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Hepatitis B (HBV) infection plays a primary role in the development of liver cancer, contributing to nearly 80% of liver cancer cases. Vietnamese males have the highest incidence of liver cancer of any ethnic group, and HBV infection is a serious and prevalent health problem among Vietnamese immigrants. Guided by the Health Belief Model framework, the purpose of the present study was to assess levels of perceived risk, severity, barriers and benefits, and cues to action in HBV screening and vaccination in relation to actual screening and vaccination behavior in a sample of Vietnamese adults. The study consisted of 359 Vietnamese adults residing in Pennsylvania and New Jersey. The majority of participants were immigrants (98.1%) and had low socio-economic and educational status. Only 8.8% of participants reported being screened and 7.3% vaccinated for HBV. Participants who had been screened reported feeling at higher risk and perceived HBV infection to be more likely to lead to liver cancer and death than those who had not been screened. In addition, participants who had been screened reported fewer perceived barriers and more cues to action than unscreened participants. Compared to participants who had been vaccinated, unvaccinated participants were more likely to report feeling healthy and a lack of knowledge about where to obtain HBV testing as barriers. Multivariate logistic regression analyses indicated that perceived barriers were negatively associated with screening behavior as well as vaccination behavior. These results suggest that community-based, culturally appropriate interventions for Vietnamese Americans should directly address barriers to screening and vaccination in order to enhance screening and vaccination rates in this underserved population. [ABSTRACT FROM AUTHOR]

OBJECTIVES: This study examined tobacco use rates and potential predictors of use among Asian Americans residing in the Delaware Valley region. METHODS: A cross-sectional survey design was used. The sample consisted of 1174 Chinese, Koreans, Vietnamese, and Cambodians. RESULTS: Findings indicated that the mean age at initiation of tobacco use was 18.3 years. Among the respondents, 40.2% had a history of tobacco use, and 29.6% were current users. Men were more likely than women to smoke. There were significant differences between never smokers, current smokers, and ex-smokers in sex, ethnicity, educational attainment, and marital and employment status. CONCLUSIONS: The findings suggest that tobacco use is still a serious public health problem among Asian Americans, especially men. [ABSTRACT FROM AUTHOR]

Alcohol is the most commonly abused substance among adolescents in the United States. Adolescent females are recognized as one group at risk for giving birth to babies with fetal alcohol syndrome (FAS). Sixth through eighth grade Native Americans were surveyed about their attitudes toward and knowledge of FAS risk factors and prevention strategies. Data revealed that 52% of students drank alcohol prior to the survey. Though sexually active, students lacked knowledge about the relationship between alcohol and FAS. The study revealed 1) limited prevention programs in middle schools and 2) the most influential factor in determining attitudes and decisions about alcohol use was the immediate family. Students felt FAS prevention is an important topic in school health education, noting the important role peers play in teaching and role modeling. Various strategies incorporating music and communication technology such as videotape and computer-assisted interactive tools into prevention materials are discussed. [ABSTRACT FROM AUTHOR]

A variety of reasons have been advanced for the high prevalence of alcohol and drug use among young adolescent American Indians. Research to date has not provided adequate information that would be helpful in the design and implementation of viable prevention programs among adolescents' in ethnic communities. This article focuses on American Indian adolescents' perceptions of risk factors and effects associated with alcohol use during pregnancy, as well as age-related prevention strategies for fetal alcohol syndrome. A focus group approach was used to elicit perceptions from participants. Results indicated that peer pressure, influences of adult drinking behaviors, stressful family environment, and the acceptance of alcohol use in the Indian community may be risk factors associated with alcohol use among American Indian youth. Participants, however, indicated lack of knowledge about the relationship between Fetal Alcohol Syndrome and alcohol use during pregnancy. Practical prevention approaches are recommended, including: (1) incorporation of alcohol prevention messages with music, posters, and communication technology tools; (2) education in risk factors and effects of alcohol use for young adolescents; (3) prevention of alcohol use through active involvement in social and physical activities; (4) empowerment of youth through peer leadership; and (5) improvement in family relationships and an environment with stronger adherence to Indian cultural traditions. [ABSTRACT FROM AUTHOR]

Grace X Ma,1 Min Qi Wang,2 Xiang S Ma,3 Steven E Shive,4 Yin Tan,5 Jamil I Toubbeh51Department of Public Health, College of Health Professions, Temple University, Philadelphia, PA, 2Department of Public and Community Health, University of Maryland, College Park, MD, 3College of Health Professions and School of Medicine, Temple University, Philadelphia, PA, 4Center for Asian Health, Temple University, and Department of Health, East Stroudsburg University, East Stroudsburg, PA, 5Center for Asian Health, Department of Public Health, College of Health Professions, Temple University, Philadelphia, PA, USABackground: The purpose of this community-based study was to develop a structural equation model for factors contributing to cervical cancer screening among Chinese American women.Methods: A cross-sectional design included a sample of 573 Chinese American women aged 18 years and older. The initial step involved use of confirmatory factor analysis, that included the following variables: access to and satisfaction with health care, and enabling and predisposing cultural and health beliefs. Structural equation model analyses were conducted on factors related to cervical cancer screening.Results: Age, marital status, employment, household income, and having health insurance, but not educational level, were significantly related to cervical screening status. Predisposing and enabling factors were positively associated with cervical cancer screening. The cultural factor was significantly related to the enabling factor or the satisfaction with health care factor.Conclusion: This model highlights the significance of sociocultural factors in relation to cervical cancer screening. These factors were significant, with cultural, predisposing, enabling, and health belief factors and access to and satisfaction with health care reinforcing the need to assist Chinese American women with poor English fluency in translation and awareness of the importance of cervical cancer screening. Community organizations may play a role in assisting Chinese American women, which could enhance cervical cancer screening rates.Keywords: Papanicolaou test, cervical cancer screening, Chinese women

Most of the sodium Americans consume comes from processed and restaurant foods. An upstream global strategy to promote health is to work with local restaurants to reduce sodium content in their food offerings, while accounting for food taste and economic considerations. In urban communities, Chinese take-out restaurants serve meals with large amounts of sodium and are clustered in low-income, racial/ethnic minority communities with a high prevalence of hypertension. The objective of this study is to assess baseline knowledge, attitudes, and behaviors related to sodium use/consumption among Chinese take-out owners and chefs recruited to participate in the Philadelphia Healthy Chinese Take-Out Initiative. A cross-sectional study of 221 Chinese take-out restaurants was conducted from August 2012 to February 2013. Items measured knowledge, attitudes, and behaviors related to salt use, salt consumption, and health. Most owners/chefs knew that excess sodium consumption contributes to high blood pressure but were less aware of other health effects and of major sources of sodium in the U.S. diet. The majority were willing and able to reduce sodium content in meals if customer demand could be maintained, and they desired training in food preparation, procurement, and marketing. Findings show a need to provide education, strategies, and support to Chinese take-out owners/chefs in preparing low-salt dishes. The results of this and future studies to reduce sodium content in meals by working with restaurant owners and chefs have global health promotion implications., (© 2014 Society for Public Health Education.)

Background: On a large scale, bio-specimen banking offers researchers the ability to newly understand areas like community genetics and to apply new sampling technologies to housed samples. Understanding cultural differences in knowledge and perceptions of bio-specimen banking allows for addressing community concerns and facilitates dissemination of culturally relevant health education., Methods: Community-based participatory approaches (CBPA) provide opportunities to solicit community input and to build mechanisms for maximizing outcomes of potential interventions. As part of a larger CBPA project, Chinese, Korean, and Vietnamese community members participated in eight focus groups on bio-specimen banking. Demographics and qualitative text were analyzed., Results: The study results indicate that education and English proficiency were the most important predictors of knowledge of bio-specimen banking. Ethnic and age differences also were identified as predictors of knowledge in bivariate analyses. Participants discussed safety in bio-specimen sample collection procedures; processes of tissue removal, including spinal and blood draws; privacy protection; trust in healthcare providers; concerns about genetic research; importance of contributing to science; and family concerns., Conclusion: The diversity of Asian American populations requires that, to increase participation in bio-specimen banking, understanding and addressing community concerns requires health education efforts that improve knowledge of innovations in sampling and cultural tailoring of health education messages. Promotion messages should highlight scientific benefits including possibilities for tailoring medical treatment and new diagnoses. Issues of health information privacy and stigma for communities at risk for certain diseases remain community worries., Competing Interests: The authors declare that they have no conflict of interest.

Objective: The purpose of this study was to validate a Sociocultural Health Behavior Model using a structural equation analysis to determine the direction and magnitude of the interdependence of model components in relation to health behavior associated with colorectal cancer (CRC) screening among Chinese Americans., Methods: A cross-sectional design included a sample of 311 Chinese American men and women age 50 and older. The initial step involved use of confirmatory factor analysis which included the following variables: access/satisfaction with health care, enabling, predisposing, cultural, and health belief factors. Structural equation modeling analyses were conducted on factors for CRC screening., Results: Education and health insurance status were significantly related to CRC screening. Those with less than a high school education and without health insurance were more likely to be "never screened" for CRC than those having more education and health insurance. The path analysis findings also lend support for components of the Sociocultural Health Belief Model and indicated that there was a positive and significant relationship between CRC screening and the enabling factors, between cultural factors and predisposing, enabling, and access/satisfaction with health care factors and between enabling factors and access/satisfaction with health care., Conclusions: The model highlights the significance that sociocultural factors play in relation to CRC screening and reinforced the need to assist Chinese with poor English proficiency in translation and awareness of the importance of CRC screening. The use of community organizations may play a role in assisting Chinese to enhance colorectal cancer screening rates.

The purpose of this community-based participatory study was to identify factors associated with colorectal cancer (CRC) screening compliance and non-compliance among Cambodians, Vietnamese, Koreans and Chinese men and women 50 years and older living in the United States. A cross-sectional design was used in the study. The completed sample included 815 Asian Americans which included Cambodians (N=215), Vietnamese (N=195), Koreans (N=94) and Chinese (N=311). A 95-item questionnaire was developed and pilot tested for content validity and reliability. An in-person data collection approach was utilized and participants were given choice in responding in English or their native language. Of the 815 participants, 79.1% (N=645) reported never-screened, 7.9% (N=64), non-compliance, and 13.0% (N=106) compliance. Education was significantly associated with never-screened for CRC for Vietnamese and Chinese; employment status for Cambodians and Koreans; lack of health insurance for Cambodians, Korean and Chinese; English fluency and years lived in the U.S. for Vietnamese, Koreans, and Chinese. Less acculturated Asian Americans were more likely to be never screened, but differentially across ethnic subgroups. Barriers to screening included lack of knowledge, language, transportation, and time. Increased culturally-targeted public awareness and education programs are needed to improve CRC screening and compliance among high risk Asian American ethnic subgroups.

This study assessed the impact of demographics and acculturation on stages of change in smoking behavior among Asian current smokers (Koreans, Chinese, Vietnamese, and Cambodians) who live in the Delaware Valley region. Three stages (precontemplation, contemplation, and preparation) that applied to current smokers in Prochaska's Transtheoretical Model were measured, with a small modification. A cross-sectional self-report survey was conducted by utilizing a stratified cluster proportional sampling technique. Recruited were 1374 Asian Americans from 26 randomly selected community organization clusters and 1174 completed the survey (83%). Data were analyzed using the Pearson chi(2) test of significance. Education was negatively associated with stages of smoking behavior change. Time living in the United States showed a statistically significant positive correlation. Individuals older than 21 years appeared more seriously inclined to quit (be in the preparation stage) than those below age 21. Among the four subgroups, Cambodians (91%) were more likely to fall in either contemplation or preparation, while Chinese had the highest rate in precontemplation stage. Men were more likely than women to be in the preparation stage. Immigration status was not a significant predictor of stages.