The Role of Medical Interpretation on Breast and Cervical Cancer Screening Among Asian American and Pacific Islander Women

We examined whether the impact of medical interpretation services was associated with the receipt of a mammogram, clinical breast exam, and Pap smear. We conducted a large cross-sectional study involving four Asian American and Pacific Islander (AAPI) communities with high proportions of individuals with limited English proficiency (LEP). Participants were recruited from community clinics, churches and temples, supermarkets, and other community gathering sites in Northern and Southern California. Among those that responded, 98% completed the survey rendering a total of 1,708 AAPI women. In a series of multivariate logistic regression models, it was found that women who typically used a medical interpreter had a greater odds of having received a mammogram (odds ratio [OR] = 1.85; 95% confidence interval [CI] = 1.21, 2.83), clinical breast exam (OR = 3.03; 95% CI = 1.82, 5.03), and a Pap smear (OR = 2.34; 95% CI = 1.38, 3.97) than those who did not usually use an interpreter. The study provides support for increasing language access in healthcare settings. In particular, medical interpreters may help increase the utilization of breast and cervical cancer screening among LEP AAPI women

The Role of Legislation and Practitioner Perceptions on the Availability of Patient Navigation Programs

Background: Immigrants with limited English capabilities and limited knowledge about the U.S. health care system may experience challenges in accessing and utilizing cancer care services. Patient navigation programs (PNPs) are emerging as a viable strategy to improve health care at the financial, organizational, social and cultural level. The Patient Navigator Outreach and Chronic Disease Prevention Act (NOA) has the potential to increase the availability of PNPs and to improve timeliness to treatment. Practitioner perceptions of PNPs are missing from the literature, and could provide evidence needed to generate support for the integration and adoption of PNPs at the system level. This dissertation is comprised of two studies that investigate the availability and quality of PNPs in Los Angeles (LA) and Orange County (OC) facilities, and the perceptions of practitioners and navigators serving Southeast Asians. Methods: Study 1 involved facility-level data collected through two surveys (Short Telephone Questionnaire and Facility Survey) and tumor registry data from the Los Angeles Cancer Surveillance Program. Study 2 used secondary data of transcripts of interviews with practitioners (n=14) and patient navigators (n=9).Results: Study 1- Survey responses revealed that legislation was not associated with the development and availability of PNPs in LA or OC facilities, but compliance with hospital certification requirements did. The proportion of patients who received surgery within 30 days was higher at pre-NOA period at facilities with PNPs. Unexpectedly, post-NOA median time to surgery after diagnosis increased regardless of the availability of PNPs, Study 2 - Practitioner perceptions of PNPs highlighted the benefit of PNPs and the need to inform cancer care clinicians and institutions about the value of navigation services to improve patient-physician communication. Navigators were instrumental in helping patients understand the disease and treatment process better, and enabled patients to be more engaged in dialogue with their physicians.Conclusion: PNPs have evolved into a mechanism for assisting under-resourced communities. Legislation alone needs to be bolstered with institutional program commitment and requirements. Practitioner perceptions of PNPs expressed in this study confirm the need to inform cancer care clinicians and cancer care institutions about the value of patient navigation services

The Role of Legislation and Practitioner Perceptions on the Availability of Patient Navigation Programs

Background: Immigrants with limited English capabilities and limited knowledge about the U.S. health care system may experience challenges in accessing and utilizing cancer care services. Patient navigation programs (PNPs) are emerging as a viable strategy to improve health care at the financial, organizational, social and cultural level. The Patient Navigator Outreach and Chronic Disease Prevention Act (NOA) has the potential to increase the availability of PNPs and to improve timeliness to treatment. Practitioner perceptions of PNPs are missing from the literature, and could provide evidence needed to generate support for the integration and adoption of PNPs at the system level. This dissertation is comprised of two studies that investigate the availability and quality of PNPs in Los Angeles (LA) and Orange County (OC) facilities, and the perceptions of practitioners and navigators serving Southeast Asians. Methods: Study 1 involved facility-level data collected through two surveys (Short Telephone Questionnaire and Facility Survey) and tumor registry data from the Los Angeles Cancer Surveillance Program. Study 2 used secondary data of transcripts of interviews with practitioners (n=14) and patient navigators (n=9).Results: Study 1- Survey responses revealed that legislation was not associated with the development and availability of PNPs in LA or OC facilities, but compliance with hospital certification requirements did. The proportion of patients who received surgery within 30 days was higher at pre-NOA period at facilities with PNPs. Unexpectedly, post-NOA median time to surgery after diagnosis increased regardless of the availability of PNPs, Study 2 - Practitioner perceptions of PNPs highlighted the benefit of PNPs and the need to inform cancer care clinicians and institutions about the value of navigation services to improve patient-physician communication. Navigators were instrumental in helping patients understand the disease and treatment process better, and enabled patients to be more engaged in dialogue with their physicians.Conclusion: PNPs have evolved into a mechanism for assisting under-resourced communities. Legislation alone needs to be bolstered with institutional program commitment and requirements. Practitioner perceptions of PNPs expressed in this study confirm the need to inform cancer care clinicians and cancer care institutions about the value of patient navigation services

Promoting educational equity among health science students through a project-based learning writing course at a Hispanic Serving Institution : A co-curricular, project-based course uses high-impact practices to teach public health writing skills to students from underserved minority populations. Findings suggest both improved student performance and practice scaffolding the academic help-seeking behaviors that support graduation.

Background:  Overall, high rates of American high school seniors lack writing proficiency (75%) and historically underrepresented minority (URM) populations fare even worse (91% of African American, 89% of Latinx) (U.S. Dept of Education, 2011), which suggests that URM college students enter college with lower writing abilities (Bracco et al., 2021).  Co-curricular writing instruction could help eliminate writing skill disparities.  The Health Science Intensive Writing Workshop (HSIWW) aimed to increase students’ perceived confidence in their writing abilities, encourage and increase academic help-seeking behaviors and networking skills. Description of Practice: A project-based learning methodology proved the best fit because of its focus on real-world problems and assessments, and emphasis on collaboration and revisions of personal work.  Outcomes: Eight upper-division health science undergraduate students participated in the 5-day HSIWW. Descriptive statistics indicated increases in perceived ability, confidence in writing abilities, and academic help-seeking behaviors.   Conclusion: To the study team’s knowledge, the HSIWW was unique as a co-curricular, project-based course that used high-impact practices to teach public health writing skills to URM students in higher education.  HSIWW’s findings suggest a positive impact on student achievement by improving student performance and scaffolding the academic help-seeking behaviors that help keep students on the path to graduation