Asians and Pacific Islanders are the only U.S. racial/ethnic population to experience cancer as the leading cause of death. Vietnamese women have the highest known cervical cancer rate in the US (43.0/100,000), five times that of non-Hispanic White women (8.7/100,000). Yet, Vietnamese women have the lowest rate of Pap test receipt among ethnic/racial groups in the U.S.

This gap in screening is not widely recognized because cancer screening rates and other health statistics for Vietnamese women are usually aggregated within Asian American women and, consequently, their unique needs may go unnoticed. Vietnamese women confront barriers to screening such as lack of knowledge about cervical...

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Asians and Pacific Islanders are the only U.S. racial/ethnic population to experience cancer as the leading cause of death. Vietnamese women have the highest known cervical cancer rate in the US (43.0/100,000), five times that of non-Hispanic White women (8.7/100,000). Yet, Vietnamese women have the lowest rate of Pap test receipt among ethnic/racial groups in the U.S.

This gap in screening is not widely recognized because cancer screening rates and other health statistics for Vietnamese women are usually aggregated within Asian American women and, consequently, their unique needs may go unnoticed. Vietnamese women confront barriers to screening such as lack of knowledge about cervical cancer and HPV, low levels of income or education, and limited fluency in English.

At the state level, data indicate that among women in Texas, Vietnamese women are the least likely to follow cervical (56%) or breast (75%) cancer screening guidelines. The need to increase cancer screening in this population is urgent. Among Vietnamese women, Vietnamese nail salon workers (VNSW) may be at even higher risk of cancer. Not only do VNSW face the same barriers as most Vietnamese women, their cancer risk is amplified by additional structural and social barriers (long hours at work, lack of insurance, and low wages) that may increase their difficulty in accessing and utilizing health care services. Yet, no cancer prevention programs have targeted VNSW. Therefore, we propose to implement a successful evidence-based program to empower VNSW to get screened for cancer.

Our overall project strategy is to adapt and deliver A Su Salud, an existing cancer prevention program, targeted to VNSW’s cultural background, health care needs, and working context. We will adopt specific evidence-based strategies (i.e., community outreach to deliver role model stories displayed in small media) that have been successfully employed in A Su Salud.

The primary goal of this project is to implement an outreach and intervention program among VNSW to increase knowledge and awareness of cancer-related risks, behavioral skills, and intentions to participate in breast and cervical cancer screening. Our secondary goal is to increase the proportion of non-compliant VNSW who participate in Pap test and mammogram screening. To achieve these goals, we will focus our recruitment in Houston’s “Asiatown,” an area identified as having multiple health needs and a high concentration of Vietnamese residents. To accomplish these project goals, we will assess the health and cancer prevention needs of VNSW, adapt and implement A Su Salud to promote breast and cervical cancer screening to VNSW at their workplaces, navigate non-compliant VNSW towards completion of cancer screening, and determine the extent to which the outreach and intervention program achieved its goals. Our program has the potential to reach 3,829 Vietnamese women and serve 1,310 VNSW.

At program completion, we expect a 20% increase in knowledge of breast and cervical cancer and a 15% increase in cancer screening among women targeted by the program. In collaboration with the HOPE Clinic, we will offer Pap tests and mammograms to every significantly out-of-compliance VNSW. If successful, our ultimate goal is to disseminate this program to other nail salons in Houston and other Texas cities, and to “brand” the project for other US cities.

We will adopt A Su Salud, an evidence-based cancer prevention program with demonstrated effectiveness among Latinos and other ethnic groups to serve the cultural and linguistic needs of VNSW, thus expanding its eventual reach to multicultural, multilingual populations. We will deliver cancer prevention to include outreach to nail salons and navigation services to an overlooked population of Vietnamese women with the highest risk for cervical cancer. By fostering ties to the HOPE Clinic, we hope to increase cancer screening and provide VNSW with a permanent medical home.

No published cancer prevention programs have focused specifically on VNSW cancer awareness and screening. The few programs for Vietnamese women have been delivered through church or community organizations which may have unwillingly excluded VNSW who do not attend participate in church or community activities due to their work schedules. We will deliver our program to their workplace, thereby bringing outreach education to them and increasing their access to health services. We expect that the program’s short-term impact will result in increased awareness and knowledge of cancer screening and services, and increased access to health services through community outreach. Our expected long term impacts are to help VNSW increase and maintain regular screening and to reduce their cancer morbidity and mortality.

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