Background Pacific Islanders (PIs) experience high cervical cancer rates in the United States. Stage of diagnosis is also later for PIs than non-Hispanic Whites. The Pap test is severely underutilized among PIs: only 71% of Asian American and Pacific Islander women age 25 years or older received a Pap test within the last 3 years (U.S. average, 82%). Community-based participatory research (CBPR) is increasingly seen as an essential approach in designing and conducting culturally relevant and appropriate studies that reduce cancer incidence and other health disparities among minority and other medically underserved populations. Purpose The purpose of this article is to describe the lessons learned thus far regarding the identification, recruitment, and retention of PI community organizations and members into a CBPR-informed, randomized, community trial promoting Pap testing. Methods This 5-year study used CBPR to develop and test the efficacy of a social support intervention for Chamorro, Samoan, and Tongan women to increase Pap testing in southern California. Eligible women were between the ages of 21 and 65, and married or in a long-term relationship with a man for at least 5 years. Women and their husbands or significant others received a 2-hour, culturally tailored workshop that include a group activity, information on Pap testing, a video, and corresponding materials. Comparison participants received a brochure about Pap testing. Three waves of data are collected from all participants: pretest (before workshop or brochure), posttest 1 (immediately after workshop or brochure), and posttest 2 (6 months follow-up). Results Of the 76 organizations approached to participate in the study, 67 (88.2%) eventually agreed to participate. Thus far, 473 women and 419 men completed the study pretest, post-test, education, and 6-month follow-up. Only 242 women and 204 men of the eligible participants have completed the follow-up survey (63.5% of women and 60.5% of men retained after 6 months). Lessons Learned The main strategy to overcome initial recruitment challenges was study staff persistence, because they averaged five contacts with each church or clan leader before receiving confirmation that an educational session can be scheduled. Personal connections provided an introduction to the most appropriate church or clan leader. Other efforts for retention include creation of an online version of the survey, re-attending church services, and creating special events organized around clan activities. Conclusions Although CBPR improves the cultural competence and relevance of study activities for ethnically diverse populations, selected past research shows that it does not ensure that such designs overcome all of the unique challenges in ethnically diverse communities. PI-specific organizational recruitment and individual retention is influenced by study issues and cultural factors in each community.

Background and Significance Despite high rates of chronic diseases like cancer, diabetes and cardiovascular disease, Pacific Islanders (PIs) are underrepresented in clinical and genetic studies designed to identify the physiological causes of poor health outcomes. There are limited genetic data and biospecimen samples from PIs under study. This paper described why PIs have reservations about donating their biospecimen samples for research. Methods Data were drawn from a pilot study designed to assess the knowledge, attitudes and beliefs surrounding biospecimen research among PIs in southern California. Utilizing a community-based participatory research approach, community and academic partners collected quantitative and qualitative data from a total of 60 PI adults with a mean age of 61 years (SD 13 years). Results “Fear”, “God or Spirituality” and “Lack of Information or Knowledge” were the most cited reasons for not participating in biospecimen research. Respondents younger than age 65 years expressed more concerns about donating their biospecimen samples than those older than age 65 years (p<0.012). No significant gender differences were found (p=0.84). Conclusion Our results emphasize the need to conduct relevant and appropriate biospecimen education among minority communities in order to address misconceptions and build support to increase PI and other minority participation in biospecimen-related studies.

Background Pacific Islanders (PIs) have one of the highest rates of cigarette use, but evidence-based smoking cessation programs designed specifically for PIs are practically nonexistent. Objectives This paper reports on the development of a culturally tailored smoking cessation curriculum designed specifically for young adult PIs using a community-based participatory research (CBPR) approach. This paper demonstrates the shared leadership and equal contribution of community and academic partnerships. Methods Together community and academic partners conceptualized and developed a smoking cessation curriculum. Data from formative studies shaped the various components of the educational modules. Results Eight educational modules were developed through CBPR. Information on the dangers of cigarettes, benefits to cessation, and ways to cope with cravings and stress through cognitive behavioral therapy were offered in both narrative and non-narrative formats. Conclusions Use of CBPR is critical in the development of the curriculum because it allowed for the sharing of ideas and knowledge between academics and community members.

Background: Pap tests comprise an essential cervical cancer prevention and detection method for women in the U.S. Unfortunately, the Pap test remains significantly underutilized among many ethnic/racial groups, particularly Pacific Islanders (PIs) who have low rates of Pap testing and high rates of cervical cancer incidence and mortality. Methods: A randomized community trial tested the efficacy of a social support-informed culturally developed intervention on increasing Pap testing among Chamorro, Samoan and Tongan women in Southern California. Using community-based participatory research (CBPR), Pacific Islander women and their husbands/partners were recruited from social organizations (churches and clans) that had been randomly assigned to receive the intervention or control education. Three waves (pretest, posttest and 6-month follow-up) of data collection included demographics, cervical cancer beliefs, social support between women and their husbands/partners, and Pap test attitudes and behaviors. Results: CBPR recruitment resulted in a total of 81 social organizations recruited that included n=575 Pacific Islander women and n=461 husbands/partners. Significant differences between groups at baseline included acculturation and health insurance coverage. Six month follow-up found that all women from baseline significantly increased knowledge and decreased fatalistic attitudes towards Pap testing. Women who were not adherent to Pap test guidelines in the intervention group had significantly higher rates of Pap testing compared to controls at six month follow-up. No differences were found in either women's perceived social support nor men's provision of social support for Pap testing. Conclusion: CBPR-informed behavioral interventions can increase cervical cancer screening in Pacific Islander women. Although social support did not mediate the relationship between women's knowledge and behavior, it did inform the development of a culturally tailored intervention for Chamorro, Samoan and Tongan women. Future studies can build upon these results by addressing other early detection (e.g., mammograms, colorectal exams, etc) and prevention (e.g., HPV vaccination) in these and other disparity populations. Citation Format: Sora Park Tanjasiri, Jie W. Weiss, Michele Mouttapa, Lola Sablan Santos. Outcomes of a Randomized Community Trial to Increase Pap Testing among Pacific Islanders in Southern California. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A37.

Background: Pacific Islanders (PIs) experience high cancer health disparities, including later stage of cervical cancer diagnosis due in large part to more than 10% lower Pap screening rates compared to non-Hispanic Whites. The aim of this community-based participatory research (CBPR) randomized control intervention is to increase rates of Pap testing among PI women residing in Southern California. Baseline data examined whether a Multi-Attribute Utility (MAU) model (a descriptive behavioral decision-making model) and women's perceived receipt of social support from their husband/partner significantly predicted Pap testing within the past three years. We also examined whether social support mediated the relationship between utility and Pap testing. Procedures: PI couples were recruited from Samoan, Tongan, and Chamorro churches and cultural social networks, and were randomly assigned to one of two educational interventions regarding cervical cancer screening. Participating women had to be between 21 and 65 years old and married or in a long-term relationship. A baseline questionnaire assessed women's MAU decision-making parameters (subjective value, subjective likelihood, and momentary salience) for eight anticipated consequences of getting a Pap test. Items also assessed female participants' perceived social support (appraisal, emotional, instrumental, and informational) from their husband/partner, and Pap testing behaviors. Results: Only half of the participants (49.9%) had received a Pap test within the past three years. A logistic regression model indicated that the total MAU score (which is the sum of the products of perceived subjective value, perceived subjective likelihood, and momentary salience across the eight parameters) was associated with higher rates of Pap testing (AOR= 1.10, p&lt; 0.01). Four additional logistic regression models were run, one for each of the four different social support subscales. Appraisal support (AOR= 1.21, p= 0.000), emotional support (AOR= 1.25, p= 0.000), informational support (AOR= 1.13, p&lt; 0.000), and instrumental support (AOR= 1.19, p= 0.000) were all associated with higher rates of Pap testing. Next, four mediational models were run, one for each of the four social support subscales, with instrumental support significantly mediating the relationship between MAU total scores and Pap testing. Specifically, the mediational model indicated MAU total scores had both a direct relationship with increased Pap testing, as well as an indirect relationship with increased Pap testing through its relationship with increased instrumental support. Conclusions: Results indicate that PI women's Pap testing follows a personal decision, with husband/partner's instrumental support enhancing the decision to receive a Pap test. Provision of such social support is the basis for the present intervention that educates men about the importance of expressing their concern for, and intention to assist with, regular Pap testing among PI women. Citation Format: Sora Park Tanjasiri, Jie Wu Weiss, Michele Mouttapa, Lola Sablan Santos, Jasmine Lacsamana DeGuzman, Vanessa Tuione May, Lourdes Quitugua, Dorothy Vaivao. Role of social support in Pap test decision making among Pacific Islander women. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B67. doi:10.1158/1538-7755.DISP13-B67