Asian American Health Asian American Health Needs AssessmentNeeds Assessment

Phase One: the AsANA survey

Beverly J. Gor, EdD, RD, LD, CDE, TruongSon Hoang, BS,Beverly J. Gor, EdD, RD, LD, CDE, TruongSon Hoang, BS,

Angelina Esparza, RN, BSN, BA, Michelle A. Detry, PhD, Angelina Esparza, RN, BSN, BA, Michelle A. Detry, PhD,

Mike Hernandez, MS, Lovell A. Jones, PhDMike Hernandez, MS, Lovell A. Jones, PhD

Center for Research on Minority Center for Research on Minority HealthHealth

Department of Health Disparities Department of Health Disparities ResearchResearch

Source: U.S. Census, 2000

Asian population in HoustonAsian population in Houston

Why is the AsANA study important?Why is the AsANA study important?

Inconsistent and inadequate collection Inconsistent and inadequate collection of Asian health dataof Asian health data

Asian American health concerns are Asian American health concerns are poorly understood and often overlookedpoorly understood and often overlooked

Groupings for “whites” or “others” Groupings for “whites” or “others” include Asians and other ethnic groupsinclude Asians and other ethnic groups

Aggregation of Asian data masks true Aggregation of Asian data masks true health problems within Asian subgroupshealth problems within Asian subgroups

Without baseline data, we are unable to Without baseline data, we are unable to focus our research or measure changesfocus our research or measure changes

Asian American Health Needs Asian American Health Needs AssessmentAssessment

To collect scientifically sound data on the health To collect scientifically sound data on the health practices and health beliefs of Asian Americans in practices and health beliefs of Asian Americans in Houston and the surrounding areaHouston and the surrounding area

To establish baseline data that can set the stage To establish baseline data that can set the stage for future studies and research projects with for future studies and research projects with Asian populationsAsian populations

To compare data with that of other minority To compare data with that of other minority groups and the general populationgroups and the general population

To provide the data to the targeted communities To provide the data to the targeted communities so they can apply for community development so they can apply for community development fundingfunding

Objectives:

To collect scientifically sound data on the health To collect scientifically sound data on the health practices and health beliefs of Asian Americans in practices and health beliefs of Asian Americans in Houston and the surrounding areaHouston and the surrounding area

To establish baseline data that can set the stage To establish baseline data that can set the stage for future studies and research projects with for future studies and research projects with Asian populationsAsian populations

To compare data with that of other minority To compare data with that of other minority groups and the general populationgroups and the general population

To provide the data to the targeted communities To provide the data to the targeted communities so they can apply for community development so they can apply for community development fundingfunding

Survey Development & Survey Development & AdministrationAdministration

Texas Community Health Texas Community Health Survey (CHS)Survey (CHS)

Translated to Vietnamese Translated to Vietnamese and Chineseand Chinese

Reviewed by Asian Reviewed by Asian Community Health Review Community Health Review PanelPanel

Randomly selected Randomly selected Chinese/Vietnamese Chinese/Vietnamese households from Asian households from Asian surname listsurname list

Participants 18+ years oldParticipants 18+ years old Informed consentInformed consent

AsANA Survey InstrumentAsANA Survey Instrument

From the Texas CHS:From the Texas CHS:

DemographicsDemographics Mental health Mental health Health practicesHealth practices Physical examsPhysical exams Cancer screeningsCancer screenings ImmunizationImmunization DiseasesDiseases Heart diseaseHeart disease DiabetesDiabetes CancerCancer BehaviorsBehaviors SmokingSmoking Alcohol useAlcohol use Nutrition Nutrition Physical activityPhysical activity

100+ questions

Added questions:Added questions:

Cancer knowledgeCancer knowledge AcculturationAcculturation Environmental exposureEnvironmental exposure Alternative therapyAlternative therapy PainPain Oral HealthOral Health Colorectal cancer Colorectal cancer

screeningscreening Men’s healthMen’s health Hepatitis B immunizationHepatitis B immunization

AsANA PostersAsANA Posters

AsANA DataAsANA Data

Data collectionData collection

4097 numbers called in nine 4097 numbers called in nine weeks weeks

1085 respondents1085 respondents 814 completed interviews:814 completed interviews:

405 Chinese (25.7% refusal rate)405 Chinese (25.7% refusal rate) 38% male, 62% female38% male, 62% female

409 Vietnamese (23.8% refusal rate)409 Vietnamese (23.8% refusal rate) 48.2% male, 51.8% female48.2% male, 51.8% female

Calls averaged 25-40 minutesCalls averaged 25-40 minutes

Age DistributionAge Distribution

4.2

6.2

10.1

22

26.3

21.5

9.7 10

22.3

18

5.2

2.3

28.6

13.6

0

5

10

15

20

25

30

35

18-24 25-34 35-44 45-54 55-64 65-74 75+ yrs

%

Chinese Vietnamese

Residency statusResidency status

14.9

94.2

0.1

5.2

94.4

0

10

20

30

40

50

60

70

80

90

100

US Born Foreign Born Unknown

%Chinese Vietnamese

Education LevelEducation Level

0

62.4

14.915.3

3.82.90.7

8.1

13.1

27.322.8

27.5

0.30.8

0

10

20

30

40

50

60

70

Never attendedGrades 1-8 Grades 9-11

Grade 12 or GEDCollege 1-3

College 4+ years

Refused

%

Chinese

Vietnamese

English proficiencyEnglish proficiency

88.1

95.5

72.373.9

60.5

95.691.8

48.9

0

20

40

60

80

100

120

Speak Eng well Read Eng wellSpeak CH/VN well Read CH/VN well

%

Chinese

Vietnamese

Do you have any form of health Do you have any form of health insurance?insurance?

20.2

13.9

51.5

26.830.6

26.9

0

10

20

30

40

50

60

No

ChineseVietnameseTX WhiteTX BlackTX HispanicTX BRFSS

In your leisure time, how many In your leisure time, how many days did you do vigorous exercise days did you do vigorous exercise

or activities?or activities?61.8

22.4

37.3

27.6

33.5 33.3

0

10

20

30

40

50

60

70

None

ChineseVietnameseTX WhiteTX BlackTX HispanicTX BRFSS

How many servings of fruits or How many servings of fruits or vegetables did you eat yesterday?vegetables did you eat yesterday?

58.1

77.179.6 77.5

92.9

74.3

01020

304050

6070

8090

100

Less than 5 servings

ChineseVietnameseTX WhiteTX BlackTX HispanicTX BRFSS

Have you smoked at least 100 Have you smoked at least 100 cigarettes in your entire life?cigarettes in your entire life?

10

21.6

18.720.4

14.3

19.3

0

5

10

15

20

25

Yes

ChineseVietnameseTX WhiteTX BlackTX HispanicTX BRFSS

Have you ever had a Have you ever had a mammogram? mammogram?

(Women 40 yrs and older)(Women 40 yrs and older)

20.4

28.6

37.8

31

25.2

30.5

0

5

10

15

20

25

30

35

40

No

ChineseVietnameseTX WhiteTX BlackTX HispanicTX BRFSS

Have you ever had a Pap smear?Have you ever had a Pap smear?(All women)(All women)

20.2

14.5

18.9

16.3

28.5

10.2

0

5

10

15

20

25

30

No

ChineseVietnameseTX WhiteTX BlackTX HispanicTX BRFSS

Have you ever had prostate cancer Have you ever had prostate cancer screening? (Men 40 yrs and older)screening? (Men 40 yrs and older)

48.8

15.5

44.7

23.5

57.9

31.5

0

10

20

30

40

50

60

70

No

ChineseVietnameseTX WhitesTX BlacksTX HispanicsTX BRFSS

Have you ever had colorectal cancer Have you ever had colorectal cancer screening? (Adults over 50 years screening? (Adults over 50 years

old)old)

48.8

59.4

47.1

74.0 73.6

59.6

0

10

20

30

40

50

60

70

80

No

ChineseVietnameseTX WhitesTX BlacksTX HispanicsTX BRFSS

What does this mean for What does this mean for Asians in Houston?Asians in Houston?

Access to health care may Access to health care may be difficultbe difficult

due to lack of insurancedue to lack of insurance Limited English proficiency Limited English proficiency Low cancer screening ratesLow cancer screening rates Less aware of health Less aware of health resources and cancer resources and cancer prevention guidelinesprevention guidelines

Where do we go from here?Where do we go from here?

Further analysis and dissemination of Further analysis and dissemination of AsANA dataAsANA data

Providing this information to Providing this information to community based organizationscommunity based organizations

Needs assessment, resource mapping Needs assessment, resource mapping and community discussionsand community discussions

Expanding this to other Asian Expanding this to other Asian populations, such as the South Asianspopulations, such as the South Asians

Future studies on other health topicsFuture studies on other health topics Periodic re-surveying of the populationPeriodic re-surveying of the population

AcknowledgementsAcknowledgementsFunding for this project was Funding for this project was provided by provided by

The National Center onThe National Center onMinority Health and HealthMinority Health and HealthDisparities (NCMHD)Disparities (NCMHD)

Purdue PharmaPurdue Pharma

Asian American Network for Asian American Network for Cancer, Awareness, Research Cancer, Awareness, Research and Trainingand Training