Motivating Underserved Vietnamese Americans to Obtain Colorectal Cancer Screening: Evaluation of a Culturally Tailored DVD Intervention

Abstract

Background: Colorectal cancer (CRC) is a leading cause of cancer death among Vietnamese Americans, yet screening remains underutilized. We investigated the effectiveness of a culturally tailored DVD intervention in promoting CRC screening among unscreened Vietnamese Americans age 50 and over. Materials and Methods: Using a community-based participatory research approach, we conducted a trial comparing twenty-eight subjects who received a mailed DVD in Vietnamese, with twenty-eight subjects who received a mailed brochure in Vietnamese. Subjects completed telephone surveys at baseline, One-month, and one-year. The primary outcome was receipt of screening. Secondary measures were participants' knowledge, attitudes, and beliefs about CRC screening. Two focus groups explored the intervention's acceptability and effectiveness. Results: At one year, CRC screening rates of 57.1% and 42.9% were observed in experimental and control group respectively (p=0.42), Subjects in both groups showed increased knowledge about CRC after one month. Focus group findings revealed that the DVD was an effective method of communicating information and would help promote screening. Conclusions: The findings suggest that culturally tailored, linguistically appropriate content is more important than the type of media used. This relatively low intensity, low cost intervention utilizing a DVD can be another useful method for outreach to the often hard-to-reach unscreened population.

The Use of Cancer-Specific Patient-Centered Technologies Among Underserved Populations in the United States: Systematic Review (Preprint)

“…Seven qualitative studies [100-106] and 7 mixed methods [75,76,[107][108][109][110][111] related to eHealth were identified. Qualitative studies primarily targeted black/AAs (n=3) or diverse populations (n=2) and target breast (n=3) and prostate cancer (n=3) patients.…”

Multilevel and multicomponent intervention to promote colorectal cancer screening among underserved Vietnamese Americans: A cluster randomized trial

“…Vietnamese Americans are disproportionately affected by CRC, with rates increasing from 35.6 to 46.3 per 100,000 men and from 30.5 to 34.2 per 100,000 women between 1990-1994 and 2009-2011, according to Surveillance, Epidemiology and End Results (SEER) program [6]. Despite this, CRC screening uptake remained suboptimal in this group [7], with only 33% to 61% [8][9][10] of eligible Vietnamese Americans are up-to-date with CRC screening, which is lower than the 68.8% screening rate in the general US population [11] as well as the 74.4% goal set forth in the Healthy People 2030 initiative [12].…”

Multilevel Pathways of Colorectal Cancer Screening Among Low-Income Vietnamese Americans: A Structural Equation Modeling Analysis

“…10 Regional studies found that CRC screening rates ranged from 33 to 61% in populations of community-dwelling Vietnamese Americans aged 50 to 79 in California (52%), 11 Washington (52% for men, 61% for women), 12 and Minnesota (33.1%). 13 These rates lag significantly behind the target CRC screening rate of 70.5% set by Healthy People 2020. 14 Among Asian American ethnicities, Vietnamese Americans had higher levels of unemployment (10.6%) and low levels of socioeconomic status in a 2013 report conducted by John Logan and Weiwei Zhang.…”

“…15 The previously conducted regional studies also identified low levels of educational attainment, English-speaking proficiency and self-rated health among Vietnamese American participants. 11 - 13 …”

“…15 The previously conducted regional studies also identified low levels of educational attainment, English-speaking proficiency and self-rated health among Vietnamese American participants. [11][12][13] Studies have attempted to identify individual-, interpersonal-, and community-level facilitators and barriers to CRC screening in Vietnamese American communities. In particular, CRC screening uptake in these communities is associated with individual-level demographic characteristics, social determinants of health (such as educational attainment), access to healthcare, and English proficiency.…”