Promoting Fish Consumption Messages: Perspectives of Hmong Women of Childbearing Age

Objectives: Through focus groups, we aimed to understand ways to promote safe and healthy fish consumption among Hmong women in Minnesota. Methods: English-speaking Hmong women aged 18-40 were eligible to participate in 90-minute focus groups. Through our questions, we sought to gain understanding of the women's health-seeking behaviors and to obtain feedback on current messaging. We recorded the focus groups and transcribed and double-coded the data using sequential directed content analysis. Results: Thirteen Hmong women participated across 3 focus groups. The final coding tree included 6 primary themes related to health messaging, with adequate inter-coder reliability for each. Women identified the Internet as the primary source of health information with website preferences driven in-part by preferences of elders. Discrepancies between health beliefs of elder and younger generations were noted, with some evidence that personal fish consumption preferences outweighed cultural norms. Messages clearly targeting the Hmong population were preferred, with discrepancy in risk-versus benefit-framed messages. Conclusions: Findings highlight the need for culturally informed messages that are clear and carefully tailored. Our findings will inform future development of safe and healthy fish consumption messaging to better support the Hmong community in Minnesota.

Assessment of women’s benefits and constraints in participating in agroforestry exemplar landscapes

Participating in the exemplar landscapes of the Developing and Promoting Market-Based Agroforestry and Forest Rehabilitation Options for Northwest Vietnam project has had positive impacts on ethnic women, such as increasing their networks and decision-making and public speaking skills. However, the rate of female farmers accessing and using project extension material or participating in project nurseries and applying agroforestry techniques was limited. This requires understanding of the real needs and interests grounded in the socio-cultural contexts of the ethnic groups living in the Northern Mountain Region in Viet Nam, who have unique social and cultural norms and values. The case studies show that agricultural activities are highly gendered: men and women play specific roles and have different, particular constraints and interests. Women are highly constrained by gender norms, access to resources, decision-making power and a prevailing positive-feedback loop of time poverty, especially in the Hmong community. A holistic, timesaving approach to addressing women’s daily activities could reduce the effects of time poverty and increase project participation. As women were highly willing to share project information, the project’s impacts would be more successful with increased participation by women through utilizing informal channels of communication and knowledge dissemination. Extension material designed for ethnic women should have less text and more visuals. Access to information is a critical constraint that perpetuates the norm that men are decision-makers, thereby, enhancing their perceived ownership, whereas women have limited access to information and so leave final decisions to men, especially in Hmong families. Older Hmong women have a Vietnamese (Kinh) language barrier, which further prevents them from accessing the project’s material. Further research into an adaptive framework that can be applied in a variety of contexts is recommended. This framework should prioritize time-saving activities for women and include material highlighting key considerations to maintain accountability among the project’s support staff.

Empowerment of Hmong women in Vietnam

Social forces dormant in people can be used in the method of empowerment. This method allows to release social forces and change the functioning of a person and social groups. This article, based on a case study, will present the strength of women from the Hmong ethnic group living in northern Vietnam. The author describes how social forces dormant in one woman can rouse to action other women from the local community and become a drive wheel to financial liberation, thereby improving the quality of ethnic minority life.

Patterns and co-occurrence of risk factors for hepatocellular carcinoma in four Asian American communities: a cross-sectional study

ObjectivesTo investigate risk factor patterns and the simultaneous occurrence of multiple risk factors in the viral, metabolic and lifestyle domains among Asian Americans, who have had the highest mortality rates from hepatocellular carcinoma (HCC).SettingSacramento County, California, USA.ParticipantsEligible participants were county residents ages 18 and older who had not been screened for chronic hepatitis B virus (HBV) and were born in a CDC-defined endemic area or whose parent was born in that area. Of 1004 enrolled, 917 were foreign-born Chinese (130 women, 94 men), Hmong (133 women, 75 men), Korean (178 women, 90 men) or Vietnamese (136 women, 81 men) with complete risk factor data.Primary and secondary outcome measuresWe tested participants for HBV and chronic hepatitis C virus (HCV); measured haemoglobin A1c and waist circumference; and recorded self-reported history of diabetes, hypertension, alcohol use and smoking status. We identified risk factor patterns using cluster analysis and estimated gender-specific age-standardised prevalence rates.ResultsWe identified four patterns: (1) viral (chronic HBV or HCV); (2) lifestyle (current smoker or alcohol user, no viral); (3) metabolic (≥2 metabolic, no lifestyle or viral); and (4) lower risk (≤1 metabolic, no lifestyle or viral). Vietnamese men (16.3%, 95% CI 7.4% to 25.3%) and Hmong women (15.1%, 95% CI 7.8% to 22.5%) had the highest viral pattern prevalence. Hmong women had the highest metabolic (37.8%, 95% CI 29.8% to 45.9%), and Vietnamese men the highest lifestyle (70.4%, 95% CI 59.1% to 81.7%) pattern prevalence. In multiple domains, Hmong men and women were most likely to have viral+metabolic risk factors (men: 14.4%, 95% CI 6.0% to 22.7%; women: 11.9%, 95% CI 5.6% to 18.3%); Vietnamese men were most likely to have lifestyle+viral (10.7%, 95% CI 2.7% to 18.8%), and lifestyle+metabolic but not viral (46.4%, 95% CI 34.4% to 58.5%) risk factors.ConclusionsEfforts to reduce HCC must comprehensively address multiple risk factors.Trial registration numberNCT02596438.