Background The incidence of non-AIDS-defining cancers has increased significantly among persons living with HIV (PLHIV). Screening education is recommended. Purpose Social learning, minority stress, and cultural safety theories informed this pilot to assess the feasibility of a colorectal cancer screening intervention targeted to PLHIV, with additional tailoring for relevance to Native Hawaiians, a group with low participation in cancer screening. Method The targeted education included behavioral modeling and barriers counseling in a culturally safe environment. Using a 2-group, pre/posttest design, AIDS service organizations were randomized to culturally responsive or standard education. AIDS service organizations consumers recruited through venue-based promotions were the unit of analysis. Knowledge–attitudes–practices, fecal occult blood test screening completion, and intervention feasibility were measured. Results Treatment arm participants, regardless of ethnicity, adhered to fecal occult blood test instructions and achieved increases in screening knowledge, attitudes, and practices. Relevance and acceptability of the educational intervention were endorsed. Discussion The culturally responsive intervention was successful in this group of PLHIV. Additional tailoring may be needed to reach PLHIV who do not participate in organizational activities. Conclusion/Translation to Health Education Practice This culturally responsive intervention shows promise for efficacy testing in a broader PLHIV population. Constituent-involving strategies were central to its development and delivery.
The overrepresentation of Native Hawaiians in Hawai‘i’s criminal justice system is among the most stunning of ethnic/racial disparities in the state. To describe the human impact of Native Hawaiians involvement in the criminal justice system, the authors interviewed persons with criminal histories, correctional officials, social workers, and others. Findings reveal systemic challenges to prison exit and community reentry, including lack of services stipulated for release and upon reentry, marginalization associated with cultural trauma, resource deficits, and stigma. The National Association of Social Workers encourages social work leadership in policy formulation and service development. Suggested are strategies for influencing community attitudes, program access, and culturally-grounded services.
24 (2), 443-449 the U.S., Guam is geographically located in Asia and 33.6% of its population is Asian (including Korean, Japanese, Chinese, and other ethnic groups, with Filipinos making up 26.3%) (Central Intelligence Agency, 2022). In 2021, it was estimated that 14,480 new cases of invasive cervical cancer will be diagnosed in the United States, with 4,290 women dying from this cancer (American Cancer Society, 2022). As it usually takes 15 to 20 years
Cultural competency is the ability to respectfully engage, understand, and communicate through conscientious interaction, enabling effective work and meaningful relationships in cross-cultural situations. Cultural competency recognizes the importance for organizations of participants’ diverse social and cultural values, beliefs, and behaviors, and has gained attention because it can bridge health perspectives, understanding, and respect between health professionals and patients. There remains a need for cultural competency in healthcare as disparities persist across the U.S. in racial and ethnic minority groups who experience worse health outcomes and lower healthcare quality than the general public. Therefore, a cultural competency training curriculum was created using various resources to improve interactions between Pacific Islander patients and healthcare professionals. This training helps to reduce racial/ethnic disparities in healthcare by encouraging mutual understanding and improving patient satisfaction, adherence to medical instructions, and overall health outcomes by highlighting patient-centered care as a result of utilizing components of cultural competency. To improve patient experiences in Hawai’i, healthcare professionals need the tools to better interact with patients from different cultures, such as Pacific Islanders. This training provides healthcare professionals with culturally-based content for improving cultural competence techniques for interacting with Pacific Island patients. This training was pilot tested with key stakeholders from community organizations and Cancer Center faculty/staff. Local health clinics, providers, and practices will have the opportunity to participate in this training through a Zoom-based electronic training format and be provided with three continuing medical education credits. The initial delivery of the training was intended for in-person sessions; however, a virtual format was adapted due to the COVID-19 pandemic and subsequent social distancing regulations. Healthcare providers are provided pre-training resources, a pre- and post-test, and a course evaluation to determine the validity of training objectives. To date, two Federally Qualified Health Centers have been provided the training, n=60, as well as one Cancer Health Equity Partnerships’ Scientific Workshop, n=40. For attendees, the analysis of correct responses from the pretest to post-test showed a significant improvement on 6 of the 12 questions. Respondents also agreed that the training resources aligned with the course objectives. Improved patient interactions from this training can help support better patient outcomes, adherence to medical advice regarding cancer screenings, and many other aspects of improving health equity for Pacific Islanders. Citation Format: Mark Lee Willingham Jr., Kevin Cassel, Angela Sy, Munirih Taafaki, Tressa P. Diaz, Angelina G. Mummert. Providing culturally responsible health care to Pacific Islander communities: The creation of a cultural competency training for healthcare professionals. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5533.
Background. Colorectal cancer (CRC) is the 2nd leading cause of cancer death in Guam, a U.S. unincorporated territory where CHamoru (Chamorro) and Filipinos comprise over 60% of the population. CHamoru have higher age-adjusted mortality rates (23.2) than the U.S. (14.2) and the overall population in Guam (17.3). Only 53.9% of persons aged 50 and above have met USPSTF screening standards compared to 74.3% in the U.S. In addition, CRC diagnoses occur in the late stages; 75.0% at Stage 3, while 18.0% occur at Stage 1. Research on early CRC onset among Pacific Island peoples are limited; data from the Guam Tumor Registry indicates 10% of colorectal cancer cases from 2013 – 2017 were diagnosed before age 50. Specific aims of this pre-pilot study are to examine cognitive and cultural beliefs associated with CRC and screening, recommendations for culturally relevant prevention, and age-specific education interventions. Methods: Qualitative methods were employed via focus groups (FG) and in-depth key informant interviews (KII) to allow for participant perspectives and facilitate storytelling, a practice in the Pacific that creates a familiar and safe space for expression. A 3-member community council comprised of a CRC surgeon, community-based organization representative, and CRC survivor advised on recruitment, data analysis, and reporting. Purposive and snowball sampling was utilized due to stigma/sensitivity related to screening. Focus groups were age and gender specific, e.g., men in their 40s, women aged 50+, etc. KII were conducted with cultural experts and cancer survivors. Data on knowledge, attitudes, and beliefs and screening education recommendations was collected. Three levels of qualitative coding for thematic codes were performed and included input from community council and KIs. Translations from CHamoru to English were applied as necessary. Results: Five FGs and four KIIs (N=29) were conducted with persons aged 40 and above. Focus group participants were CHamoru (60%), Filipino (32%), mixed ethnicity (8%), female (56%), male (44%), and had a primary care provider (84%). Mean age was 55.0. Overall, 24.0% reported ever having had a FIT/FOBT test and 56.0% ever having had a colonoscopy. Data analysis for FGs and KIIs will be finalized in September. Initial reviews indicate mixed methods of delivery for community health educator interventions, e.g., use of a culturally relevant video, storytelling from CRC survivors, and efforts to educate families as a whole, as opposed to limiting education to screening-age adults. Conclusion: This study explores culturally relevant components of an education intervention providing a pre-emptive look at screening education for persons aged 40 and above. Findings may give insight toward age-specific and culturally-tailored CRC screening education with use of community health educators as a novel intervention for CHamoru and Filipino families and to create a pilot education intervention to improve CRC screening participation in these underserved minority populations. Citation Format: Tressa P. Diaz, Angela Sy, Elizabeth Elmore, Santino Camacho, Marc Rollon. Tailoring a culturally relevant and age-specific colorectal cancer screening education intervention for CHamoru and Filipinos in guam [abstract]. In: Proceedings of the AACR Special Conference on Colorectal Cancer; 2022 Oct 1-4; Portland, OR. Philadelphia (PA): AACR; Cancer Res 2022;82(23 Suppl_1):Abstract nr A025.
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