Improving the Health of Cambodian Americans: Grassroots Approaches and Root Causes

A Community-Defined Approach to Address Trauma Among Cambodian Immigrants and Refugees

Asian American and Pacific Islanders are one of the fastest growing and most diverse groups in the United States. Yet, they are often aggregated as a single group, masking within-group differences in rates of disease and demographic characteristics commonly associated with elevated health risk. While more than four decades have passed since the Khmer Rouge genocide, Cambodians continue to experience trauma-related psychiatric disorders, including post-traumatic stress disorder and major depression. Funded by the California Department of Public Health Office of Health Equity, the Community Wellness Program (CWP) aimed to reduce mental health disparities among Cambodians in Long Beach and Santa Ana, California, using community-defined approaches. The 6-month program comprised community outreach, educational workshops, strengths-based case management, and social and spiritual activities. Our study aimed to examine the effects of the CWP on trauma symptoms. Program evaluation followed an incomplete stepped wedge waitlist design with two study arms. A linear mixed models analysis revealed that participants reported fewer trauma symptoms as a result of participation in the CWP and that participants experienced fewer symptoms over time. This is an especially important finding, as trauma can lead to long-term individual health effects and to social and health repercussions on an entire cultural group by way of intergenerational trauma. As the number of refugees and displaced individuals continues to grow, there is an urgent need for programs such as the CWP to prevent the lasting effects of trauma.

Impact of a Science Art Exhibit on Public Interest and Student Comprehension of Disease Ecology Research

Art is a common approach for communicating and educating about science, yet it remains unclear the extent to which science art can benefit varied audiences in varied contexts. To examine this gap, we developed an art exhibit based on the findings of two publications in disease ecology. In study 1, we asked visitors with varying formal science, technology, engineering, and math (STEM) education backgrounds to complete a survey about their interest in science research before and after viewing the exhibit. In study 2, we recruited upper-level ecology undergraduate students to receive one of three treatments: engage with the art exhibit, read the abstracts of the papers, or do neither. Students completed a comprehension quiz immediately after their learning treatment and again 2 weeks later to evaluate retention. Following the exhibit, visitors who did not report a career or major in STEM showed a greater increase in research interest than visitors who did report a career or major in STEM. For the ecology undergraduate students, comprehension quiz scores were higher for students in the abstract group than the art exhibit group, while both groups scored higher than the control group. Retention of information did not significantly differ between the three groups. Overall, these findings suggest that science art exhibits are an effective method for increasing the accessibility of science to broader audiences and that audience identifiers (e.g., level of formal education in STEM) play an important role in audience experience of science communication and science education initiatives.

Community Health Worker Activities in Public Health Programs to Prevent Violence: Coding Roles and Scope

In multiple and related forms, violence is a serious public health issue with lasting impacts on health and wellness in the United States. Community health workers (CHWs) are frontline public health workers and trusted members of communities. We aimed to analyze recent examples of CHW activities in violence prevention public health programs with a goal of informing future programs and research. We collected more than 300 documents published between 2010 and 2020 to identify public health programs to prevent violence including CHW activities. We used an iterative process to develop and apply a coding scheme to the CHW activities. We identified 20 public health programs to prevent violence which included CHW activities. CHWs most often addressed community violence, youth violence, and family violence and played an average of 8 of 10 core roles per program. Fewer than a third (i.e., 6 programs) reported community-focused CHW activities to address upstream and structural determinants of health inequities. This first examination, to our knowledge, of the intersection of the CHW and violence prevention literature shows that CHWs have played many of their core roles in public health programs to address multiple forms of violence. (Am J Public Health. 2022;112(8):1191-1201. https://doi.org/10.2105/AJPH.2022.306865).

Perceptions and Beliefs of Memory Loss and Dementia Among Korean, Samoan, Cambodian, and Chinese Older Adults: A Cross-Cultural Qualitative Study

Older adults who are Asian American and Pacific Islander (AAPI) represent one of the fastest growing populations in the United States and face a significant burden of Alzheimer's disease and related dementias (ADRD). Little is known about ADRD among AAPI subgroups. The current study aimed to: (a) explore perceptions and beliefs of memory loss and dementia among Korean, Samoan, Cambodian, and Chinese older adults in the United States; and (b) identify culturally relevant facilitators and barriers of participation in a brain health program among four AAPI subgroups. Seven focus groups comprising 14 Cambodian, 21 Chinese, 14 Korean, and 13 Samoan older adults were conducted. Data were analyzed using inductive and indigenous coding approaches. Similar and unique perceptions and experiences related to memory loss were identified. Future research could include developing and testing culturally tailored and language congruent strategies regarding ADRD education and resources to facilitate ADRD early detection among AAPI older adults. [Journal of Gerontological Nursing, 48(6), 40-48.].

Engaging citizens living in vulnerable circumstances in research: a narrative review using a systematic search

Although public engagement in research is increasingly popular, the involvement of citizens living in vulnerable circumstances is rarely realized. This narrative review aims to describe and critically analyse concerns and corresponding strategies, tools, and methods that could support the inclusion of these citizens in health research. The 40 studies that are included were thematically analysed using the socioecological model. Concerns originate most often on the intrapersonal level of the socioecological model, but concerns were also identified at institutional, community, and policy levels. It is thought-provoking that there is a lack of attention for the research and policy structure in which engagement practices are designed, implemented and evaluated. More research is needed to explore how these cultures could be changed in a way that promotes rather than restrains the engagement of citizens living in vulnerable circumstances in research and policymaking.

Understanding alcohol use among U.S. Cambodians: how useful is the concept of cultural norms?

Observed differences in substance use are frequently attributed to cultural norms, which in turn are often interpreted as fixed properties of ethnically defined groups. During a community-based participatory research study (2009-2011), U.S. Cambodian women identified community-specific drinking behaviors and beliefs. To test how widely other U.S. Cambodians shared their views, we formulated them into a series of normative statements and surveyed local community members (N = 172). We identified few consensualized norms, which suggests that (A) norms may not be reducible to normative statements; and/or (B) norms may not be shared by all group members; and (C) if neither A nor B holds, then the attribution of observed drinking patterns to cultural norms lacks internal validity. Study's limitations were noted.