Hmong Participants Research Articles

Population pharmacokinetics, pharmacodynamics and pharmacogenetics modelling of oxypurinol in Hmong adults with gout and/or hyperuricemia.

The aim of this study was to quantify identifiable sources of variability, including key pharmacogenetic variants in oxypurinol pharmacokinetics and their pharmacodynamic effect on serum urate (SU). Hmong participants (n = 34) received 100 mg allopurinol twice daily for 7days followed by 150 mg allopurinol twice daily for 7days. A sequential population pharmacokinetic pharmacodynamics (PKPD) analysis with non-linear mixed effects modelling was performed. Allopurinol maintenance dose to achieve target SU was simulated based on the final PKPD model. A one-compartment model with first-order absorption and elimination best described the oxypurinol concentration-time data. Inhibition of SU by oxypurinol was described with a direct inhibitory Emax model using steady-state oxypurinol concentrations. Fat-free body mass, estimated creatinine clearance and SLC22A12 rs505802 genotype (0.32 per T allele, 95% CI 0.13, 0.55) were found to predict differences in oxypurinol clearance. Oxypurinol concentration required to inhibit 50% of xanthine dehydrogenase activity was affected by PDZK1 rs12129861 genotype (-0.27 per A allele, 95% CI -0.38, -0.13). Most individuals with both PDZK1 rs12129861 AA and SLC22A12 rs505802 CC genotypes achieve target SU (with at least 75% success rate) with allopurinol below the maximum dose, regardless of renal function and body mass. In contrast, individuals with both PDZK1 rs12129861 GG and SLC22A12 rs505802 TT genotypes would require more than the maximum dose, thus requiring selection of alternative medications. The proposed allopurinol dosing guide uses individuals' fat-free mass, renal function and SLC22A12 rs505802 and PDZK1 rs12129861 genotypes to achieve target SU.

The Identification of Novel CYP2D6 Variants in US Hmong: Results From Genome Sequencing and Clinical Genotyping.

Objective: Hmong individuals represent a unique East Asian subpopulation in whom limited information concerning pharmacogenetic variation exists. The objectives of this study were to comprehensively characterize the highly polymorphic CYP2D6 gene in Hmong, estimate allele and phenotype frequencies and to compare results between two testing platforms. Methods: DNA from 48 self-identified Hmong participants were sequenced using a targeted next-generation sequencing (NGS) panel. Star allele calls were made using Astrolabe, manual inspection of NGS variant calls and confirmatory Sanger sequencing. Structural variation was determined by long-range (XL)-PCR and digital droplet PCR (ddPCR). The consensus diplotypes were subsequently translated into phenotype utilizing the activity score system. Clinical grade pharmacogenetic testing was obtained for 12 of the 48 samples enabling an assessment of concordance between the consensus calls and those determined by clinical testing platforms. Results: A total of 13 CYP2D6 alleles were identified. The most common alleles were CYP2D6*10 and its structural arrangements (37.5%, 36/96) and the *5 gene deletion (13.5%, 13/96). Three novel suballeles (*10.007, *36.004, and *75.002) were also identified. Phenotype frequencies were as follows: ultrarapid metabolizers (4.2%, 2/48), normal metabolizers (41.7%, 20/48) and intermediate metabolizers (52.1%, 25/48); none of the 48 participants were predicted to be poor metabolizers. Concordance of diplotype and phenotype calls between the consensus and clinical testing were 66.7 and 50%, respectively. Conclusion: Our study to explore CYP2D6 genotypes in the Hmong population suggests that this subpopulation is unique regarding CYP2D6 allelic variants; also, a higher portion of Hmong participants (50%) are predicted to have an intermediate metabolizer phenotype for CYP2D6 compared to other East Asians which range between 27 and 44%. Results from different testing methods varied considerably. These preliminary findings underscore the importance of thoroughly interrogating unique subpopulations to accurately predict a patient’s CYP2D6 metabolizer status.

Prevalence and Susceptibility to Hepatitis B virus and the Need for Community Health Education in Milwaukee's Hmong Community.

Chronic Hepatitis B virus infection, the leading cause of hepatocellular carcinoma worldwide, disproportionately affects Asian Pacific Islanders (APIs) within the USA. Among APIs, the Hmong have one of the highest rates of chronic HBV infection-up to 18% compared to 0.1% for non-Hispanic Caucasians. This study sought to estimate the prevalence of HBV infection and assess the need for community HBV education within Milwaukee County's Hmong. Between 3/2013 and 12/2019, 287 Hmong participants were screened for HBV and 271 were provided targeted HBV education to evaluate its impact on HBV knowledge. Among participants screened, 178 (62%) were immune; 77 (27%) susceptible; 27 (9%) positive; and 5 (2%) in a "gray zone." Targeted health education showed statistically significant improvement in HBV knowledge. With 38% lacking immunity to HBV and 9% with active infection, there remains a significant need for HBV screening, vaccination, and education in Milwaukee's Hmong community.

Evaluation of the Use of Colors and Drawings for Pain Communication for Hmong Patients

AimsThe aim of the present study was to explore: (1) the feasibility of using color and pain drawing to describe pain; (2) the cultural appropriateness of pain body diagram (PBD); and (3) the cultural meaning of colors used in pain expression within one cultural group—the Hmong residing in the United States. DesignA qualitative-descriptive study. MethodsData were collected sequentially in two phases with different Hmong participants from a Midwestern city using (1) focus groups to determine colors used for pain intensity and qualities along with preferences for drawing versus using the PBD; and (2) individual interviews to determine pain-related meanings of colors and cultural appropriateness of PBDs. Interviews were recorded, transcribed, and analyzed using summative and directed content analyses. ResultsOf 67 participants, 73% were female, the average age was 53.7±14.9 years, and 67% received Medicaid. In Phase I, most participants were unable to draw their pain on a blank page and preferred using a PBD. Most could select colors for pain intensity levels, with white and red indicating no pain and severe pain, respectively. In Phase II, white, red, and black had cultural meanings related to pain while colors such as yellow, orange, and blue had personal meanings. All participants perceived the PBD to be culturally appropriate. ConclusionsThe study's findings have implications for how to use colors in pain communication and confirm that PBDs can be used with Hmong patients.

Hmong participants' reactions to return of individual and community pharmacogenetic research results: "A positive light for our community".

Pharmacogenetic research has historically lacked racial and ethnic diversity, limiting the application of findings to minority populations. Recent studies, including the Hmong, have gauged communities' interest in participating in genomic research and receiving their individual results. This study was conducted to create a culturally and linguistically appropriate format to return pharmacogenomic results and identify Minnesota Hmong research participants' reactions to their personal and collective results. Using a community-based participatory research approach, researchers collaborated with Hmong community members to format the pharmacogenetic disclosure process. Three focus groups were completed with 24 Hmong participants and three major themes emerged using thematic analysis. Many Hmong focus group participants viewed the results positively, finding them useful for themselves and their community as a means to optimize responses to and avoid harms from medicines. However, some participants expressed concerns about harms that the pharmacogenetic information could bring, including anxiety, misunderstanding, discrimination, exploitation, and lack of a clinician involvement in interpreting and applying the result. Many participants interpreted their results through an experiential lens, trusting their experience of medicines more than trusting genetic information, and through a cultural lens, expressing the belief that environmental factors may influence how people's bodies respond to medicines by influencing their inherited flesh and blood (roj ntsha). Lastly, participants stressed the importance of disseminating the information while acknowledging the complex linguistic, educational, and cultural factors that limit understanding of the results. Researchers, genetic counselors, pharmacists, and healthcare providers should strive to return results in meaningful ways to all members of society.

Potential Clinical Relevance of Differences in Allele Frequencies Found within Very Important Pharmacogenes between Hmong and East Asian Populations.

Implementing pharmacogenetics for very important pharmacogenes (VIPs) holds the promise of improving clinical outcomes through optimal medication selection and dosing. However, significant differences in the frequency of actionable variants in VIPs may exist within subpopulations of a given ancestral group. Furthermore, these differences can potentially impact drug selection and dosing. The purpose of this study was to ascertain allele frequencies for VIPs and to predict medication requirements using Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines in Hmong and compare with published data for East Asians. Using a community-based participatory action research approach, DNA collected from 194 Hmong adults living in the United States was analyzed for 22 genetic variants within eight VIPs (CYP2C9, CYP2C19, CYP4F2, DPYD, G6PD, SLCO1B1, TPMT, VKORC1). Allele frequencies for VIPs and predicted medication requirements using CPIC guidelines were compared between Hmong participants and East Asians. Significant differences in allele frequencies between the Hmong and East Asians were found for 23% (5/22) of the CPIC-actionable variants tested. Allele frequencies for VIPs in Hmong versus East Asians were 16.6% versus 3.4% in CYP2C9*3A, 42.2% versus 29.0% for CYP2C19*2, 0.3% versus 8.3% in CYP2C19*3, 6.5% versus 22.1% in CYP4F2*3, and 3.6% versus 0.1% in SLCO1B1*5, respectively. These differences significantly influenced predicted medication usage recommendations in warfarin, simvastatin, and phenytoin between Hmong and East Asians. Important differences in allele frequencies for key genetic variants influencing selection of medications and dosages were found between the Hmong and East Asians. The magnitude and nature of these differences can be expected to result in different medication recommendations for the Hmong relative to East Asians.

IT HURTS AS IF: PAIN LANGUAGE, VISUAL CHARACTERIZATION, AND STORY-TELLING IN HMONG OLDER ADULTS

Culture and language affect pain reporting, diagnosis, and treatment. Ethnic subgroup populations, such as the Hmong, are understudied in pain research. The study’s purpose is to qualitatively understand older Hmong adults’ pain expression and their pain communication with providers. Sixty-seven participants were recruited from one healthcare system and community. A directed content analysis revealed that all Hmong participants describe pain using stories with reference to the temporal context, causal attribution, co-occurring symptoms or related experiences, magnitude, and consequences of pain. Several participants also characterized their pain by associating it with visual metaphors as objects and animals. Some participants shared that their stories are often underappreciated by providers, and are therefore not understood by providers. This leads to subsequent feelings of stress, not receiving needed medication or other healthcare, and having less frequent contact with providers or switching providers. These findings have implications for more culturally attentive and appropriate pain care.

"It Hurts as If…": Pain-Associated Language, Visual Characterization, and Storytelling in Hmong Adults.

Pain is challenging to diagnose and manage in primary care, especially when patients have limited English proficiency (LEP). Little is known about whether LEP patients can provide pain information that is consistent with the process and the content that providers expect in a clinical interaction. We explore how LEP Hmong patients communicate their pain to providers in primary care settings. A qualitative study with 67 Hmong participants (63% female and x̄ age = 53.7 years) were recruited from a Midwestern state. Semistructured interviews on pain communication were conducted, audio-recorded, transcribed, and analyzed using directed content analysis. The Hmong participants described pain using stories that generally had the same dimensions of information that providers require for pain assessment. These included references to time, causality, associated symptoms or related experiences, intensity, and consequences of pain. However, the participants expressed some pain dimensions in language that was not shared by providers: visual metaphors that were generally in reference to pain quality and fewer words for pain location, intensity, and some qualities. Participants used two strategies to decide whether they should tell their pain story: assessing the provider and determining whether their story was appreciated. The perception that providers underappreciated their stories resulted in dissatisfaction and undertreatment of pain. Ultimately, this resulted in having less frequent contact with providers or changing providers. Findings demonstrate a discordance in the expected process and content of the clinical interaction between LEP Hmong patients and providers, suggesting the need for culturally appropriate pain assessments in this population.

Hmong Older Adults' Perceptions of Insider and Outsider Researchers: Does It Matter for Research Participation?

Recruiting racial/ethnic minorities into health research is challenging. Although researchers affiliated with members of the study population (seen as insiders) may increase research participation of racial/ethnic minorities, little is known about who participants see as insiders and how they respond to insider versus outsider researchers. The aim of the study was to examine perceptions of Hmong older adults toward insider versus outsider researchers and the influence of these perceptions on their willingness to participate in research. Participants in a study evaluating use of a culturally and linguistically adapted audio computer-assisted self-interviewing system with helper assistance (ACASI-H) provided information about what they thought would encourage others in their community to participate in research. ACASI-H was used for collection of health data with 30 Hmong older adults. Participants rated the likelihood of participation if the researcher was Hmong and answered open-ended questions about participation when the researcher was not Hmong. Conventional content analysis was used to analyze open-ended questions. Sixteen (53%) participants reported that they would be "likely" to participate in the research if the researcher was Hmong. Fourteen (47%) participants reported that they would participate in research if the researcher was not Hmong. In addition to ethnic affiliation, trust in the researcher could shift the perception of the researcher toward insider status, thereby increasing willingness of Hmong adults to participate in research. Trust in the researcher and movement toward insider status could be increased by calling out a connection between the researcher and the participant or creating reciprocity. Findings suggest that increasing research participation of Hmong (and possibly other) participants, particularly when researchers do not share ethnic membership, can be achieved by building trust. This study also suggests a more nuanced perception of insider status, as a continuum, rather than a dichotomy, may be a more accurate reflection of the relationship between participants and researchers.

Engaging Hmong adults in genomic and pharmacogenomic research: Toward reducing health disparities in genomic knowledge using a community-based participatory research approach

Advancing precision medicine relies in part on examining populations that may exhibit unique genetic variants that impact clinical outcomes. Failure to include diverse populations in genomic-based research represents a health disparity. We implemented a community-based participatory research (CBPR) process with the Hmong community in Minnesota, who were refugees from Laos, in order to assess the feasibility of conducting genomic and pharmacogenomic-based research for genetic variants that are relevant to the Hmong community. Our Hmong Genomics Board, consisting of Hmong and non-Hmong professionals, used CBPR principles and built on previous formative research to create and implement culturally and linguistically appropriate informed consent processes for Hmong people at six community venues. The Board chose genetic variants for diabetes risk and warfarin response as relevant to the community. The Institutional Review Board approved aggregate but not individual return of results. Two hundred thirty-seven Hmong participants with mean (range) age of 30.2 (18-81) years and diverse levels of education (22% without and 75% with high-school education) provided saliva for genetic (DNA) analyses. Eighty-five percent of participants agreed to store DNA for future analyses, 82% agreed to share DNA with other researchers, and 78% agreed to be contacted for future studies. Twenty-five elders refused to participate because they wanted individual results. Aggregate results were shared with all participants. This CBPR approach proved highly successful to obtain informed consent and recruit a sample from the Hmong community for a genomic and pharmacogenomic study. Investment in the CBPR process may prove successful to address the gap of genomic information in under-represented communities.

Western or Traditional Healers? Understanding Decision Making in the Hmong Population.

Research has documented the influence of cultural values, beliefs, and traditional health practices on immigrants' health care utilization in their host countries. We describe our findings of how Hmong immigrants to the United States make decisions about whether and when to use traditional and/or Western health services. We conducted semi-structured interviews with 11 Hmong adults. We found their decisions depended on whether they classified the illness as spiritual or not and how they evaluated the effectiveness of different treatment options for their illness. Hmong participants' expectations for effective treatment in traditional or Western health care encounters combined with physical evidence of an illness influenced their decisions and often led them to shift from one type of care to the other. Understanding cultural differences in perceptions of the causes of illnesses and the link between perceived cause and treatment is important to improving care for the Hmong population.

Understanding Possible Roles of Locally-grown Ethnic Produce in Dietary Practices and Food Cultures: An Exploratory Study

The objective of this study was to explore possible roles of locally-grown ethnic produce in dietary practices and food cultures in rural northern California. Four focus groups were conducted with Hmong, Mexican, and white participants (N = 24). Focus group results indicate that availability and accessibility of fresh ethnic produce may be a key to preservation of traditional food practices among ethnic groups. Focus groups also revealed that sharing food cultures across different groups through ethnic produce promotion at farmers’ markets may contribute to both openness to other food cultures and preservation efforts of traditional food practices.

Applying Concept Mapping Methodology to Identify the Perceptions of Risk and Protective Factors for Childhood Obesity among Southeast Asian Refugees.

This study identifies Southeast Asian refugee parents' and grandparents' perceptions of the risk and protective factors for childhood obesity. We used a mixed methods approach (concept mapping) for data collection and analyses. Fifty-nine participants engaged in modified nominal group meetings where they generated statements about children's weight status and structuring meetings where they sorted statements into piles based on similarity and rated statements on relative importance. Concept Systems® software generated clusters of ideas, cluster ratings, and pattern matches. Eleven clusters emerged. Participants rated "Healthy Food Changes Made within the School" and "Parent-related Physical Activity Factors" as most important, whereas "Neighborhood Built Features" was rated as the least important. Cambodian and Hmong participants agreed the most on cluster ratings of relative importance (r = 0.62). The study findings may be used to inform the development of culturally appropriate obesity prevention interventions for Southeast Asian refugee communities.

Bonding and Bridging Social and Cultural Capitals: Perceived Factors Associated With Family Eating Practices Among Hmong, Latino, and White Mothers and Fathers

ObjectiveTo examine perceived social and cultural capitals associated with family eating practices among Hmong, Latino, and white mothers and fathers. MethodsSix focus groups composed of 52 Hmong, Latino, and white mothers and fathers of young children were conducted to examine parental perceptions of social and cultural capitals associated with eating practices. ResultsWhereas Hmong participants unanimously emphasized the healthfulness of their traditional food, Latino groups had divergent views on their traditional foods' healthfulness. Hmong parents highly valued their traditional foods whereas white and Latino mothers were more accepting of new foods from other cultures. Participants noted divergent views on gender roles in family eating practices and food culture preservation efforts. Conclusions and ImplicationsIdentifying and promoting bonding and bridging of cultural assets for healthy dietary practices among different cultural groups may be important for developing successful nutrition education programs across ethnicities in the community.

Limited English proficient Hmong- and Spanish-speaking patients’ perceptions of the quality of interpreter services

BackgroundLanguage barriers are a large and growing problem for patients in the US and around the world. Interpreter services are a standard solution for addressing language barriers and most research has focused on utilization of interpreter services and their effect on health outcomes for patients who do not speak the same language as their healthcare providers including nurses. However, there is limited research on patients’ perceptions of these interpreter services. ObjectiveTo examine Hmong- and Spanish-speaking patients’ perceptions of interpreter service quality in the context of receiving cancer preventive services. MethodsTwenty limited English proficient Hmong (n=10) and Spanish-speaking participants (n=10) ranging in age from 33 to 75 years were interviewed by two bilingual researchers in a Midwestern state. Interviews were audio taped, transcribed verbatim, and translated into English. Analysis was done using conventional content analysis. ResultsThe two groups shared perceptions about the quality of interpreter services as variable along three dimensions. Specifically, both groups evaluated quality of interpreters based on the interpreters’ ability to provide: (a) literal interpretation, (b) cultural interpretation, and (c) emotional interpretation during the health care encounter. The groups differed, however, on how they described the consequences of poor interpretation quality. Hmong participants described how poor quality interpretation could lead to: (a) poor interpersonal relationships among patients, providers, and interpreters, (b) inability of patients to follow through with treatment plans, and (c) emotional distress for patients. ConclusionsOur study highlights the fact that patients are discerning consumers of interpreter services; and could be effective partners in efforts to reform and enhance interpreter services.

Evaluating Teaching Techniques in the Hmong Breast and Cervical Cancer Health Awareness Project

Cancer health disparities are a reality for Hmong women who are often diagnosed at a later stage and have low literacy and experienced care that are not culturally appropriate. Lack of attention to cultural appropriateness and literacy levels of cancer screening materials may contribute to disproportionately low levels of cancer screening among Hmong women. The purposes of this study were to evaluate the Hmong Health Awareness Project (HHAP), a program designed to create awareness and acceptance of breast and cervical cancer screening, and to examine participants' perceptions of the utility of the content of the workshops. Hmong researchers partnered with three Midwestern Hmong community centers to implement six workshops. Three teaching techniques: pictographs, videos, and hands-on activities were utilized to teach Hmong participants about cancer screening. Participants included 150 Hmong (male participants = 30 and female participants = 120). Teach-back method was used to assess the participants' understanding of cancer screening throughout the workshops. Qualitative data were collected in focus groups to assess the feasibility of teaching methods and participants' perceptions of the utility of the content of the workshops. Directed content analysis was used to analyze participants' responses. The three teaching techniques were helpful in increasing the Hmong people's understanding about breast and cervical cancer screening. Nearly, all participants perceived an increased in their understanding, greater acceptance of cancer screening, and increased willingness to be screened. Men expressed support for screening after the workshops. Findings can guide future interventions to improve health communications and screening and reduce diagnostic disparities among Hmong and immigrant populations.

Welfare Reform Impacts on Hmong Families in Minnesota

A composite of two descriptive interview studies regarding the implementation and impact of Minnesota's Temporary Assistance for Needy Families (TANF) program on Hmong recipients is presented. The first study was an examination of Hmong engagement with Minnesota's welfare reform program and paid work. The second study was an examination of impacts of the program on the well-being of Hmong families. Both studies found that Hmong participants had difficulty with the program's paid work expectations given limited English, lack of formal education, and low wages. Both studies also emphasized the Hmong's commitment to family caregiving, which conflicted with program work requirements.

Generational Differences among a Small Group of Hmong Americans

Few studies have looked at the differences in culture, language, and educational attainments among generations of Hmong in the United States since the beginning of their immigration to the United States. This study of 195 Hmong participants examines the effects of generational status on Hmong immigrants across several factors including marriage and family planning practices, cultural identity, and educational attainment. Cultural identity and family practices of immigrants lean toward increased adaptation to American culture with each successive generation; however, educational attainment was lower among second-generation immigrants when compared to their first-generation counterparts. Explanations for lower educational attainment may be due to confounding factors such as time effect. This study informs social work practice by exploring the variations in acculturation trajectories among the Hmong in the United States.

Perspectives from the Hmong Population on Type 2 Diabetes

The primary goal of the study was to determine perceptions the Hmong population has about Type 2 diabetes. Specific information to be gathered from the Hmong participants were: reactions after being diagnosed with Type 2 diabetes, knowledge and beliefs about medications, and how pharmacists can help them with their diabetes care. Learning the beliefs of this population related to Type 2 diabetes will help identify methods to improve diabetes care and education for Hmong patients. A focus group was conducted with Hmong participants with Type 2 diabetes to explore their perceptions and experiences with diabetes. There were 9 participants in the focus group which lasted approximately 90 minutes. The major themes were a misunderstanding of diabetes and its treatment, a reluctance to adhere to medications, a reluctance to change cultural diet, and the need for clear education from pharmacists. Participant recommendations for pharmacists were to improve their diabetes care by educating them about the condition, medication, and available treatments.
 
 Type: Original Research

Abstract A28: Increasing the contribution of blood biospecimen collection by Hmong Americans: An empirically and literature-informed intervention

Abstract Background/Aim: Access to sufficient quantities of racially-specific blood samples for research purposes increases the likelihood of developing personalized approaches for cancer treatment and insights that can result from enhanced molecular and genomic characterizations of biospecimens. However, blood samples from Asian Americans who are the only U.S. racial/ethnic group to experience cancer as the leading cause of death appear to be extremely limited. Hence the aim of our study was to test the feasibility of developing, implementing, and evaluating an intervention to increase the number of blood biospecimens contributed by Asian Americans. Since all Asian Americans are not alike, this presentation focuses only on one Asian American group, the Hmong, who represent one of the most recent groups of Asian Americans. Methods: We first conducted a community needs assessment to identify factors that appear to affect Asian Americans’ decisions to contribute biospecimens. That assessment revealed that blood specimens ranked in the bottom four choices of biospecimens that Asian Americans (Chinese, Hmong, Vietnamese) preferred to contribute. With respect to contributing biospecimens, the first preference (43%) for Hmong was to contribute biospecimens during a community event. The main reason Hmong participants would consider contributing biospecimens was to look at diseases passed down in families. Of the three Asian groups, the Hmong preferred visual and oral education over written materials. Second, we exhaustively reviewed the limited literature on biospecimens contributions. Hmong consider blood as the source of strength and vitality and believe that there is a limited amount of blood in their bodies. Once drawn, they believe that blood cannot be replaced. Hence, some Hmong patients are more apt to refuse blood draws because they believe blood is not renewed. The needs assessment and literature review thus depicted considerable cultural and cognitive factors that needed to be integrated into a successful intervention to collect biospecimens from Hmong. Thus, we partnered with a trusted community-based organization, Hmong Women's Heritage Association (HWHA), with whom we have collaborated with for over 8 years. Based on that collaboration, we developed an intervention that incorporated our empirical findings and literature review. That intervention relied on preparing HWHA bilingual, bicultural Hmong lay health workers to explain the value of blood donations as ways to contribute to cancer research and to explain how cancer may be addressed. We held the blood drive during a well-publicized community event and we provided modest incentives for participation. Results: On April 16, 2011, the Asian American National Center for Reducing Cancer Health Disparities in collaboration with the UC Davis Cancer Center Biorepository and the Hmong Women's Heritage Association hosted the first-ever Asian American biospecimen community drive. Expecting only to draw 40 samples, we collected 174 vials of blood from 87 “healthy” volunteers, 82 were Hmong volunteers. Conclusions: Despite the overwhelming cultural and cognitive barriers associated with blood as a means of biospecimen contribution, the outpour of community support is a testament to 1) The trust the community has in Hmong Women's Heritage Association; 2) The time, commitment, and dedication of the staff; and lastly 3) The talent of the those individuals who worked on everything from the IRB consenting process to the talent of the community for rising above their cultural reservations and who wholeheartedly contributed to the greater good of their community. Developing an effective intervention to increase the collection of blood biospecimens must be customized to the population group. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A28.