Chinese LHW
Vietnamese LHW
Internet Stop Smoking
Faith-Based Advance Directives
Reduce Smoking in Vietnamese Men
Smoking among Chinese/Vietnamese
Vietnamese Social Network
Jenkins Bernen Endowment

Current Projects:

Title: Asian American Network for Cancer Awareness, Research, and  Training--National Center for Reducing Asian American Cancer Health Disparities (AANCART National Center)
Funding Agency: National Cancer Institute
Funding Period:  09/13/10-07/31/15

The overall mission of the AANCART National Center  is to reduce cancer health disparities by conducting community-based participatory education, training, and research, by, for, and with Asian Americans. The Center continues and expands the work of AANCART, which was established in 2000.  AANCART National Center focuses on research, with its centerpiece being a randomized controlled trial led by UCSF  investigators of the effectiveness of lay health worker outreach on the rates of colorectal cancer screening among Korean Americans in Los Angeles, Filipino Americans in Hawaii and Hmong Americans in Sacramento, A pilot project will explore how Chinese Americans in San Francisco view the collection of biospecimens.  The Center will also conduct outreach using a partnership model between community groups and university researchers to address cancer education, particularly for Chinese, Filipino, Hmong, Korean, and Vietnamese Americans in their native languages.  In addition, there are training activities to develop the careers of young Asian American investigators whose research interests span a variety of cancer health disparities affecting Asian Americans.  AANCART National Center will continue to function as a consortium of organizations, including UC Davis, UC San Francisco, Chinese Community Health Resource Center (CCHRC), Hmong Women’s Heritage Association in Sacramento, UC Los Angeles, University of Hawaii and the University of Washington.  The San Francisco site of AANCART National Center comprises of UCSF and CCHRC.

Title: Lay Health Workers and Colorectal Cancer Screening among Chinese Americans Study

Funding Agency: National Cancer Institute
Funding Period:  09/01/09-08/31/14

Colorectal cancer (CRC) screening saves lives but CRC screening rates remain low among Chinese Americans, the most populous Asian American group. Little is known about how to conduct effective and culturally appropriate community-based health promotion in this ethnic group. Lay Health Worker Outreach (LHWO) is an effective modality to promote some healthy behaviors in some communities, but much remains unknown about this approach and no prior work has been done with Chinese Americans.

This proposed project seeks to expand understanding of what constitutes a “lay health worker (LHW),” how those characteristics determine the effectiveness of LHWs as health educators on CRC screening, and the relationship of those characteristics to a particular community and culture. Using quantitative and qualitative methods and a community-based participatory research (CBPR) approach, the project will develop and implement a group randomized controlled trial to evaluate LHW effectiveness in promoting CRC screening among Chinese Americans age 50 and older with a pilot component to evaluate the role of Traditional Chinese Medicine (TCM) healers as health educators.

We will refine and implement a culturally and linguistically appropriate community outreach program based on LHWs to promote CRC screening among Chinese Americans age 50 to 75. The developmental work will be based on a prior successful pilot project, focus groups, and key informant inputs. These materials will be used in the first aim, which is to evaluate the effectiveness of LHWO on receipt of CRC screening among Chinese Americans in a group randomized trial using LHWs to deliver CRC education (intervention) compared to a CRC brochure  (comparison) in a sample of Chinese Americans age 50 to 75, living in San Francisco, and recruited through social networks of LHWs. Twenty-six LHWs each will be assigned to the intervention arm and 26 to the comparison arm.  The LHWs will each recruit 12 participants from their social network for a total of 312 participants in each arm. The intervention group participants will be exposed to 2 LHWO sessions and 2 telephone calls aimed at increasing their CRC screening receipt. The comparison group will receive a bilingual CRC brochure as well as a lecture on healthy nutrition for cardiovascular health. Effectiveness of the intervention will be measured by pre-intervention and post-intervention surveys of community participants’ CRC screening behaviors, with validation of self-reports. The second aim is to examine the processes through which LHWs work as health educators in this community.  This aim will be achieved by using mixed methods including surveys (of the LHWs and participants), focus groups (of the LHWs and participants), and observations conducted during LHW educational sessions. The third aim is to examine and expand the current paradigm of “lay” health education in Asian communities by exploring the roles that TCM practitioners such as herbalists and acupuncturists may play in delivering health education messages focused on a biomedical model of cancer prevention. This aim will be implemented and evaluated using the methodologies employed in the developmental, implementation, and evaluation process in the prior 2 aims.

The proposal also will explore ways through which LHWO can be disseminated and community capacity can be sustained. The findings of this project will greatly expand understanding about effective and culturally appropriate cancer health promotion among ethnic minority communities.

Title: Reducing disparities in colorectal cancer screening in Vietnamese Americans

Funding Agency: National Cancer Institute
Funding Period: 04/01/08-03/31/13

This project is a collaboration among the Vietnamese Community Health Promotion Project, Vietnamese Reach for Health Coalition, and the lead agency, Northern California Cancer Center (NCCC).  The Principal Investigator is Bang Nguyen, Dr.PH. at NCCC.  Colorectal cancer (CRC) screening rates in Vietnamese Americans are lower than those in non-Hispanic whites. 
Consistent with our long-term goal of reducing morbidity and mortality caused by colorectal cancer, we propose to disseminate an evidence-based lay health worker (LHW) intervention to increase CRC screening in this poor and medically underserved population. The specific aims of this study are to: 1) evaluate the effectiveness of a CRC LHW intervention in increasing CRC screening among Vietnamese Americans aged 50 to 74 who have never had a CRC screening test, 2) identify predictors of CRC screening, and 3) evaluate the process of community participation. Following formative research using a cognitive testing approach to develop culturally and linguistically appropriate health education materials and survey instruments, we will conduct a cluster randomized trial among Vietnamese Americans aged 50-74 in Santa Clara County California, who have never had a CRC screening test prior to recruitment. We will follow two longitudinal cohorts among whom we will conduct a pre-intervention survey of participants’ knowledge, intention, and behavior as regards CRC screening; implement CRC screening educational sessions in an experimental group and nutrition educational sessions in a comparison group; and conduct a post- intervention survey. Each of the two cohorts will include 150 men and 150 women to have a total sample size of 600. We will evaluate the effectiveness of the intervention by comparing the frequency of screening using pre- and post-intervention surveys. In addition, we will conduct process evaluation of the intervention and community participation. If this intervention is found to be effective, this LHW model could be applied in health promotion programs to further reduce disparities in CRC screening in Vietnamese Americans and evaluated in other behavioral objectives and settings to reduce health disparities in other poor and underserved populations.

Title: A Family Intervention to Reduce Smoking among Chinese and Vietnamese Men
Funding Agency: National Institute on Drug Abuse
Funding Period: 3/01/2011 - 2/28/2013

R21 DA030569-01 (Janice Tsoh, PhD, Principal Investigator/Tung Nguyen, MD Co-Investigator/Stephen J. McPhee, MD Co-Investigator). The goal of the proposed research project is a proof-of-concept to examine the feasibility and acceptability of a family intervention using lay health worker outreach to involve both smokers and their family members in promoting smoking cessation in theChinese and Vietnamese populations where tobacco-related dispari­ties remain disproportionately high. This study will use a mixed methods research design to develop and pre-test a family intervention using lay health worker outreach to involve both smokers’ families and smokers to promote smoking cessation in Chinese- and Vietnamese-American men in San Francisco

Title: Innovative Faith-Based Education on Advance Directives in Asian American Communities
Funding Agency: NIH/ National Center on Minority Health and HealthDisparities
Funding Period: 10/01/2010 - 09/30/12

(Angela Sun, PhD/Principal Investigator/Stephen J. McPhee, MD, Co-Investigator/Janice Tsoh PhD, Co-Investigator/Quynh Bui, MD, Co-Investigator)  R21 MD006024-01. The overall goal of this study is to develop a lasting partnership between community health educators, academic researchers, and faith communities to improve understanding and utilization of advance care planning among Chinese and Vietnamese Americans. The study aims to: 1) build and strengthen a collaboration between the Chinese Community Health Resource Center (CCHRC),academic researchers, and faith-based organizations to conduct community-based participatory research (CBPR) on advance care planning among Chinese and Vietnamese Americans; 2) design an effective intervention involving faith-based organizations to address advance care planning in Chinese and Vietnamese American communities; and 3)evaluate the impact and efficacy of a faith-based intervention to increase knowledge and completion of advance directives among Chinese and Vietnamese Americans..

Title: A Family Intervention to Reduce Smoking in Vietnamese Men
Funding Agency: CA-Tobacco Related Disease Research Program
Funding Period:  7/01/2010 - 6/30/2012

19XT-0083 H (Janice Tsoh, PhD, Principal Investigator/Tung Nguyen, MD Co-Investigator/Stephen J. McPhee, MD Co-Investigator). The main goal of this study is to develop a family intervention using lay health worker (LHW) outreach to promote smoking cessation in Vietnamese American men. The specific aims are to: 1) Develop a culturally and linguistically appropriate family intervention with LHW outreach targeting Vietnamese smokers and their families for smoking cessation. 2) Conduct a pilot feasibility trial using one-group pre- and post-intervention design to examine feasibility. Participants will be recruited from the Santa Clara County of California, the county with the second-largest Vietnamese American population.

Title: The Chinese Community Internet Stop Smoking Project
Funding Agency: CA-Tobacco Related Disease Research Program
Funding Period: 7/01/2010 - 6/30/2012

19BT-0039 (Angela Sun, PhD, Community Principal Investigator/ Janice Tsoh, PhD, Academic Principal Investigator). This project's main goal is to form a community-academic partnership task force to develop Internet stop smoking intervention targeting Chinese immigrants in California.

Title: Vietnamese Social Networks Study

Funding Agency: National Cancer Institute
Funding Period:  09/30/09-09/29/11

Prior research demonstrated that lay health worker (LHW) interventions using social networks to recruit participants could achieve the desired outcomes of increasing breast and cervical cancer screening rates among Vietnamese American women.  However, little is known about social networks, social support, social influence of male and female Vietnamese Americans and how LHWs use their social networks to recruit participants, provide support, and influence their participants to promote screening behaviors.  To fill this critical gap in knowledge, we propose a pilot study to describe the characteristics of social networks and their roles in LHW interventions and colorectal cancer (CRC) screening. The specific aims are: 1) to qualitatively identify and describe social networks, social support, and social influence of male and female Vietnamese American lay health workers (LHW) and their educational session (ES) participants and 2) to quantitatively measure the extent of social networks, social support, and social influence of LHWs and ES participants.  Elucidating the mechanisms through which LHW interventions are effective in behavior changes will enable researchers and practitioners in the fields of epidemiology, cancer control, and behavioral sciences to better design interventions and target aspects of social networks that are facilitators to screening behaviors.