Overcoming Barriers to Cancer Care Through Health Navigation Programs
Section snippets
The Need for Culturally Tailored Programs to Reduce Cancer Disparities
The American Cancer Society set goals of eliminating disparities in the cancer burden among population groups by reducing age-adjusted cancer incidence and mortality rates and by improving quality of life in the poor and medically underserved by the year 2015.4 Accomplishing these goals requires changes in cancer prevention and control research, education/training, programming and evaluation to better understand the effects of sociocultural variables on health status and behavior, along with
Cancer in AAPI Communities and Barriers to Care
According to the 2000 Census, there were 12,504,636 Asian Americans and 874,414 Native Hawaiian and other Pacific Islanders (AAPIs) in the US, alone or in combination with one or more other races, making up a total of approximately 4.5% of the total US population. For AAPIs, cancer is a growing burden afflicting these heterogeneous communities. For instance, cancer is the leading cause of death for both Asian American women and men.9, 10, 11 Compared with other ethnic groups, Pacific Islanders
Addressing Cancer Disparities Through Community-Based Health Navigation
Recently, the importance of community-driven programs has received increasing emphasis on using community health navigators (CHNs) to promote and apply concepts such as collaboration, responsiveness, inclusiveness, and empowerment in their design, delivery, and evaluation. Many community-based participatory research studies collaborate with community lay health volunteers or paid staff who are knowledgeable about their communities and are aware of the most effective methods and strategies to
REACH 2010 Initiative/PATH for Women Program
In 1999, The Centers for Disease Control and Prevention (CDC) launched the Racial and Ethnic Approaches to Community Health (REACH 2010) Demonstration Project to eliminate disparities. The priority racial and ethnic groups included African Americans, American Indians, Alaska Natives, Asian Americans, Hispanic Americans, and Pacific Islanders.99 The purpose of the REACH 2010 project was to assist communities in organizing and preparing the infrastructure for the development and conduct of
Conclusion
In summary, this article has provided a general overview of cancer disparities in AAPI communities, discussed the conceptual issues important in understanding what is needed to culturally tailor health interventions, and highlighted innovative community-based cancer navigation programs that have been developed to address these disparities, particularly the PATH for Women program focused on seven Southeast Asian and Pacific Islander communities in California. Despite the advances in cancer
Acknowledgment
The authors gratefully acknowledge the work and contributions of the Promoting Access to Health (PATH) for Women Project research team, community health navigators, and collaborative partners from the Cambodian, Chamarro, Laotian, Samoan, Thai, Tongan, and Vietnamese communities in Northern and Southern California. We also thank Mary Anne Foo and Jacqueline H. Tran for their reviews of drafts of the paper. This project was supported by a grant (no. 20001547) from the CDC Foundation through the
Tu-Uyen Ngoc Nguyen, PhD, MPH: Assistant Professor, Asian American Studies, California State University Fullerton (CSUF), Fullerton, CA.
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Advanced cancer in underserved populations
2010, Seminars in Oncology NursingHealthy Colon, Healthy Life. A Novel Colorectal Cancer Screening Intervention
2010, American Journal of Preventive MedicineCitation Excerpt :In our intervention, this included language adaptation of all messages and materials, the development of unique brochures with images and messages found to be appealing and acceptable to each ethnic group, and perhaps most importantly, the use of ethnically concordant telephone counselors who possessed an innate understanding of the social context (the sociocultural forces that shape people's day-to-day experiences and that directly and indirectly affect health and behavior) of our target audiences.24 Culturally tailored messages have been used in successful cancer screening programs targeting diverse ethnic groups,25–31 demonstrating a positive impact on cancer screening rates. Second, the CRC screening messages were tailored by adoption stage according to the transtheoretical model of behavior change (TTM) which assesses an individual's readiness to engage in a behavior.32,33
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Tu-Uyen Ngoc Nguyen, PhD, MPH: Assistant Professor, Asian American Studies, California State University Fullerton (CSUF), Fullerton, CA.
Marjorie Kagawa-Singer, PhD, RN, MN: Professor, School of Public Health and Asian American Studies Department, University of California Los Angeles (UCLA), Los Angeles, CA.