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Background Cancer is the leading cause of death among Asian Americans, who face barriers to cancer care. Cancer supportive care needs among Asian Americans remain understudied. Methods We recruited 47 Asian American adults with colorectal, liver, or lung cancer who spoke Chinese, English, or Vietnamese, and were starting or undergoing cancer treatment. We assessed cancer supportive care needs in four domains: cancer information, daily living, behavioral health, and language assistance. Hierarchical cluster analysis was used to identify clusters of participants based on their need profiles to further examine the association between need profiles and quality of life (QoL) assessed by the Functional Assessment of Cancer Therapy (FACT-G). Results Participants (mean age=57.6) included 72% males and 62% spoke English less than very well. Older participants (age >65) and those with annual income Conclusions Cancer supportive care needs among Asian American patients with colorectal, liver and lung cancer were associated with patient characteristics and QoL. Understanding cancer supportive care needs will inform future interventions to improve care and QoL for Asian American cancer patients.

Background: Cancer is the leading cause of death for Asian Americans. Patient navigation has shown benefits in enhancing cancer treatment outcomes and quality of life. Navigational needs in accessing cancer supportive care among Asian American cancer patients and how to address such needs, however, remain understudied. Asian Americans face unique language and cultural barriers in cancer care. We designed a culturally and linguistically-tailored pilot patient navigation intervention, Patient COUNTS, to better understand and address the needs of Asian American cancer patients. Objective: To examine cancer supportive care needs and resource use among patients, who participated in a pilot study that aimed to provide culturally and linguistically-tailored navigation for Asian American cancer patients. Methods: We recruited Asian American adults diagnosed with stage I-III colorectal, liver, or lung cancer from the Greater Bay Area Cancer Registry and San Francisco hospitals. Participants spoke English, Chinese, or Vietnamese and had not completed treatment. Participants were assigned a language-concordant patient navigator, who provided support for six months. This study describes participants' cancer supportive care needs and resource use from telephone and self-administered surveys collected at baseline, three, and six months. Participants included 24 Asian Americans with cancer who completed the baseline survey, with 18 (75%) who completed at least one of the follow-up surveys. Results: Of the study sample (n=24), 63% were men, 55% were 65 years or older, and 42% did not complete high school. A majority (75%) spoke limited English; participants' preferred language included Cantonese/Mandarin (61%), Vietnamese (26%) and English (13%). Most participants had stage I (54%) or III (42%) cancer of the lung (42%), colon (37%), or liver (21%). Across the three surveys, the most frequently reported types of needs by the 24 participants were: cancer information (83%), language translation (54%), basic resources such as financial, transportation, legal, housing, and food access resources (50%), access to healthcare (42%), and mental health (33%). Among the 18 participants who completed the three- or six-month surveys, 90% reported using one or more resources that navigators directed them to. Specifically, of the 18 patients, the most frequently used resources included healthcare (77%), basic needs (67%), language translation (56%), and mental health (28%). Conclusions: The Asian American cancer patients enrolled in Patient COUNTS, a pilot patient navigation program, had a variety of cancer supportive care needs. Findings provided preliminary support of Patient COUNTS as a promising approach to assess cancer supportive care needs and assist navigation of resources among Asian American cancer patients. These findings will inform future interventions to improve the care that Asian American cancer patients receive. Citation Format: Katarina Wang, Janice Tsoh, Carmen Ma, Ching Wong, Hoan Bui, Corina Liew, Junlin Chen, Salma Shariff-Marco, Janet N. Chu, Laura Allen, Mei-Chin Kuo, Debora L. Oh, Scarlett L Gomez, Tung T. Nguyen. Cancer supportive care needs and resource use among Asian American cancer patients: Preliminary findings from a pilot patient navigation intervention, “Patient COUNTS” [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-032.

Introduction Low socioeconomic status is associated with high rates of cigarette smoking, and socioeconomic differences in cigarette smoking tend to emerge during young adulthood. To further our understanding of socioeconomic differences in smoking among young adults, we examined correlates of smoking, with attention to multiple socioeconomic indicators that have not been examined in this population. Methods We analyzed data from the 2011–2012 California Health Interview Survey. The analytic sample consisted of young adults aged 18–30 years who were considered socioeconomically disadvantaged as measured by education and poverty. Logistic regression analyses were conducted to examine factors associated with smoking status in this group, and multinomial logistic regression analyses were conducted to examine correlates of smoking frequency. Results In this sample (N = 1,511; 48% female, 66% Hispanic/Latino, 18% non-Hispanic white), 39.7% reported experiencing food insecurity in the past year. Smoking prevalence was significantly higher among young adults who reported being food insecure (26.9%) than among those who reported being food secure (16.4%). Past-year food insecurity was significantly associated with current smoking, independent of sociodemographic characteristics and alcohol use. Specifically, food insecurity was significantly associated with daily but not nondaily smoking. Conclusion Socioeconomically disadvantaged young adults with food insecurity may be considered a high-risk group with respect to cigarette smoking. Efforts to reduce tobacco-related health disparities should address diverse sources of socioeconomic influences, including experiences of food insecurity.

Since 1964, smoking prevalence in the United States has declined because of nationwide intervention efforts. However, smoking interventions have not been implemented uniformly throughout all communities. Some of the highest smoking rates in the United States have been reported among Southeast Asian men, and socioeconomic status has been strongly associated with smoking. To compare the effect in reducing racial and ethnic disparities between men in Southeast Asian (Vietnamese and Cambodian) communities and men residing in the same states, CDC analyzed 2002-2006 data from The Racial and Ethnic Approaches to Community Health (REACH) project. The prevalence of current smoking significantly decreased and the quit ratio (percentage of ever smokers who have quit) significantly increased in REACH Vietnamese and Cambodian communities, but changes were minimal among all men in California or all men in Massachusetts (where these communities were located). The smoking rate also declined significantly, and the quit ratio showed an upward trend in U.S. men overall; however, the changes were significantly greater in REACH communities than in the nation. Stratified analyses showed decreasing trends of smoking and increasing trends of quit ratio in persons of both high and low education levels in Vietnamese REACH communities. The relative disparities in the prevalence of smoking and in the quit ratio decreased or were eliminated between less educated Vietnamese and less educated California men and between Cambodian and Massachusetts men regardless of education level. Eliminating health disparities related to tobacco use is a major public health challenge facing Asian communities. The decline in smoking prevalence at the population level in the three REACH Vietnamese and Cambodian communities as described in this report might serve as a model for promising interventions in these populations. The results highlight the potential effectiveness of community-level interventions, such as forming community coalitions, use of local media, and enhancing communities' capacity for systems change. The Office of Minority Health and Health Equity selected this intervention analysis and discussion to provide an example of a program that might be effective for reducing tobacco use-related health disparities in the United States.

Vietnamese-American women underutilize breast cancer screening.An RCT was conducted comparing the effect of lay health workers (LHWs) and media education (ME) to ME alone on breast cancer screening among these women.Conducted in California from 2004 to 2007, the study included 1100 Vietnamese-American women agedor = 40 years who were recruited through LHW social networks. Data were analyzed from 2007 to 2009.Both groups received targeted ME. The intervention group received two LHW educational sessions and two telephone calls.Change in self-reported receipt of mammography ever, mammography within 2 years, clinical breast examination (CBE) ever, or CBE within 2 years.The LHW+ME group increased receipt of mammography ever and mammography in the past 2 years (84.1% to 91.6% and 64.7% to 82.1%, p0.001) while the ME group did not. Both ME (73.1% to 79.0%, p0.001) and LHW+ME (68.1% to 85.5%, p0.001) groups increased receipt of CBE ever, but the LHW+ME group had a significantly greater increase. The results were similar for CBE within 2 years. In multivariate analyses, LHW+ME was significantly more effective than ME for all four outcomes, with ORs of 3.62 (95% CI=1.35, 9.76) for mammography ever; 3.14 (95% CI=1.98, 5.01) for mammography within 2 years; 2.94 (95% CI=1.63, 5.30) for CBE ever; and 3.04 (95% CI=2.11, 4.37) for CBE within 2 years.Lay health workers increased breast cancer screening among Vietnamese-American women.Future research should focus on how LHWs work and whether LHW outreach can be disseminated to other ethnic groups [corrected].

California has significantly decreased racial/ethnic and educational disparities in smoke-free home and indoor work policies. California's ethnic-specific surveys present an opportunity to disaggregate data and examine the impact of California's smoke-free social norm campaign for Asian-American women.The California Tobacco Use Surveys for Chinese Americans and Korean Americans were conducted in 2003 and analyzed in 2008 to compare women with lower (or= high school graduate) or higher education status for smoke-free policy adoption and enforcement.Lower-educated and higher-educated women had similar proportions of smoke-free policies at home (58%) or indoor work (90%). However, lower-educated women were more likely than higher-educated women to report anyone ever smoking at home (OR=1.62, 95% CI=1.06, 2.48, p=0.03) and exposure during the past 2 weeks at an indoor workplace (OR=2.43, 95% CI= 1.30, 4.55, p=0.005), even after controlling for ethnicity, smoke-free policy, knowledge about the health consequences of secondhand smoke exposure, and acculturation. There was no interaction between education and knowledge about secondhand smoke health harms.The intended consequences of California's tobacco-control efforts have resulted in similar rates of smoke-free policies at home and in indoor work environments among Asian-American women across educational levels. However, an unintended consequence of this success is a disparity in enforcement by educational status, with lower-educated Asian-American women reporting greater smoke exposure despite similar rates of knowledge about the health consequences of secondhand smoke exposure. Besides establishing policies, lower-educated Asian-American women may need to be empowered to assert and enforce their right to smoke-free environments.