Identifying priorities for Vietnamese health in Santa Clara County, California: The importance of community-engaged research

BACKGROUND/ OBJECTIVES: Engaging underrepresented voices is central to addressing health disparities. Such engagement can be challenging for local public health agencies, particularly with populations that may view health-related questions as overly invasive and may mistrust government agencies based on adverse experiences in countries of origin. We describe the process and lessons learned from engaging one such population, Vietnamese residents of Santa Clara County (SCC), California, in a community health assessment.

METHODS: The assessment was conducted by the SCC Public Health Department in 2011. An advisory board (AB) guided the assessment, consisting of Vietnamese county agency staff, leaders from Vietnamese CBOs, and supervisorial aides. The AB requested that the assessment 1) be representative countywide 2) utilize a “grassroots” approach, given concerns that community members would not respond to personal questions especially from a government agency 3) include Vietnamese leaders. SCCPHD responded by utilizing a mixed-methods approach including a random-digit-dial telephone survey; community events surveys conducted by a Vietnamese CBO; and key informant interviews.

RESULTS: The process identified health priorities, such as diabetes, that had not traditionally been a focus of Vietnamese health in SCC. It included indicators not routinely assessed by SCCPHD but of importance to the community, such as gambling. Facilitators included establishing clear roles; balancing rigorous and grassroots approaches to data collection; and creating multi-level decision-making structures.

DISCUSSION: Our approach demonstrates the efficacy of flexible approaches to data collection and decision-making for engaging underrepresented groups and prompting local public health agencies to identify new priorities for community health.