Primary Health-Care Delivery Gaps among Medically Underserved Asian American and Pacific Islander Populations

Weir, Rosy Chang; Tseng, Winston; Yen, Irene H.; Caballero, Jeffrey

doi:10.1177/003335490912400611

Cited by 14 publications

(16 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Using communication techniques such as Ask-Tell-Ask and Closing the Loop 1, 34 the health coach would ensure the patient understood the care plan and would reinforce key plan elements. Behavioral or self-care goals were then formulated collaboratively, captured on a Self-Management Action Plan Form, and copied for the patient to take home.…”

Section: Methodsmentioning

confidence: 99%

“…1 The gaps in data and the lack of data disaggregation among Chinese and other Asian Americans mask dramatic health disparities and make it difficult to measure progress toward health disparities reduction initiatives. 2,3 Medically-underserved Chinese Americans face multiple challenges in accessing health care due to poverty, limited English proficiency, lack of cultural orientation in care, and lack of culturally and linguistically proficient care.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Evaluating a Culturally and Linguistically Competent Health Coach Intervention for Chinese-American Patients With Diabetes

Ivey¹,

Tseng²,

Kurtovich³

et al. 2012

Diabetes Spectrum

Self Cite

View full text Add to dashboard Cite

Background. Type 2 diabetes is a growing concern among medically underserved Chinese Americans. However, very few interventions have been developed or adapted for Chinese Americans with diabetes. Objective. To use a participatory research approach to evaluate the effectiveness of a culturally tailored, linguistically appropriate model for diabetes care employing health coaches to improve A1C levels among Chinese-American patients in a federally qualified health center setting. Methods. We compared change in A1C between intervention participants (n = 46), who received a health coaching intervention, and control participants (n = 46), who received usual care over a period of ~ 6 months. Results. Intervention participants showed a decrease in mean A1C at follow-up (−0.40%) compared to control subjects (+0.04%), although this difference was not statistically significant. At the 6-month follow-up, a significantly higher percentage of intervention participants (45.7%) had well-controlled A1C levels compared to control subjects (23.9%) (P = 0.048). Conclusions. It is feasible to implement a culturally tailored, linguistically appropriate teamlet model of care for Chinese Americans with type 2 diabetes. Such a model may be helpful in reducing A1C levels. Given trends in A1C improvement during a 6-month pilot, future randomized trials with a larger sample capable of providing adequate statistical power to detect improvements are warranted.

show abstract

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Evaluating a Culturally and Linguistically Competent Health Coach Intervention for Chinese-American Patients With Diabetes

Ivey¹,

Tseng²,

Kurtovich³

et al. 2012

Diabetes Spectrum

Self Cite

View full text Add to dashboard Cite

show abstract

“…Most prominently, AAPCHO researchers developed a Medically Underserved AA and NHPI Communities’ Index, consisting of population, poverty, limited English proficiency, and primary care to physician ratio indicators, to identify underserved areas not captured by existing federal indices for AAs and NHPIs nationwide. 15 They also demonstrated the feasibility and need to include those culturally appropriate measures—most notably, limited English proficiency—in the federal designations of underserved areas, 15,16 supporting advocacy with good science.…”

Section: Strategies To Lead Research Efforts For Aa and Nhpi Populationsmentioning

confidence: 99%

“…32 AAPCHO has also published in the peer-reviewed literature with AAPCHO staff as the lead authors, 15-17 and in recognizing the importance of disseminating research results back to the community, has also developed in-language materials (e.g., factsheets) for community members. 33 In an effort to better understand best practices in research dissemination, AAPCHO is collaborating with University of Washington in a project funded by the NIH National Cancer Institute to learn how to more effectively integrate research-tested interventions to CHCs in their future research.…”

Section: Strategies To Lead Research Efforts For Aa and Nhpi Populationsmentioning

confidence: 99%

Improving Asian American, Native Hawaiian, and Pacific Islander Health: National Organizations Leading Community Research Initiatives

Cook¹,

Weir²,

Ro³

et al. 2012

cpr

Self Cite

View full text Add to dashboard Cite

Background Functionally, many CBPR projects operate through a model of academic partners providing research expertise and community partners playing a supporting role. Objectives To demonstrate how national umbrella organizations deeply rooted in communities, cognizant of community needs, and drawing on the insights and assets of community partners, can lead efforts to address health disparities affecting their constituents through research. Methods Case studies of two Asian American, Native Hawaiian, and Pacific Islander national organizations Results Strategically engaging a diverse range of partners and securing flexible funding mechanisms that support research were important facilitators. Main challenges included limited interest of local community organizations whose primary missions as service or health care providers may deprioritize research. Conclusions Efforts to make research relevant to the work of community partners and to instill the value of research in community partners, as well as flexible funding mechanisms, may help to promote community-driven research.

show abstract

“…Pacific Islanders (PIs) are indigenous people from Micronesia, Melanesia, or Polynesia; they historically have faced multiple socioeconomic and health disparities in their countries and in the continental United States (Chang Weir et al, 2009). The combination of theoretical positions in Rhodes’ heuristic is useful for framing HIV and HPV vulnerabilities among PIs in the U.S., because it acknowledges the critical importance of culture and its interplay with socioeconomic conditions.…”

Section: Introductionmentioning

confidence: 99%

Contextualization of HIV and HPV risk and prevention among Pacific Islander young adults in Southern California

DiStefano

Hui

Barrera-Ng

et al. 2012

Social Science & Medicine

View full text Add to dashboard Cite

HIV and sexually transmitted human papillomavirus (HPV) are associated with each other and with the development of comorbid cancer. Current epidemiology indicates that among Pacific Islanders in the United States, young adults are at highest risk of HIV and HPV. In our inductive community based participatory research study, we used focus groups and key informant interviews (March – August 2010) with young adults, parents, community leaders, and providers (n = 95) to identify and contextualize factors that shape HIV and HPV risk and prevention among young adults in Chamorro and Tongan communities in Southern California. We identified nine themes that incorporated the following principal factors: misinformation and otherization; dominant concerns regarding premarital pregnancy; restricted intergenerational communication; family shame and privacy; gendered manifestations of religio-cultural norms; barriers impeding access to sexual health resources; parents’ role in prevention; community vs. individual responsibility; and family and ethnic pride. Our thematic findings fit well with Rhodes’ “risk and enabling environment” heuristic (2009), which we used to contextualize risk and prevention at micro and macro levels of physical, social, economic, and policy environments. We propose the addition of a separate cultural environment to the heuristic and conclude that a focus on applying individual and community agency at the micro-level would be an approachable starting point for intervention for our local Pacific Islander communities and groups in similar ecological contexts globally. Enhanced community-led education programs and engagement of religious and other community leaders to facilitate intergenerational communication could counteract taboos that obstruct prevention.

show abstract

Primary Health-Care Delivery Gaps among Medically Underserved Asian American and Pacific Islander Populations

Abstract: This project complements federal efforts to identify medically underserved health service areas and identifies U.S. counties that need new or expanded health services for medically underserved AAPIs.

Cited by 14 publications

References 20 publications

Evaluating a Culturally and Linguistically Competent Health Coach Intervention for Chinese-American Patients With Diabetes

Evaluating a Culturally and Linguistically Competent Health Coach Intervention for Chinese-American Patients With Diabetes

Improving Asian American, Native Hawaiian, and Pacific Islander Health: National Organizations Leading Community Research Initiatives

Contextualization of HIV and HPV risk and prevention among Pacific Islander young adults in Southern California

Contact Info

Product

Resources

About