Case Study in Chamorro Community and Academic Engagement for a Community-Partnered Research Approach

Objective: We describe the development of a community and academic research partnership, share reflections on processes for collaborations, and identify key factors for establishing strong and effective relationships to foster high-quality research. Background: A community-based participatory research (CBPR) effort evaluating a community-based patient navigation program assisting Chamorro women to access breast cancer services in Southern California served as the foundation for the development of the community-academic partnership. Methods: Using a CBPR approach focusing on active involvement of community members, organizational representatives, and academic researchers in all aspects of research process, faculty from a research university and a local community-based organization were brought together to build a partnership. Community and academic partners engaged in a series of meetings where dialogue focused on developing and nurturing trust and shared values, respect for community knowledge, and establishing community-defined and prioritized needs and goals. Partners have also focused on defining and developing explicit structures and policies to implement an equal partnership. Results: Experiences and lessons learned are shared, reflecting the processes of relationship building, and planning and implementing preliminary research steps. Lessons Learned: Adequate time for relationship-building, open and honest communication, flexibility, and ongoing examination of assumptions are keys to developing successful CBPR partnerships

Tongan American Health Professionals Association Promoting Health Through Sharing, Mentoring and Networking

Introduction: Tongan-Americans face severe disparities in health including diabetes, cardiovascular disease, and cancer. Educational disparities also affect health opportunities and well-being, influencing health status and community capacity to address disparities. Few resources have been identified within the Tongan-American community to address these concerns. The Tongan American Health Professionals Association (TAHPA) was conceived to identify and develop health and health career resources for the Tongan community. Through TAHPA, the Tongan-American community is utilizing a communityempowerment approach to address disparities and well-being. Methods: TAHPA was formed in 2008 through the leadership of individuals with a vision of a healthier Tongan-American community. TAHPA's purpose was to inspire and empower the Tongan-American community by developing an organization of Tongan-American health care professionals and pre-professionals, celebrating their accomplishments, and providing resources and support for educational and career development. Founders gathered in small work groups in community settings to discuss health concerns, well-being and solutions. Key community members facilitated the process to establish goals and objectives. Next Steps: To date, 40 Tongan health professionals and pre-professionals have become members. TAHPA's vision and outreach processes have been developed. TAHPA’s uniqueness and strength is that it is rooted in the community, created by the community to serve the community

Developing and testing a decision aid for use by providers in making recommendations: about mammography screening in older women.

Breast cancer incidence increases with age, but many older women do not receive appropriate mammography screening. A tool to support provider decision making holds potential to help providers and patients reach the best-informed decisions possible. We developed and tested a decision aid (DA) for healthcare providers to use in mammography screening recommendations in older women. Literature review, expert opinion, focus groups, and pilot testing of the DA were conducted in a university ambulatory geriatrics practice. Provider evaluations of the DA after piloting were collected and analyzed. Geriatricians reported important factors in decision making included patient life-expectancy, preferences, cognitive function, and individualization. Geriatricians reported the DA would have helped them make recommendations for mammography screening in 66% of pilot cases. It was less helpful when there was more certainty regarding decision making

Assessing the Effectiveness of Educational Workshops for Breast Cancer Prevention and Early Detection among Samoan and Pacific Islander Women in Southern California

Background: Samoans experience among the worst five-year breast cancer survival rates in the U.S., largely due to late stage diagnosis. There is great potential for screening interventions to reduce cancer mortality among Samoans. This paper examines the effectiveness of a culturally and linguistically tailored breast cancer education workshop for Samoan and other Pacific Islander women in Southern California. Methods: Educational workshops were conducted in churches, homes, and the Samoan National Nurses Association office to Pacific Islander women. Effectiveness was assessed using pre- and post-tests. Selfadministered questionnaires queried participants about demographics, access, personal or family breast cancer history, screening knowledge and behaviors, and plans to obtain screening (n=495). Results: Participants were predominantly Samoan, with 57% reporting they were ≥40 years of age. At pre-test, half of the participants did not know how to perform Breast Self Examination (BSE), 40% never had a Clinical Breast Examination (CBE), and 30% never had a mammogram. Less than 40% reported having a mammogram in the past two years. At post-test, 98% reported increased knowledge. Older women were more likely to report plans for screening at post-test. Conclusions: Health educators in Samoan and other Pacific Islander communities must recognize and appropriately address screening barriers such as cultural beliefs and lack of knowledge, and should consider working with important institutions such as the church