Vietnamese American women’s beliefs and perceptions on cervical cancer, cervical cancer screening, and cancer prevention vaccines: A community-based participatory study

Cervical cancer remains commonly diagnosed in Vietnamese American women. Despite efforts to increase cervical cancer screening among Vietnamese American women, participation rates are persistently lower than the national goal. The objective of this study is to explore beliefs of Vietnamese American women about cervical cancer, cervical cancer screening, and cancer prevention vaccines. A qualitative descriptive investigation captured group perceptions about meaning and beliefs of cervical cancer, screening, and cancer prevention vaccines, and participants’ stories using a community-based participatory research approach. Forty Vietnamese American women were recruited from the Portland, Oregon metropolitan area into four focus groups. Using a process of directed content analysis, focus group transcripts were coded for themes. We found that cervical cancer continues to be a difficult topic to discuss, and Vietnamese American women may not bring the topic up themselves to their health care providers. Some women experienced intense emotions of fear or shame of having their cervix examined. Women delayed seeking cervical cancer screening and needed to have early warning signs, which guided them as to when to seek health care. Women focused on cleanliness through vaginal and/or perineal washing as primary prevention for cervical cancer. There were limited awareness and knowledge about cancer prevention vaccines, specifically the human papillomavirus. Some women relied heavily on their informal social networks of family, friends, or community for health knowledge. Fear and misunderstanding dominated the beliefs of Vietnamese American women about cervical cancer screening and prevention. These findings underscored the importance of having culturally-specific findings, which will inform a multicomponent intervention to promote cervical cancer screening and cancer prevention vaccine uptake within this population

Evaluating a First-Year Veterans Affairs Nurse Practitioner Residency Program: Analysis for Change

Background: The Veteran Affairs Portland Healthcare System (VAPORHCS) is experiencing a shortage of primary care physicians. To help meet this demand for primary care providers in outpatient clinics, VAPORHCS turned to nurse practitioners (NPs). A primary care nurse practitioner residency (PC-NPR) program was developed to support novice NP’s transition to practice. Purpose: To describe the development of evaluation tools and an evaluation of the effectiveness and efficiency of the PC-NPR program’s curriculum in supporting NP residents’ progression through the program and transition to practice utilizing accreditation standards. Methods: The development of evaluation tools using a combined approach guided by Meleis’ Transition Theory and the Centers for Disease Control and Prevention Program Evaluation Framework. Evaluation tools included a 12-item curriculum questionnaire developed from national accreditation pre-publication standards and a focus group interview. Results: There was a 54% (n=13) response rate. The questionnaire had some negative responses to three statements. The remaining responses were positive. The two main themes of the focus group were transition to practice support and curricular improvement. Conclusion: This evaluation contributed to a comprehensive program evaluation. Results are being used to make timely improvements to the program objectives and curriculum in preparation for seeking the Commission on Collegiate Nursing Education national accreditation

Feasibility of a Multicomponent Breast Health Education Intervention for Vietnamese American Immigrant Women

Purpose/Objectives: To determine the feasibility and acceptability of an intervention with targeted cultural and health belief messages to increase rates of mammography among Vietnamese American (VA) immigrant women. Design: One-group, pre-/post-test, pilot, quasiexperimental design. Setting: Portland, Oregon, metropolitan area. Sample: 40 VA immigrant women aged 50 years or older. Methods: Participants who had not had a mammogram within the past 12 months were recruited. The intervention consisted of one interactive group teaching session, followed by individual counseling delivered about 10 days later to overcome barriers to screening. Participants completed a baseline survey prior to the group teaching and again at 12 weeks after the session. Main Research Variables: The intervention, guided by the Transtheoretical Model of Change and the Health Belief Model, involved movement in stage of change based on women’s readiness, as well as perceived susceptibility, perceived benefits, perceived common barriers, and perceived cultural barriers. Mammogram completion and knowledge of breast cancer and mammography were examined. Findings: The recruitment response rate was 58%. Knowledge about breast cancer, breast cancer susceptibility, and the benefits of mammography as related to breast cancer significantly increased following the intervention. Conclusions: Acceptability of the targeted program, good feasibility, and very low attrition was achieved. Implications for Nursing: This intervention can be adapted for other populations, including other Asian groups, and other cancer screenings

An Antiracism Community-Based Participatory Research With Organizations Serving Immigrant and Marginalized Communities, Including Asian Americans and Native Hawaiians/Pacific Islanders in the United States Pacific Northwest: Qualitative Description Study With Key Informants

BackgroundAsian American (AA) community leaders, Native Hawaiian/Pacific Islander (NH/PI) community leaders, and allies in the United States Pacific Northwest expressed concern that there are families and children from AA communities and NH/PI communities who experience and witness acts of xenophobia and racism. This can cause racial trauma. The long-time practice of aggregating AA and NH/PI data contributes to erasure and makes it challenging to advance health equity, such as allocating resources. According to AAPI Data’s long-awaited report in June 2022, there are over 24 million AAs and 1.6 million NHs/PIs in the United States, growing by 40% and 30%, respectively, between 2010 and 2020. Philanthropic investments have not kept up with this substantive increase. The National Academies of Sciences, Engineering, and Medicine emphasized the need for effective partnerships to advance the health and well-being of individuals and communities in antiracism and system-level research. ObjectiveThe aim of this community-based participatory research qualitative description study was to identify perceptions and experiences regarding racial discrimination, race-based stress, and racial trauma; intergenerational healing and resiliency; and sharing the body with science from key informants of an academic and community partnership to inform antiracism coalition work. This partnership includes academic researchers and community leaders from community-based organizations and a health care organization serving immigrant and marginalized communities, including AAs and NHs/PIs in the United States Pacific Northwest. MethodsIn total, 10 key informants joined 1 of 2 participatory group discussions via videoconference for 2 hours in 2022. We used a semistructured and open-ended group interview guide. A qualitative participatory group-level assessment was conducted with the key informants and transcribed. Interpretations and meanings of the main points and the main themes were reflected upon, clarified, and verified with the key informants in real time. The field note–based data transcripts were manually coded using conventional content analysis. Reflexivity was used. ResultsThere were 6 main themes: prejudice plus power in racism definition and working in solidarity to counter lateral oppression/false sense of security, microaggression as multilayers, “not assimilationist by nature” and responding differently to white superiority, intergenerational- and identity-related trauma, what is healing among People of Color and through a lens of resiliency and intergenerational connection and knowledge, and mistrust and fear in the research and health care systems surrounding intentions of the body. ConclusionsThe themes highlight the importance of internal and intergenerational healing from racial trauma and the need for solidarity among communities of color to combat white supremacy and colonization. This work was foundational in an ongoing effort to dismantle racism and uplift the community voice through a cross-sector academic and community partnership to inform antiracism coalition work