but substantially more in the LHWO+ME group. Significantly more LHWO+ME women said they intended to have a Pap test. CONCLUSIONS: Media education campaigns can increase Vietnamese women’s awareness of the importance of Pap tests, but lay health workers are more effective at encouraging women to actually obtain the tests. Lay health workers are effective because they use their cultural knowledge and social networks to create change. Researchers, community members, and community-based organizations can share expert knowledge and skills, and build one another’s capacities. Key Words cervical cancer screening Vietnamese lay health worker media
This research was funded by the Centers for Disease Control and Prevention under Cooperative Agreement #U50/CCU917412. Its contents are solely the responsibility of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention. The Asian American Network for Cancer Awareness, Research and Training also supported Ms. Nguyen and Drs. McPhee and Mock through National Cancer Institute Cooperative Agreement #U01/CA86322.
Israel BA, Schulz AJ, Parker EA, Baker AB. Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Public Health. 1998;19:173–202.
Lantz PM, Viruell-Fuentes E, Israel BA, Softley D, Guzman R. Can communities and academia work together on public health research? Evaluation results from a community-based participatory research partnership in Detroit. J Urban Health. 2001;78:495–507.
Schulz AJ, Parker EA, Israel BA, Becker AB, Maciak BJ, Hollis R. Conducting a participatory community-based survey: collecting and interpreting data for a community health intervention on Detroit’s East Side. J Public Health Manag Pract. 1998;4:10–24.
Macaulay A, Gibson N, Commanda L, McCabe M, Robbins C, Twohig P. Responsible Research with Communities: Participatory Research in Primary Care. North American Primary Care Research Group Policy Statement. November 6, 1998. Available at: http://napcrg.org/exec.html. Accessed March 13, 2002.
Miller BA, Kolonel LN, Bernstein L, et al. (eds). Racial/Ethnic Patterns of Cancer in the United States 1988–1992. National Cancer Institute Publication NIH 96-4104. Bethesda, Md: National Cancer Institute; 1996.
McPhee SJ, Bird JA, Davis T, Ha NT, Jenkins CN, Le B. Barriers to breast and cervical cancer screening among Vietnamese-American women. Am J Prev Med. 1997;13:205–13.
McPhee SJ, Stewart S, Brock KC, Bird JA, Jenkins CN, Pham GQ. Factors associated with breast and cervical cancer screening practices among Vietnamese-American women. Cancer Detect Prev. 1997;21:510–21.
Jenkins CNH, McPhee SJ, Bird JA, et al. Effect of a medialed education campaign on breast and cervical cancer screening among Vietnamese-American women. Prev Med. 1999;28:395–406.
Nguyen TT, McPhee SJ, Nguyen T, Lam T, Mock J. Predictors of cervical Pap smear screening awareness, intention, and receipt among Vietnamese-American women. Am J Prev Med. 2002;23:207–14.
Yi JK. Factors associated with cervical cancer screening behavior among Vietnamese women. J Community Health. 1994;19:189–200.
Yi JK. Acculturation and Pap smear screening practices among college-aged Vietnamese women in the United States. Cancer Nurs. 1998;21:335–41.
Jenkins CNH, McPhee SJ, Bird JA, Bonilla NT. Cancer risks and preventive behaviors among Vietnamese refugees. West J Med. 1990;153:34–9.
Pham CT, McPhee SJ. Knowledge, attitudes, and practices of breast and cervical cancer screening among Vietnamese women. J Cancer Educ. 1992;1:305–10.
Centers for Disease Control. Behavioral risk factor survey of Vietnamese-California, 1991. MMWR Morb Mortal Wkly Rep. 1992;41:69–72.
Jenkins CNH, Le T, McPhee SJ, Stewart S, Ha NT. Health care access and preventive care among Vietnamese immigrants: do traditional beliefs and practices pose barriers? Soc Sci Med. 1996;43:1049–56.
Bird JA, McPhee SJ, Ha NT, Le B, Davis T, Jenkins CN. Opening pathways to cancer screening for Vietnamese-American women: lay health workers hold a key. Prev Med. 1998;27:821–9.
Racial and Ethnic Approaches to Health REACH 2010. Centers for Disease Control; 1999. Available at: http://www.cdc.gov/reach 2010. Accessed May 6, 2002.
U.S. Census Bureau. American Fact Finder, 2000. Available at: http://factfinder.census.gov/serlet/BasicFactsServlet. Accessed April 2, 2002.
Bouvier LF, Martin P. Population Change and California’s Future. Washington, DC: Population Reference Bureau; 1985.
McPhee SJ. Caring for a 70-year-old Vietnamese woman. Clinical Crossroads. JAMA. 2002;287:495–503.
Walsh JME, McPhee SJ. A systems model of clinical preventive care: an analysis of factors influencing patient and physician. Health Educ Q. 1992;19:157–75.
Hiatt RA, Pasick RJ, Perez-Stable E, McPhee SM, Engelstad L, Lee M. Pathways to early cancer detection in the multiethnic population of the San Francisco Bay Area. Health Educ Q. 1996;23(Suppl):10–27.
Green LW, Kreuter MW. Health Promotion Planning: An Educational and Environmental Approach, 2
nd ed. Mountain View, Calif: Mayfield; 1991.
Jenkins CNH, McPhee SJ, Le A, Pham GQ, Ha N-T, Stewart S. Effectiveness of a media-led intervention to reduce smoking prevalence among Vietnamese men. Am J Public Health. 1997;87:1031–4.
Lai KQ, McPhee SJ, Jenkins CNH, Wong C. Applying the Quit & Win contest model in the Vietnamese community in Santa Clara County. Tob Control. 2000;9:1–4.
McPhee SJ, Nguyen T, Wong C, Euler GL, Chau B, Do S. Successful promotion of hepatitis B immunizations among Vietnamese-American children aged 3 to 18: results of a controlled trial. Pediatrics. 2003;111:1278–88.
Bird JA, Otero-Sabogal R, Ha NT, McPhee SJ. Tailoring lay health worker interventions for diverse cultures: lessons learned from Vietnamese and Latina communities. Health Educ Q. 1996;23(Suppl):105–22.
McPhee SJ. Promoting breast and cervical cancer screening among Vietnamese American women: two interventions. Asian Am Pac Isl J Health. 1998;6:344–50.
Navarro AM, Senn KL, McNicholas L, Kaplan R, Roppe B, Campo M. Por La Vida model intervention enhances use of cancer screening tests among Latinas. Am J Prev Med. 1998;15:32–41.
McPhee SJ, Nguyen TT, Shema SJ, et al. Validation of recall of breast and cervical cancer screening by women in an ethnically diverse population. Prev Med. 2002;35:463–73.
PubMed CrossRef Copyright information
© Society of General Internal Medicine 2003