Effectiveness of a controlled trial to promote colorectal cancer screening in Vietnamese Americans.

OBJECTIVES: We conducted a controlled trial of a public education and provider intervention to increase colorectal cancer (CRC) screening rates among Vietnamese Americans, who typically have lower rates than non-Hispanic Whites. METHODS: The public education intervention included a Vietnamese-language CRC screening media campaign, distribution of health educational material, and a hotline. The provider intervention consisted of continuing medical education seminars, newsletters, and DVDs. Vietnamese in Alameda and Santa Clara Counties, California, received the intervention from 2004 to 2006; Vietnamese in Harris County, Texas, were controls and received no intervention. A quasi-experimental study design with pre- and postintervention surveys of the same 533 participants was used to evaluate the combined intervention. RESULTS: The postintervention-to-preintervention odds ratio for having ever had a sigmoidoscopy or colonoscopy was 1.4 times greater in the intervention community than in the control community. Knowledge and attitudes mediated the effect of the intervention on CRC screening behavior. Media exposure mediated the effect of the intervention on knowledge. CONCLUSIONS: Improving CRC knowledge through the media contributed to the effectiveness of the intervention.

Effectiveness of continuing medical education in increasing colorectal cancer screening knowledge among Vietnamese American physicians.

Colorectal cancer (CRC) screening rates are lower in Vietnamese Americans than in non-Hispanic Whites. Most Vietnamese Americans have ethnically concordant physicians and are willing to have CRC screening if their physicians recommend it. We conducted two continuing medical education (CME) seminars with participants recruited from the Vietnamese Physician Association of Northern California to increase their CRC screening knowledge. We used pre- and post-CME surveys to evaluate the CMEs and per-item McNemar's tests to assess changes in knowledge. Correct responses increased significantly from pre- to post-CME for all five items on CRC burden and four of 11 items on screening guidelines and practices at the first CME and for five of seven items on screening guidelines and practices at the second CME. Continuing medical education seminars were effective in increasing CRC screening knowledge among Vietnamese American physicians. This increase may lead to physicians' recommending and their patients' completing CRC screening tests.

Colorectal cancer screening in Vietnamese Americans.

BACKGROUND: Rates of colorectal cancer screening in Vietnamese Americans are lower than those in non-Hispanic Whites. In this article, we describe rates of colorectal screening, identify determinants, and recommend educational strategies to improve screening. METHODS: A cross-sectional sample of 867 Vietnamese aged 50 to 74 years drawn from a sampling frame of individuals in the Alameda and Santa Clara Counties, California, and Harris County, Texas, area telephone directories with Vietnamese surnames were interviewed in 2004. RESULTS: Colorectal screening recognition, receipt, currency, and intention rates were low. CONCLUSIONS: Although the screening rates are low, Vietnamese are receptive to screening if providers recommend it.

Using focus groups to develop interventions to promote colorectal cancer screening among Vietnamese Americans.

BACKGROUND: Colorectal cancer is the third most common cancer in Vietnamese Americans. Their colorectal screening rates are lower than the rates of whites. METHODS: Four focus groups were conducted to identify Vietnamese American sources and credibility of health information, media utilization, and intervention approaches. RESULTS: Vietnamese Americans trusted doctors and patient testimonials and had access to, and received most of their health information from, Vietnamese- language print and electronic media. Recommended intervention approaches include promoting doctors' recommendation of screening and using Vietnamese-language mass media, print materials, and oral presentations. CONCLUSIONS: Focus groups are useful in determining communication channels and intervention approaches.

Encouraging Vietnamese-American women to obtain Pap tests through lay health worker outreach and media education.

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.