Heterogeneity within the Asian American community

BACKGROUND: Educational interventions are grounded on scientific data and assumptions about the community to be served. While the Pan Asian community is composed of multiple, ethnic subgroups, it is often treated as a single group for which one health promotion program will be applicable for all of its cultural subgroups. Compounding this stereotypical view of the Pan Asian community, there is sparse data about the cultural subgroups' similarities and dissimilarities. The Asian Grocery Store based cancer education program evaluation data provided an opportunity to compare data collected under identical circumstances from members of six Asian American cultural groups. METHODS: A convenience sample of 1,202 Asian American women evaluated the cultural alignment of a cancer education program, completing baseline and follow-up surveys that included questions about their breast cancer knowledge, attitudes, and screening behaviors. Participants took part in a brief education program that facilitated adherence to recommended screening guidelines. RESULTS: Unique recruitment methods were needed to attract participants from each ethnic group. Impressions gained from the aggregate data revealed different insights than the disaggregate data. Statistically significant variations existed among the subgroups' breast cancer knowledge, attitudes, and screening behaviors that could contribute to health disparities among the subgroups and within the aggregate Pan Asian community. CONCLUSION: Health promotion efforts of providers, educators, and policy makers can be enhanced if cultural differences are identified and taken into account when developing strategies to reduce health disparities and promote health equity

The Quality of Care of International Medical Graduates: How does it Compare to that of U.S. Medical Graduates?

This article reviews the literature on the quality of care provided by foreign-trained physicians (international medical graduates or IMGs) compared with that of U.S. medical graduates (USMGs). As concerns are raised about IMGs in the U.S. physician workforce, there are suggestions that IMGs do not deliver care equal in quality to that of USMGs. The review of process and outcome studies finds little support for this claim. However, lower IMG levels of performance on structural measures of quality like credentialing examinations exist and may indicate quality differences. Because no consistent evidence exists that there is a connection between IMG test scores and process or outcome measures of quality of care, whether test scores matter in clinical practice and its outcome is uncertain. Until research shows the contrary, one should be cautious in accepting IMG-USMG quality arguments to support policy to reduce the size of the IMG component of the physician workforce.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68767/2/10.1177_107755879705400401.pd