Lam Tram K, McPhee Stephen J, Mock Jeremiah, Wong Ching, Doan Hiep T, Nguyen Thoa, Lai Ky Q, Ha-Iaconis Tuyet, Luong Thien-Nhien
Suc Khoe La Vang!(Health is Gold!),Vietnamese Community Health Promotion Project, Division of General Internal Medicine, University of California-San Francisco, San Francisco, CA, USA.
J Gen Intern Med. 2003 Jul;18(7):516-24. doi: 10.1046/j.1525-1497.2003.21043.x.
Five times more Vietnamese-American women develop cervical cancer than white women. Few studies have examined whether community-based participatory research can effectively address Asian immigrants' health problems. This article reports the preliminary evaluation of 1 such project.
A coalition of 11 organizations in Santa Clara County, California worked with university researchers to design and simultaneously implement a media education (ME) campaign and a lay health worker outreach (LHWO) program to increase Vietnamese-American women's cervical cancer awareness, knowledge, and screening. Two agencies each recruited 10 lay health workers (LHWs), who, in turn, each recruited 20 women who were then randomized into 2 groups: 10 to LHWO+ME (n = 200) and 10 to ME alone (n = 200). LHWs organized meetings with women to increase their knowledge and to motivate them to obtain Pap tests. Participants completed pre- and post-intervention questionnaires.
At post-intervention, significantly more LHWO+ME women understood that human papillomavirus and smoking cause cervical cancer. The number of women who had obtained a Pap test increased significantly among women in both LHWO+ME and ME groups, but substantially more in the LHWO+ME group. Significantly more LHWO+ME women said they intended to have a Pap test.
Media education campaigns can increase Vietnamese women's awareness of the importance of Pap tests, but lay health workers are more effective at encouraging women to actually obtain the tests. Lay health workers are effective because they use their cultural knowledge and social networks to create change. Researchers, community members, and community-based organizations can share expert knowledge and skills, and build one another's capacities.
越南裔美国女性患宫颈癌的几率是白人女性的五倍。很少有研究探讨基于社区的参与性研究能否有效解决亚洲移民的健康问题。本文报告了对这样一个项目的初步评估。
加利福尼亚州圣克拉拉县的11个组织组成的联盟与大学研究人员合作，设计并同时实施了一项媒体教育（ME）活动和一项外展非专业卫生工作者（LHWO）项目，以提高越南裔美国女性对宫颈癌的认识、知识水平并增加她们的筛查率。两个机构各招募了10名非专业卫生工作者（LHWs），这些非专业卫生工作者又各自招募了20名女性，并将她们随机分为两组：10人分到LHWO+ME组（n = 200），10人分到仅ME组（n = 200）。非专业卫生工作者组织与女性会面，以增加她们的知识并激励她们进行巴氏试验。参与者完成了干预前和干预后的问卷调查。
在干预后，显著更多的LHWO+ME组女性了解到人乳头瘤病毒和吸烟会导致宫颈癌。在LHWO+ME组和ME组的女性中，进行巴氏试验的女性数量均显著增加，但LHWO+ME组增加的幅度更大。显著更多的LHWO+ME组女性表示她们打算进行巴氏试验。
媒体教育活动可以提高越南女性对巴氏试验重要性的认识，但非专业卫生工作者在鼓励女性实际进行检查方面更有效。非专业卫生工作者之所以有效，是因为他们利用自己的文化知识和社会网络来促成改变。研究人员、社区成员和社区组织可以分享专业知识和技能，并相互增强能力。
