A Community-Based Approach to Biospecimen Collection Among Pacific Islanders.

This study tested the feasibility of collecting saliva samples from Pacific Islanders (PIs) via a community-based participatory research approach. Collection of saliva samples were conducted by trained and trusted PI community leaders at various partner sites. A total of 214 saliva samples were donated by PIs living in Southern California, more than half of whom were females between the ages of 18 and 35 years. Donors indicated that they donated because they wanted to help science and their community. A majority of donors reported a very positive experience with the donation process and were willing to donate saliva and hair samples in the future. The positive findings of this article highlight the importance of community input and participation.

Design and Outcomes of a Community Trial to Increase Pap Testing in Pacific Islander Women.

BACKGROUND: Pap tests remain an essential cervical cancer detection method in the United States, yet they are underutilized among Pacific Islanders (PI) who experience elevated cervical cancer incidence and mortality. This study describes the design, methods, participants, and outcomes of a multiyear (2010-2016), community-based randomized intervention trial in southern California. Based upon strong collectivistic norms, the trial tested the efficacy of a unique social support intervention targeting Chamorro, Samoan, and Tongan women and their male husbands/partners. METHODS: A single-session educational intervention was designed and tailored for ethnic- and gender-specific groups to increase men's social support for their female wives/partners to receive a Pap test, and for women to receive a Pap test. The comparison group received preexisting brochures on Pap testing (for women) or general men's health (for men). Pretest and 6-month follow-up data were analyzed. RESULTS: Intervention and comparison groups were mostly equivalent on pretest demographics and outcome variables. Intervention women who were not compliant with Pap screening recommendations at pretest were significantly more likely to have scheduled and received a Pap test at 6-month follow-up. However, 6-month follow-up results indicated no intervention effect on changes in women's Pap testing knowledge, fatalistic attitudes, or perceived social support from their male partner. CONCLUSIONS: Ethnic- and gender-tailored community interventions can successfully increase Pap test behaviors for PI women, although more research is needed on the specific pathways leading to behavior change. IMPACT: Collaborative community-based interventions lead to increases in women's cancer prevention and early detection for Pacific Islander and other collectivistic communities.

Biospecimen Education Among Pacific Islanders in Southern California.

Despite increasing rates of cancer, biospecimen donations for cancer research remains low among Pacific Islanders (PIs). To address this disparity, researchers partnered with PI community organizations to develop and test a theory-based culturally tailored educational intervention designed to raise awareness about the issues surrounding biospecimen research. A total of 219 self-identified PI adults in Southern California were recruited to participate in a one-group pre-post design study. Participants completed questionnaires that assessed their knowledge and attitude regarding biospecimen research before and after viewing an educational video and receiving print materials. Results showed that participants' overall knowledge and attitude increased significantly from pre-test to post-test (p < .0001). Over 98% of participants also reported that they would be willing to donate at least one type of biospecimen sample. Efforts such as these that utilize culturally tailored education interventions may be instrumental in improving biospecimen donation rates in the PI community as well as other minority populations.

Decision making for Pap testing among Pacific Islander women.

This study employed a Multi-Attribute Utility (MAU) model to examine the Pap test decision-making process among Pacific Islanders (PI) residing in Southern California. A total of 585 PI women were recruited through social networks from Samoan and Tongan churches, and Chamorro family clans. A questionnaire assessed Pap test knowledge, beliefs and past behaviour. The three MAU parameters of subjective value, subjective probability and momentary salience were measured for eight anticipated consequences of having a Pap test (e.g., feeling embarrassed, spending money). Logistic regression indicated that women who had a Pap test (Pap women) had higher total MAU utility scores compared to women who had not had a Pap test within the past three years (No Pap women) (adjusted Odds Ratio = 1.10). In particular, Pap women had higher utilities for the positive consequences 'Detecting cervical cancer early, Peace of mind, and Protecting my family', compared to No Pap women. It is concluded that the connection between utility and behaviour offers a promising pathway toward a better understanding of the decision to undergo Pap testing.

Associations Between Women's Perception of Their Husbands'/Partners' Social Support and Pap Screening in Pacific Islander Communities.

Pacific Islanders experience high rates of cervical cancer incidence and mortality. This cross-sectional study examined the extent to which Samoan, Chamorro, and Tongan women's perceived receipt of social support from their husbands or male partners was associated with rates of routine cancer screening- specifically Pap testing. A total of 585 Pacific Islander women who live in the United States completed a self-report survey. Women who reported having a Pap test within the past 3 years had significantly higher scores on support from their husbands/male partners. Furthermore, the relationship of emotional support and informational support with increased Pap testing was significantly stronger for Tongan women. The findings suggest that men play an important role in promoting women's cancer prevention behaviors in Pacific Islander and potentially other collectivistic populations. Incorporating social support messages into interventions may be a simple yet effective strategy to increase women's Pap testing.

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.

Financial Distress among Pacific Islanders in Southern California.

Pacific Islanders experience enduring and growing poverty in the United States, yet our understanding of their financial distress and needs is limited. Financial institutions, government agencies, and community-based organizations in areas with large Pacific Islander communities need better information with which to develop tailored programs, improve outreach and education, and improve economic security for these and other underserved populations. This paper describes the results from a unique in-language survey that asked detailed questions regarding the financial knowledge, status, and needs of Pacific Islanders, including poverty and wealth questions beyond those in the Census, in Los Angeles, Orange, and San Diego counties of Southern California.

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.

What promotes cervical cancer screening among Chamorro women in California?

Pacific Islander women represent a significant at-risk population for cervical cancer, yet little is known about the modifiable factors associated with routine Pap testing. Therefore, the aims of this paper are to report and discuss the known and unknown factors associated with cervical cancer screening among Chamorro women in California. This cross-sectional study explored the factors associated with receipt of regular Pap testing among Chamorro women age 18 years and older in California. A self-administered survey was designed and distributed to women in order to understand their knowledge, beliefs and behaviors regarding routine receipt of Pap tests. Only about two-thirds of women had received a Pap test within the past 2 years, which is below the U.S. average of 72 %. Significant predictors included younger age, health insurance coverage, knowledge of screening frequency, and medically correct beliefs regarding risk groups. These factors, however, accounted for less than 16 % of the variance in Pap testing behavior. We discuss the poor predictive value of existing demographic and theoretical variables, and discuss potentially new areas of research that can aid in the development of future intervention studies. Study limitations and implications are also discussed.

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.

A Case Study in Chamorro Community and Academic Engagement for a Community-Partnered Research Approach.

OBJECTIVE: We describe the development of a community and academic research partnership, share reflections on processes for collaborations, and identify key factors for establishing strong and effective relationships to foster high-quality research. BACKGROUND: A community-based participatory research (CBPR) effort evaluating a community-based patient navigation program assisting Chamorro women to access breast cancer services in Southern California served as the foundation for the development of the community-academic partnership. METHODS: Using a CBPR approach focusing on active involvement of community members, organizational representatives, and academic researchers in all aspects of research process, faculty from a research university and a local community-based organization were brought together to build a partnership. Community and academic partners engaged in a series of meetings where dialogue focused on developing and nurturing trust and shared values, respect for community knowledge, and establishing community-defined and prioritized needs and goals. Partners have also focused on defining and developing explicit structures and policies to implement an equal partnership. RESULTS: Experiences and lessons learned are shared, reflecting the processes of relationship building, and planning and implementing preliminary research steps. LESSONS LEARNED: Adequate time for relationship-building, open and honest communication, flexibility, and ongoing examination of assumptions are keys to developing successful CBPR partnerships.

Promoting breast cancer screening among Chamorro women in Southern California.

BACKGROUND: Asian American and Pacific Islander women represent a significant at-risk population for breast cancer, with their mortality rates rising while rates fall for all other racial groups. METHODS: This 3-year study employed a quasi-experimental design to test the influence of an intervention on screening rates among women age 50 years and older in Southern California compared to Northern California. RESULTS: Despite significant exposure of women to the educational elements in Southern California, the intervention did not increase women's knowledge, attitudes, or screening behaviors. CONCLUSIONS: We discuss several study design and implementation limitations that could have influenced the study's results.

Developing a community-based collaboration to reduce cancer health disparities among Pacific Islanders in California.

Cancer is a leading cause of death for Asians and Pacific Islanders in the United States, but education and research efforts addressing the needs ofPacific Islanders in the continental U.S. is sparse. The purpose of this paper is to describe the development of a community-based participatory research network dedicated to addressing cancer health disparities among Chamorros, Marshallese, Native Hawaiians, Samoans and Tongans in Southern California. Community-based organizations (CBO) comprise the focus of the network, and their efforts have included increasing cancer-related awareness in their communities, developing capacities regarding cancer control, and initiating collaborative research efforts with academic partners. First year processes and outcomes are described, and specific examples are given from two CBO partners.