Need: There are a total of 1,236,852 Asian Americans (AAs) living in the Houston-Galveston, Dallas-Fort Worth-Arlington (DFW) and Austin areas, accounting for 84% of Texas' total AA population. AAs vary substantially with respect to demographic, cultural, linguistic and socio-economic characteristics, and cancer burdens. With the exception of Asian Indians, a disproportionately large number of Asian subgroups speak a language other than English at home (US Census Bureau, 2018). Cancer is the leading cause of death among AA populations in the US and Texas (NCHS, 2019; Texas DSHS, 2010). For AAs in Texas, from 2011 to 2015, the five most common sites of cancer death were: lung, liver, colon, b...

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Need: There are a total of 1,236,852 Asian Americans (AAs) living in the Houston-Galveston, Dallas-Fort Worth-Arlington (DFW) and Austin areas, accounting for 84% of Texas' total AA population. AAs vary substantially with respect to demographic, cultural, linguistic and socio-economic characteristics, and cancer burdens. With the exception of Asian Indians, a disproportionately large number of Asian subgroups speak a language other than English at home (US Census Bureau, 2018). Cancer is the leading cause of death among AA populations in the US and Texas (NCHS, 2019; Texas DSHS, 2010). For AAs in Texas, from 2011 to 2015, the five most common sites of cancer death were: lung, liver, colon, breast and pancreas (49% of all cancer deaths, Texas Cancer Registry, 2018). Significant evidence indicates incidences and deaths resulting from these cancers can be reduced or prevented if people adopt healthier lifestyles, avoid tobacco use, increase physical activities, improve nutrition, and use early detection screenings (NCI, 2020). However, statistics show lower than average screening rates for prostate, colorectal, breast and cervical cancers, and hepatitis C virus among AAs (ACS, 2016). Language barriers, cultural stigmas, lack of insurance, and few bilingual services offerings contribute majorly to service gaps. Lack of coordinated efforts and resource sharing among local providers and AA community-based organizations further contribute to these gaps. The proposed project will adopt a multisector collaborative approach and expand the scope of the previous two CPRIT-funded projects to include AAs living in the Texas Gulf Coast area, Vietnamese community in Austin area, and Chinese and Vietnamese communities in DFW area. Establishing a multisector collaboration and culturally and linguistically competent cancer prevention and support program within each AA community is key to effectively reducing service gaps, diagnoses and deaths in different AA populations. Overall Project Strategy: The proposed project is a joint effort of seven AA community-based organizations, eight local healthcare providers and one university. The project targets Vietnamese, Chinese, Filipino and Korean communities in the Houston-Galveston, DFW and Austin areas. Its three major components include: prevention/education; screening; and survivorship/navigation services. The cancer prevention and screening components address colon, breast, cervical and liver cancer. The methods of service delivery include seminars, workshops, web-based and in-person classes, one-on-one education, and local TV and newspaper articles. The survivorship/navigation program provides group-based interventions and one-on-one peer and navigation support for patients with abnormal screening results or cancer diagnosis. Specific Goals: The main project goal is to reduce cancer incidences and deaths among AA populations in the Houston-Galveston, DFW and Austin areas. The specific goals are to: (1) engage four AA communities in systematic changes toward desired health behaviors; (2) increase screening rates for breast cancer, colon cancer, cervical cancer, and Hepatitis B and C within four AA communities; (3) enhance the quality of life among AA cancer patients and/or survivors in four AA communities. It is expected that at least 275,000 will be reached (indirect contact) and 12,660 AAs will be educated (direct contact) pertaining to knowledge related to: breast, lung, colorectal and liver cancer prevention; risk factors; the importance of screening and early detection; and healthy lifestyle behaviors. An additional 3,930 AAs will receive screenings via mammograms, FIT, Hepatitis B or C screenings, and Pap smears. At least 1,100 cancer patients or patients with abnormal screening results will receive support services including healthcare system navigation, transportation and language assistances, and psychosocial consultations (10,000 units). Significance and Impact: The project will build upon the success of the programs already implemented in the previous two CPRIT-funded projects and other evidence-based practices recommended by the Community Preventive Services Task Force. Using various outreach mechanisms in different AA communities, the project expects to reach more of the target population and generate more behavioral changes. Through multisector coordinated efforts, resource sharing, and providing appropriate training for staff and volunteers, the proposed project will significantly enhance AA communities' capacities in addressing cancer disparities within different AA subgroups in Texas. Since DFW currently lacks a comprehensive cancer prevention and support program specifically designed to address the AA population's needs, the project will also benefit AA populations in the DFW area and add services to Vietnamese communities in Texas Gulf Coast and Austin areas.

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