Sources of health information among Vietnamese American men

Disparities by Race/Ethnicity and Immigration Status in Perceived Importance of and Access to Culturally Competent Health Care in the United States

While cultural competence has been proposed as an important framework for enhancing health care equity, how members of different racial/ethnic groups consider the importance of cultural competence and their access to culturally competent health care are insufficiently understood. Despite continuously increasing immigrants into the US, it is unclear how immigration status intersects with race/ethnicity to shape individuals' perception of and access to culturally competent care in the US health care system. To fill this research gap, this study examined how the intersection of race/ethnicity and immigration status is associated with people's perception of and access to culturally competent health care and among immigrants, whether their length of stay matters, using data from the 2017 National Health Interview Survey. The results show that while racial and ethnic minority members reported greater importance of culturally competent care than non-Hispanic whites, Asian, black and other-race immigrants reported even greater importance than their US-born counterparts. Additionally, although racial/ethnic minorities reported greater limited access to culturally competent care than their white peers, this gap in access was observed primarily among US-born racial/ethnic minorities. Shorter length of residence (fewer than 15 years) was associated with greater perceived importance than residence of at least 15 years among immigrants, but access to culturally competent care did not differ by length of residence. The findings speak to racial/ethnic minorities' greater desire for culturally competent care and their unmet needs.

Sources of Health Information Among Select Asian American Immigrant Groups in New York City

Health information can potentially mitigate adverse health outcomes among ethnic minority populations, but little research has examined how minorities access health information. The aim of this study was to examine variations in the use of health information sources among Asian American (AA) subgroups and to identify differences in characteristics associated with the use of these sources. We analyzed data from a foreign-born community sample of 219 Asian Indians, 216 Bangladeshis, 484 Chinese, and 464 Koreans living in New York City. Results found that use of health information sources varied by AA subgroup. Print media source use, which included newspapers, magazines, and/or journals, was highest among Chinese (84%), Koreans (75%), and Bangladeshis (80%), while radio was most utilized by Chinese (48%) and Koreans (38%). Television utilization was highest among Bangladeshis (74%) and Koreans (64%). Koreans (52%) and Chinese (40%) were most likely to use the Internet to access health information. Radio use was best explained by older age and longer time lived in the United States, while print media were more utilized by older individuals. Results also highlighted differences in native-language versus non-native-language media sources for health information by subgroup. Media sources can be used as a vehicle to disseminate health information among AAs.

Internet use by international graduate students in the USA seeking health information

Purpose

– Considering that the internet is a useful source for health information, especially by foreign-born students, this exploratory study aimed to investigate international graduate students' internet use in the context of seeking health information.

Design/methodology/approach

– Data were collected from 54 Korean graduate students in the USA using a survey questionnaire. Quantitative analysis using SPSS was conducted to describe Korean graduate students' internet use for seeking health information and to identify factors that possibly influence their health-information seeking activities.

Findings

– The survey participants preferred Korean resources because of language problems and the internet was the primary source. They reported difficulties in identifying appropriate health information sources and understanding medical information. They often sought online health information to solve their or their family's current health problems and consequently, personal relevance was regarded as an important evaluation criterion, as was accuracy.

Research limitations/implications

– By looking at an understudied user group, this study leads to a better understanding of the patterns of internet use for seeking health information among a specific ethnic group. The findings of this study demonstrate the needs of health education materials and guidelines that introduce credible health information sources and medical information for Korean graduate students and their families.

Originality/value

– Despite the increasing number of international students in the USA, there is a lack of research on the health information-seeking behavior of international students. The findings of this study will help health education specialists and health information professionals provide international students with necessary health information.

Mental health consequences of international migration for Vietnamese Americans and the mediating effects of physical health and social networks: results from a natural experiment approach

Although the existing literature on immigrant mental health is extensive, major substantive and methodological gaps remain. Substantively, there is little population-based research that focuses on the mental health consequences of migration for Vietnamese Americans. More generally, although a wide range of mental health problems among immigrants has been identified, the potential causal or mediating mechanisms underlying these problems remain elusive. This latter substantive shortcoming is related to a key methodological challenge involving the potentially confounding effects of selection on migration-related outcomes. This article addresses these challenges by employing a "natural experiment" design, involving comparisons among three population-based samples of Vietnamese immigrants, never-leavers, and returnees (N=709). Data were collected in Ho Chi Minh City and in New Orleans between 2003 and 2005. The study investigates the long-term impact of international migration on Vietnamese mental health, and the potential mediating effects of social networks and physical health on these migration-related outcomes. The results reveal both mental health advantages and disadvantages among Vietnamese immigrants relative to the two groups of Vietnamese nationals. Selection can be ruled out for some of these differences, and both social networks and physical health are found to play important explanatory roles.

Health sources of cancer screening knowledge for Vietnamese women

The study examined sources of health information among Vietnamese women and whether these sources were associated with cancer screening outcomes. One hundred eleven participants completed a questionnaire with measures of breast and cervical cancer screening attitudes, efficacy, and behavior. A factor analysis of items that measured sources for information on cancer screening produced three factors: English media sources, Vietnamese media sources, and informal sources. These sources were included along with demographic variables in regression analyses to predict cancer screening outcomes. Results indicated that using informal sources for breast screening information predicted positive attitudes toward breast cancer screening and efficacy for breast and cervical cancer screening. Reliance on Vietnamese media sources was associated with lower cervical screening efficacy. Being older, having health insurance, and a higher income were associated with favorable cancer screening outcomes. The findings suggest that cancer screening programs for Vietnamese women should take into consideration preferred mediums for receiving health information.

Low health literacy, limited English proficiency, and health status in Asians, Latinos, and other racial/ethnic groups in California

This study estimated health status by low health literacy and limited English proficiency alone and in combination for Latino, Chinese, Korean, Vietnamese, and White respondents in a population-based sample: 48,427 adults from the 2007 California Health Interview Survey, including 3,715 with limited English proficiency. Multivariate logistic models examined self-reported health by health literacy and English proficiency in the full sample and in racial/ethnic subgroups. Overall, 44.9% with limited English proficiency reported low health literacy, versus 13.8% of English speakers. Among the limited English proficient, Chinese respondents had the highest prevalence of low health literacy (68.3%), followed by Latinos (45.3%), Koreans (35.6%), Vietnamese (29.7%), and Whites (18.8%). In the full sample, respondents with both limited English proficiency/low health literacy reported the highest prevalence of poor health (45.1%), followed by limited English proficiency-only (41.1%), low health literacy-only (22.2%), and neither (13.8%), a hierarchy that remained significant in multivariate models. However, subanalyses revealed that limited English proficient Latinos, Vietnamese, and Whites had equal or greater odds of poor health compared with low health literate/limited English proficient respondents. Individuals with both limited English proficiency and low health literacy are at high risk for poor health. Limited English proficiency may carry greater health risk than low health literacy, though important racial/ethnic variations exist.

Health information in Vietnamese-American print media: results of a content analysis

PURPOSE

Vietnamese-Americans (VA) constitute a large minority community that is mostly foreign born with limited English proficiency. This article compares the health content of free print media targeting VA with that of free English-language print media.

DESIGN

Content analysis.

SETTING

All free print media available at the three largest VA-serving supermarkets in Philadelphia, Pennsylvania, were reviewed. Comparison English-language periodicals included free and purchased publications.

MEASURES

We identified and coded 254 health content-containing articles from 22 issues of six periodicals (four free Vietnamese, one free English language, and one purchased English language) collected over a 4-week period.

ANALYSIS

Chi-square and t-tests for independent samples were used to compare free Vietnamese- and free English-language periodicals. Additional analyses included all English-language periodicals as the comparison group.

RESULTS

Higher proportions of advertisements and "pseudonews" articles (ads formatted like news stories) were found in free Vietnamese- vs. free English-language publications (overt ads, 61% vs. 28%; pseudonews, 18% vs. 0%). Moreover, Vietnamese-language publications did not contain many articles addressing diseases most commonly found in Asian-Americans.

DISCUSSION

The significant proportion made up by profit-motivated health content in VA print media points to an untapped opportunity to provide evidence-based information about health topics of interest to this community. Future studies should examine secular trends, assess multiple communities, and develop community-based participatory approaches to improving access to quality health information among minorities with limited English proficiency.

Sources of drug information for patients with chronic conditions in Alexandria, Egypt

Objectives

This study sought to identify patients' perceived drug knowledge, need for more information and drug information sources, and how they varied by patient characteristics, particularly education level.

Methods

A convenience sample of 366 adult patients was interviewed when leaving 20 Egyptian pharmacies after collecting a dispensed prescription. Patients were asked about their (1) perceived knowledge of their drugs' purpose, (2) use of package inserts (PIs) to learn about side effects, contraindications and drug interactions, (3) perceived need to know more about their drugs and (4) general sources of drug information beyond healthcare providers.

Key findings

More than 30% of the patients reported that they did not know the purpose of at least one of their drugs and only read PIs selectively. Whereas 36% read about drug interactions, more reported reading about side effects (65%) and contraindications (60%) in PIs. Sixty-nine per cent of patients reported that they needed more information about their drugs. This was true for 86.8% of patients with limited education compared to 48.5% of university graduates. University graduates reported using PI topics, newspapers, internet, TV and family and friends as sources of drug information at significantly higher rates than did patients with lower levels of education.

Conclusion

There is a need for healthcare professionals to evaluate patient comprehension and needs for drug information, especially for patients with less schooling. Healthcare providers should also consider other information sources that a patient is using.

Hepatitis B testing and vaccination among Vietnamese- and Cambodian-Americans

We determined hepatitis B virus (HBV) testing and vaccination levels and factors associated with testing and vaccination among Vietnamese- and Cambodian-Americans. We also examined factors associated with healthcare professional (HCP)-patient discussions about HBV. We analyzed 2006 Racial and Ethnic Approaches to Community Health (REACH) 2010 Risk Factor Survey data from four US communities. We used logistic regression to identify variables associated with HBV vaccination, testing, and HCP-patient discussions about HBV. Of the 2,049 Vietnamese- and Cambodian-American respondents, 60% reported being tested for HBV, 35% reported being vaccinated against hepatitis B, and 36% indicated that they had discussed HBV with a HCP. Cambodian-Americans were less likely than Vietnamese-Americans to have been tested for HBV, while respondents with at least a high school diploma were more likely to have been tested for HBV. Respondents born in the US, younger individuals, and respondents with at least some college education were more likely to have been vaccinated against hepatitis B. HBV testing and vaccination remain suboptimal among members of these populations. Culturally sensitive efforts that target Vietnamese- and Cambodian-Americans for HBV testing and vaccination are needed to identify chronic carriers of HBV, prevent new infections, and provide appropriate medical management. HCPs that serve these populations should be encouraged to discuss HBV with their patients.

Cancer and communication in the health care setting: experiences of older Vietnamese immigrants, a qualitative study

BACKGROUND

As patients grow older, accurate communication with health care providers about cancer becomes increasingly important. However, little is known about the cancer communication experiences of older Asian immigrants.

OBJECTIVE

To learn about the cancer-related communication experiences of older Vietnamese immigrants from the insider perspective.

DESIGN

Qualitative study (grounded theory, constant comparative method) using individual interviews with older Vietnamese immigrants with the purpose of discussing how they learn about cancer. Interviews were conducted in Vietnamese.

PARTICIPANTS

Vietnamese immigrants aged 50-70 years, recruited through community-based organizations. Most had low education and limited English proficiency. The sample size of 20 was sufficient to achieve theoretical saturation.

RESULTS

We identified 3 categories of themes concerning informants' experiences with cancer communication in the health care setting: (1) attitudes about addressing screening with providers, (2) issues/problems communicating with physicians about cancer, and (3) language/translation difficulties. There was substantial overlap between informants who mentioned each theme category, and 40% of the participants mentioned all 3 categories.

CONCLUSION

Clinicians should be aware of and act upon specific cancer communication needs/challenges of their older immigrant patients. Moreover, health care systems need to be prepared to address the needs of an increasingly multiethnic and linguistically diverse patient population. Finally, community-level interventions should address baseline knowledge deficits while encouraging immigrant patients to engage their doctors in discussions about cancer screening.