Abstract A28: Increasing the contribution of blood biospecimen collection by Hmong Americans: An empirically and literature-informed intervention
Authors: Dang Julie H.T. , Moua Dao Fang , Chen Moon S. 
Published: June 2012

Background/Aim: Access to sufficient quantities of racially-specific blood samples for research purposes increases the likelihood of developing personalized approaches for cancer treatment and insights that can result from enhanced molecular and genomic characterizations of biospecimens. However, blood samples from Asian Americans who are the only U.S. racial/ethnic group to experience cancer as the leading cause of death appear to be extremely limited. Hence the aim of our study was to test the feasibility of developing, implementing, and evaluating an intervention to increase the number of blood biospecimens contributed by Asian Americans. Since all Asian Americans are not alike, this presentation focuses only on one Asian American group, the Hmong, who represent one of the most recent groups of Asian Americans.

Methods: We first conducted a community needs assessment to identify factors that appear to affect Asian Americans’ decisions to contribute biospecimens. That assessment revealed that blood specimens ranked in the bottom four choices of biospecimens that Asian Americans (Chinese, Hmong, Vietnamese) preferred to contribute. With respect to contributing biospecimens, the first preference (43%) for Hmong was to contribute biospecimens during a community event. The main reason Hmong participants would consider contributing biospecimens was to look at diseases passed down in families. Of the three Asian groups, the Hmong preferred visual and oral education over written materials.

Second, we exhaustively reviewed the limited literature on biospecimens contributions. Hmong consider blood as the source of strength and vitality and believe that there is a limited amount of blood in their bodies. Once drawn, they believe that blood cannot be replaced. Hence, some Hmong patients are more apt to refuse blood draws because they believe blood is not renewed.

The needs assessment and literature review thus depicted considerable cultural and cognitive factors that needed to be integrated into a successful intervention to collect biospecimens from Hmong. Thus, we partnered with a trusted community-based organization, Hmong Women's Heritage Association (HWHA), with whom we have collaborated with for over 8 years. Based on that collaboration, we developed an intervention that incorporated our empirical findings and literature review. That intervention relied on preparing HWHA bilingual, bicultural Hmong lay health workers to explain the value of blood donations as ways to contribute to cancer research and to explain how cancer may be addressed. We held the blood drive during a well-publicized community event and we provided modest incentives for participation.

Results: On April 16, 2011, the Asian American National Center for Reducing Cancer Health Disparities in collaboration with the UC Davis Cancer Center Biorepository and the Hmong Women's Heritage Association hosted the first-ever Asian American biospecimen community drive. Expecting only to draw 40 samples, we collected 174 vials of blood from 87 “healthy” volunteers, 82 were Hmong volunteers.

Conclusions: Despite the overwhelming cultural and cognitive barriers associated with blood as a means of biospecimen contribution, the outpour of community support is a testament to 1) The trust the community has in Hmong Women's Heritage Association; 2) The time, commitment, and dedication of the staff; and lastly 3) The talent of the those individuals who worked on everything from the IRB consenting process to the talent of the community for rising above their cultural reservations and who wholeheartedly contributed to the greater good of their community. Developing an effective intervention to increase the collection of blood biospecimens must be customized to the population group.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A28.