Leading causes of death in Vietnamese Americans: An ecological study based on national death records from 2005-2020.

BACKGROUND: Disaggregated data is a cornerstone of precision health. Vietnamese Americans (VietAms) are the fourth-largest Asian subgroup in the United States (US), and demonstrate a unique burden of disease and mortality. However, most prior studies have aggregated VietAms under the broader Asian American category for analytic purposes. This study examined the leading causes of death among VietAms compared to aggregated Asian Americans and non-Hispanic Whites (NHWs) during the period 2005-2020. METHODS: Decedent data, including underlying cause of death, were obtained from the National Center for Health Statistics national mortality file from 2005 to 2020. Population denominator estimates were obtained from the American Community Survey one-year population estimates. Outcome measures included proportional mortality, age-adjusted mortality rates per 100,000 (AMR), and annual percent change (APC) in mortality over time. Data were stratified by sex and nativity status. Due to large differences in age structure, we report native- and foreign-born VietAms separately. FINDINGS: We identified 74,524 VietAm decedents over the study period (71,305 foreign-born, 3,219 native-born). Among foreign-born VietAms, the three leading causes of death were cancer (26.6%), heart disease (18.0%), and cerebrovascular disease (9.0%). Among native-born VietAms the three leading causes were accidents (19.0%), self-harm (12.0%), and cancer (10.4%). For every leading cause of death, VietAms exhibited lower mortality compared to both aggregated Asians and NHWs. Over the course of the study period, VietAms witnessed an increase in mortality in every leading cause. This effect was mostly driven by foreign-born, male VietAms. CONCLUSIONS AND RELEVANCE: While VietAms have lower overall mortality from leading causes of death compared to aggregated Asians and NHWs, these advantages have eroded markedly between 2005 and 2020. These data emphasize the importance of racial disaggregation in the reporting of public health measures.

Supportive Care Needs in Chinese, Vietnamese, and Korean Americans With Metastatic Cancer: Mixed Methods Protocol for the DAWN Study.

BACKGROUND: Asian Americans with metastatic cancer are an understudied population. The Describing Asian American Well-Being and Needs in Cancer (DAWN) Study was designed to understand the supportive care needs of Chinese-, Vietnamese-, and Korean-descent (CVK) patients with metastatic cancer. OBJECTIVE: This study aims to present the DAWN Study protocol involving a primarily qualitative, convergent, mixed methods study from multiple perspectives (patients or survivors, caregivers, and health care professionals). METHODS: CVK Americans diagnosed with solid-tumor metastatic cancer and their caregivers were recruited nationwide through various means (registries, community outreach newsletters, newspapers, radio advertisements, etc). Potentially eligible individuals were screened and consented on the web or through a phone interview. The study survey and interview for patients or survivors and caregivers were provided in English, traditional/simplified Chinese and Cantonese/Mandarin, Vietnamese, and Korean, and examined factors related to facing metastatic cancer, including quality of life, cultural values, coping, and cancer-related symptoms. Community-based organizations assisted in recruiting participants, developing and translating study materials, and connecting the team to individuals for conducting interviews in Asian languages. Health care professionals who have experience working with CVK patients or survivors with metastatic solid cancer were recruited through referrals from the DAWN Study community advisory board and were interviewed to understand unmet supportive care needs. RESULTS: Recruitment began in November 2020; data collection was completed in October 2022. A total of 66 patients or survivors, 13 caregivers, and 15 health care professionals completed all portions of the study. We completed data management in December 2023 and will submit results for patients or survivors and caregivers to publication outlets in 2024. CONCLUSIONS: Future findings related to this protocol will describe and understand the supportive care needs of CVK patients or survivors with metastatic cancer and will help develop culturally appropriate psychosocial interventions that target known predictors of unmet supportive care needs in Chinese, Vietnamese, and Korean Americans with metastatic cancer. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/50032.

Tips to Quit Smoking: Perspectives from Vietnamese Healthcare Providers, Community Leaders, and Past Tobacco Users in the United States.

This study focuses on smoking-cessation strategies for United States (US) Vietnamese individuals, a group with high smoking rates, particularly those with limited English proficiency (LEP). The researchers conducted 16 in-depth interviews with a diverse group of participants, including healthcare professionals, community leaders, and former tobacco users. Data were analyzed using the Phase-Based Model of smoking cessation, resulting in several helpful strategies across the four phases: Motivation, Preparation, Cessation, and Maintenance. Prominent advice for the Motivation Phase included having a strong determination to quit and a reason why, such as protecting loved ones. For the Preparation and Cessation Phases, participants recommended healthy coping mechanisms, avoiding triggers, changing habits, and gradually reducing the number of cigarettes smoked. In the Maintenance Phase, strategies included regular exercise and setting boundaries with other people who smoke. Participants also stressed the importance of social support throughout all four phases. These findings have implications for healthcare providers working with US Vietnamese who smoke, especially those with LEP. By understanding the unique challenges this group faces in accessing smoking-cessation resources, providers can offer tailored support and guidance. Ultimately, this study provides useful strategies for helping US Vietnamese quit smoking, improving their health outcomes and quality of life.

Cognitive Functioning and Nail Salon Occupational Exposure among Vietnamese Immigrant Women in Northern California.

Introduction: Vietnamese nail salon technicians are continuously exposed to neurotoxins linked to cognitive impairments and Alzheimer's disease. This study examined the association of occupational exposure with cognitive function and depressive symptoms among Vietnamese nail salon technicians. Methods: The sample included 155 current or former Vietnamese female nail technicians and 145 control group participants. Measures included the Montreal Cognitive Assessment (MoCA) and the Center for Epidemiologic Studies Depression Scale (CES-D). Results: Average cognitive functioning was significantly higher for the control compared to the nail technician group (mean difference = 1.2, p < 0.05). No differences were observed for depression. Multivariate findings revealed that exposure was negatively associated with cognitive functioning (ß = −0.29, 95% CI: −0.53, −0.05, p < 0.05). Discussion: Nail salon work and the extent of occupational exposure were associated with lower cognitive functioning among Vietnamese nail technicians. Longitudinal research can further examine the risk for cognitive decline and dementia for this vulnerable population.

Multilevel Pathways of Colorectal Cancer Screening Among Low-Income Vietnamese Americans: A Structural Equation Modeling Analysis.

BACKGROUND: Colorectal cancer (CRC) disproportionately affects Vietnamese Americans, especially those with low income and were born outside of the United States. CRC screening tests are crucial for prevention and early detection. Despite the availability of noninvasive, simple-to-conduct tests, CRC screening rates in Asian Americans, particularly Vietnamese Americans, remain suboptimal. The purpose of this study was to evaluate the interplay of multilevel factors - individual, interpersonal, and community - on CRC screening behaviors among low-income Vietnamese Americans with limited English proficiency. METHODS: This study is based on the Sociocultural Health Behavior Model, a research-based model that incorporates 6 factors associated with decision-making and health-seeking behaviors that result in health care utilization. Using a community-based participatory research approach, we recruited 801 Vietnamese Americans from community-based organizations. We administered a survey to collect information on sociodemographic characteristics, health-related factors, and CRC screening-related factors. We used structural equation modeling (SEM) to identify direct and indirect predictors of lifetime CRC screening. RESULTS: Bivariate analysis revealed that a greater number of respondents who never screened for CRC reported limited English proficiency, fewer years of US residency, and lower self-efficacy related to CRC screening. The SEM model identified self-efficacy (coefficient = 0.092, P < .01) as the only direct predictor of lifetime CRC screening. Educational attainment (coefficient = 0.13, P < .01) and health beliefs (coefficient = 0.040, P < .001) had a modest significant positive relationship with self-efficacy. Health beliefs (coefficient = 0.13, P < .001) and educational attainment (coefficient = 0.16, P < .01) had significant positive relationships with CRC knowledge. CONCLUSIONS: To increase CRC screening uptake in medically underserved Vietnamese American populations, public health interventions should aim to increase community members' confidence in their abilities to screen for CRC and to navigate associated processes, including screening preparation, discussions with doctors, and emotional complications.

Disaggregated mortality from gastrointestinal cancers in Asian Americans: Analysis of United States death records.

Asian Americans (AAs) are heterogeneous, and aggregation of diverse AA populations in national reporting may mask high-risk groups. Gastrointestinal (GI) cancers constitute one-third of global cancer mortality, and an improved understanding of GI cancer mortality by disaggregated AA subgroups may inform future primary and secondary prevention strategies. Using national mortality records from the United States from 2003 to 2017, we report age-standardized mortality rates, standardized mortality ratios and annual percent change trends from GI cancers (esophageal, gastric, colorectal, liver and pancreatic) for the six largest AA subgroups (Asian Indians, Chinese, Filipinos, Japanese, Koreans and Vietnamese). Non-Hispanic Whites (NHWs) are used as the reference population. We found that mortality from GI cancers demonstrated nearly 3-fold difference between the highest (Koreans, 61 per 100 000 person-years) and lowest (Asian Indians, 21 per 100 000 person-years) subgroups. The distribution of GI cancer mortality demonstrates high variability between subgroups, with Korean Americans demonstrating high mortality from gastric cancer (16 per 100 000), and Vietnamese Americans demonstrating high mortality from liver cancer (19 per 100 000). Divergent temporal trends emerged, such as increasing liver cancer burden in Vietnamese Americans, which exacerbated existing mortality differences. There exist striking differences in the mortality burden of GI cancers by disaggregated AA subgroups. These data highlight the need for disaggregated data reporting, and the importance of race-specific and personalized strategies of screening and prevention.

Development and Validation of a Scoring System to Predict Severe Acute Lower Gastrointestinal Bleeding in Vietnamese.

BACKGROUND/AIMS: The prevalence of acute lower gastrointestinal bleeding (ALGIB) has progressively increased worldwide but there are few studies in Asian populations. This study aimed to develop and validate a scoring system to predict severe ALGIB in Vietnamese. METHODS: Risk factors for severe ALGIB were identified by multiple logistic regression analysis using data from a retrospective cohort of 357 patients admitted to a tertiary hospital. These factors were weighted to develop the severe acute lower gastrointestinal bleeding (SALGIB) score to predict severe ALGIB. The performance of SALGIB was validated in a prospective cohort of 324 patients admitted to 6 other hospitals using area under the receiver operating characteristics curve (AUC) analysis. RESULTS: There were four factors at admission independently associated with severe ALGIB in the derivation cohort: heart rate ≥ 100/min, systolic blood pressure < 100 mmHg, hematocrit < 35%, and platelets ≤ 150 × 103/µL. The SALGIB score determined severe ALGIB with AUC values of 0.91 and 0.86 in the derivation and validation cohorts, respectively. A SALGIB score < 2 associated with low risk of severe ALGIB in both cohorts (3.7% and 1.2%; respectively). CONCLUSIONS: The SALGIB score has good performance in discriminating risk of severe ALGIB in Vietnamese.

"Let's Chat": process evaluation of an intergenerational group chat intervention to increase cancer prevention screening among Vietnamese American families.

Vietnamese Americans have a higher rate of cervical and colorectal cancer (CRC) compared to other ethnicities. Increasing CRC screening, Pap testing, and HPV vaccination is critical to preventing disproportionate cancer burden among Vietnamese families. To describe the successes and challenges of implementing a novel intergenerational family group chat intervention that encourages CRC screening, Pap testing, and HPV vaccination. Young adult Family Health Advocates (FHAs) were trained to facilitate online family group chat conversations to encourage cancer screenings. Ten families participated in a 4-week intervention. Data collection included screenshot data of family group chat conversations, family member surveys, and post-intervention FHA interviews. Intervention implementation successes included (a) cultural and language brokering, (b) active co-facilitation by family members to follow up on cancer screenings, (c) high levels of family group chat engagement, (d) high acceptability of intervention among families, and (e) accessibility of intervention curriculum. FHA challenges to implement the intervention included (a) sustaining cancer prevention conversations, (b) comfort with navigating family conversations around cancer screening, (c) relevance for all family members, and (d) missed opportunities for correcting misinformation. Researcher challenges included family recruitment and retention. The intervention made cancer-screening messages more accessible and was well accepted by Vietnamese families. Scaling up the intervention will require (a) training FHAs to monitor family conversations and build confidence in sharing medical accurate messages, (b) segmenting group chats by age and gender, and (c) employing multiple family engagement strategies.

Suc Khoe là Hanh Phúc (Health is Happiness): promoting mammography and pap test adherence among Vietnamese nail salon workers.

Vietnamese nail salon workers have low cancer screening rates and confront multiple socioeconomic disparities as immigrants to the US. The Suc Khoe là Hanh Phúc (Vietnamese for "Health is Happiness") program was adapted to the cultural and work needs of this population and implemented at nail salons to increase cancer screening adherence. A total of 186 study participants were recruited from 59 nail salons in a neighborhood with mostly Asian population. After being pretested, workers were enrolled in a cancer education session delivered by Vietnamese lay health workers. Non-adherent cases were offered navigation to cancer screening services to a local federally qualified health center. Participants completed a posttest survey five months, on average. At posttest, navigated non-adherent participants were more likely to report a recent Pap test compared to cases not navigated (83.8% vs. 50.0%), an effect not observed for mammography uptake (77.3% vs. 71.4%). Time in the US, marital status, insurance status, having a primary care provider and/or a gynecologist were significantly associated with cancer screening adherence. Low rates of adherence to cancer screening among Vietnamese nail salons workers can be improved by community based programs addressing cultural and work-related barriers confronted by this population.

Inhibitory effect on human platelet aggregation and coagulation and antioxidant activity of C. edulis Ker Gawl rhizome and its secondary metabolites.

ETHNOPHARMACOLOGICAL RELEVANCE: Although Canna edulis Ker Gawl rhizome has been used in Traditional Vietnamese Medicine to prevent and treat heart diseases without thorough scientific evidence, limited intensive search for the bioactivities and useful substances has been done. AIM OF THE STUDY: This study aims to investigate the antiplatelet aggregation, anticoagulant and antioxidant activity of extracts from C. edulis rhizome, separate and purify its compounds from the most active fraction and evaluate the antiplatelet aggregation, anticoagulant and antioxidant activity of isolated compounds. MATERIALS AND METHODS: C. edulis rhizome was extracted with ethanol, then fractionated with n-hexane, ethyl acetate and water. The inhibitory effect on adenosine diphosphate- and collagen-induced human platelet aggregation was evaluated. Prothrombin time, activated partial thromboplastine time and thrombine time were measured to examine the anticoagulant activity. The free radical scavenging ability was assessed with DPPH and ABTS assays. The fraction that showed the most active was used to separate and purify compounds. The structures of compounds were elucidated by NMR and MS spectroscopic methods. Isolated compounds were also tested for antiplatelet, anticoagulant and antioxidant activity. RESULTS: The ethyl acetate fraction showed the most potent antiplatelet aggregation, anticoagulant and antioxidant activity. Subsequent fractionation of this active fraction resulted in the isolation of seven known compounds: 5-hydroxy-6-methyl-2H-pyran-2-one (1), epimedokoreanone A (2), nepetoidin B (3), ferulic acid (4), caffeic acid (5), hydroxytyrosol (6), and 1H-indole-3-carboxaldehyde (7). Previous studies reported the antiplatelet, anticoagulant and antioxidant activity of ferulic acid (4), caffeic acid (5) and hydroxytyrosol (6) and the antioxidant activity of nepetoidin B (3). This study demonstrated that both epimedokoreanone A (2) and nepetoidine B (3) also exhibited good antiplatelet effect and epimedokoreanone A (2) also had effective anticoagulant and antioxidant activity, while 5-hydroxy-6-methyl-2H-pyran-2-one (1) showed weaker antiplatelet and antioxidant activity but no anticoagulant effect. CONCLUSIONS: This is the first experimental study to demonstrate the potent dose-dependent antiplatelet aggregation, anticoagulant and antioxidant activity of C. edulis rhizome and its pure compounds, supporting the traditional use of this plant for the treatment of heart diseases. The C. edulis rhizome is a potential source of bioactive compounds or functional food for treatment and/or prevention of heart- and oxidative stress-related diseases and its bioactive compounds are good candidates for drug development of anti-thrombosis and antioxidant agents.

A Cluster Randomized Controlled Trial of a Lay Health Worker Intervention to Increase Healthy Eating and Physical Activity Among Vietnamese Americans.

INTRODUCTION: Americans have low levels of knowledge of and adherence to recommendations for healthy eating of fruits and vegetables and for physical activity (HEPA). We conducted a cluster randomized controlled trial of a lay health worker intervention to increase HEPA among Vietnamese Americans. METHODS: We randomized 64 lay health workers to 2 intervention arms. Each lay health worker recruited 10 participants aged 50 to 74. From 2008 to 2013, using flip charts, lay health workers led 2 educational sessions on HEPA (intervention) or colorectal cancer (comparison). We assessed HEPA knowledge and self-reported behaviors by preintervention and postintervention surveys 6 months apart. RESULTS: Of the 640 participants, 50.0% were female, 38.4% had lived in the United States for 10 years or fewer, and 71.4% reported limited English proficiency. Knowledge of the recommended intake of fruits and vegetables (≥5 servings daily) increased from 2.6% to 60.5% in the intervention group (n = 311) and from 2.9% to 6.7% in the comparison group (n = 316) (intervention vs comparison change, P < .001). Knowledge of the physical activity recommendation (≥150 minutes weekly) increased from 2.6% to 62.4% among intervention participants and from 1.0% to 2.5% among comparison participants (P < .001). Consumption of 5 or more daily servings of fruits and vegetables increased more in the intervention group (8.4% to 62.1%) than in the comparison group (5.1% to 12.7%) (P < .001). Participants reporting 150 minutes or more of physical activity weekly increased from 28.9% to 54.0% in the intervention group and from 38.0% to 46.8% in the comparison group (intervention vs comparison change, P = .001). CONCLUSION: A lay health worker intervention increased both healthy eating and physical activity knowledge and self-reported behaviors among older Vietnamese Americans.

Acculturation and Exposure to Secondhand Smoke in the Home Among Vietnamese Immigrants in Metropolitan Atlanta.

This study represents the first effort to examine associations between various measures of acculturation and past 30-day secondhand smoke (SHS) exposure among Vietnamese-Americans in metro-Atlanta, one of the areas with the highest number of Vietnamese-Americans in the U.S. Survey data of 96 Vietnamese-American nonsmoking adults attending health fairs/programs hosted by community-based organizations (2017-2018) were analyzed. Acculturation-related predictors included Vancouver Acculturation Index, language fluency, years in the U.S., and area-level proportion of Asian residents. The sample was an average 37.49 years old and 65.3% female; the average number of years in the U.S. was 18.17 years. Past 30-day SHS exposure was reported by 21.9%. In multiple logistic regressions, the only variable associated with SHS exposure was the number of years living in the U.S. [OR = 0.91, CI = (0.85-0.99), p = 0.02]. Newly-immigrated Vietnamese-Americans have increased SHS exposure risk. Education about smoke-free policies and harmful effects of SHS may benefit this population.

Thalassemia and Hemoglobinopathies in an Ethnic Minority Group in Northern Vietnam.

This study assessed thalassemia and hemoglobinopathies in a group of the Tay ethnic minority. Participants included 289 women of reproductive-age who enrolled in a pilot screening program for thalassemia conducted at six communities of Thai Nguyen Province, northern Vietnam. Standard procedures including complete blood count (CBC), hemoglobin (Hb) and DNA analyses were performed for all samples. The prevalence of thalassemia in 289 Tay women was 15.6% (gene frequency 0.078) for α0-thalassemia (α0-thal), 10.0% (gene frequency 0.050) for α+-thal, 7.3% (gene frequency 0.036) for ß-thalassemia (ß-thal), 2.4% (gene frequency 0.012) for Hb Constant Spring [Hb CS; α142, Term→Gln, TAA>CAA (α2), HBA2: c.427T>C] and 1.7% (gene frequency 0.009) for Hb E [ß26(B8)Glu→Lys, GAG>AAG; HBB: c.79G>A]. Further analysis of ß-globin gene abnormalities identified four mutations including codons 41/42 (-TCTT) (HBB: c.126_129delCTTT), codon 17 (A>T) (HBB: c.52A>T), codons 71/72 (+A) (HBB: c.216_217insA), and -28 (A>G) (HBB: c.78A>G). The results hint at the remarkably high frequencies of severe forms of thalassemia that indicate a serious public health problem requiring further exploration, and most probably, also intervention within the country.

Associations of health belief and health literacy with Pap smear practice among Asian immigrant women.

PURPOSE: To examine associations of health belief and health literacy with Pap smear practice among Asian immigrant women in South Korea. METHODS: This study used a descriptive, cross-sectional study design. A survey was conducted among 196 migrant women who were married to South Korean men, using a questionnaire translated into English, Chinese, Vietnamese, and Korean. Trained research assistants read the questionnaire and the participants gave their answers. RESULTS: The most common birthplace of the immigrant women was Vietnam (43.0%), followed by China (12.2%) and the Philippines (5.6%). Of the participants, 76.5% answered that they had never had a Pap smear test. Multiple logistic regression analysis revealed that age and functional health literacy were associated with Pap smear practice among Asian immigrant women. With a one-year increase in participants' age, Pap smear practice increased 1.15 times (OR = 1.15, 95% CI: 1.07, 1.23). Furthermore, with a one point increase in functional health literacy, Pap smear practice increased 1.18 times (OR = 1.18, 95% CI: 1.02, 1.37). CONCLUSIONS: Results suggest that more information about Pap smear tests should be provided to young immigrant women. Health providers should be made aware that Pap smear practice among young immigrant women might be infrequent and should actively recommend that they receive the tests. To improve Pap smear practice among immigrant women, it is also crucial for educational strategies to include functional health literacy. Nurses could play an important role in explaining and recommending the Pap smear test through communication with immigrant women.

Community-Based Cervical Cancer Education: Changes in Knowledge and Beliefs Among Vietnamese American Women.

Low cervical cancer screening rates among Vietnamese American women have been attributed, in part, to inadequate knowledge about cervical cancer and health beliefs that hinder screening. A community-based educational program was developed to improve knowledge and attitudes toward cervical cancer screening in this underserved population. It was hypothesized that the program would result in increases in knowledge, as well as enhanced health beliefs and self-efficacy toward obtaining cervical cancer screening. Using a group-randomized design, 1488 women from 30 Vietnamese community-based organizations were assigned to either the intervention (n = 816) or control (n = 672) conditions. The intervention group received cervical cancer education delivered by bilingual community health educators. Intervention content addressed individual beliefs and expectancies regarding cervical cancer screening (e.g., perceived risk of developing cervical cancer; perceived benefits and barriers to screening; social and cultural norms regarding screening). The control group received general health education, including information about cancer screening. Knowledge and health beliefs were assessed at baseline and post-intervention. Among women in the intervention group, overall knowledge about cervical cancer and screening guidelines increased from pre- to post-program (30% vs. 88%, p < 0.001), perceived benefits of screening increased (3.50 vs. 4.49, p < 0.001), and perceived barriers to screening decreased (3.13 vs. 2.25, p < 0.001). Changes in knowledge and health beliefs were not observed among women in the control group. A community-based educational program can help increase knowledge about cervical cancer and screening, promote positive changes in women's beliefs about the benefits of cervical cancer screening, and reduce perceived barriers to screening. Such programs may play an important role in addressing health disparities and informing underserved populations about recommended screening tests.

Tobacco Smoking and Antisocial Deviance among Vietnamese, Vietnamese-American, and European-American Adolescents.

Tobacco smoking is one of the most significant modifiable behavioral health risk factors worldwide. Although smoking rates in some high-income countries (HIC) have declined, rates in many low-and-middle-income countries (LMIC) remain high. Adolescence is a key developmental risk period for smoking initiation. Research indicates that a major adolescent risk factor for tobacco smoking is antisocial deviance, which includes such behaviors as aggression, risk-taking, and rule-breaking. The linkages between antisocial deviance and smoking suggest that these behaviors and their underlying attitudes can be important targets for smoking prevention programs, but for public health efficiency it is important to target the components of antisocial deviance most closely linked smoking. However, although 80% of smokers live in LMIC, most relevant research has been conducted in HIC and its applicability to LMIC is unclear, given cultural differences between many HIC and LMIC. The purpose of the present study was to assess cross-cultural variations in relations among components of antisocial deviance and self-reported tobacco smoking among 2,724 10th and 11th grade Vietnamese, Vietnamese-American, and European-American students. Within the combined sample the relation between self-reported smoking and overall antisocial deviance was ß = 0.33. However, the component of antisocial deviance most strongly related to smoking varied across groups, with Risk-taking most strongly related to smoking for Vietnamese-American (ß = 0.37) and Vietnamese (ß = 0.36) adolescents, and Rule-breaking Behavior most strongly related to smoking for European-American (ß = 0.51) adolescents. These and other findings suggest the possible importance of culturally-tailored foci for smoking prevention programs emphasizing different aspects of antisocial deviance.

Social Media for Hepatitis B Awareness: Young Adult and Community Leader Perspectives.

Screening for hepatitis B (HBV) among high-risk young adults can help prevent its transmission and lead to earlier treatment and better long-term health outcomes. Yet few interventions have focused on increasing HBV awareness among young adults. Social media (SM) may be an effective method for disseminating information and engaging young adults about HBV. In this pilot study, qualitative and quantitative methods were applied to collect information on current use and perceptions toward SM through semistructured interviews and focus groups with young Chinese and Vietnamese adults and community leaders from local organizations in Philadelphia. Additionally, survey items were collected during the interviews and focus groups to provide quantitative data. Results from the interviews provided evidence that young adults and local organizations are already using SM and are open to using it to share general health information that is specific to their community. The focus groups suggested that using group pages or chats could be most appropriate for reaching young adults and that credible sources should be used to deliver messages that are tailored to the audience. The findings from this study will support the development of an SM intervention aimed at increasing HBV awareness.

Excessive postextraction bleeding associated with Cordyceps sinensis: a case report and review of select traditional medicines used by Vietnamese people living in the United States.

Many older people who have emigrated from Vietnam to the United States continue to use the traditional medicines that they used in their country of origin. Clinicians trained in the West may not be familiar with these products. We reviewed 6 Asian traditional medicines that are popular among older Vietnamese people living in the United States. Each medicine has significant side effects that can lead to complications in patients undergoing surgery. Here, we present the case of a patient who used Cordyceps sinensis daily as a tonic and experienced prolonged bleeding after dental surgery.

Cancer patterns in Hmong in Minnesota, 2000 to 2012.

BACKGROUND: Minnesota has the second largest Hmong population in the United States. The objective of the current study was to estimate the cancer incidence among Hmong individuals in Minnesota between 2000 and 2012 to determine targets for screening and interventions. METHODS: Cancer cases in Minnesota between 2000 and 2012 were obtained from the Minnesota Cancer Surveillance System, and proportional incidence ratios (PIRs) were calculated. The 2000 and 2010 US Census reports were used to obtain total population estimates. Age-adjusted cancer incidence rates (AAR) and 95% confidence intervals (95% CIs) were calculated for Hmong individuals, Asian/Pacific Islander individuals, and all Minnesotans using direct method and Poisson regression. RESULTS: Compared with all Minnesotans, the Hmong had elevated PIRs and AARs for malignancies related to infections, including nasopharyngeal, stomach, liver, and cervical cancers. The AAR ratios in Hmong versus all Minnesotans were found to be significantly increased for nasopharyngeal (AAR, 15.90; 95% CI, 9.48-26.68), stomach (AAR, 2.99; 95% CI, 2.06-4.33), liver (AAR, 1.77; 95% CI, 1.04-3.02), and cervical (AAR, 3.88; 95% CI, 2.61-5.77) cancers. The AARs in Hmong versus all Minnesotans were significantly lower for all-cause cancer (AAR, 0.39; 95% CI, 0.35-0.44); cancers of the breast, lung, and colorectum; melanoma; and non-Hodgkin lymphoma. Compared with Asian/Pacific Islander individuals, the rates in Hmong were significantly higher for melanoma and cervical cancer, with AAR ratios of 2.23 (95% CI, 1.09-4.56) and 1.59 (95% CI, 1.01-2.49), respectively. CONCLUSIONS: Compared with all Minnesotans, the Hmong have an increased incidence of cancers related to infectious agents. These findings indicate a need for cancer prevention and screening programs in this population.