Gathered in a multi-purpose room at the church that represents
the hub of the local Vietnamese community, a group of women
gets familiar with a sobering reality.
As immigrants from Southeast Asia, they're at a higher
risk to develop breast cancer than women who stayed in
their native Southeast and South Asian countries. And because
of language and cultural barriers, they're also less likely
than Caucasian or African-American women to catch the cancer
early when their odds of survival are better.
Tsu-Yin Wu, an associate professor of nursing at Eastern
Michigan University, hopes the breast health clinics she
organized for immigrant Indian, Filipino and Vietnamese
women in metropolitan Detroit will begin to improve those
odds.
"We find Asian women are being diagnosed at later stages,
and there's something we can work on there — increasing
awareness," Wu said. "The screening rate for Asian women
is much lower than the general population."
The clinics were part of a three-year project supported
by a $249,096 grant from the Susan G. Komen For the Cure.
With the grant, Wu, who's also director of the Healthy
Asian Americans Project at the University of Michigan,
pulled together teams of nurses, nurse practitioners and
students to run the clinics.
Working closely with social anchors like temples and churches,
as well as with focus groups and cancer survivors, Wu developed
clinics with an emphasis on clearer communication and cultural
sensitivity.
"We had one Filipino nurse in a focus group who said it's
a sin to talk about any (part of the body) that's supposed
to be covered," Wu said.
Each clinic started with a culturally appropriate PowerPoint
presentation about breast cancer screening. Each was offered
in the native language of that country, and included the
testimonials of breast cancer survivors -- themselves
immigrants from the same country as the audience. They
shared their stories, including the things that, in hindsight,
they would have done differently. These including mentioning
breast irregularities to a doctor and insisting on
a second opinion.
"The mammogram is, for sure, the gold standard in the
medical profession, but a lot of women have the taboo and
don't want to go," Wu said.
With that in mind, Wu's clinics stressed three screening
techniques — self-exams, clinical exams and mammograms
— in hopes that, if women rejected one, they'd still use
the others.
Working with interpreters, nurses and nurse practitioners,
the women learned not only how to advocate for themselves
in the doctor's office, but also how to perform a breast
self-exam and how often they should do it. Nurse practitioners
did exams on-site, and there was information available
about a program that provides free mammograms, a screening
many of them have no experience with. In their home countries,
a mammogram, if it's used at all, is more likely to be
the last step in a diagnosis rather than the first step
in detection, Wu explained.
Wu's study is now in its final phase — conducting interviews
with women who attended the clinics to see if the information
has translated into action. She's hoping the information
not only sticks, but begins to change perceptions about
screening and mammograms.
"We provide them with a very comfortable environment,
and we bring in all of the vital statistics," Wu said. "We
really give them the knowledge, the skills and the access
to increase their self-advocacy,"
