Building Safe Didactic Dialogues for Action Model: Mobilizing Community with Micronesian Islanders

An Antiracism Community-Based Participatory Research With Organizations Serving Immigrant and Marginalized Communities, Including Asian Americans and Native Hawaiians/Pacific Islanders in the United States Pacific Northwest: Qualitative Description Study With Key Informants

BACKGROUND

Asian American (AA) community leaders, Native Hawaiian/Pacific Islander (NH/PI) community leaders, and allies in the United States Pacific Northwest expressed concern that there are families and children from AA communities and NH/PI communities who experience and witness acts of xenophobia and racism. This can cause racial trauma. The long-time practice of aggregating AA and NH/PI data contributes to erasure and makes it challenging to advance health equity, such as allocating resources. According to AAPI Data's long-awaited report in June 2022, there are over 24 million AAs and 1.6 million NHs/PIs in the United States, growing by 40% and 30%, respectively, between 2010 and 2020. Philanthropic investments have not kept up with this substantive increase. The National Academies of Sciences, Engineering, and Medicine emphasized the need for effective partnerships to advance the health and well-being of individuals and communities in antiracism and system-level research.

OBJECTIVE

The aim of this community-based participatory research qualitative description study was to identify perceptions and experiences regarding racial discrimination, race-based stress, and racial trauma; intergenerational healing and resiliency; and sharing the body with science from key informants of an academic and community partnership to inform antiracism coalition work. This partnership includes academic researchers and community leaders from community-based organizations and a health care organization serving immigrant and marginalized communities, including AAs and NHs/PIs in the United States Pacific Northwest.

METHODS

In total, 10 key informants joined 1 of 2 participatory group discussions via videoconference for 2 hours in 2022. We used a semistructured and open-ended group interview guide. A qualitative participatory group-level assessment was conducted with the key informants and transcribed. Interpretations and meanings of the main points and the main themes were reflected upon, clarified, and verified with the key informants in real time. The field note-based data transcripts were manually coded using conventional content analysis. Reflexivity was used.

RESULTS

There were 6 main themes: prejudice plus power in racism definition and working in solidarity to counter lateral oppression/false sense of security, microaggression as multilayers, "not assimilationist by nature" and responding differently to white superiority, intergenerational- and identity-related trauma, what is healing among People of Color and through a lens of resiliency and intergenerational connection and knowledge, and mistrust and fear in the research and health care systems surrounding intentions of the body.

CONCLUSIONS

The themes highlight the importance of internal and intergenerational healing from racial trauma and the need for solidarity among communities of color to combat white supremacy and colonization. This work was foundational in an ongoing effort to dismantle racism and uplift the community voice through a cross-sector academic and community partnership to inform antiracism coalition work.

Perceptions, Beliefs, and Experiences of Asians and Micronesian Islanders on Family Health History Genetic Cancer Screening Community Outreach

Cancer carries stigma, taboos, and shame including, for diverse communities, who can have difficulty understanding and communicating about family health history genetic cancer screening (GCS). The Oregon Health Authority ScreenWise Program reached out to our academic-community research team to explore Asians and Micronesian Islanders (MI) perceptions on public health education outreach on GCS due to having previously only worked with the Latinx community. The purpose of the qualitative description pilot study was to elicit perceptions, beliefs, experiences, and recommendations from Asian and MI community leaders and community members regarding family health history GCS outreach in communities. Twenty Asians (Chinese and Vietnamese) and Micronesian Islanders (Chuukese and Marshallese) were recruited from the US Pacific Northwest. Nineteen participants are immigrants with an average 21.4 and 18.5 years having lived in the USA, respectively. Individual in-depth interviews were conducted using a semi-structured, open-ended interview guide and analyzed using conventional content analysis. Three main transcultural themes were identified: (1) degree of knowing and understanding cancer screening versus family health history GCS, (2) needing culturally relevant outreach messaging on family health history GCS, and (3) communication and decision-making regarding discussing with family and health care providers about cancer screening and GCS. Culturally relevant messaging rather than generic messaging is needed for inclusive outreach. Healthcare providers are encouraged to assess a client's family health history routinely because Asian and MI clients may not understand the information requested, may be hesitant to offer, or unable to provide information about their personal or family history of cancer.

Development of a Culturally Specific Leadership Curriculum through Community-Based Participatory Research and Popular Education

Background: The purpose of this innovative capacity building pilot project was to develop, implement, and evaluate a nine-workshop curriculum, Rekki Lemnak [Thinking of] Parent Leadership, to prepare community and academic partners for community organizing within the Micronesian Islander community. The purpose of the partnership was to build team leadership and research capacity to lay a foundation for implementing a change in healthcare and school systems. Working collaboratively helped ensure access to shared leadership through the learning by doing approach, enabling a culturally responsive method to build a sustainable partnership.

Approach: Community-based participatory research and Popular Education tenets and reflection were used as a guide in the development of the Rekki Lemnak [Thinking of] Parent Leadership curriculum. Nine workshops (two hours for eight workshops and three hours for one workshop) were held over a period of a year. Community and academic partners developed the learning objectives, capacity building topics, experiential activities, and an evaluation on the strengths and areas for improvement. The partnership consisted of seven Micronesian Islander parent leaders who are residents from the community at large, the Micronesian Islander Community organization including the Executive Director who is a community primary researcher and certified community health worker, and a Micronesian Islander-certified community health worker staff member, and the academic primary nurse researcher and another academic nurse researcher from Washington State University. A range from five to 10 partners with an average of eight attended the workshops, of which an average of five Micronesian Islander parent leaders attended the workshops. Community partners from the Micronesian Islander Community organization and the academic primary nurse researcher co-led four workshops. Community partners from the Micronesian Islander Community organization and MI parent leaders led two workshops respectively; academic nurse researcher partners led one workshop.

Outcomes: We identified three main themes: initially shy and humble MI parent leaders who through their participation transformed to empowered voices, togetherness—coming from different Islands and academia, and the need for more outreach to Micronesian Islanders.

Conclusions: Key elements of the Rekki Lemnak [Thinking of] Parent Leadership curriculum may be translatable to other community and academic partnerships. Culturally responsive research is more than a process in conducting a study. This requires an ongoing investment to establish and sustain authentic partnerships to conduct research with MI communities.