Need: The Asian American Health Coalition (AAHC) dba HOPE Clinic is requesting funding from the Cancer Prevention and Research Institute of Texas (CPRIT) as a Continuation/Expansion project under the Evidence-Based Prevention Services component. The proposed “Eliminating Cancer Disparities in Medically Underserved Immigrant and Refugee Populations in Houston, TX” project will target Asian immigrants living primarily in Southwest Houston, as well as refugees that may come from elsewhere in the city.

Houston’s foreign-born Asian population is growing significantly and increased 48% from 2000 to 2010. In addition, the number of refugees from other countries settling in Houston is also increasi...

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The Asian American Health Coalition (AAHC) dba HOPE Clinic is requesting funding from the Cancer Prevention and Research Institute of Texas (CPRIT) as a Continuation/Expansion project under the Evidence-Based Prevention Services component. The proposed “Eliminating Cancer Disparities in Medically Underserved Immigrant and Refugee Populations in Houston, TX” project will target Asian immigrants living primarily in Southwest Houston, as well as refugees that may come from elsewhere in the city.

Houston’s foreign-born Asian population is growing significantly and increased 48% from 2000 to 2010. In addition, the number of refugees from other countries settling in Houston is also increasing. More than 4,000 refugees settled in Harris County during FY 2011-2012, and approximately half of these are seen at HOPE Clinic for primary and preventive care. In 2013, 73% of clinic patients were best served in a language other than English.

Cancer disparities are high for Asian populations, particularly liver cancer, in which incidence is 69% and mortality 36% higher for the local Asian population than for the county. Breast cancer has been found to be the leading cancer diagnosis among Asian American women and nation-wide, Asian American women are the least likely to have had a mammogram. Colorectal cancer is among the three most commonly diagnosed cancers for Asian Americans, and they have the lowest colorectal cancer screening rates of all ethnic groups. Cervical cancer also affects Asian populations, particularly Vietnamese, as women from this sub-group have the highest incidence and death rates according to the American Cancer Society. Lung cancer is the leading cause of cancer deaths for AAPI women and second leading cause for Asian/Pacific Islander men. Smoking rates vary by Asian sub-group; however, those from Southeast Asian countries as well as China tend to have higher rates than other groups.

Barriers to accessing prevention and quality health services include linguistic isolation, insufficient health information, and a shortage of ethnically sensitive and lack of culturally competent health facilities. With staff that speak more than 22 languages among them and demonstrated cultural competence, HOPE Clinic is the only clinic in Houston uniquely suited to serve these refugees and Asian immigrants.

HOPE Clinic will continue providing linguistically and culturally competent prevention and related education services to address breast, cervical and liver cancer, and will expand services to address colorectal screening and smoking cessation. In addition, HOPE will provide health nutrition education to address obesity and malnutrition which impact various forms of cancer. Clinical evidence-based services will be provided by HOPE Clinic providers, which include specialists in Family Practice, Internal Medicine, Obstetrics/Gynecology, and professionals in behavioral health and nutrition. These functions are supported with translators, patient educators, care coordinators, and outreach staff.

As conducted through the previous CPRIT grant, services will include: clinical breast exams, mammography, diagnostic mammograms, Pap tests, colposcopy, Hepatitis B screening, and vaccines to prevent Hepatitis B and Human Papilloma Virus (HPV), complemented with education and outreach strategies tailored to the multicultural target population. Educational materials will be made available in a number of languages. HOPE Clinic will enhance its services to include a mass cervical cancer screening event, conduct more targeted outreach to the area’s Asian businesses, provide “healthy cooking” classes and grocery store tours, and various smoking cessation services.

Clinical screening, diagnosis, education and intervention services will be provided to a total of 16,890 individuals, while general health education through community events and media is expected to reach 26,000. Specific goals of the project are to: 1. Reduce the burden of breast cancer on Asian and refugee women; 2. Reduce the burden of cervical cancer on Asian and refugee women; 3. Reduce the burden of liver cancer and Hepatitis B on Asian and refugee populations; 4. Reduce the burden of colorectal cancer on Asian and refugee populations.

Asian immigrants and refugees in Houston are hard to reach because of differences in language, habits, customs, and values. Each group is different from the other, not only in culture, but also in cancer incidence rates and specific needs. Projects targeting Asians and refugees need to include tailored strategies for reaching out to these distinct groups and require special expertise to be developed. Among other evidence-based strategies, HOPE Clinic uses the Chronic Care Model from the National Health Disparities Collaborative to develop a comprehensive, cost effective and high quality cancer control program.

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