Southeast Asian Breast Health Navigation
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: Southeast Asian (Cambodian, Laotian, Thai, and Vietnamese) women have the lowest rates of breast cancer screening among Asian and Pacific Islander women. Many Southeast Asian (SEA) women encounter enormous barriers to breast cancer screening and treatment services due to limited English proficiency; lack of transportation; living in impoverished conditions; working long hours and not being able to take time off from work for health care appointments; and lack of information and resources for their communities. While some studies exist showing lower screening rates among SEAs, there are very few studies and programs focused upon the Cambodian, Laotian, Thai, and Vietnamese communities in relation to cancer prevention and treatment. In recent years, there has been an increasing emphasis on the importance of employing community health outreach workers and navigators to reach those who have traditionally been labeled as “hard-to-reach.” However, while some studies have defined, described, and evaluated health navigator programs using a hospital and clinic-based model, relatively few studies have examined health navigator programs in community-based settings. And no studies to date have looked at patient navigation in Southeast Asian communities. Therefore, we are proposing a study to document what patient navigators do and describe how they perform their work to help women in the SEA communities to access breast health services. 
 
 
 
 
 
 
 
 By identifying and understanding the essential elements involved in a community-based patient navigation program, we will then develop a formal curriculum that can be used to train patient navigators helping women with breast health services in other underserved communities. 
 
 
 
 
 
 
 
 We seek to answer the following three research questions: 1) what are the important factors at the individual, interpersonal, and larger community levels that need to be addressed in an effective breast health navigation program? 2) how do navigators culturally tailor their strategies to help Southeast Asian women obtain necessary services from initial breast cancer screening exams through diagnostic, treatment and rehabilitation services? 3) what specific training components are necessary in a navigation program curriculum to successfully increase access to and utilization of quality breast health services for SEA women? 
 
 
 
 
 
 
 
 The project focuses on two main ideas: 1) that there are certain activities that can be done through patient navigation (interpretation, transportation, case management, social and family support, education, improved relations and communications with their provider, resource development, etc.) that help support a low income, limited English speaking Southeast Asian woman to be able to access breast health services; and 2) that this information can be used to develop a training curriculum for patient navigators helping women with breast health services in other underserved communities. 
 
 
 
 
 
 
 
 We will interview 24 medical care providers and 14 community health navigators and will train bilingual/ bicultural facilitators to conduct focus groups with 120 women to understand their experiences and perceptions of the elements needed in a patient navigation model to help support women gaining access to breast health prevention, diagnostic, treatment, and rehabilitation services. Findings from our study will also help us to develop a formal patient navigation curriculum that can be tested for its impact on increasing breast health among low income SEA women. 
 
 
 
 
 
 
 
 No published studies have looked at patient navigation in SEA communities, so our project will be the first of its kind to look at patient navigation for breast health services in these communities. The project is also unique in that we will be studying navigation processes and experiences not just from the navigator point of view, but from the multiple perspectives of the patient, medical provider, and navigator in order to identify the essential elements and describe the processes, skills, and strategies needed for a successful patient navigation training curriculum and program. 
 
 
 
 
 
 
 
 SEA community members are involved in every aspect of the program, including acting as co-investigators and advisory committee members. Community members, leaders, and health workers as well as breast cancer survivors and advocates helped to initiate and conceptualize our research study. They will also help guide the development of focus group and interview questions, review of translations, and will help us to interpret and disseminate our study findings. Our interviewers come from the SEA community and are all bilingual and bicultural and have more than 20-30 years of experience working in their communities. In addition, community members will help us to develop easy-to-understand reports summarizing the study findings and will organize bilingual community forums to publicize and disseminate the study results.