Vietnamese American Research Articles

Patient-Reported Experiences in Discussing Prescribed Medications with a Health Care Provider: Evidence for Racial/Ethnic Disparities in a Large Health Care Delivery System.

The objective was to understand patient-reported experiences in communicating with a health care provider about prescribed medications in a health care setting serving diverse racial/ethnic groups. Adult patients who completed a patient-experience survey and received a prescription for a hypertension, hyperlipidemia, or diabetes medication at the surveyed encounter were studied (N = 19,006). Data were collected in a large mixed-payer outpatient health care system in northern California between 2011 and 2014. Surveys were linked to the electronic health records of the office visit to which the survey refers, with detailed information on visit content, provider, and patient characteristics. The focus was on 2 survey questions asking about providers' efforts to include patients in treatment decisions and the information received about medications. Logistic regression was used to assess factors associated with survey responses, which were dichotomized as very good or not (ie, good, fair, poor, very poor). Chinese (OR: 0.59; 95% CI: 0.50-0.70), Asian Indians (0.68; 0.54-0.84), Japanese (0.74; 0.57-0.98), Koreans (0.46; 0.25-0.83), Vietnamese (0.51; 0.27-0.98), and African Americans (0.74; 0.55-0.99) vs. non-Hispanic whites (NHWs) reported poorer experiences of involvement in treatment decisions. Similarly, Chinese (0.59; 0.49-0.70), Asian Indians (0.67; 0.54-0.83), Koreans (0.38; 0.21-0.70), Vietnamese (0.46; 0.25-0.87), African Americans (0.65; 0.49-0.87), and Mexicans (0.77; 0.61-0.98) vs. NHWs reported poorer experiences for information received about medications. Almost all racial/ethnic groups report poorer experiences with involvement in treatment decisions and information received about medications than NHWs in the same clinical setting, which may contribute to poorer adherence and outcomes among racial/ethnic minority groups.

Global Economy, Citizenship Pluralism, Transmigrant Mobility, and the Sojourn-Immigrant Vietnamese Americans

Drawing on empirical analysis, this essay examines the migrant experience of a new Vietnamese transmigrant community whose migratory impetuses are prompted by better educational and professional conditions in the United States and rendered possible by both their citizenship pluralism and their human/social capital. This newer Viet Kieu generation often has strong financial, business, and professional ties to the sending country; many either split their time equally between the two countries or have resettled or plan to resettle in Vietnam. Such migratory nuances and mobility blur the boundary between sojourner and immigrant and foster an interesting Vietnamese migrancy and new generation of Vietnamese American transmigrants, whom I call the sojourn-immigrant Viet Kieu. This article attempts to provide a counter-narrative to the often uni-directional studies of migration that presupposes the United States to be the permanent place of resettlement for Vietnamese migrants. I argue that a globalized sojourn-immigrant Viet Kieu identity has emerged and taken shape in response to fast-changing contemporary socioeconomic demands. The sojourn-immigrant identity thus encompasses a more flexible articulation of citizenship(s) to reflect a new form of Vietnamese transmigrant mobility within the Vietnamese diaspora.

Affective and Cognitive Attitudes on Cervical Health Behaviors Among Asian American Women.

Cervical cancer is a major cause of death for Vietnamese and Korean American women, yet their screening rates remain low. This study explored factors influencing cervical health behaviors of these populations, using a 2-dimensional model (ie, affect and cognition) of attitude structure approach. Semistructured interviews were conducted with 33 participants. A semantic content analysis was used to identify major codes and themes across the transcripts. Multiple aspects of both negative and positive affect and cognition, which led to 3 different cervical health behaviors (avoidance, ambivalence, and acceptance), emerged from the interviews. The clinical implications of these findings are discussed.

Community-Based Cervical Cancer Education: Changes in Knowledge and Beliefs Among Vietnamese American Women.

Low cervical cancer screening rates among Vietnamese American women have been attributed, in part, to inadequate knowledge about cervical cancer and health beliefs that hinder screening. A community-based educational program was developed to improve knowledge and attitudes toward cervical cancer screening in this underserved population. It was hypothesized that the program would result in increases in knowledge, as well as enhanced health beliefs and self-efficacy toward obtaining cervical cancer screening. Using a group-randomized design, 1488 women from 30 Vietnamese community-based organizations were assigned to either the intervention (n = 816) or control (n = 672) conditions. The intervention group received cervical cancer education delivered by bilingual community health educators. Intervention content addressed individual beliefs and expectancies regarding cervical cancer screening (e.g., perceived risk of developing cervical cancer; perceived benefits and barriers to screening; social and cultural norms regarding screening). The control group received general health education, including information about cancer screening. Knowledge and health beliefs were assessed at baseline and post-intervention. Among women in the intervention group, overall knowledge about cervical cancer and screening guidelines increased from pre- to post-program (30% vs. 88%, p < 0.001), perceived benefits of screening increased (3.50 vs. 4.49, p < 0.001), and perceived barriers to screening decreased (3.13 vs. 2.25, p < 0.001). Changes in knowledge and health beliefs were not observed among women in the control group. A community-based educational program can help increase knowledge about cervical cancer and screening, promote positive changes in women's beliefs about the benefits of cervical cancer screening, and reduce perceived barriers to screening. Such programs may play an important role in addressing health disparities and informing underserved populations about recommended screening tests.

Providing Culturally Respectful Care for Seriously Ill Vietnamese Americans

Vietnamese Americans are a heterogeneous population with a rich, shared experience and historical and cultural influences from Asia and Europe. Societal upheaval resulting from the Vietnam War and varied immigration patterns to the U.S. and levels of acculturation layer complexity to this resilient population. These experiences influence how the communities as a whole and how the family as a unit approach health care issues, their attitudes toward serious illness and care at the end of life. Challenges with caring for this population include lack of resources and training to provide culturally sensitive care, lack of appropriate advance care planning, and lack of interpreters or culture-specific care programs. All contribute to poor end-of-life care. An understanding of how these complexities interplay may help clinicians provide compassionate and patient-centric care to these patients, their families, and their supporting communities. This article provides an overview of culturally effective care for seriously ill Vietnamese American patients and makes recommendations for potential strategies for providing respectful end-of-life care.

Unpopularity with same- and cross-ethnicity peers as predictors of depressive symptoms during adolescence

This longitudinal study examined associations between perceptions of unpopularity with same- and cross-ethnicity peers and depressive symptoms in an ethnically diverse adolescent peer group. Participants were 393 Vietnamese and Mexican American adolescents (209 boys, 184 girls; Mage = 15.04 years, SD = 0.73, age range: 14–17 years) followed across two consecutive school years. Participants completed a demographic survey, self-report measures of depressive symptoms and ethnic identity, and a peer-nomination inventory assessing unpopularity. Unpopularity with same-ethnicity peers predicted increases in depressive symptoms for boys but not girls. Cross-ethnicity attitudes were not predictive of psychological difficulties. The findings of this study provide the first known evidence that, for boys, perceptions of unpopularity by same-ethnicity peers may be a more significant threat to emotional functioning than similar perceptions by peers of a different ethnicity. Results indicate that a nuanced perspective on risk mechanisms accounting for same- and cross-ethnic relations and gender may be warranted.

Prediction of Osteoporosis Among Vietnamese Women

Screening for osteoporosis and fracture risk in Vietnamese American women younger than 65 years is not well described. Controversy exists over who among this group should receive bone mineral density testing. This study compared the predictive value of 2 prescreening tools, the Osteoporosis Self-Assessment Tool for Asians and the Fracture Risk Assessment Tool. A 6-month retrospective health record review was completed on 149 postmenopausal Vietnamese American women, 45 to 64 years old, in a primary care setting in Southern California. Demographic and clinical risk factors were used to calculate Osteoporosis Self-Assessment Tool for Asians and Fracture Risk Assessment Tool scores. Sensitivity and specificity to predict bone mineral density results are reported.

Weathering Katrina: Culture and Recovery among Vietnamese Americans

Weathering Katrina: Culture and Recovery among Vietnamese Americans

Correction: Patel et al. Resilience: Examining the Impacts of the Deepwater Horizon Oil Spill on the Gulf Coast Vietnamese American Community. Soc. Sci. 2018, 7(10), 203

The authors wish to make the following change to their paper (Patel et al. 2018). [...]

Unpacking the 'black box' of lay health worker processes in a US-based intervention.

Prior studies have supported the effectiveness of the use of Lay Health Workers (LHWs) as an intervention model for managing chronic health conditions, yet few have documented the mechanisms that underlie the effectiveness of the interventions. This study provides a first look into how LHWs delivered a family-based intervention and the challenges encountered. We utilize observation data from LHW-led educational sessions delivered as part of a randomized controlled trial (RCT) designed to test a LHW outreach family-based intervention to promote smoking cessation among Vietnamese American smokers. The RCT included experimental (smoking cessation) and control (healthy living) arms. Vietnamese LHWs were trained to provide health information in Vietnamese to groups of family dyads (smoker and family member). Bilingual, bicultural research team members conducted unobtrusive observations in a subset of LHW educational sessions and described the setting, process and activities in structured fieldnotes. Two team members coded each fieldnote following a grounded theory approach. We utilized Atlas.ti qualitative software to organize coding and facilitate combined analysis. Findings offer a detailed look at the 'black box' of how LHWs work with their participants to deliver health messages. LHWs utilized multiple relational strategies, including preparing an environment that enables relationship building, using recognized teaching methods to engage learners and co-learners as well as using humor and employing culturally specific strategies such as hierarchical forms of address to create trust. Future research will assess the effectiveness of LHW techniques, thus enhancing the potential of LHW interventions to promote health among underserved populations.

The Lived Experience of Religiosity and Stress among Middle-Aged Vietnamese American Catholic Immigrants

Based on findings from an interpretative phenomenological study, this article reports the lived experiences of religiosity and stress among six middle-aged Vietnamese-born American Catholic immigrants. The findings indicate how midlife is defined; types of midlife stressors; how participants coped with midlife stressors; religious strategies for coping with midlife stressors; and wisdom related to midlife. Implications for both clinical and congregational practice with Vietnamese American Catholic immigrants are outlined and include insights regarding how religious beliefs and practices can promote healthy coping with midlife stressors and facilitate resilience. Clinical implications and directions for future research are discussed.

Hypertension Prevalence, Treatment, and Related Behaviors Among Asian Americans: An Examination by Method of Measurement and Disaggregated Subgroups.

Data on hypertension among Asian Americans is lacking and often aggregated, which can mask important ethnic differences. This study aims to provide a comprehensive view of hypertension and hypertension-related behaviors, including hypertension treatment, management, and information seeking, among Chinese, Korean, and Vietnamese Americans. Data were collected from 600 foreign-born Asian Americans (201 Chinese, 198 Korean, and 201 Vietnamese participants) in the Washington-Baltimore metropolitan area, aged 18years and over, from 2013 to 2014. Hypertension was assessed using direct measurement and self-report of having ever been told by a physician. Hypertension prevalence was compared based on the method of assessment, ethnicity, and sex. The age-adjusted hypertension prevalence from direct measurement was 27.5%, which is higher than the 2011-2014 National Health and Nutrition Examination Survey estimate for Asians (24.9%). Hypertension prevalences from self-report among Chinese, Korean, and Vietnamese were 13.4%, 23.2%, and 22.9%, respectively, which are lower than 2014 California Health Interview Survey estimates (15.6%, 18.4%, and 25.8%) with the exception of Korean participants. In regard to hypertension-related behaviors, 67.8% of hypertensive adults received management, 64.3% took antihypertensive medication, and 67.0% sought information to improve their hypertension. Disaggregated data on hypertension based on measured blood pressure may prevent underestimation from self-report, particularly among those with limited healthcare access. More accurate and objective assessment of hypertension is needed for improved monitoring of hypertension among Asian-American subgroups.

Going Beyond a Single Story: Experiences and Education of Refugee Children at Home, in School, and in the Community

One of us (Wang) recently attended a talk by Viet Thanh Nguyen, the Vietnamese American author of The Refugees and The Sympathizer and a Pulitzer winner and 2017 MacArthur Foundation Fellow. He sha...

The Association Between Perceived Stress and Hypertension Among Asian Americans: Does Social Support and Social Network Make a Difference?

Prior research suggests that stress plays role in the etiology and progression of hypertension. To lend a more accurate depiction of the underlying mechanisms between stress and hypertension, this study aims to assess the associations between perceived stress and hypertension across varying levels of social support and social network among Asian Americans. We conducted a cross-sectional study using data on 530 Chinese, Korean and Vietnamese Americans recruited from a liver cancer prevention program in the Washington D.C.-Baltimore metropolitan area. Hypertension prevalence was 29.1%. Individuals with high perceived stress were 61% more likely to have hypertension compared to those with low levels of perceived stress (odds ratio 1.61, 95% confidence interval 1.15, 2.46). There was no evidence that social support and social network acted as effect modifiers. Social support had a direct beneficial effect on hypertension, irrespective of whether individuals were under stress. The relationship between perceived stress and hypertension was modified by gender and ethnicity whereby a significant positive association was only observed among male or Chinese participants. Our study highlights the importance of understanding the associations between stress, social support, and hypertension among Asian American subgroups. Findings from the study can be used to develop future stress management interventions, and incorporate culturally and linguistically appropriate strategies into community outreach and education to decrease hypertension risk within the Asian population.

Psychosocial Predictors of Acculturative Stress among Female and Male Immigrant Asian Americans: A Gender Comparison Study

The purpose of this study was to examine whether gender differences existed and how the predictors were linked to acculturative stress across gender among a national sample of 1639 immigrant Chinese, Filipino, Vietnamese, and other Asian Americans. The data were from the National Latino and Asian American Study (NLAAS) conducted in 2002 and 2003, the first national epidemiological household survey of Asian Americans in the United States. The participants took part in face-to-face interviews, which were conducted with computer-assisted interviewing software in Mandarin, Cantonese, Tagalog, Vietnamese, and English. After fitted bivariate correlations to examine the relationships between acculturative stress and psychosocial variables, data were analyzed using two multiple regressions to identify the most significant predictors of acculturative stress for men and women separately. Results indicated that the psychosocial predictors of acculturative stress varied with gender status. For all men and women, longer years in the U.S., higher English proficiency, and less perceived discrimination predicted related to less acculturative stress. Social network was not the predictor for both men and women. Age of immigration, marital status, family cohesion and social position were additional significant predictors of acculturative stress only for men, but not for women. The implications of these results were discussed.

Eating Pathology in International Vietnamese and White American Undergraduate Women in the United States

Eating Pathology in International Vietnamese and White American Undergraduate Women in the United States

Ultramontanism, Nationalism, and the Fall of Saigon: Historicizing the Vietnamese American Catholic Experience

Notwithstanding the steady growth of Vietnamese Catholics in the United States, the lack of historical research has left many gaps and led to a generic and imprecise understanding of their experience. The scholarship from the social sciences and religious studies has shed light on some areas but also leaves out the historical dimensions, particularly the exilic identity that formed among Catholic refugees during the initial period of resettlement. This identity came from three major historical developments: the impact of ultramontanism during the nineteenth and twentieth centuries, the experience of nationalism and anticommunism, and the abrupt end of the Vietnam War. To deal with national loss, family separation, and the challenges of living in a foreign society, Catholic refugees resorted to their ultramontane legacy and anticommunist nationalism. Although Vietnamese American Catholics no longer identify themselves as exilic, their initial experience formed some of the most important aspects about their identity to this day.

Hai-Dang PhanReenactments

Books in Review Hai-Dang Phan Reenactments Louisville, Kentucky. Sarabande Books. 2019. 98 pages. Historical reenactments have gained a burgeoning popularity recently. According to Jenny Thompson, author of War Games (2004), more than eight thousand historians , war enthusiasts, and adventure seekers gather annually to stage a historical battle. Although these re-creations can be surprisingly authentic, the stakes are never as high as they are for those portrayed in Hai-Dang Phan’s debut poetry collection, Reenactments (2019), who frequently confront, and are confronted by, reenactments of the Vietnam War. Phan, who also wears the hats of the translator and the literary critic, was born in Vietnam in 1980 and came to the United States as a refugee when he was almost two years old. For him, the war doesn’t need to be performed by makeshift actors. The war is still here. Phan’s debut begins with the epigraphwarning “Maybe nothing ever happens once and is finished,” which is drawn from the seemingly unlikely source of William Faulkner’s Absalom, Absalom! (1936). It is an ambitious addition to Vietnam War literature and a fearless contribution to the small, albeit energetic, body of verse by the new generation of Vietnamese American refugees. His poems, somewhat like reenactors , don different garments and come in different sizes and forms—there is a ghazal, a haiku, prose poems, sequence poems, poems written in unrhymed couplets and triplets, translations of Vietnamese poems, poems that include the Vietnamese language , and poems with indented lines. While the urge to impress and show range is common in most debuts, what is uncommon in Reenactments is the level of control that is exercised. It whispers what it needs to say, not necessarily because it is afraid to scream but because it understands that screaming is not always the best way to communicate. This is true even in heart-wrenching poems, like “Video Elegy,” where the poetic voice, which has the tenderness of a maternal lamentation, addresses a fallen soldier: “They sent you back / nicely packaged, / cleanly and precisely // converted / into VHS. Forever // I will mourn / the record of your face, / personally // and professionally .” These lines, like the lines of so many of Phan’s poems, are linguistically simple but emotionally complex. The fallen soldier is in some sense preserved by being “converted / into VHS,” but, concurrently, his humanity is lost in the way he is “packaged” and commodified. He comes back from the war only virtually; he is not buried in a grave but in the tapes that contain his last living moments. Phan returns repeatedly to different visual representations of the war and of Vietnam in his collection, often to briefly have access to a time and place that are unfamiliar to him. In “Quiet Americans,” a family watches the Phillip Noyce–directed film that adapts Graham Greene’s novel The Quiet American, and they are “spellbound / by old Saigon flickering in the rear window .” Similarly, in “My Viet Cong,” there is an admission that “As a kid, I watched every single Vietnam War movie. / Apocalypse Now. The Deer Hunter. Full Metal Jacket. Platoon. // You name it. I was too young to realize I was after / my own face on the NVA soldiers and VC guerillas.” What’s striking in these moments is Phan’s ability to inquire into the complex psychology of refugees and ask important questions: How do images of the past affect the generation that has not participated in the events? What happens when this generation realizes , like the speaker in “My Viet Cong,” that these moving images are themselves fraught with historical inaccuracies, that “they shot the war in the Philippines” and that, ironically, “Vietnamese refugees were hired to act various roles, like VC”? The answers are implicitly planted throughout the collection, like mines. That they are not thrown at the reader like grenades should not imply that the ironies of war escape the poet’s sharp eye. In fact, Phan is at war and at war with these ironies from the beginning of Reenactments. In “Small Wars,” he “pulled the pin on the smoke grenade, tossed it / under a tremendous wing, then slumped over my aircraft like a / limp ragdoll.” It is...

Promising results from a pilot study to reduce distress in Vietnamese American dementia and memory loss caregivers

IntroductionThis study developed and examined the feasibility of a culturally tailored, evidence-based skill-building program to reduce stress and depression of Vietnamese American dementia caregivers. MethodsThis pilot randomized controlled trial included pretest and posttest measures using the Center for Epidemiologic Studies-Depression Scale and the Revised Memory and Behavior Problems Checklist. The intervention (n = 30) group participated in a culturally tailored, 4-week Vietnamese-language cognitive-behavioral skills evidenced-based program (Our Family Journey); caregivers in the control condition (n = 30) received dementia-related educational materials (education control condition). ResultsOur Family Journey caregivers showed significantly lower somatic scores on the Center for Epidemiologic Studies-Depression Scale and reported lower frequency of care recipients' disruptive behaviors. However, they also reported being more stressed by their care recipients' depressive symptoms on the Revised Memory and Behavior Problems Checklist compared to caregivers in the education control condition. DiscussionThese promising results suggest that a culturally adapted program can benefit Vietnamese dementia caregivers. Additional research is needed to develop and evaluate stronger, more impactful interventions for this underserved group.

Unpacking the 'black box' of lay health worker processes in a US-based intervention.

Prior studies have supported the effectiveness of the use of Lay Health Workers (LHWs) as an intervention model for managing chronic health conditions, yet few have documented the mechanisms that underlie the effectiveness of the interventions. This study provides a first look into how LHWs delivered a family-based intervention and the challenges encountered. We utilize observation data from LHW-led educational sessions delivered as part of a randomized controlled trial (RCT) designed to test a LHW outreach family-based intervention to promote smoking cessation among Vietnamese American smokers. The RCT included experimental (smoking cessation) and control (healthy living) arms. Vietnamese LHWs were trained to provide health information in Vietnamese to groups of family dyads (smoker and family member). Bilingual, bicultural research team members conducted unobtrusive observations in a subset of LHW educational sessions and described the setting, process and activities in structured fieldnotes. Two team members coded each fieldnote following a grounded theory approach. We utilized Atlas.ti qualitative software to organize coding and facilitate combined analysis. Findings offer a detailed look at the 'black box' of how LHWs work with their participants to deliver health messages. LHWs utilized multiple relational strategies, including preparing an environment that enables relationship building, using recognized teaching methods to engage learners and co-learners as well as using humor and employing culturally specific strategies such as hierarchical forms of address to create trust. Future research will assess the effectiveness of LHW techniques, thus enhancing the potential of LHW interventions to promote health among underserved populations.