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Cancer Control Research

Abstract

DESCRIPTION (Adapted from the Applicant's Abstract): Little is known about the disease prevention behavior of Southeast Asian immigrants, and few studies have addressed cancer control in this disadvantaged population. However, it is known that two malignancies in particular, carcinoma of the cervix and hepatocellular carcinoma, occur more frequently among Vietnamese Americans than among individuals of an, other race/ethnicity. Almost all invasive cervical cancers could be prevented by Papanicolaou testing, and up to 80 percent of liver cancers could be prevented by hepatitis B vaccination. There is a clear need for programs that can successfully enhance the uptake of Papanicolaou testing among Vietnamese women; and increase the proportion of Vietnamese adults who have been tested for evidence of hepatitis B infection (and, therefore, have either been vaccinated, are screened for hepatocellular carcinoma, or know they are immune). Cancer control programs targeting less acculturated immigrant groups should be based on a thorough understanding of culturally based attitudes and practices. The study has three specific objectives: collect qualitative and quantitative data about the cervical and liver cancer prevention behavior of Vietnamese Americans; design a culturally and linguistically appropriate household cancer control intervention targeting cervical cancer, hepatitis B infection, and hepatocellular carcinoma among Vietnamese; and evaluate the intervention program's acceptability to the Vietnamese community as well as its feasibility in terms of program delivery. Community involvement will be emphasized. The PRECEDE framework and qualitative methods will be used to guide the development of a quantitative survey instrument. Qualitative and quantitative findings will both be used to develop the intervention components. All interventions will be delivered by bicultural Vietnamese outreach workers. A total of 60 Seattle households that under-use preventive care will receive the intervention program; these households will be identified from a population-based survey of 650 households. Intervention components will include home visits, barrier specific counseling, the use of videotapes and print materials, and logistic assistance. A comprehensive process evaluation of the intervention will be conducted. If the intervention program proves to be acceptable and feasible, the investigators will subsequently apply for funding to conduct a randomized controlled trial and evaluate the effectiveness of the program with respect to outcomes.