Embed Size (px)
Citation preview
Community Conversations on Cancer
Storm Lake, Iowa
Carlos Gallego M.Ed.Intercultural Cancer Council
Sarah Kitchell B.A.NCI’s Cancer Information Service
Iowa Comprehensive Cancer Control Program
Project
Team
Getting Started
• Worked with CIS to identify target community• Researched community: Both culture and needs• Connected to community leaders via cold calls• Identified key community partners/leaders• Developed Interview questions with input from
community leaders assisting with project• Explained to community how findings will be
used and how you will share information community
How the Project Came About
• CIS staff at Mayo requested presentation on Intercultural Cancer Council at Annual Iowa Comprehensive Cancer Consortium (ICCC) Meeting
• Invited to join ICCC• Significant lack of underserved representation on
Committee• RFP to do Cancer project available through IDPH• Partnered with CIS at Holden Comprehensive Cancer
Center, Iowa City
To collect baseline data around cancer knowledge, perceptions and barriers confronting the Tai Dam and Latino communities of
rural Iowa.
Purpose
Korean, Tai Dam, Latino, Urban African American
Iowa Disparity Project
Demographic research, cancer data,
minority population centers
Storm Lake, Tai Dam and Latino communities
Identified community leaders
•Sioux City
• Storm Lake, population 9,882
• Des Moines
Data
Healthcare
Northwest Area Foundation
Buena Vista county’s incidence rate for colorectal cancer, 34.6 per 100,000, is the highest in the state.
8
Data
0
2
4
6
8
10
12
14
16
18
20
Asian, 2005 Latino,2005
ForeignBorn, 2000
Buena Vista County
Iowa
U.S. Census Bureau
Buena Vista County Demographics
Iowa 90% of Tai Dam in the United
States live in Iowa.
Roughly 4,000 Tai Dam live in Iowa with 3,000 concentrated
in Des Moines
Data
Community Experts
-access to the community-interpreters
-space-recruitment
Method
Tai Dam History • In 1250 BC many Tai Dam moved south to the Chinese border as Mongol leader
Kubilai Khan invaded and destroyed their kingdom, Nan Chao. Tai Dam divided into groups. Some went to Laos, others to Thailand and other followed the Black River to North Vietnam and built their town and cities.
• Tai Dam lived with neighbors, the Vietnamese and Laotians. In the 1900's French colonized Laos, Vietnam and Cambodia. In the early 1950's, the French began losing their colonies.
• In North Vietnam under the leadership of Ho Chi Minh, the French were defeated at the battle of Dien Bien Phu (a major Tai Dam city called Muong Theng or the city of the God). Many Tai Dam who had been French soldiers, government employees, and top government officials, and fled as political refugees in 1954.
• Many Tai Dam moved to Laos because of similarities in language and culture. Others move to South Vietnam.
• In November 1975, under leadership of Governor Robert D. Ray, people of Iowa welcomed this group of refugees from SE Asia known as the Tai Dam.
• Today 90 percent of the Tai Dam live and work in Iowa. Iowa is called the free capital of the Tai Dam in the world.
Conversation Groups
Group Design
Recruitment
Method
Findings
Latino Community
Cost
False-positives
Environmental issues
Cost-benefit of screening
Incorrect medical information
Findings
When should you have your first pap smear?
“After you have a baby”
“After you get married”
“After your 3rd baby”
“If you have a family history, begin exams after age 30”
“After 40-45 years of age”
Latinas answer:
Navigating health care system
Inability to pay
Inevitability
Workplace concerns
Findings
Tai Dam
“First of all, I don’t have any knowledge about cancer. I would
like you to explain, what is cancer? Where does it come from?..My
mother died of breast cancer, how can I prevent cancer from coming
to all the kids?”
Findings
Tai Dam male conversations participant
Quote from Tai Dam females
• “They call it Women’s Center but I think it is the man who is the doctor . . . Women’s Center should have women doctors. . . It would be good to have more female doctor’s some of us are too shy.”
• “I went to see my family doctor last week and I asked many questions. He said, I worry too much. Yes, I worry, my kids are still young and I am young and I don’t want to die yet. . .and he laughed at me. . .”
Tai Dam Culture• Tai Dam believe in benevolent and malevolent spirits. They believe there are
supernatural forces that decide their lives and destiny. The creator of heaven and earth is the "Then Luong." On earth the "Phi" who are the henchman of the "Then" control every affair of man's deeds.
Tai Dam hold man to be a part of nature. Man is superior over nature, but man is happiest when is at one with nature. However, Tai Dam are very tolerant of other's beliefs.
• Also a strong influence of Confucianism. Improve self, family community. Also now a strong influence from Christianity. There are also Buddhist Tai Dam.
• Tightly Night extended families
• Child rearing is generally more conservative and stricter than the mainstream. stricter and less permissive than America. Parents, brothers, sisters, & other family members and elders have responsibility to help raise a child.
• The younger people show respect to parents, grandparents, and deceased ancestors; disrespect is not tolerated. For the Taidam, the aged are society's most respected people.
Recommendations
•Accessible and appropriate healthcare information
•Provider Education
•Work in collaboration with faith communities
•Encourage patient advocacy
•Develop local health disparities work groups
Recommendations
Health Professionals:
• Cultural competency training
• Information in several preferred languages
• Information provided at an appropriate literacy level
• Convenient location and time of services
• Family involvement
Recommendations
Health providers and educators should considers the following issues:
• Poverty
• Gender
• Transportation
• Family Dynamics
• Education Level
• Basic Health Literacy
Thank
You
Cyndi ChenStatus of Iowans Asian and Pacific Islander HeritageIowa Department of Human Rights
Sara ComstockIowa Comprehensive Cancer Control ProgramNational Cancer Institute’s Cancer Information Service
Janice Edmunds-WellsOffice of Multicultural Health, Iowa Department of Public Health
Jill Myers GeadelmannIowa Comprehensive Cancer Control Program, Iowa Department of Public Health
Sarah KitchellIowa Comprehensive Cancer Control ProgramNational Cancer Institute’s Cancer Information Service
Kellee McCroryIowa Center for Evaluation Research National Resource Center for Family-Centered PracticeUniversity of Iowa, School of Social Work
Renea SeagrenUnited Community Health Center, Storm Lake, Iowa
Holly SmithIowa Comprehensive Cancer Control Program, Iowa Department of Public Health
Pastor Barry ThongvanhSoutheast Asian Community Christian Church
Michele YehieliProject EXPORT at the University of Northern Iowa
Contact
Information
Carlos Gallego, M. Ed.
Intercultural Cancer Council
(651) 225-6085 or 952-361-0586
Sara Comstock, M.S.W.
National Cancer Institute’s Cancer Information Service
Iowa Consortium for Comprehensive Cancer Control
(319) 335-8144
Questions?
