Study sheds light on adapting cancer education across cultures

Cancer intervention may be successful through the implementation of cross-cultural education, according to a study published in the Journal of Cancer Education (2010 Mar 19. [Epub ahead of print]).

The 3-year study, conducted by Tracy Schroepfer, an assistant professor of social work at the University of Wisconsin-Madison, and collaborator Viluck Kue, focused on the Hmong population to investigate why the traditional approaches to medical education were ineffective.

According to background information provided by the authors, the Hmong, originally a hill tribe in Laos, immigrated to the United States after the Vietnam war and about 60,000 Hmong people now live in Wisconsin. “A lot of Hmong were scared of chemotherapy and radiation, they saw people who were not helped, who passed away, and so they begun to turn down chemo and radiation in favor of traditional herbal treatment,” said Kue. “We want to make sure that people are not scared away from western medical treatment, [and we] want to show that these treatments can be helpful.”

Using a strategy called community-based participatory research, Schroepfer and Kue asked leaders of the Hmong population in Wisconsin about the community's efforts to address cancer. Other questions concerned knowledge, beliefs, and traditions related to cancer, prevention, and western medicine. “They own the data, and I have to obtain permission to use it,” Schroepfer explained. “It's a very different way to do research, and it takes a long time because the researcher must be committed to spending the time to build a relationship with community partners.”

Researchers found that the Hmong had a radically different view of health care. For one, early detection had no relevance to the Hmong. Schroepfer reported that “some leaders told us there had been no need: ‘In Laos, we had no machines to see inside the body. We had to wait until something hurt.'”

Schroepfer and Kue also found that Hmong people tend to make decisions as groups, not as individuals. “If somebody in the family is sick, they will usually want the consent of the elders in a medical decision,” said Kue. “If my uncle has a heart problem, the doctor may want to do bypass surgery. But if he discusses it with the family and a lot of people think it is dangerous, he'll decide against it.”

In their interviews, leaders of the Wisconsin Hmong said that in order to educate the population, “Hmong community members need to be the educators. They understand the belief system and can talk to people about it [and] reframe the experience of cancer.”

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