Community-Based Recruitment Strategies for Young Adult Pacific Islanders into a Randomized Community Smoking Cessation Trial.

BACKGROUND: Lung cancer represents the leading cause of cancer death for Pacific Islanders in the United States, but they remain underrepresented in studies leading to the lack of evidence-based cessation programs tailored to their culture and lifestyle. OBJECTIVES: This paper aims to describe the development of culturally tailored and community informed recruitment materials, and provide lessons learned regarding implementation and adaptation of strategies to recruit Pacific Islander young adult smokers into a randomized cessation study. METHODS: Development of recruitment materials involved a series of focus groups to determine the cessation program logo and recruitment video. The initial recruitment strategy relied on community-based participatory research partnerships with Pacific Islander community-based organizations, leaders and health coaches with strong ties to the community.Results/Lessons Learned: While the recruitment materials were well received, initial strategies tapered off after the first 3 months of recruitment resulting in the need to revise outreach plans. Revised plans included the creation of a list with more than 200 community locations frequented by Pacific Islander young adult smokers, along with the hiring of part-time recruitment assistants who reflected the age and ethnicities of the desired cessation study participants. These materials and strategies ultimately yielded 316 participants, 66% of whom were recruited by the revised strategies. CONCLUSIONS: Community-based participatory research approaches not only inform the design of culturally tailored intervention recruitment material and strategies, but also result in innovative solutions to recruitment challenges to address the National Cancer Institute's gaps in science regarding small populations.

Development of an Online Smoking Cessation Curriculum for Pacific Islanders: A Community-Based Participatory Research Approach.

BACKGROUND: Pacific Islanders (PIs) have one of the highest rates of cigarette use, but evidence-based smoking cessation programs designed specifically for PIs are practically nonexistent. OBJECTIVES: This paper reports on the development of a culturally tailored smoking cessation curriculum designed specifically for young adult PIs using a community-based participatory research (CBPR) approach. This paper demonstrates the shared leadership and equal contribution of community and academic partnerships. METHODS: Together community and academic partners conceptualized and developed a smoking cessation curriculum. Data from formative studies shaped the various components of the educational modules. RESULTS: Eight educational modules were developed through CBPR. Information on the dangers of cigarettes, benefits to cessation, and ways to cope with cravings and stress through cognitive behavioral therapy were offered in both narrative and non-narrative formats. CONCLUSIONS: Use of CBPR is critical in the development of the curriculum because it allowed for the sharing of ideas and knowledge between academics and community members.

Developing an Internet- and Mobile-Based System to Measure Cigarette Use Among Pacific Islanders: An Ecological Momentary Assessment Study.

BACKGROUND: Recent prevalence data indicates that Pacific Islanders living in the United States have disproportionately high smoking rates when compared to the general populace. However, little is known about the factors contributing to tobacco use in this at-risk population. Moreover, few studies have attempted to determine these factors utilizing technology-based assessment techniques. OBJECTIVE: The objective was to develop a customized Internet-based Ecological Momentary Assessment (EMA) system capable of measuring cigarette use among Pacific Islanders in Southern California. This system integrated the ubiquity of text messaging, the ease of use associated with mobile phone apps, the enhanced functionality offered by Internet-based Cell phone-optimized Assessment Techniques (ICAT), and the high survey completion rates exhibited by EMA studies that used electronic diaries. These features were tested in a feasibility study designed to assess whether Pacific Islanders would respond to this method of measurement and whether the data gathered would lead to novel insights regarding the intrapersonal, social, and ecological factors associated with cigarette use. METHODS: 20 young adult smokers in Southern California who self-identified as Pacific Islanders were recruited by 5 community-based organizations to take part in a 7-day EMA study. Participants selected six consecutive two-hour time blocks per day during which they would be willing to receive a text message linking them to an online survey formatted for Web-enabled mobile phones. Both automated reminders and community coaches were used to facilitate survey completion. RESULTS: 720 surveys were completed from 840 survey time blocks, representing a completion rate of 86%. After adjusting for gender, age, and nicotine dependence, feeling happy (P=<.001) or wanting a cigarette while drinking alcohol (P=<.001) were positively associated with cigarette use. Being at home (P=.02) or being around people who are not smoking (P=.01) were negatively associated with cigarette use. CONCLUSIONS: The results of the feasibility study indicate that customized systems can be used to conduct technology-based assessments of tobacco use among Pacific Islanders. Such systems can foster high levels of survey completion and may lead to novel insights for future research and interventions.

Let's Move for Pacific Islander Communities: an Evidence-Based Intervention to Increase Physical Activity.

Pacific Islander (PI) populations of Southern California experience high obesity and low physical activity levels. Given PI's rich cultural ties, efforts to increase physical activity using a community-tailored strategy may motivate members in a more sustainable manner. In this paper, we (1) detail the program adaptation methodology that was utilized to develop the Weaving an Islander Network for Cancer Awareness, Research and Training (WINCART) Center's PI Let's Move Program, a culturally tailored program aimed to increase physical activity levels among members of PI organizations in Southern California, and (2) share the program's pilot evaluation results on individual and organizational changes. The WINCART Center applied the National Cancer Institute's program adaptation guidelines to tailor the evidence-based Instant Recess program to fit the needs of PIs. The end product, the PI Let's Move Program, was piloted in 2012 with eight PI organizations, reaching 106 PI adults. At baseline, 52 % of participants reported that they were not physically active, with the average number of days engaged in medium-intensity physical activity at 2.09 days/week. After the 2-month program, participants increased the number of days that they engaged in medium-intensity physical activity from 2.09 to 2.90 days/week. Post-pilot results found that 82 % of participants reported intentions to engage in physical activity for at least the next 6 months. At baseline, only one organization was currently implementing a physical activity program, and none had implemented an evidence-based physical activity program tailored for PIs. After the 2-month timeframe, despite varying levels of capacity, all eight organizations were able to successfully implement the program. In conclusion, results from our program provide evidence that disparity populations, such as PIs, can be successfully reached through programs that are culturally tailored to both individuals and their community organizations.

Reservations to Participate in Biospecimen Research among Pacific Islanders.

BACKGROUND AND SIGNIFICANCE: Despite high rates of chronic diseases like cancer, diabetes and cardiovascular disease, Pacific Islanders (PIs) are underrepresented in clinical and genetic studies designed to identify the physiological causes of poor health outcomes. There are limited genetic data and biospecimen samples from PIs under study. This paper described why PIs have reservations about donating their biospecimen samples for research. METHODS: Data were drawn from a pilot study designed to assess the knowledge, attitudes and beliefs surrounding biospecimen research among PIs in southern California. Utilizing a community-based participatory research approach, community and academic partners collected quantitative and qualitative data from a total of 60 PI adults with a mean age of 61 years (SD 13 years). RESULTS: "Fear", "God or Spirituality" and "Lack of Information or Knowledge" were the most cited reasons for not participating in biospecimen research. Respondents younger than age 65 years expressed more concerns about donating their biospecimen samples than those older than age 65 years (p<0.012). No significant gender differences were found (p=0.84). CONCLUSION: Our results emphasize the need to conduct relevant and appropriate biospecimen education among minority communities in order to address misconceptions and build support to increase PI and other minority participation in biospecimen-related studies.

Use of a community-based participatory research approach to assess knowledge, attitudes, and beliefs on biospecimen research among Pacific Islanders.

Objectives. The purpose of this article is to describe a community-based participatory research pilot project conducted to investigate the knowledge, attitudes, and beliefs that Pacific Islanders (PIs) hold toward biospecimen collection, use, and banking, all of which will help drive higher PI participation rates in both medical and behavioral research studies. Method. Academic and community partners worked side by side to develop a conceptual model, study measures, and study protocols. PI community partners screened, recruited, and conducted data collection, which consisted of a paper-and-pencil survey and a 1-hour semistructured interview administered by trained community workers. Results. A total of 60 PI adults representing various PI ethnic groups completed the surveys and interviews. Results showed a general support for biospecimen studies that would benefit the community, and many are willing to provide their biospecimen samples if asked. Conclusion. Due to the established level of trust, community partners were able to successfully recruit and collect data for the study. Many of those interviewed also called for more outreach and education about the importance of biospecimen research in their communities.

Eliminating tobacco disparities among native Hawaiian Pacific Islanders through policy change: the role of community-based organizations.

Although cigarette smoking in the general U.S. population has decreased considerably over the past several decades, prevalence rates among Native Hawaiian Pacific Islanders (NHPI) have remained elevated by comparison with other groups. The aggregation of NHPI smoking data with that of Asians has drawn attention away from the serious smoking problems that NHPIs experience, thus, limiting funding, programs, and policies to reduce tobacco-related health disparities in their communities. In California, community-based organizations (CBOs) have played a major role in supporting the state's comprehensive tobacco control program, which is arguably one of the most successful in the nation. In this commentary, we describe the tobacco control activities of five NHPI-serving CBOs in Southern California and how they have provided anti-tobacco education for thousands of Native Hawaiians, Chamorros, Marshallese, Samoans, Tongans, and other Pacific Islander subgroups, and used advocacy and coalition building to promote smoke-free environment policies in their communities. The concerted efforts of the CBOs and their community members have made vital contributions to the reduction of tobacco-related disparities for NHPI populations in California.

Balancing community and university aims in community-based participatory research: a Pacific Islander youth study.

BACKGROUND: Community-based participatory research (CBPR) holds the promise of improving the planning, conduct, and long-term translation of research findings into community settings. OBJECTIVES: This 2-year, exploratory study applied CBPR structures and processes to the identification of individual, cultural and community factors associated with obesity among Pacific Islander (PI) youth in Southern California. METHODS: We describe the CBPR principles and strategies used by a community-university partnership to develop, implement, and report on the findings from assessments of obesity, physical activity, and nutritional intake among PI youth. RESULTS: Although CBPR planning processes led to successes in community-based youth recruitment and retention, we learned key lessons regarding implementation of tailored assessment protocols, often involving problems arising from the university side of the CBPR collaborative. CONCLUSION: CBPR has its strengths and limits; more studies are needed that report on processes to increase our understanding of how to balance research rigor with community sustainability.

HIV testing behavior among Pacific Islanders in Southern California: exploring the importance of race/ethnicity, knowledge, and domestic violence.

This article presents an analysis of a 2008 community needs assessment survey of a convenience sample of 179 Pacific Islander respondents in southern California; the needs assessment focused on HIV knowledge, HIV testing behavior, and experience with intimate partner/relationship violence. Multivariate logistic regression results indicated that race/ethnicity and reported experience with intimate partner/relationship violence were the most important variables in explaining the variation in reported HIV testing among Chamorro/Guamanian and Samoan respondents. However, when analyzed separately, self-reported experience with intimate partner/relationship violence was associated with reported HIV testing only for Chamorro respondents and not for Samoan respondents. As U.S. Pacific Islanders experience a high degree of HIV health disparities, additional research is needed to clarify the links among race/ethnicity, intimate partner/relationship violence, and HIV testing behavior.

Hepatitis B among Pacific Islanders in Southern California: how is health information associated with screening and vaccination?

We measured Hepatitis B virus (HBV) transmission knowledge and self-reported screening/testing behavior among Pacific Islanders (Guamanians/Chamorros, Samoans, and Tongans) in Southern California. We also examined access and trust by Pacific Islanders of varying health information sources. We administered and analyzed survey data (N = 297), using a convenience sample in Los Angeles, Orange, and San Diego Counties in spring 2009. We found that while Pacific Islander respondents reported that they receive health information from physicians, and largely trust this source, information from and trust in physicians were not statistically significant in explaining whether respondents sought HBV screening or vaccination.