Cambodians in Lowell, Massachusetts, experience significant health disparities. Understanding the trauma they have experienced in Cambodia and as refugees has been the starting point for Lowell Community Health Center's whole community approach to developing community-based interventions. This approach places physical-psychosocial-spiritual needs at the center of focus and is attentive to individual and institutional barriers to care. Interventions are multilevel. The effect of the overall program comes from the results of each smaller program, the collaborations and coordination with the Cambodian community and community-based organizations, and the range and levels of services available through the health center.

Literature and practice are limited on strategies to reach elder Southeast Asian refugees by using their strengths and resilience. This article presents the Centers for Disease Control and Prevention-funded Cambodian Community Health 2010 Program in Lowell, Massachusetts, as a case example and provides refugee history, project background, community survey results about strengths and risks, literature on strengths-based approaches, outreach activities, and evaluation. The focus is elimination of health disparities in cardiovascular disease and diabetes. "Community conversations" and a daylong forum with community leaders were used to develop plans for outreach. A Cambodian Elders Council provided information and guidance used to refine the program. Key findings highlight involving elders in organizing events, avoiding reliance on literacy, integrating health promotion with socialization, using ties with Buddhist temples, developing transportation alternatives, and utilizing local Khmer-language media. Implications include applicability to other refugee communities with low literacy, high levels of trauma, limited English, and strong religious involvement.

We determined hepatitis B virus (HBV) testing and vaccination levels and factors associated with testing and vaccination among Vietnamese- and Cambodian-Americans. We also examined factors associated with healthcare professional (HCP)-patient discussions about HBV. We analyzed 2006 Racial and Ethnic Approaches to Community Health (REACH) 2010 Risk Factor Survey data from four US communities. We used logistic regression to identify variables associated with HBV vaccination, testing, and HCP-patient discussions about HBV. Of the 2,049 Vietnamese- and Cambodian-American respondents, 60% reported being tested for HBV, 35% reported being vaccinated against hepatitis B, and 36% indicated that they had discussed HBV with a HCP. Cambodian-Americans were less likely than Vietnamese-Americans to have been tested for HBV, while respondents with at least a high school diploma were more likely to have been tested for HBV. Respondents born in the US, younger individuals, and respondents with at least some college education were more likely to have been vaccinated against hepatitis B. HBV testing and vaccination remain suboptimal among members of these populations. Culturally sensitive efforts that target Vietnamese- and Cambodian-Americans for HBV testing and vaccination are needed to identify chronic carriers of HBV, prevent new infections, and provide appropriate medical management. HCPs that serve these populations should be encouraged to discuss HBV with their patients.

Smoking prevalence decreased in Asian communities served by the REACH project, and these decreases were larger than nationwide decreases in smoking prevalence observed for the same period. However, disparities in smoking prevalence remain a concern among Cambodian men and non-English-speaking Vietnamese men; these subgroups continue to smoke at a higher rate than do men nationwide.

Background Parents have general influence over their children’s health and health behavior. However, given the dearth of specific literature regarding knowledge level and social and cultural factors influencing HPV vaccination behaviors among Cambodian American (CA) parents, it is difficult to develop an effective, evidence-based public health HPV vaccination program for this particular population without further investigation. Methods CA mothers (n=130) completed a health survey through face-to-face interviews in either English or Khmer language. Results Girls vaccination rates were 29% while that of boys was 16%. Awareness and knowledge of HPV among CA mothers was very low, and many believed that their daughters, who speak English and were educated in the U.S., had more knowledge about health than they did. Logistic regression analysis showed that Cambodian American girls had significantly higher odds of vaccination when their mothers possessed a higher level of English reading ability and had greater awareness and knowledge of HPV. Conclusions The strikingly low rates of HPV vaccination among CA girls and boys underscore the need to improve vaccination outreach, education, and uptake. The findings can be used to develop targeted public health HPV vaccination programs for CAs which will reduce cervical cancer disparities.