259774 A Multifaceted Culturally Appropriate Intervention to Increase Cervical Cancer Screening among Vietnamese Americans

Wednesday, October 31, 2012

Grace X. Ma, PhD , Center for Asian Health, Department of Public Health, Temple University, Philadelphia, PA
Yin Tan, MPH, MD , Center for Asian Health, Department of Public Health, Tempel University, Philadelphia, PA
Carolyn Y. Fang, PhD , Fox Chase Cancer Center, Cancer Prevention and Control Program, Philadelphia, PA
Ziding Feng, PhD , Biostatistics Program, Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, WA
Jamil I. Toubbeh, PhD , Center for Asian Health, Department of Public Health, Temple University, Philadelphia, PA
Shaokui Ge, PhD , Biostatistics Program, Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, WA
Cuc Nguyen , Vietnamese Women Association, Marlton, NJ
Background: Vietnamese American women represent the ethnic subgroup at greatest risk for cervical cancer, but have the lowest cervical cancer screening rates.

Objective: To evaluate the impact of a multifaceted community-based participatory intervention on increasing cervical cancer screening and reducing healthcare access barriers among medically underserved and low income Vietnamese women.

Methods: This was a community-based group randomized controlled trial, built on our success in pilot studies among Vietnamese and other Asian Americans. Vietnamese women (n=1,450) were recruited into the study from 30 Vietnamese community-based organizations in U.S. mid-Atlantic region, 15 sites were assigned as culturally appropriate intervention group and the other 15 as control. The intervention group received Vietnamese community health educator-led group cervical cancer education, client-physician interaction, and patient navigation. The control group received general cancer education, including cervical cancer and screening. Assessments including screening behavior were obtained at baseline, postintervention and12 months.

Results: At 12 months postintervention, 60.1% of the women in the intervention group had obtained screening compared with 1.6% in the control group. The difference was 58.5% (95% CI: 44.7-72.3%), P < 0.001. The difference of Pap test rates adjusted from a GLIMMIX covariate model was 64%, similar to the difference of unadjusted raw rates. The covariate adjusted odd ratio is 191 (95% CI: 171-212).

Conclusion: A multifaceted intervention emphasizing both individual and healthcare system access barriers resulted in significantly increased cervical cancer screening rates. Future studies should focus on testing the adherence of Pap test and other cervical cancer tests among Vietnamese Americans.

Learning Areas:
Assessment of individual and community needs for health education
Diversity and culture
Planning of health education strategies, interventions, and programs
Public health or related nursing
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. By the end of the session, participants will be able to discuss and apply the results of this study to the development of culturally appropriate intervention strategies to increase cervical cancer screening rates among Vietnamese women and other Asian Americans.

Keywords: Cervical Cancer, Cancer Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator of multiple federally funded grants focusing on behavioral health intervention trials, health disparities/transcultural health care for underserved Asian Americans and other ethnic minority populations, cancer prevention and intervention, tobacco control and lung cancer, chronic disease intervention, public health education and community health, health promotion, and global or international health. Among my scientific interests has been the development of strategies of preventing cancer, chronic disease and tobacco control.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.