Human papillomavirus (HPV) is the most common sexually transmitted infection in the US. HPV vaccine is a viable source of prevention against high-risk strains that are likely to cause cancer. However, particularly among racial and ethnic minorities such as Chinese Americans, HPV vaccination rates are suboptimal. The goal of this study was to evaluate the effect of a culturally tailored intervention on HPV vaccine uptake in Chinese Americans. We designed and implemented a multilevel longitudinal pilot study to examine the efficacy of the HPV intervention among Chinese American parents/guardians. We recruited 180 participants from federally qualified health center and community-based clinics that serve predominantly low-income Chinese Americans in Philadelphia. Participants were randomized into an intervention group (n = 110) or a control group (n = 70). The intervention group received an HPV specific intervention, while the control group received a general health intervention. The primary outcome was medical record-confirmed receipt of first shot and completion of HPV vaccine within six months of receiving the interventions. Repeated measure ANOVA was utilized to examine the intervention effect on knowledge between intervention and control groups. Knowledge differed significantly, with participants in the intervention group demonstrating the greatest improvement following the intervention. A multivariable logistic regression was used to examine the association between HPV vaccine initiation and study group assignment. There was a significant effect of provider recommendation, parent’s gender, and health insurance status on HPV vaccine uptake. This study demonstrated positive impact of a culturally tailored intervention on HPV vaccination uptake among Chinese Americans.
Human papillomavirus (HPV) is one of the most common sexually transmitted infections in the USA. HPV is acknowledged as one of the leading causes of anal cancer, with an increased risk in men who have sex with men (MSM), when compared to age-matched heterosexual men. This study highlights the various factors that influence and impede HPV vaccination uptake among a multiracial cohort of young-MSM (YMSM). A total of 444 participants aged 18 to 27 in the Greater Philadelphia region completed an online survey. Approximately 75.79% ( n = 335) of participants did not receive at least one dose of the HPV vaccine. Having a healthcare provider recommendation (OR = 25.54, 95% CI: 25.54–85.42, p < 0.001) and a one unit increase in experiences of adverse effects of stigma and homophobia (OR = 1.06, 95% CI: 1.01–1.11, p = 0.044) were associated with a greater likelihood of receiving the HPV vaccine uptake. Having a greater number of sexual partners (OR = 0.85, 95% CI: 0.75–0.97, p = 0.014) and having had condomless anal sex in the past 6 months (OR = 0.31, 95% CI: 0.15–0.58, p < 0.001) were associated with a lower odds of HPV vaccine uptake. In conclusion, healthcare provider-focused interventions and educational programs are needed to increase awareness and uptake of the HPV vaccine to mitigate the risks associated with sexual behaviors among this population.
Background Asian American women face disproportionate burden of cervical cancer (CC) than non-Hispanic white women in the U.S. The goal of this study was to assess the feasibility and impact of a culturally tailored intervention to promote Human papillomavirus (HPV) self-sampling test among hard-to-reach Asian American women. Methods We adopted the community-based participatory research (CBPR) approach to conduct this efficacy study. A total of 156 female participants (56 Chinese, 50 Korean, and 50 Vietnamese) were recruited from community-based organizations (CBOs) in the greater Philadelphia metropolitan area. The intervention components included HPV-related education, HPV self-sampling test kit and instructions, group discussions, and patient navigations, all available in Asian languages. We examined several outcomes, including the completion of HPV self-sampling, HPV-related knowledge, perceived social support, self-efficacy, and comfort with the self-sampling test at post-intervention assessment. Results The majority of Asian American women had low annual household income (62.3% earned less than $20,000) and low educational attainment (61.3% without a college degree). We found significant increase in participants’ knowledge on HPV (baseline: 2.83, post: 4.89, P <.001), social support (baseline: 3.91, post: 4.09, P < .001), self-efficacy (baseline: 3.05, post: 3.59, P < .001), and comfortable with HPV self-sample test (baseline: 3.62, post: 4.06, P < .001). Conclusion To the best of our knowledge, this is the first intervention study that promoted HPV self-sampling test among Asian American women. Our findings showed that CBPR culturally tailored intervention of self-sampling was highly effective in empowering low-income Asian American women to conduct HPV self-sampling tests.
Colorectal cancer (CRC) is one of the most predominant cancers in the USA and ranks third among all cancers in incidence and mortality. Vietnamese Americans exhibit persistently lower screening rates compared to the general U.S. population, due to cultural, economic, and environmental barriers. The impact of environmental factors in particular is not well known, and lack of geographical access may be a significant barrier to accessing screening. This study aims to elucidate build and neighborhood environmental factors affecting CRC screening rates among Vietnamese Americans. A total of 517 Vietnamese Americans 50 years and older residing in Philadelphia County were included in the study. Surveys were collected to determine CRC screening behavior and sociodemographic characteristics. Individual neighborhood characteristics, which included the Walk Score, was obtained based on the participant’s address. Neighborhood characteristics were calculated using census-tract level data for the social deprivation index, ethnic composition, and presence of hospitals or federally qualified health centers (FQHC). The generalized linear mixed model revealed that residing in an ethnically dense neighborhood was negatively associated with CRC screening (β = −0.67, SE = 0.29, p = .01), while social deprivation (β = 0.30, SE = 0.27, p = .27) and presence of FQHCs or hospitals (β = 0.16, SE = 0.30, p = .58) were not. Individual neighborhood characteristics including the Walk Score (β = 0.21, SE = 0.26, p = .43) was not associated with CRC screening behavior. Neighborhood characteristics, specifically ethnic density is associated with lower uptake of screening in this population. Future interventions should aim to target specific Vietnamese American and other Asian ethnic neighborhoods that may experience disparities in screening.
Background: Although Asian Americans only make up about 6% of the total U.S. population, they comprise almost 60% of individuals living with chronic hepatitis B (CHB). Asian Americans are disproportionately affected by CHB; and are more likely to develop Hepatitis B Virus (HBV)-related cirrhosis and hepatocellular carcinoma (HCC). Mental health may impact patient adherence to long-term management and treatment of chronic conditions such as CHB. Increased likelihood to report depressive symptoms and lower health-related quality of life (HRQOL) has been established among patients with CHB compared to the general population. Physical inactivity and smoking have also been associated with lower HRQOL among U.S. adults with depression. This study aims to examine the association between modifiable lifestyle behaviors (physical activity, smoking, alcohol use) and depression among Asian Americans with CHB by medication status. Methods: Chinese- and Vietnamese-Americans with CHB were recruited through outpatient clinics and community-based organizations to participate in an in-person assessment at baseline, as part of an ongoing intervention trial aimed at improving long-term adherence to monitoring/treatment. Participants were asked to report on their socio-demographic characteristics, health-related behaviors, depression symptoms, and modifiable lifestyle behaviors, among others. Bivariate analyses (two sample t- test, chi square test of independence) and multivariable logistic regression were conducted to examine association between exposures to modifiable lifestyle behaviors and outcomes of depression. Results: The study analysis sample consists of 289 participants (219 Chinese- and 70 Vietnamese-Americans). Bivariate analyses showed that there is no statistically significant difference in mean depression scores among those on CHB medication vs. those not (4.73 vs. 4.78, p 0.94), with 38.71% and 39.39% reporting mild to severe depression, respectively. In terms of lifestyle behaviors, when controlling for socio-demographic factors, multivariable logistic regression showed that while none of the three lifestyle behaviors (physical activity, smoking, alcohol use) were significantly associated with depression (p > 0.05) among participants not on medication, being physically inactive was significantly associated with a higher risk of depression (OR = 5.10, 95% CI = 1.72-15.10, p < 0.01) among participants currently on CHB medications, with other covariates held constant. Conclusion: Our study found a significant association between physical inactivity and depression among Asian Americans currently on CHB medication. Our findings suggest a need to incorporate physical activity, as part of a mental health intervention for patients with CHB, particularly for those on medication. Larger studies are needed to determine the association between depression and smoking and/or alcohol use among Asian Americans with CHB. Citation Format: Winterlyn Gamoso, Lin Zhu, Timmy R. Lin, Yin Tan, Grace X. Ma. The association between modifiable lifestyle behaviors and depression among Asian Americans with chronic hepatitis B by medication status [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-137.
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