Ethnic Enclave Effect on Vietnamese Breast Cancer Patients
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: Introduction: Vietnamese is the 4th largest and fast-growing ethnic Asian population group in the US with over 2 million individuals. Breast cancer is the most common cancer among Vietnamese American women. However, it is very difficult to find breast cancer data and research specific to Vietnamese, because they often get lumped together with other Asian Americans. This has been a serious problem for the Vietnamese community to help the increasing number of its breast cancer survivors. The Vietnamese population in the United States (US) is uniquely different from other Asian ethnic groups for several reasons. It has a much shorter immigration history that started in 1975 when the Vietnam War ended. Most Vietnamese came as refugees eligible for US government’s refugee settlement programs and family reunification programs. Most Vietnamese Americans live in neighborhoods with a high concentration of Vietnamese residents. Such places are called “ethnic enclaves”. Orange County (OC) in California has the largest concentration of Vietnamese population in the US. 
 
 Our community-academic research partnership has enabled us to perform preliminary analysis using California Cancer Registry (CCR) data. We found that despite having lower socioeconomic status and limited opportunities, Vietnamese breast cancer patients have better 5-year observed survival than non-Hispanic white (NHW) women in California. This observation begs the question of what in the Vietnamese community attributes to the better breast cancer outcomes. We would like to examine the impact of Vietnamese ethnic enclaves on breast cancer survivorship outcomes. 
 
 Question(s) or hypotheses: 
 1) Does living inside Vietnamese enclaves affect breast cancer outcomes for Vietnamese women as compared to those living outside the enclaves? 2) What are the factors associated with Vietnamese enclaves responsible for positive or negative breast cancer outcomes? 3) What can we do with the knowledge learned from this project to improve breast cancer outcomes? 
 We hypothesize that there are positive health promoting factors that exist within the Vietnamese enclave that can be identified, strengthened, and shared with other ethnic communities to promote better breast cancer outcomes. 
 
 General methodology: 
 We will first define the Vietnamese enclaves in OC by using the 2013-2017 American Community Survey data at census tract level. Then we will use the CCR data to calculate the Vietnamese breast cancer survival statistics by geography of inside or outside the Vietnamese enclaves in OC. We then will use CCR records to enroll 20 randomly selected Vietnamese breast cancer survivors (10 living inside and 10 outside the Vietnamese enclaves) for pilot-testing the methodology and questionnaire for an in-depth patient interview survey to collect patient self-reported information on breast cancer outcomes and characteristics associated with enclave-living status to prepare for a future larger-scale patient survey study. Our project will be conducted under the guidance of our Community Advisory Board (CAB) which will be actively involved in all aspects of this study. Findings from the study will be shared with community partners, stakeholders, health department, etc. to identify new service opportunities to improve breast cancer survivorship. 
 
 Innovative elements:
 Our proposed pilot project is the first to focus on examining the impact of ethnic enclaves in relation to breast cancer outcomes in the understudied Vietnamese population. It overcomes the flaws of previous studies. It is originated from the community’s needs and developed into a thriving community-academic partnership. It takes advantage of the largest Vietnamese community in OC, and this novel approach has received a wide range of support from community advocates to state and congressional representatives. It looks into the existing strengths of the community to identify ways to improve breast cancer outcomes. It has the potential to empower the Vietnamese community and inspire other ethnic communities. 
 
 Community involvement: 
 This project was initiated by the community for finding Vietnamese-specific breast cancer data, which led to the formation of this research partnership and the development of this proposal. The community is the driving force behind this collaboration. 
 
 Future Plans: 
 We plan to build on the knowledge and insights gained from this pilot study to submit a full CRC proposal to conduct a large-scale survey of Vietnamese breast cancer survivors with more statistical power to determine the ethnic enclave effect on breast cancer outcomes.