Community Health Navigators for Breast- and Cervical-Cancer Screening Among Cambodian and Laotian Women: Intervention Strategies and Relationship-Building Processes
Restricted accessResearch articleFirst published online October, 2008
Community Health Navigators for Breast- and Cervical-Cancer Screening Among Cambodian and Laotian Women: Intervention Strategies and Relationship-Building Processes
In recent years, there has been a growing number of programs employing health navigators to assist underserved individuals in overcoming barriers to obtaining regular and quality health care. This article describes the perspectives and experiences of community-based health navigators in the Cambodian and Laotian communities involved in a REACH 2010 project to reduce health disparities in breast and cervical cancer among Pacific Islander and Southeast Asian communities in California. These community health navigators, who have extensive training and knowledge about the cultural, historical, and structural needs and resources of their communities, are well equipped to build trusting relationships with community members traditionally ignored by the mainstream medical system. By comparing the different social support roles and intervention strategies employed by community health navigators in diverse communities, we can better understand how these valuable change agents of the health workforce are effective in improving health access and healthy behaviors for underserved communities.
American Cancer Society. (2003). California cancer facts and figures 2004. Oakland: California Division and Public Health Institute, California Cancer Registry .
2.
American Cancer Society. (2004). Cancer facts and figures 2004. Atlanta, GA: Author.
3.
Bailey, S., Bennett, P., Hicks, J., Kemp, C., & Warren, S.H. (1996). Cancer detection activities coordinated by nursing students in community health. Cancer Nursing, 19(5), 348-352.
4.
Banner, R.O., DeCambra, H., Enos, R., Gotay, C., Hammond, O.W., Hedlung, N., et al. (1995). A breast and cervical cancer project in a native Hawaiian community: Wai'anae cancer research project. Preventive Medicine, 24(5), 447-453.
5.
Bird, J.A., McPhee, S.J., Ha, N.T., Le, B., Davis, T., & Jenkins, C.N. (1998). Opening pathways to cancer screening for Vietnamese-American women: Lay health workers hold a key. Preventive Medicine , 27(6), 821-829.
6.
Bird, J.A., Otero-Sabogal, R., Ha, N.T., & McPhee, S.J. (1996). Tailoring lay health worker interventions for diverse cultures: Lessons learned from Vietnamese and Latina communities. Health Education Quarterly, 23(Suppl.), S105-S122.
7.
Brownstein, J.N., Cheal, N., Ackermann, S.P., Bassford, T.L., & Campos-Outcalt, D. (1992). Breast and cervical cancer screening in minority populations: A model for using lay health educators . Journal of Cancer Education, 7(4), 321-326.
8.
Burhansstipanov, L., Wound, D.B., Capelouto, N., Goldfarb, F., Harjo, L., Hatathlie, L., et al. (1998). Culturally relevant "Navigator" patient support. The Native sisters. Cancer Practice, 6(3), 191-194.
9.
Centers for Disease Control and Prevention (CDC). (1994). Community health advisors: Models, research, and practice (Vols. I and II). Atlanta, GA: U.S. Department of Health and Human Services, CDC.
10.
Charles, C., & DeMaio, S. (1993). Lay participation in health care decision making: A conceptual framework. Journal of Health Politics, Policy and Law, 18(4), 881-904.
11.
Cwikel, J.M., & Israel, B.A. (1987). Examining mechanisms of social support and social networks: A review of health-related intervention studies. Public Health Review, 15(3), 159-193.
12.
Dignan, M., Michielutte, R., Blinson, K., Wells, H.B., Case, L.D., Sharp, P., et al. (1996). Effectiveness of health education to increase screening for cervical cancer among Eastern-band Cherokee Indian women in North Carolina. Journal of the National Cancer Institute, 88(22), 1670-1676.
13.
Earp, J.A., & Flax, V.L. (1999). What lay health advisors do: An evaluation of advisors' activities. Cancer Practice, 7(1), 16-21.
14.
Eng, E., Hatch, J., & Callan, A. (1985). Institutionalizing social support through the church and into the community. Health Education Quarterly , 12(1), 81-92.
15.
Eng, E., Parker, E., & Harlan, C. (1997). Lay health advisor intervention strategies: A continuum from natural helping to paraprofessional helping. Health Education & Behavior, 24(4), 413-417.
16.
Eng, E., & Smith, J. (1995). Natural helping functions of lay health advisors in breast cancer education. Breast Cancer Research and Treatment , 35(1), 23-29.
17.
Freeman, H.P., Muth, B.J., & Kerner, J.F. (1995). Expanding access to cancer screening and clinical follow-up among the medically underserved. Cancer Practice , 3(1), 19-30.
18.
Frelix, G.D., Rosenblatt, R., Solomon, M., & Vikram, B. (1999). Breast cancer screening in underserved women in the Bronx. Journal of the National Medical Association, 91(4), 195-200.
Frye, B.A. (1995). Use of cultural themes in promoting health among Southeast Asian refugees. American Journal of Health Promotion , 9(4), 269-280.
21.
Frye, B.A., & McGill, D. (1993). Cambodian refugee adolescents: Cultural factors and mental health nursing. Journal of Child and Adolescent Psychiatric and Mental Health Nursing, 6(4), 24-31.
22.
Gotay, C.C., Banner, R.O., Matsunaga, D.S., Hedlund, N., Enos, R., Issell, B.F., et al. (2000). Impact of a culturally appropriate intervention on breast and cervical screening among native Hawaiian women. Preventive Medicine, 31(5), 529-537.
23.
Heaney, C.A., & Israel, B.A. (2002). Social networks and social support. In K. Glanz, B. K. Rimer , & F. M. Lewis (Eds.), Health behavior and health education: Theory, research, and practice (3rd ed., pp. 185-273). San Francisco: Jossey-Bass.
24.
Hiatt, R.A., Pasick, R.J., Stewart, S., Bloom, J., Davis, P., Gardiner, P., et al. (2001). Community-based cancer screening for underserved women: Design and baseline findings from the Breast and Cervical Cancer Intervention Study. Preventive Medicine, 33(3), 190-203.
25.
House, J.S. (1981). Work stress and social support. Reading, MA: Addison-Wesley.
26.
Israel, B.A., & McLeroy, K.R. (1985). Social networks and social support: Implications for health education (Introduction). Health Education Quarterly , 12(1), 1-4.
27.
Jackson, E.J., & Parks, C.P. (1997). Recruitment and training issues from selected lay health advisor programs among African Americans: A 20-year perspective . Health Education & Behavior, 24(4), 418-431.
28.
Jackson, J.C., Taylor, V.M., Chinarong, K., Mahloch, J., Fischer, M., Sam, R., et al. (2000). Development of a cervical cancer control intervention program for CambodianAmerican women. Journal of Community Health, 25(5), 359-375.
29.
Kelly, A.W., Fores-Chacori, M., Wollan, P.C., Trapp, M.A., Weaver, A.L., Barrier, P.A., et al. (1996). A program to increase breast and cervical cancer screening for Cambodian women in a midwestern community. Mayo Clinic Proceedings, 71(5), 437-444.
30.
Landen, J. (1992). Community health representatives: The vital link in Native American health care. I.H.S. Primary Care Provider , 17, 101-102.
31.
Love, M.B., Gardner, K., & Legion, V. (1997). Community health workers: Who they are and what they do. Health Education & Behavior, 24(4), 510-522.
32.
Matsunaga, D.S., Enos, R., Gotay, C.C., Banner, R.O., DeCambra, H., Hammond, O.W., et al. (1996). Participatory research in a native Hawaiian community. The Wai'anae Cancer Research Project. Cancer, 78(7 Suppl.), 1582-1586.
33.
McElroy, A., & Jezewski, M. (2000). Cultural variation in the experience of health and illness. In G. Albrecht, R. Fitzpatrick, & S. Scrimshaw (Eds.), The handbook of social studies in health and medicine (pp. 191-202). Thousand Oaks, CA: Sage.
34.
Muecke, M.A. (1983). In search of healers-Southeast Asian refugees in the American health care system. Western Journal of Medicine , 139(6), 835-840.
35.
Navarro, A.M., Senn, K.L., McNicholas, L.J., Kaplan, R.M., Roppe, B., & Campo, M.C. (1998). Por La Vida model intervention enhances use of cancer screening tests among Latinas. American Journal of Preventive Medicine, 15(1), 32-41.
36.
Nguyen, T.N., Kagawa-Singer, M., & Kar, S.B. (2003). Multicultural health evaluation literature review and critique. Woodland Hills: The California Endowment.
37.
Pasick, R., D'Onofrio, C., & Otero-Sabogal, R. (1996). Similarities and differences across cultures: Questions to inform a third generation for health promotion research. Health Education Quarterly, 23(Suppl.), S142-S161.
38.
Pew Health Professions Commission. (1994). Primary care workforce 2000-federal policy paper. San Francisco : University of California, San Francisco, Center for the Health Professions.
39.
Sadler, G.R., Nguyen, F., Doan, Q., Au, H., & Thomas, A.G. (1998). Strategies for reaching Asian Americans with health information. American Journal of Preventive Medicine, 14(3), 224-228.
40.
Sadler, G.R., Thomas, A.G., Yen, J.Y., Dhanjal, S.K., Marie-Ko, C., Tran, C.H., et al. (2000). Breast cancer education program based in Asian grocery stores. Journal of Cancer Education, 15(3), 173-177.
41.
Schulz, A.J., Israel, B.A., Becker, A.B., & Hollis, R.M. (1997). "It's a 24-hour thing…a living-for-each-other concept": Identity, networks, and community in an urban village health worker project. Health Education & Behavior, 24(4), 465-480.
42.
Special Service for Groups. (2001). Report on the breast and cervical cancer screening needs and recommendations for Cambodians, Chamorros, Laotians, Samoans, Thais, Tongans, and Vietnamese . Los Angeles: Author.
43.
Sung, J.F., Blumenthal, D.S., Coates, R.J., Williams, J.E., Alema-Mensah, E., & Liff, J.M. (1997). Effect of a cancer screening intervention conducted by lay health workers among inner-city women. American Journal of Preventive Medicine, 13(1), 51-57.
44.
Tanjasiri, S.P., Kagawa-Singer, M., Foo, M.A., Chao, M., Linayao-Putman, I., Lor, Y.C., et al. (2001). Breast cancer screening among Hmong women in California. Journal of Cancer Education, 16(1), 50-54.
45.
Tanjasiri, S.P., Kagawa-Singer, M., Nguyen, T.N., & Foo, M.A. (2002). Collaborative research as an essential component for addressing cancer disparities among Southeast Asian and Pacific Islander women. Health Promotion Practice, 3(2), 144-154.
46.
Taylor, V.M., Schwartz, S.M., Jackson, J.C., Kuniyuki, A., Fischer, M., Yasui, Y., et al. (1999). Cervical cancer screening among Cambodian-American women. Cancer Epidemiology Biomarkers and Prevention, 8(6), 541-546.
47.
The California Endowment. (2000). Highlights from the Promotores/Community Health Workers Grantees Convening June 2000. Woodland Hills, CA: Author.
48.
U.S. Bureau of the Census. (2000). Census of population and housing, profile of general demographic characteristics (DP-1), Summary File 1. Suiltland, MD: Author.
49.
Witmer, A., Seifer, S.D., Finocchio, L., Leslie, J., & O'Neil, E.H. (1995). Community health workers: Integral members of the health care workforce. American Journal of Public Health , 85(8,Pt.1), 1055-1058.
50.
Yi, J.K. (1996). Factors affecting cervical cancer screening behavior among Cambodian women in Houston, Texas. Family and Community Health, 18(4), 49-57.
51.
Yi, J.K., & Prows, S.L. (1996). Breast cancer screening practices among Cambodian women in Houston, Texas. Journal of Cancer Education, 11(4), 221-225.
