Korean American Community Research Articles

Adherence to Cervical Cancer Screening in Korean American Immigrant Women: Identifying Malleable Variables for Intervention Development.

Introduction. Despite Korean American women having a high incidence rate of cervical cancer, many are unaware of the significance of Pap test. The purpose of this research was to examine the rates of Pap test receipt and factors associated with the uptake. Method. The study was guided by Andersen's Model of Health Service Use and used a cross-sectional research design. A sample of 230 women residing in metro-Atlanta, Georgia, participated in this study. Results. Slightly more than half (55.7%) had lifetime Pap tests while less than half (45.7%) had it within the last 3 years. Binary logistic regression indicated that marital status, monthly income, and annual checkups were significantly correlated with receiving Pap tests. Discussion. Special attention is needed for women who are unmarried and have low income to increase Pap test receipt. Suggested intervention programs include better communication strategies, extended Medicare coverage, and outreach programs within Korean American community.

Cancer Control Continuum in Korean American Community Newspapers: What Is the Association with Source Nationality-US vs. Korea?

Prior research suggests that cancer information obtained from Korean American community media, which are the primary health information sources among the population, does not connect to Korean Americans' increased cancer knowledge or cancer protective/detective behavior. We aim to identify the reason by analyzing cancer type, cancer control continuum, and cancer topic presented in Korean American community newspapers. The nationality of news source, US and Korea, and its association with the cancer coverage were examined. We found that among articles that cited any source, nearly one third used a source from Korea. The source nationality was associated with cancer coverage. In particular, cancer risk factors and screening were more likely to be discussed when a US source was cited as compared to when no source was cited. Korean sources were never or rarely observed in articles focusing on a few cancer sites (e.g., breast and prostate, which Korean Americans have higher risks compared to native Koreans), cancer preventive behaviors (diet, physical activity, no smoking), and specific cancer detection methods (mammogram, pap-smear). We suggest Korean American media to reflect the cancer priority and information needs among Korean Americans, which are varied from native Koreans, and to acknowledge the differences in cancer prevention and detection guidelines between the U.S. and Korean healthcare system. Also, the U.S. government should disseminate cancer screening and prevention guidelines, customized to racial/ethnic groups' cancer prevalence and communication preference.

Health Literacy and Outcomes of a Community-Based Self-Help Intervention: A Case of Korean Americans With Type 2 Diabetes.

Although scientific reports increasingly document the negative impact of inadequate health literacy on health-seeking behaviors, health literacy's effect on health outcomes in patients with diabetes is not entirely clear, owing to insufficient empirical studies, mixed findings, and insufficient longitudinal research. The aim of this study was to empirically examine underlying mechanisms of health literacy's role in diabetes management among a group of Korean Americans with Type 2 diabetes mellitus. Data from a randomized clinical trial of a health literacy-focused Type 2 diabetes self-management intervention conducted during 2012-2016 in the Korean American community were collected at baseline and at 3, 6, 9, and 12 months. A total of 250 Korean Americans with Type 2 diabetes participated (intervention, 120; control, 130). Participants were first-generation Korean American immigrants. Health literacy knowledge was measured with the original Rapid Estimate of Adult Literacy in Medicine and the diabetes mellitus-specific Rapid Estimate of Adult Literacy in Medicine. Functional health literacy was measured with the numeracy subscale of the Test of Functional Health Literacy in Adults and the Newest Vital Sign screening instrument, which also uses numeracy. Primary outcomes included glucose control and diabetes quality of life. Multivariate analyses included latent variable modeling. A series of path analyses identified self-efficacy and self-care skills as significant mediators between health literacy and glucose control and quality of life. Education and acculturation were the most significant correlates of health literacy. Despite inconsistent findings in the literature, this study indicates that health literacy may indirectly influence health outcomes through mediators such as self-care skills and self-efficacy. The study highlights the importance of health literacy, as well as underlying mechanisms with which health literacy influences processes and outcomes of diabetes self-management.

Coming-Out in the Intersections: Examining Relationality in How Korean Gay Men in Seattle Navigate Church, Culture and Family through a Pacific Lens

ABSTRACT This paper uses Pacific Research Methodologies (PRM) to explore intersectionality in how Korean gay men navigate culture, family, and religion in relation to coming-out publicly in Seattle. By framing this study within a Pacific itulagi (worldview), I construct an argument that posits that Korean gay men in Seattle—due to the Korean American community being intertwined with the Christian Church—often find their sense of ethnic identity and family relationally co-constructed by a Christian one. Informants navigated this using Narratives of Convenience (NoC), whereby they reveal their sexual identity to a family member(s) and together, build a story that projects a heteronormative image of the self to the wider Korean American community. Contextually, a NoC helps avoid friction in wider familial and community circles, permitting informants to live gay lives openly with partners in US society. A full coming-out narrative by contrast often had a detrimental effect on other informants.

A Qualitative Analysis of Barriers to Colorectal Cancer Screening among Korean Americans.

Colorectal cancer (CRC) is the second most-commonly diagnosed cancer among Korean Americans after breast cancer, with incidence rates exceeding that of lung, prostate, and stomach cancers. However, CRC screening rates are lower among Korean Americans than the general U.S. population. To understand barriers to screening in this population, we conducted 11 focus groups with 51 Korean Americans ages 40+ in the Washington, DC, metropolitan area between 2011 and 2016. Our analysis used the Health Belief Model as a framework. Motivators to seek screening include a family or personal history of cancer or gastrointestinal disease (high perceived susceptibility), knowing people with CRC (high severity), favorable test results reducing worry (high benefits), and physician recommendations (cues to action). Barriers to screening include the common misperception that Korean lifestyles prevent CRC (low susceptibility), the belief that cancer is normal for older adults (low severity), the assumption that screening only benefits symptomatic people (low benefits), the costs and potential risks of testing along with a preference for traditional Korean approaches to wellness (high barriers), and lack of health insurance (low self-efficacy). Interventions seeking to increase the rate of cancer screening in the Korean American community will benefit from emphasizing the burden from CRC among Korean Americans (increasing perceived susceptibility to CRC), explaining that colonoscopies can prevent CRC rather than just diagnosing it (increasing perceived benefits of screening), reducing anxieties about test procedures and embarrassment (reducing perceived barriers to screening), and improving clinical communication (improving cues to action and self-efficacy).

Dynamic Korea and Rhythmic Form

Dynamic Korea and Rhythmic Form

Abstract 4182: Community and cancer registry collaboration to reduce persistent stomach cancer disparity in Korean Americans: Asian American Stomach Cancer Task Force

Abstract South Korea and Japan have the highest stomach cancer incidence rates worldwide. Using 1988-2012 data from the California Cancer Registry, we have previously reported a striking stomach cancer disparity in Korean Americans, marked by 5 times higher incidence than in non-Hispanic whites (NHWs) and two times higher incidence than in Japanese Americans, the racial/ethnic group with the second highest incidence. The majority of Korean American adults were born in Korea while the majority of Japanese Americans adults were born in the US. Although Korean Americans had a more favorable stage distribution than other Californians in our earlier study, Korean Americans had a worse stage distribution compared to populations in Korea or Japan, where population-based screening is available. Data from South Korea demonstrated benefits of screening endoscopy in improving stage at diagnosis as well as mortality from stomach cancer. Bi-annual stomach cancer screening is now recommended for South Korean adults aged 40 or above, with an estimated participation rate of 75%. The United States lacks well-defined stomach cancer screening guidelines. In this study, we used the 2010-2014 Surveillance, Epidemiology, and End Results (SEER) data and compared stage distribution in Korean Americans in Los Angeles County, other areas in California, and SEER regions outside California. The proportion of early stage disease was highest in Korean Americans in Los Angeles County (49%), followed by other areas in California (41%) and SEER regions outside California (36%). The earlier diagnosis in Los Angeles County compared to other SEER regions was not observed for Japanese Americans or NHWs. It is reasonable to speculate that the increased public and physician awareness particularly in areas with a large Korean community helped Korean Americans somewhat overcome the disparity coming from the high incidence. However, the proportion of localized disease among Los Angeles County Korean Americans was still much lower than the proportion in Korea during the same time period (60-66%), indicating the need for targeted screening or well-defined guidelines for diagnostic endoscopy. Dissemination of these cancer registry findings led to a collaborative partnership between a number of Korean American community physician organizations and Los Angeles County SEER cancer registry, the Los Angeles Cancer Surveillance Program, establishing the ‘Asian American Stomach Cancer Task Force’ (AASCTF). The overarching goal of AASCTF is to reduce stomach cancer disparity in Korean Americans and other immigrants from high risk regions by promoting stomach endoscopy through community campaign and supporting research activities to help the medical community and policy makers to make evidence-based decisions. Citation Format: Eunjung Lee, Juanjuan Zhang, Sohee Park, Amie E. Hwang, Lihua Liu, Haeseong Park, Sang-Hoon Ahn, Anna H. Wu, Dennis Deapen. Community and cancer registry collaboration to reduce persistent stomach cancer disparity in Korean Americans: Asian American Stomach Cancer Task Force [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4182.

Exploring the Need of HPV Education Programs in Korean American Communities

ABSTRACTGiven the significantly higher cervical cancer risks faced by Korea Americans (KA), the aim of this study was to explore cultural influences and barriers affecting human papillomavirus (HPV) vaccination decisions and preferred educational methods to effectively deliver HPV information. Focus groups included 20 KA parents. This study found a lack of knowledge about HPV and the vaccine, along with negative perceptions about the vaccine, affects HPV vaccination decision-making. Ineffective conversations and a lack of HPV vaccine recommendations by health care providers influenced by cultural beliefs were found to be another major barrier. These findings reveal new insights to guide the development of HPV education programs.

Acceptance and Proliferation of Democratic Republicanism before the March 1st Movement

한국에서 공화제는 민주정체와 결합한 민주공화제로 한정되어 받아들여졌 는데, 그 과정이 혁명을 수반하는 대신에 국민국가 담론이 군주제를 단계적으로 잠식해가는 방식으로 진행되었다는 데 하나의 특징이 있었다. 한국에서 민주공화제 수용의 바탕은 국민국가의 발견을 통해 만들어졌다. 독립협회는 왕조에 대한 충군 개념을 디딤돌 삼아 이를 국민국가에 대한 애국 으로 확장시키는 ‘충군애국’의 구호와 다양한 상징조작을 통해 왕조와 국가를 구분함으로써 국민통합에 기초한 근대 국가를 상상할 수 있게끔 하였다. 이후 대한제국기에 공화제 논의는 금기시되었으나, 고종의 강제 퇴위를 거치며 점차 변화하는 양상을 띠어 군주에 대한 국가의 우위를 내세우는 가운데 민주공화제를 가장 바람직한 정치제도로 보는 논설이 속속 등장하였다. 그럼 에도 불구하고 당시 지식인 사회의 주류는 민주공화제의 도입을 시기상조로 바라보면서 점진적 개혁을 주장하였다. 그러한 경향은 기존에 공화제를 표방한 단체로 받아들여졌던 신민회의 경우도 예외가 아니었다. 신민회 인사들이 공화제의 실행을 유예한 데는 황실 타도로 운동의 전선을 분산시키기에는 당면한 국권회복의 과제가 너무도 막중하 다는 현실인식 또한 작용하고 있었다. 더불어 그들이 근거했던 사회진화론의 입장에서 볼 때에도 형체만 남아 있을지라도 경쟁 주체로서 대한제국이라는 국가는 보존되어야 했다.이렇게 유예된 공화제 구상은 대한제국의 멸망 이후 미주 한인사회의 ‘정신상 신한국’ 담론을 통해 비로소 그 실체를 드러냈다. 국망의 소식에 접한 미주 한인사회는 형질상 대한제국의 멸망을 정신상 민주주의 신한국의 시작으로 받아들였다. 그 같은 담론은 삼권분립의 미국식 공화제 민주주의 임시정부 건설 론으로 이어져, 새로운 생존경쟁의 주체로서 신한국을 설정한 가운데 독립운 동에 다시 불을 지필 수 있게끔 하였다.In Korea, republicanism was accepted narrowly as a system of democratic republic combined with democracy. And its development went through the process of making the nation-state discourses encroach on monarchy gradually rather than accompanying a revolution. The acceptance of democratic republic system in Korea was grounded upon the recognition of nation-state. The Independence Club(Dongnip Hyophoe) has made it possible to imagine a modern nation on the basis of national integration. In this effort, it distinguished the notion of the state from that of the dynasty, by instigating and expanding the slogan of the ’Chung’gun Aeguk’ (a stepping stone to the ideology of loyalty to the dynasty) to the patriotism of the nation state. The debate on republican system was officially banned during the whole period of the Daehan Empire. But with the forced deportation of Emperor Gojong, the issue was revived with the consideration of the democratic republic system as the most desirable political system. Nonetheless, the intellectual society advocated a gradual reform and regarded the adoption of democratic republican system as premature. It was no exception to the New People’s Association(Sinminhoe), which had been accepted as a representative of republicanism. The members of the New People’s Association recognized that the task of restoring the national sovereignty would be much more important than that of turning into the front line of the movement against the Imperial Regime. In addition, from the standpoint of the social evolution doctrine on which they were based, the state of the Daehan Empire had to be preserved as the subject of competition. This deferred plan for republicanism was realized in the discourse on ’New Korea’ initiated by the Korean American community after the fall of the Daehan empire. The Korean American community accepted the fall of the Daehan Empire as the beginning of democratic New Korea. Such a discourse led to the conceptual development of doctrines on republican democracy and provisional government construction, and set up New Korea as the subject of survival competition, which could eventually allow the independence movement to be ignited again.

Disparities in retail marketing for little cigars and cigarillos in Los Angeles, California

IntroductionEvidence of a concentration of cigarette advertising in predominantly low-income, non-White neighborhoods underscores the need to examine retail marketing and promotions for novel tobacco products like little cigars and cigarillos (LCCs). We sought to investigate neighborhood racial/ethnic disparities in LCC marketing at retail, including availability, advertising, price promotions, and product placement in Los Angeles, California. MethodsBetween January 2016 and April 2017, community health workers (n = 19) conducted in-person observational audits from tobacco retail stores (n = 679) located in zip codes with a high percentage of non-Hispanic White (n = 196), Black (n = 194), Hispanic/Latino (n = 189), or Korean American (n = 100) residents. To account for clustering effect of zip codes, multilevel modeling approach for a dichotomized outcome was conducted to evaluate the association between racial/ethnic neighborhood sample and dependent variables. ResultsStores located in zip codes with a high percentage of non-Hispanic Blacks had more than eight times higher odds of selling LCCs (OR = 8.10; 95% CI = 3.10–21.11 vs. non-Hispanic White), more than five times higher odds of selling flavored LCCs (OR = 5.20; 95% CI = 2.33–11.61 vs. non-Hispanic White), and more than six times higher odds of displaying storefront exterior LCC signage (OR = 6.03; 95% CI = 2.93–12.40 vs. non-Hispanic White). Stores in Hispanic/Latino and Korean American communities had about three times higher odds of selling LCCs (OR = 3.02; 95% CI = 1.15–7.93 vs. non-Hispanic White; OR = 2.99; 95% CI = 1.33–6.71 vs. non-Hispanic White). ConclusionsLCCs are heavily marketed in retail establishments in Los Angeles, with disproportionate targeting of predominantly non-White neighborhoods, especially stores in neighborhoods with a higher proportion of African Americans. Local, state, and federal flavor restrictions, minimum pack size standards, preventive messages, and campaigns could counter the influence of LCC marketing in retail establishments.

The Politics of Shame: The Glendale Comfort Women Memorial and the Complications of Transnational Commemorations

Since 2010, Korean-American communities, with the support of local governments, have sponsored ten “comfort women” memorials throughout the United States. This study focuses on the memorial statue dedicated in Glendale, California as a case study for the contentious politics of “comfort women” commemorations in distinctly American contexts. Dedicated in 2013, the Glendale Comfort Women Memorial became enmeshed in a heated controversy that resulted in a federal court case. Animated by the powerful affect of shame, the debate in which this memorial was embroiled reveals the desire to lay claim to memory on a geopolitical stage, engaging issues of gender and ethnic identities and global politics. This article argues that the Glendale Comfort Women Memorial demonstrates the ways memorials in a globalised society can be employed to assign moral culpability outside of official governmental channels and disseminate histories of oppression that might previously have been forgotten. In doing so, the memorial and the public controversy that ensued also expose the limits and complications of transnational commemorations in foreign settings.

Development and Evaluation of Culturally and Linguistically Tailored Mobile App to Promote Breast Cancer Screening.

Background: While a significant breast cancer burden exists for Korean American immigrant women, their cancer screening behavior is strikingly poor, and few interventions have focused on this population. To promote breast cancer screening behavior in Korean American immigrant women, a mobile phone multimedia messaging intervention (mMammogram) was developed. Objective: The current study explores the impact of mMammogram on changes to study participants’ screening behavior and proposes suggestions for how the intervention can be improved for wide dissemination and implementation in the Korean American community. Material and Methods: Data were collected through qualitative research methods. Three focus groups were conducted with 14 Korean immigrant women who completed the mMammogram. Findings: Three themes emerged: (1) better understanding of breast cancer and screening through mMammogram (e.g., increased knowledge on breast cancer and screening methods, increased understanding of the importance of regular mammography, and reduced anxiety about mammography); (2) health navigators as a trigger to promote mammography (e.g., providing resources for free or low-cost mammograms and scheduling mammogram appointments); and (3) suggestions for mMammogram (e.g., technical issues and program period). Conclusions: Mobile app intervention that is culturally tailored, along with health navigation services, can be a feasible, effective, and acceptable tool to promote breast cancer screening behaviors in underserved immigrant women. A mobile app can cover a broad range of breast cancer health topics and the health navigator can further help women overcome barriers to screening. A health navigation service is critical in overcoming language, transportation, and health accessibility barriers and triggering a positive change in their health screening behavior, especially for newly arrived immigrant populations.

Influence of Community-Level Cultural Beliefs about Autism on Families' and Professionals' Care for Children.

This qualitative study aimed to understand how community-level cultural beliefs affect families' and professionals' care for children with autism and developmental delays in immigrant communities, as a first step towards promoting early identification and access to early intervention services. The study was part of the larger New York City (NYC) Korean Community Autism Project, which was designed to identify strategies to increase awareness of autism and reduce delays in treatment seeking within the NYC Korean-American community. Our study elicited early childcare workers' and church leaders' beliefs about autism and developmental disorders and, in particular, early intervention. We also elicited responses to newly developed outreach materials targeting this community. An inductive approach was used to identify concepts and categories associated with autism. Our study confirmed that discomfort, stigma and discrimination are the prevailing community attitudes toward autism and developmental disorders in the Korean-American community. Families' and professionals' understanding of autism and their care for children are affected by these community beliefs. Approaching immigrant communities with general information about child development and education rather than directly talking about autism and developmental disorders is likely to engage more families and professionals in need for diagnostic evaluation and early intervention for autism.

Tobacco regulatory compliance with STAKE Act age-of-sale signage among licensed tobacco retailers across diverse neighborhoods in Southern California.

INTRODUCTIONThe California Stop Tobacco Access to Kids Enforcement (STAKE) Act requires licensed tobacco retailers to post minimum age-of-sale signage at the point of sale. This study investigated STAKE Act compliance in licensed tobacco retailers across four racial/ethnic communities in Southern California.METHODSThe sample consisted of 675 licensed tobacco retailers (excluding chain store supermarkets and pharmacies) randomly selected based on zip codes from predominantly non-Hispanic White (n=196), African American (n=193), Hispanic/Latino (n=186), and Korean American (n=100) communities. A protocol for assessing signage was completed at each store by community health workers (promotoras de salud). The law changed from a minimum age of 18 to 21 years (Tobacco 21) during data collection, as of 9 June 2016. Differences in signage compliance were evaluated before and after changes in the State law.RESULTSOverall, 45% of the stores were compliant with posting the required age-of-sale signage (which varied in minimum age by date of collection); 14% of stores did not have any store interior age-of-sale signs, and 41% of stores had some type of age-of-sale sign but were not compliant with the STAKE Act (e.g. 29.5% of the stores had non-compliant tobacco industry We Card signs but not STAKE Act signs). Stores observed after the 2016 implementation of Tobacco 21 had significantly lower STAKE Act signage compliance rates (38.6%) compared to stores observed before the change in the State law (70.9%) (z=6.8623, p<0.001). The difference in STAKE Act sign compliance between stores located in AA communities (16.9%) and stores located in NHW communities (41.5%) observed within the first three months after the change in law was statistically significant (χ2(1)=20.098, p<0.001).CONCLUSIONSFindings suggest the need for prompt, educational outreach to licensed tobacco retailers on age-of-sale signage changes, multiple compliance checks, and enforcement.

"Reflections on Migration and Economic Globalization: The 1992 L.A. Riots and the Korean American Community"

The second largest Korean diasporic community resides in the U.S. The Korean American population increased in the 1960s/70s. These new urban immigrants found themselves in a new America where minority civil rights had just been gained and economic globalization changed the face of the American corporate business model. However, Koreans who migrated to the U.S. in the 1960s/70s were ignorant of the tumultuous racial and fiscal issues of their new homeland. Inner cities like South Central LA and Detroit, suffered the brunt of the downfall of the US economy as manufacturers left those once bustling towns. Faced with discrimination in corporate America, Korean Americans were forced into opening small businesses in those inner cities. While economic globalization had opened trade, and increased the interdependency of international economies, domestic racial and discrimination issues persisted in the US. Cultural differences, the disparity between the haves and the have-nots, government neglect, and police brutality, would fuel the anger and resentment of the inner-city minority population of African Americans toward the middle man “model minority” Korean American community. Not realizing that Korean Americans shared similar racial and discriminatory experiences, African Americans believed Korean Americans were taking advantage of the black community. By the 1980s, the black-Korean conflict made headlines. Then the Rodney King verdicts would spark the 1992 LA Riots and the targeting of Korean American businesses. The question is, how did migration and economic globalization contribute to the 1992 LA Riots and the Korean American experience? How did the Korean American identity change since then, especially as cultural globalization and things like the Hallyu Wave have deconstructed our traditional ideas of identity? My paper will seek to answer the aforementioned questions.

The Virginia Tech Shooting and the Politics of Excessive Apology

“The Virginia Tech Shooting and the Politics of Excessive Apology Se-Hyoung Yi, Ph.D. Abstract On April 16, 2007, Seung-Hui Cho, a Korean student at Virginia Tech, shot and killed 32 people and wounded 17 others. Immediately after the tragedy, Koreans and Korean government officials issued public apologies for Cho’s crime. The Korean Ambassador to the United States urged the Korean American community to repent and join a 32-day fast, one day for each victim. Many observers attribute this sense of collective guilt and responsibility to the collectivist and nationalistic culture among Koreans, dismissing it as strange and inappropriate. Drawing on the concept of “model minority,” this essay argues that the excessive apologies provide a new perspective to analyze the dynamics of race and ethnicity in the United States. Full Text: PDF DOI: 10.15640/rhps.v5n1a1

Moo-Young Han

Moo-Young Han

The Participation of a Northern New Jersey Korean American Community in Local and National Language Variation

This study investigates the variable patterning of two English phonemes, /ɔ/ and /æ/, in the speech of 24 second- and 1.5-generation Korean Americans from Bergen County, New Jersey, which borders New York City and contains the most densely populated Korean American community in the United States. Detailed acoustic phonetic analysis reveals that in general Bergen County Korean Americans produce a raised /ɔ/ nucleus, in accordance with New York City English, and tense /æ/ in prenasal environments, in accordance with General American English. Positive correlations between speaker age and the frontness of /ɔ/ and distance in vowel space between /ɔ/ and /ɑ/ suggest a change in apparent time toward fronting of /ɔ/ and shortening of the distance between two vowels (and hence possibly movement toward a low back merger). Speaker sex patterns are also apparent, with female speakers showing a closer distance and more overlap between /ɔ/ and /ɑ/ than male speakers, and females showing a clearer split between tense /æ/ in prenasal environments and lax /æ/ elsewhere. In general, the patterning of variation for /æ/ among Bergen County Korean Americans shows an alignment to the general American norm, while the patterning for /ɔ/ suggests that Korean Americans are adopting the local norm. Future research will be needed to corroborate these patterns across a wider range of speaker ages.

Mental health disparities impacting Christian Korean Americans: a qualitative examination of pastors’ perspectives

ABSTRACTMental health disparities impacting Korean Americans are multifaceted. Although encouraging developments have been made in the knowledge of mental health prevalence and professional help-seeking behaviours of Asian Americans, Korean Americans continue to experience many challenges and unique needs that require more ethnic- and culture-specific knowledge. Given the prominent role that religion, particularly Christianity, plays in the Korean American context, we conducted exploratory interviews with 10 Korean American pastors regarding their perspectives on mental health issues impacting the Korean American community. Using consensual qualitative research, we found four salient domains: (a) Barriers to seeking mental health services, (b) Challenges that pastors experience, (c) Pastor’s assessment of church’s current climate in approaches to mental health issues, and (d) What is needed. Implications for research and practice in addressing mental health disparities are discussed.

A community- based hepatitis B linkage-to-care program: a case study on Asian Americans chronically infected with hepatitis B virus.

BackgroundHepatitis B is an important disease of ethnic disparity which affects Asian Americans and other minority populations disproportionately. Despite the high prevalence of hepatitis B in Asian Americans, many of them remain unscreened and untreated. A majority of the individuals chronically infected with hepatitis B virus (HBV) are not linked to care, for instance, due to a lack of culturally competent programs. There are many serious barriers preventing linkage to care (LTC), including personal, socio-cultural, and economic issues. The purpose of this study was to evaluate various barriers affecting LTC and to investigate the role and efficacy of a community-based Patient Navigator (PN) program in expediting LTC and in improving health outcomes for hepatitis B patients in a high risk population.MethodsA total of 45 individuals chronically infected with HBV were identified through community screening events and were subsequently linked to patient navigators (PN), who then arranged for the patients to have a medical evaluation with a provider of their choice in their communities. The navigators kept detailed records of the patients’ progress towards goal, and planned follow up visits for each patient. A self-report questionnaire was employed to assess patients’ demographics, history of HBV infection, and barriers in accessing health care. Specifically, the levels of importance of the barriers due to language, culture, financial reasons were assessed.ResultsThe study revealed that 38 of the 45 HBV infected individuals knew about their infection status from previous screening. Forty two out of 45 HBV infected individuals were linked to care within a 12 month period, demonstrating a high linkage rate. Most significant barriers identified were language and finance, followed by cultural barrier and others.ConclusionThere are specific barriers to accessing adequate care for the patients affected by chronic hepatitis B (CHB) in Korean American community. The implementation of a PN program in conjunction with the community network of health care providers may help to overcome the barriers and facilitate LTC in hepatitis B.