Community Conversations
on Cancer
Storm Lake, Iowa
Carlos Gallego M.Ed.
Project
Team
Intercultural Cancer Council
Sarah Kitchell B.A.
NCI’s Cancer Information Service
Iowa Comprehensive Cancer Control
Program
Getting Started
•
•
•
•
•
Worked with CIS to identify target community
Researched community: Both culture and needs
Connected to community leaders via cold calls
Identified key community partners/leaders
Developed Interview questions with input from
community leaders assisting with project
• Explained to community how findings will be
used and how you will share information
community
How the Project Came About
• CIS staff at Mayo requested presentation on
Intercultural Cancer Council at Annual Iowa
Comprehensive Cancer Consortium (ICCC) Meeting
• Invited to join ICCC
• Significant lack of underserved representation on
Committee
• RFP to do Cancer project available through IDPH
• Partnered with CIS at Holden Comprehensive Cancer
Center, Iowa City
Purpose
To collect baseline data around
cancer knowledge, perceptions
and barriers confronting the Tai
Dam and Latino communities of
rural Iowa.
Korean, Tai Dam, Latino, Urban African American
Iowa
Disparity
Project
Demographic research, cancer data,
minority population centers
Storm Lake, Tai Dam and Latino communities
Identified community leaders
• Storm Lake, population 9,882
•Sioux City
• Des Moines
Healthcare
Buena Vista county’s incidence rate for colorectal
cancer, 34.6 per 100,000, is the highest in the
state.
Data
Northwest Area Foundation
8
Buena Vista County
Demographics
Data
20
18
16
14
12
10
8
6
4
2
0
Buena Vista County
Iowa
Asian, 2005
Latino,
2005
Foreign
Born, 2000
U.S. Census Bureau
Iowa
90% of Tai Dam in the United
States live in Iowa.
Data
Roughly 4,000 Tai Dam live in
Iowa with 3,000 concentrated
in Des Moines
Community Experts
Method
-access to the community
-interpreters
-space
-recruitment
Tai Dam History
•
In 1250 BC many Tai Dam moved south to the Chinese border as Mongol leader
Kubilai Khan invaded and destroyed their kingdom, Nan Chao. Tai Dam divided
into groups. Some went to Laos, others to Thailand and other followed the Black
River to North Vietnam and built their town and cities.
•
Tai Dam lived with neighbors, the Vietnamese and Laotians. In the 1900's
French colonized Laos, Vietnam and Cambodia. In the early 1950's, the French
began losing their colonies.
•
In North Vietnam under the leadership of Ho Chi Minh, the French were
defeated at the battle of Dien Bien Phu (a major Tai Dam city called Muong
Theng or the city of the God). Many Tai Dam who had been French soldiers,
government employees, and top government officials, and fled as political
refugees in 1954.
•
Many Tai Dam moved to Laos because of similarities in language and culture.
Others move to South Vietnam.
•
In November 1975, under leadership of Governor Robert D. Ray, people of Iowa
welcomed this group of refugees from SE Asia known as the Tai Dam.
•
Today 90 percent of the Tai Dam live and work in Iowa. Iowa is called the free
capital of the Tai Dam in the world.
Conversation Groups
Method
Group Design
Recruitment
Latino Community
Cost
Findings
False-positives
Environmental issues
Cost-benefit of screening
Incorrect medical information
When should you have your
first pap smear?
Findings
Latinas answer:
“After you have a baby”
“After you get married”
“After your 3rd baby”
“If you have a family history, begin exams after
age 30”
“After 40-45 years of age”
Tai Dam
Navigating health care system
Findings
Inability to pay
Inevitability
Workplace concerns
Findings
“First of all, I don’t have any
knowledge about cancer. I would
like you to explain, what is cancer?
Where does it come from?..My
mother died of breast cancer, how
can I prevent cancer from coming
to all the kids?”
Tai Dam male conversations participant
Quote from Tai Dam females
• “They call it Women’s Center but I think it is the
man who is the doctor . . . Women’s Center
should have women doctors. . . It would be good
to have more female doctor’s some of us are too
shy.”
• “I went to see my family doctor last week and I
asked many questions. He said, I worry too
much. Yes, I worry, my kids are still young and I
am young and I don’t want to die yet. . .and he
laughed at me. . .”
Tai Dam Culture
•
Tai Dam believe in benevolent and malevolent spirits. They believe there are
supernatural forces that decide their lives and destiny. The creator of heaven
and earth is the "Then Luong." On earth the "Phi" who are the henchman of the
"Then" control every affair of man's deeds.
Tai Dam hold man to be a part of nature. Man is superior over nature, but man
is happiest when is at one with nature. However, Tai Dam are very tolerant of
other's beliefs.
•
Also a strong influence of Confucianism. Improve self, family community. Also
now a strong influence from Christianity. There are also Buddhist Tai Dam.
•
Tightly Night extended families
•
Child rearing is generally more conservative and stricter than the mainstream.
stricter and less permissive than America. Parents, brothers, sisters, & other
family members and elders have responsibility to help raise a child.
•
The younger people show respect to parents, grandparents, and deceased
ancestors; disrespect is not tolerated. For the Taidam, the aged are society's
most respected people.
Recommendations
•Accessible and appropriate healthcare information
•Provider Education
•Work in collaboration with faith communities
•Encourage patient advocacy
•Develop local health disparities work groups
Recommendations
Health Professionals:
• Cultural competency training
• Information in several preferred languages
• Information provided at an appropriate literacy level
• Convenient location and time of services
• Family involvement
Recommendations
Health providers and educators should considers
the following issues:
• Poverty
• Gender
• Transportation
• Family Dynamics
• Education Level
• Basic Health Literacy
Cyndi Chen
Status of Iowans Asian and Pacific Islander Heritage
Iowa Department of Human Rights
Sara Comstock
Iowa Comprehensive Cancer Control Program
National Cancer Institute’s Cancer Information Service
Janice Edmunds-Wells
Office of Multicultural Health, Iowa Department of Public Health
Jill Myers Geadelmann
Iowa Comprehensive Cancer Control Program, Iowa Department of Public Health
Thank
You
Sarah Kitchell
Iowa Comprehensive Cancer Control Program
National Cancer Institute’s Cancer Information Service
Kellee McCrory
Iowa Center for Evaluation Research
National Resource Center for Family-Centered Practice
University of Iowa, School of Social Work
Renea Seagren
United Community Health Center, Storm Lake, Iowa
Holly Smith
Iowa Comprehensive Cancer Control Program, Iowa Department of Public Health
Pastor Barry Thongvanh
Southeast Asian Community Christian Church
Michele Yehieli
Project EXPORT at the University of Northern Iowa
Carlos Gallego, M. Ed.
Intercultural Cancer Council
(651) 225-6085 or 952-361-0586
[email protected]
Contact
Information
Sara Comstock, M.S.W.
National Cancer Institute’s Cancer Information Service
Iowa Consortium for Comprehensive Cancer Control
(319) 335-8144
[email protected]
Questions?
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Community Conversations on Cancer: Tai Dam & Latino