Improving the Health of Cambodian Americans: Grassroots Approaches and Root Causes

Abstract

Background Cambodian Americans experience great disparities in health compared to other Americans, yet may be underserved by conventional healthcare systems. CBPR is a means to engage underserved communities in health research and programming. We describe results of our efforts to engage the Cambodian grassroots members as well as formal leaders in Oakland, CA. Objectives In addition to a community advisory group, we convened a Community Work Group (CWG), composed of ten grassroots community women of varying ages and backgrounds. The project aimed to leverage the lived experiences of these women and their understandings of health and wellness in identifying specific health issues and developing culturally resonant strategies. Methods The CWG met weekly with staff facilitators using methods for collective analysis including theater, body mapping, and other expressive arts. Results The approach proved logistically challenging, but resulted in novel analyses and strategies. The group identified trauma, along with poor access to education, un- and under-employment, social isolation, and generation gap, together with community violence, as root causes of key behavioral health issues, i.e. alcohol abuse, gambling, prescription drug misuse, and domestic violence. Strategies proposed and implemented by the group and project staff were a community garden, Cambodian New Year’s celebrations, and a museum exhibit on the Cambodian refugee experiences. Conclusions Grassroots community engagement can support projects in identifying social determinants of health and developing the capacities of community members to conduct research and actions to improve health.

Engaging citizens living in vulnerable circumstances in research: a narrative review using a systematic search

“…church, CBO, school or playground, or the street, using culturally sensitive pamphlets [ 41 , 65 , 68 , 75 , 82 ] Make use of local news on TV or radio [ 17 , 23 , 25 , 30 , 63 , 68 , 71 , 75 ] Build on the capacities and knowledge and empower those involved by offering easily accessible activities [ 47 , 25 , 48 , 51 ] Storyboards [ 59 , 60 , 67 ] Digital storytelling [ 48 , 68 ] Photo-voice methodology [ 2 ] Theatre-related activities [ 25 , 47 ] Unstructured dialogue with creative components [ 47 , 57 , 65 , 75 ] Invite people to a familiar location [ 40 , 47 , 58 , 72 ] Plan the meeting at a location that participants prefer [ 23 , 27 , 30 , 39 , 41 , 61 , 63 , 68 , 72 , 79 , 84 ], most often identified as a familiar place, such as a café-style environment, a church, a community centre, or their own...…”

“…peers or students) [ 17 , 20 , 23 , 54 , 57 , 60 , 63 , 65 , 66 , 79 , 82 ] Involve community members, i.e. social workers [ 3 ], health-care professionals [ 4 , 53 , 63 ], bicultural experts [ 67 ], CBOs [ 27 , 47 , 48 , 52 , 54 , 63 , 65 , 66 ], gatekeepers [ 67 ], or lay-community group members [ 3 , 20 , 39 , 42 , 44 , 48 , 51 , 54 , 59 , 60 , 61 , 63 , 71 , 79 , 82 ] Let community members give feedback on protocol [ 3 , 4 , 20 , 30 , 39 , 44 , 48 , 51 , 54 , 57 , 58 , 60 , 61 , 63 , 65 , 66 , 71 ...…”

“…those involving references to popular theatre or rangoli-related craft activities, can help to elicit informal conversations in which citizens more easily share stories concerning sensitive topics. For instance, Lee et al [ 47 ] used popular theatre with Cambodian women to understand health-related issues such as alcohol use and misuse and domestic violence. Third, the included articles also noted (again) the need to build a less threatening environment .…”

“…For example, this review emphasizes the added value of creative methods, such as theatre-related activities, drawing or art (e.g. [ 25 , 47 ]). These creative or art-based methods are not only helpful to empower citizens living in vulnerable circumstance but are also helpful more generally to open up science to the general public [ 32 ].…”

“…Word-of-mouth recruitment is most often [7,65,79,84], bicultural researchers [54,60,71,84], or someone from the network of the researcher [51,68,84] Use snowball recruitment [41,49,51,75] Recruit at a place that people are familiar with [2,4,17,23,27,43,51,71], e.g. church, CBO, school or playground, or the street, using culturally sensitive pamphlets [41,65,68,75,82] Make use of local news on TV or radio [17,23,25,30,63,68,71,75] Build on the capacities and knowledge and empower those involved by offering easily accessible activities [47,25,48,51] Storyboards [59,60,67] Digital storytelling [48,68] Photo-voice methodology [2] Theatre-related activities [25,…”