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Jennifer Kue, Elizabeth Takahashi, & Carrie Furrer APHA 2008, San Diego, California

Tobacco use & Cessation among Asian Oregonians: A community-based participatory approach for reducing tobacco related health disparities in the Asian Population. Jennifer Kue, Elizabeth Takahashi, & Carrie Furrer APHA 2008, San Diego, California. Who are we?.

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Jennifer Kue, Elizabeth Takahashi, & Carrie Furrer APHA 2008, San Diego, California

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  1. Tobacco use & Cessation among Asian Oregonians: A community-based participatory approach for reducing tobacco related health disparities in the Asian Population Jennifer Kue, Elizabeth Takahashi, & Carrie Furrer APHA 2008, San Diego, California

  2. Who are we? • Asian Pacific Islander (API) Tobacco Prevention and Education Program (TPEP) • Asian Family Center, a program of the Immigrant and Refugee Community Organization (IRCO) • Non-profit community-based organization • Specific population grantee of the Oregon DHS TPEP • NPC Research, private research & evaluation firm

  3. Goals of Presentation • Describe project development process using a community-based participatory research (CBPR) approach • Explain quantitative phase (mail survey) • Explain qualitative phase (interviews) • Preliminary findings • Next steps/Lessons learned

  4. What is CBPR? • Approach to research & evaluation that engages community stakeholders in each project phase • Promotes shared learning & power • Iterative process • Values community expertise, traditions, priorities

  5. Collaborators • Asian Family Center • Oregon Tobacco Quit Line • Oregon Department of Human Services • NPC Research • International Language Bank (ILB) • API Health Network • Community members

  6. What Is the Problem? • 21% of adult Oregonians currently smoke cigarettes, compared to 10% of API adults (DHS, 2007) • Some evidence that specific API subpopulations bear a greater burden of tobacco use (e.g., 31% for Korean men; Lew & Tanjasiri, 2003) • Gap in knowledge of tobacco use & cessation resource utilization among Asian Oregonians

  7. Project Overview • What factors are related to tobacco use and utilization of cessation resources among Asian Oregonians? • demographics • linguistic acculturation • perceptions of harm of tobacco use • Two-phase mixed-methods research project to collect information: 1) mail survey & 2) in-person interview.

  8. Instrument Development: Survey • Brief assessment of • tobacco use • linguistic acculturation • perceptions of harm • attitudes toward and use of cessation resources • Items adapted from • Behavioral Risk Factor Surveillance System (BRFSS) • California Korean Tobacco Cessation Survey • Hmong Tobacco Use Survey Project

  9. Instrument Development: Translation • Translated into Simplified Chinese, Japanese, Korean, Lao, Mien, Tagalog, & Vietnamese • Iterative process with ILB’s professional translators and community members • Goal: balance cultural appropriateness and consistency

  10. Instrument Development: Interview • In-depth assessment of • attitudes toward tobacco use • cultural use of cigarettes • acculturation, perceptions of harm • motivation to quit • knowledge & utilization of cessation resources • Goal: Compliment and enrich information collected through brief survey.

  11. Instrument Development: Interview • Mix of qualitative and quantitative questions adapted from: • Behavioral Risk Factor Surveillance System (BRFSS) • Diverse Racial & Ethnic Groups and Nations (DREAGAN) Study • Hmong Tobacco Use Survey • Iterative process, including pilot testing • Conducted in English

  12. Research Design: Mail Survey • Selected 10 counties with the highest population of Asian Oregonians while maintaining geographical diversity • 1100 addresses from Survey Sampling International • Surnames identified as Asian • List only included larger Asian ethnic subgroups • Random sample within county • 200 addresses from IRCO database • IRB approval through Portland State University

  13. Research Design: Mail Survey • Process • Introduction letter • Survey + $2 incentive • Reminder cards • Second round of surveys • $100 lottery incentive • 45% response rate (N=491) • Acceptable range for mail surveys: 45-55%

  14. Research Design: Interview • Recruitment methods (N=19) • Press releases in Asian ethnic newspapers, radio stations, fliers, and mainstream media outlets • Word-of-mouth • Interview process • Recorded 1-hour interviews • Monetary incentive ($20 gift card) • Transcription

  15. Preliminary Findings: Sample N=432 Number in parentheses = # respondents of that ethnicity

  16. Preliminary Findings: Sample Number in parentheses = # respondents from that region

  17. Preliminary Findings: Sample Number in parentheses = # respondents in that age group

  18. Preliminary Findings: Prevalence • 12.6% currently smoke cigarettes • 14.0% currently use some form of tobacco • 8.6% current smokers (BRFSS definition) • 100+ cigarettes & currently smoke cigarettes • Smoking prevalence among Asian and Pacific Islanders was 10% (DHS, 2004-05).

  19. Preliminary Findings: Prevalence Number in parentheses = # respondents of that ethnicity

  20. Preliminary Findings: Prevalence N=425 Number in parentheses = # respondents in that age group

  21. Preliminary Findings: Prevalence Number in parentheses = # respondents of that gender

  22. Preliminary Findings: Prevalence N=426 Number in parentheses = # respondents from that region

  23. Preliminary Findings: Quit Line • What is the Oregon Tobacco Quit Line? • Telephone-based counseling service for tobacco cession (cognitive-behavioral therapy, educational materials, nicotine-replacement therapy). • Less than 1% of the callers in the 2007–08 contract year were APIs. • 36% had heard of the Oregon Tobacco Quit Line, but varied for different groups of respondents.

  24. Preliminary Findings: Quit Line N=405 Number in parentheses = # respondents of that ethnicity

  25. Preliminary Findings: Quit Line N=405 Number in parentheses = # respondents of that gender

  26. Preliminary Findings: Quit Line N=410 Number in parentheses = # respondents with that level of education

  27. Preliminary Findings: Quit Line N=413 Number in parentheses = # respondents from that region

  28. Results from a CBPR Perspective • AFC and NPC Research works together to develop research products • Results shared with community members for feedback and interpretation assistance • Products go to DHS for review • Dissemination based on the needs of the community, DHS, AFC/IRCO

  29. Lessons Learned • Need for collaboration • Difficulty in accessing target population • Challenges with translation • How to get a satisfactory response rate from a mail survey with limited resources • Challenges recruiting for interview • Need for support in managing and analyzing data collected

  30. Contact Information • Jennifer Kue, MPH & Elizabeth Takahashi, MPH • Asian Family Center, 4424 NE Glisan St., Portland, OR 97213 • Phone: (503) 235-9396 ext. 121 • jenniferk@mail.irco.org & elizabetht@mail.irco.org • www.irco.org • Carrie Furrer, Ph.D. • NPC Research, 4380 SW Macadam Ave., Ste. 530, Portland, OR 97239 • Phone: (503) 243-2436 ext. 110 • furrer@npcresearch.com • www.npcresearch.com

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