Chau Trinh

Methodological issues in the collection, analysis, and reporting of granular data in Asian American populations: historical challenges and potential solutions
Islam, Nadia Shilpi; Khan, Suhaila; Kwon, Simona; Jang, Deeana; Ro, Marguerite; Trinh-Shevrin, Chau
2010 Nov;21(4):1354-1381, Journal of health care for the poor & underserved
There are close to 15 million Asian Americans living in the United States, and they represent the fastest growing populations in the country. By the year 2050, there will be an estimated 33.4 million Asian Americans living in the country. However, their health needs remain poorly understood and there is a critical lack of data disaggregated by Asian American ethnic subgroups, primary language, and geography. This paper examines methodological issues, challenges, and potential solutions to addressing the collection, analysis, and reporting of disaggregated (or, granular) data on Asian Americans. The article explores emerging efforts to increase granular data through the use of innovative study design and analysis techniques. Concerted efforts to implement these techniques will be critical to the future development of sound research, health programs, and policy efforts targeting this and other minority populations
— id: 135075, year: 2010, vol: 21, page: 1354, stat: Journal Article,

Cancer screening practices among physicians serving Chinese immigrants
Aragones, Abraham; Trinh-Shevrin, Chau; Gany, Francesca
2009 Feb;20(1):64-73, Journal of health care for the poor & underserved
Chinese immigrants in the United States are broadly affected by cancer health disparities. We examined the cancer screening attitudes and practices of physicians serving Chinese immigrants in the New York City (NYC) area by mailing a cancer screening survey, based on current guidelines, to a random sample of physicians serving this population. Fifty three physicians (44%) completed the survey. Seventy-two percent reported following the guidelines for breast cancer, 35% for cervical cancer screening, and 45% for all colorectal cancer screening tests. Sixty-eight percent of physicians were satisfied with their current rates of cancer screening with their Chinese immigrant patient population. Physicians serving the Chinese community in NYC follow cancer screening guidelines inadequately. Cancer screening rates in this population could likely be increased by interventions that target physicians and improve awareness of guidelines and recommended best practices
— id: 95044, year: 2009, vol: 20, page: 64, stat: Journal Article,

Mexican immigrant male knowledge and support toward breast and cervical cancer screening
de Bocanegra, Heike Thiel; Trinh-Shevrin, Chau; Herrera, Angelica P; Gany, Francesca
2009 ;11(4):326- 333, Journal of Immigrant Health
Background: We conducted a focus group study to assess the influence of partner communication on breast and cervical cancer screening and the perceived existing and potential support from male partners in participating in cancer screening. Secondarily, Mexican male and female views on health care and cancer were explored. Methods: Seven focus groups (two female-only, three male-only, and two couples) were conducted in Spanish. Results: Findings suggest that knowledge about cervical cancer was significantly less than knowledge about breast cancer among both men and women. Barriers to cancer screening included language barriers, lack of health insurance, and lack of awareness of the need for screening. Male partners expressed willingness to support their female partners in cancer screening activities. Conclusion: Cervical cancer education is desperately needed, including education on the availability of free and low cost screening services. Education efforts should include the male community members, especially as the males perceive themselves as responsible for the financial burden of care.
— id: 106904, year: 2009, vol: 11, page: 326, stat: Journal Article,

Mexican Immigrant Male Knowledge and Support Toward Breast and Cervical Cancer Screening
Thiel de Bocanegra, Heike; Trinh-Shevrin, Chau; Herrera, Angelica P; Gany, Francesca
2009 Aug;11(4):326-333, Journal of Immigrant & Minority Health
Background We conducted a focus group study to assess the influence of partner communication on breast and cervical cancer screening and the perceived existing and potential support from male partners in participating in cancer screening. Secondarily, Mexican male and female views on health care and cancer were explored. Methods Seven focus groups (two female-only, three male-only, and two couples) were conducted in Spanish. Results Findings suggest that knowledge about cervical cancer was significantly less than knowledge about breast cancer among both men and women. Barriers to cancer screening included language barriers, lack of health insurance, and lack of awareness of the need for screening. Male partners expressed willingness to support their female partners in cancer screening activities. Conclusion Cervical cancer education is desperately needed, including education on the availability of free and low cost screening services. Education efforts should include the male community members, especially as the males perceive themselves as responsible for the financial burden of care
— id: 90137, year: 2009, vol: 11, page: 326, stat: Journal Article,

Asian American communities and health : context, research, policy and action
Trihn-Shevrin, Chau; Islam, Nadia Shilpi; Rey, Mariano Jose
San Francisco CA : Jossey-Bass, 2009,
— id: 1794, year: 2009, vol: , page: , stat: ,

Promoting community-based participatory research at the institutional level
Trihn-Shevrin, Chau; Islam, Nadia Shilpi; Rey, Mariano Jose
Asian American communities and health : context, research, policy and action San Francisco CA : Jossey-Bass, 2009,
— id: 4972, year: 2009, vol: , page: ?, stat: Chapter,

Toward a contextual understanding of Asian American health
Trihn-Shevrin, Chau; Islam, Nadia Shilpi; Rey, Mariano Jose
Asian American communities and health : context, research, policy and action San Francisco CA : Jossey-Bass, 2009,
— id: 4971, year: 2009, vol: , page: ?, stat: Chapter,

Cancer screening and Haitian immigrants: the primary care provider factor
Gany, Francesca; Trinh-Shevrin, Chau; Aragones, Abraham
2008 Jun;10(3):255-261, Journal of Immigrant & Minority Health
BACKGROUND: Haitian immigrants, among the fastest growing immigrant communities in the United States, have low cancer screening rates. Several patient barriers have been identified and associated with low screening rates but little is known on provider barriers for cancer screening. To address this gap, we assessed the cancer screening practices, attitudes, and beliefs of primary care providers serving the Haitian community. METHODS: We surveyed a random sample of physicians serving first generation Haitian immigrants in New York City, identified through their zip codes of practice. Participants completed a questionnaire to assess their beliefs, attitudes and practices surrounding cancer screening, and their perceptions of patient barriers to screening. RESULTS: 50 of 87 physicians (58%) consented to participate in the study. Cancer site-specific and overall cancer screening scores were created for breast, cervical, and colorectal cancer screening. 75% of providers followed breast cancer screening guidelines, 16% for cervical cancer, and 30% for colorectal cancer. None of the providers in the sample were following guidelines for all three cancer sites. Additionally, 97% reported recommending digital rectal exam and PSA annually to patients 50 years or older with no family history, and 100% to patients over 50 years old with family history. CONCLUSIONS: The reported practices of providers serving the Haitian immigrant community in New York City are not fully consistent with practice guidelines. Efforts should be made to reinforce screening guideline knowledge in physicians serving the Haitian immigrant community, to increase the utilization of systems that increase cancer screening, and to implement strategies to overcome patient barriers
— id: 78684, year: 2008, vol: 10, page: 255, stat: Journal Article,

Lack of oral health care for adults in harlem: a hidden crisis
Zabos, Georgina P; Northridge, Mary E; Ro, Marguerite J; Trinh, Chau; Vaughan, Roger; Howard, Joyce Moon; Lamster, Ira; Bassett, Mary T; Cohall, Alwyn T
2008 Sep;98(9 Suppl):S102-S105, American journal of public health. AJPH
OBJECTIVES: Profound and growing disparities exist in oral health among certain US populations. We sought here to determine the prevalence of oral health complaints among Harlem adults by measures of social class, as well as their access to oral health care. METHODS: A population-based survey of adults in Central Harlem was conducted from 1992 to 1994. Two questions on oral health were included: whether participants had experienced problems with their teeth or gums during the past 12 months and, if so, whether they had seen a dentist. RESULTS: Of 50 health conditions queried about, problems with teeth or gums were the chief complaint among participants (30%). Those more likely to report oral health problems than other participants had annual household incomes of less than $9000 (36%), were unemployed (34%), and lacked health insurance (34%). The privately insured were almost twice as likely to have seen a dentist for oral health problems (87%) than were the uninsured (48%). CONCLUSIONS: There is an urgent need to provide oral health services for adults in Harlem. Integrating oral health into comprehensive primary care is one promising mechanism
— id: 90131, year: 2008, vol: 98, page: S102, stat: Journal Article,

Using Community-Based Participatory Research as a Guiding Framework for Health Disparities Research Centers
Chau, Trinh-Shevrin; Islam, Nadia; Tandon, Darius; Ho-Asjoe, Henrietta; Rey, Mariano
2007 ;1(2):195-205, Progress in community health partnerships : research, education, & action
There has been growing interest in conducting community-based health research using a participatory approach that involves the active collaboration of academic and community partners to address community-level health concerns. Project EXPORT (Excellence in Partnerships, Outreach, Research, and Training) is a National Center for Minority Health and Health Disparities (NCMHD) initiative focused on understanding and eliminating health disparities for racial and ethnic minorities and medically underserved populations in the United States. The New York University (NYU) Center for the Study of Asian American Health (CSAAH) is 1 of 76 Project EXPORT sites. This paper describes how CSAAH developed partnerships with varied Asian American community stakeholders as a first step in establishing itself as a Project EXPORT center that uses community-based participatory research (CBPR) as its orienting framework. Three guiding principles were followed to develop community-academic partnerships: (1) creating and sustaining multiple partnerships; (2) promoting equity in partnerships; and (3) commitment to action and research. We discuss strategies and action steps taken to put each principle into practice, as well as the successes and challenges we faced in doing so. Developing community-academic partnerships has been essential in our ability to conduct health disparities research in Asian American communities. Approaches and lessons learned from our experience can be applied to other communities conducing health disparities research
— id: 95045, year: 2007, vol: 1, page: 195, stat: Journal Article,

Drive-by readings: a creative strategy for tuberculosis control among immigrants
Gany, Francesca M; Trinh-Shevrin, Chau; Changrani, Jyotsna
2005 Jan;95(1):117-119, American journal of public health. AJPH
OBJECTIVES: We explored an innovative strategy for targeted testing and disease management among immigrant communities at risk for tuberculosis. METHODS: Taxi drivers were recruited at an airport holding lot to undergo tuberculin skin testing (Mantoux). After receiving their test results in a location convenient for them, drivers with positive results were referred for evaluation and treatment. We conducted baseline and follow-up assessments. RESULTS: Of 123 drivers who participated, two thirds (82) were at high risk for tuberculosis. Seventy-eight (63%) of the 123 returned for test readings; 62% of these drivers had positive test results. All drivers with positive results received a complete physician evaluation, but 64% of those evaluated were not treated for latent TB infection. Of the untreated drivers, 37.5% were at high risk. Systemic and physician barriers (e.g., lack of knowledge, erroneous beliefs regarding vaccines) affected adherence to evaluation and treatment. CONCLUSIONS: Targeted testing and treatment are important to the control of tuberculosis. The results of this study highlight the need for an aggressive physician educational campaign to identify latent tuberculosis infection and to tailor service delivery to meet the unique needs of foreign-born communities
— id: 48113, year: 2005, vol: 95, page: 117, stat: Journal Article,

Response to Lamivudine Treatment in Children with Chronic Hepatitis B Virus Infection
Hagmann, Stefan; Chung, May; Rochford, Gemma; Jani, Mudra; Trinh-Shevrin, Chau; Sitnitskaya, Yekaterina; Neumann, Avidan U; Pollack, Henry
2003 Dec 1;37(11):1434-1440, Clinical infectious diseases
Despite the recent approval of lamivudine for the treatment of children with chronic hepatitis B virus (HBV) infection, there is insufficient information on the kinetics of HBV clearance and the factors that predict a favorable treatment response to lamivudine in this population. In a small retrospective study of 16 HBV-infected children treated with lamivudine, we examined changes in virus load and other factors associated with hepatitis B e antigen (HBeAg) clearance. High pretherapy alanine aminotransferase level, low serum HBV DNA load, and age at the start of treatment were independently associated with HBeAg clearance. HBeAg clearance was also associated with the achievement of specific levels of virus suppression, and failure to achieve those levels was associated with the development of lamivudine resistance. Additional studies are necessary to provide better indications and guidelines for the treatment of children with chronic HBV infection
— id: 38996, year: 2003, vol: 37, page: 1434, stat: Journal Article,

The impact of detention on the health of asylum seekers
Keller, Allen S; Ford, Douglas; Sachs, Emily; Rosenfeld, Barry; Trinh-Shevrin, Chau; Meserve, Chris; Leviss, Jonathan A; Singer, Elizabeth; Smith, Hawthorne; Wilkinson, John; Kim, Glen; Allden, Kathleen; Rockline, Paul
2003 Oct-Dec;26(4):383-385, Journal of ambulatory care management
Asylum seekers arriving in the United States are often imprisoned for months or years while their asylum claims are processed. Recently, Physicians for Human Rights and the Bellevue/New York University Program for Survivors of Torture released the findings of the first systematic study examining the health of detained asylum seekers. The study found that the mental health of asylum seekers interviewed was extremely poor, including high levels of symptoms for anxiety, depression, and posttraumatic stress disorder, which worsened the longer individuals were in detention. The study also raises concerns about the manner in which asylum seekers are treated upon arrival in the United States and then while in detention. These findings support assertions that detention has a harmful effect on the health and well-being of asylum seekers. Policies regarding the long-term detention of asylum seekers should be reconsidered
— id: 46071, year: 2003, vol: 26, page: 383, stat: Journal Article,

Mental health of detained asylum seekers
Keller, Allen S; Rosenfeld, Barry; Trinh-Shevrin, Chau; Meserve, Chris; Sachs, Emily; Leviss, Jonathan A; Singer, Elizabeth; Smith, Hawthorne; Wilkinson, John; Kim, Glen; Allden, Kathleen; Ford, Douglas
2003 Dec 22;362(9397):1721-1723, Lancet
Asylum seekers arriving in the USA are likely to be held in detention for months or years pending adjudication of their asylum claims. We interviewed 70 asylum seekers detained in New York, New Jersey, and Pennsylvania. We used self-report questionnaires to assess symptoms of anxiety, depression, and post-traumatic stress disorder. At baseline, 54 (77%) participants had clinically significant symptoms of anxiety, 60 (86%) of depression, and 35 (50%) of post-traumatic stress disorder; all symptoms were significantly correlated with length of detention (p=0.004, 0.017, and 0.019, respectively). At follow-up, participants who had been released had marked reductions in all psychological symptoms, but those still detained were more distressed than at baseline. Our findings suggest detention of asylum seekers exacerbates psychological symptoms
— id: 46289, year: 2003, vol: 362, page: 1721, stat: Journal Article,

Dental caries experience in northern Manhattan adolescents
Mitchell, Dennis A; Ahluwalia, Kavita P; Albert, David A; Zabos, Georgina P; Findley, Sally E; Trinh-Shevrin, Chau B; Marshall, Stephen E; Lamster, Ira B; Formicola, Allan J
2003 Summer;63(3):189-194, Journal of public health dentistry
OBJECTIVE: The study sought to document dental caries among adolescents residing in northern Manhattan, New York, by race, sex, and community. METHODS: Clinical and demographic data were collected from children aged 12-17 years at five school-based dental clinics in northern Manhattan. Data on dental caries were collected by calibrated examiners using the National Institute of Dental and Craniofacial Research criteria for oral examinations. RESULTS: A total of 566 children participated in the study. They were predominantly Hispanic (64%) or African American (28%). Compared to data from the National Health and Nutrition Examination Survey III, mean DMFT (3.36 vs 2.53; P<.01) and the prevalence of untreated disease (36% vs 16%; P<.01) were significantly higher for northern Manhattan adolescents. Of the adolescents evaluated, 13 percent had at least one severely carious tooth with pulpal involvement that required either extraction or endodontic therapy. CONCLUSIONS: Adolescents in northern Manhattan have higher caries prevalence and higher levels of untreated caries than their national counterparts. Carious lesions progress to pulpal involvement in a high percentage of northern Manhattan children and require extraction or root canal therapy as treatment. There is an urgent need for affordable and available dental primary care services targeted to economically disadvantaged communities
— id: 90138, year: 2003, vol: 63, page: 189, stat: Journal Article,

Psychological morbidity and perceived access to health care among detained asylum seekers
Keller, A; Meserve, C; Trinh, C; Ford, D; Leviss, J; Kim, G; Rosenfeld, B
2002 Apr;17(5):162-162, Journal of general internal medicine
— id: 27450, year: 2002, vol: 17, page: 162, stat: Journal Article,

Pre-treatment and early treatment predictors of eAg clearance in HBV-infected children treated with lamivudine
Pollack, H; Hagmann, S; Neumann, AU; Chung, M; Rochford, G; Lau, C; Trinh-Sherin, C
2002 DEC ;7(4):L95-L96, Antiviral therapy
— id: 37140, year: 2002, vol: 7, page: L95, stat: Journal Article,

Lack of oral health care for adults in Harlem: a hidden crisis
Zabos, Georgina P; Northridge, Mary E; Ro, Marguerite J; Trinh, Chau; Vaughan, Roger; Moon Howard, Joyce; Lamster, Ira; Bassett, Mary T; Cohall, Alwyn T
2002 Jan;92(1):49-52, American journal of public health. AJPH
OBJECTIVES: Profound and growing disparities exist in oral health among certain US populations. We sought here to determine the prevalence of oral health complaints among Harlem adults by measures of social class, as well as their access to oral health care. METHODS: A population-based survey of adults in Central Harlem was conducted from 1992 to 1994. Two questions on oral health were included: whether participants had experienced problems with their teeth or gums during the past 12 months and, if so, whether they had seen a dentist. RESULTS: Of 50 health conditions queried about, problems with teeth or gums were the chief complaint among participants (30%). Those more likely to report oral health problems than other participants had annual household incomes of less than $9000 (36%), were unemployed (34%), and lacked health insurance (34%). The privately insured were almost twice as likely to have seen a dentist for oral health problems (87%) than were the uninsured (48%). CONCLUSIONS: There is an urgent need to provide oral health services for adults in Harlem. Integrating oral health into comprehensive primary care is one promising mechanism
— id: 90132, year: 2002, vol: 92, page: 49, stat: Journal Article,

Cost-effectiveness of tuberculosis screening and observed preventive therapy for active drug injectors at a syringe-exchange program
Perlman DC; Gourevitch MN; Trinh C; Salomon N; Horn L; Des Jarlais DC
2001 Sep;78(3):550-567, Journal of urban health
This study examined whether costs associated with tuberculosis (TB) screening and directly observed preventive therapy (DOPT) among drug injectors attending a syringe exchange are justified by cases and costs of active TB cases prevented and examined the impact of monetary incentives to promote adherence on cost-effectiveness. We examined program costs and projected savings using observed adherence and prevalence rates and literature estimates of isoniazid (INH) preventive therapy efficacy, expected INH hepatoxicity rates, and TB treatment costs; we conducted sensitivity analyses for a range of INH effectiveness, chest X-ray (CXR) referral adherence, and different strategies regarding anergy among persons affected with human immunodeficiency virus (HIV). For 1,000 patients offered screening, incorporating real observed program adherence rates, the program would avert $179,934 in TB treatment costs, for a net savings of $123,081. Assuming a modest risk of TB among HIV-infected anergic persons, all strategies with regard to anergy were cost saving, and the strategy of not screening for anergy and not providing DOPT to HIV-infected anergic persons resulted in the greatest cost savings. If an incentive of $25 per person increased CXR adherence from the observed 31% to 50% or 100%, over a 5-year follow-up the net cost savings would increase to $170,054 and $414,856, respectively. In this model, TB screening and DOPT at a syringe exchange is a cost-effective intervention and is cost-saving compared to costs of treating active TB cases that would have occurred in the absence of the intervention. This model is useful in evaluating the cost impact of planned program refinements, which can then be tested. Monetary incentives for those referred for screening CXRs would be justified on a cost basis if they had even a modest beneficial impact on adherence
— id: 43560, year: 2001, vol: 78, page: 550, stat: Journal Article,

Bringing the mountain to Mohammed: a mobile dental team serves a community-based program for people with HIV/AIDS
Zabos, G P; Trinh, C
2001 Aug;91(8):1187-1189, American journal of public health. AJPH
In spite of the direct referral system and family-centered model of primary oral health care linking medical and dental care providers, most HIV-positive patients at the Columbia Presbyterian Medical Center received only emergency and episodic dental care between 1993 and 1998. To improve access to dental care for HIV/AIDS patients, a mobile program, called WE CARE, was developed and colocated in community-based organizations serving HIV-infected people. WE CARE provided preventive, early intervention, and comprehensive oral health services to minorities, low-income women and children, homeless youths, gays and lesbians, transgender individuals, and victims of past abuse. More efforts to colocate dental services with HIV/AIDS care at community-based organizations are urgently needed
— id: 90134, year: 2001, vol: 91, page: 1187, stat: Journal Article,

Protecting the uninsured human research subject
Vasgird, D R; Hensleigh, M; Berkman, A; Schachne, E; Trinh, C
2000 Nov;6(6):37-47, Journal of public health management & practice
Currently, research institutions are not mandated to provide free medical care or compensation to research participants for research-induced injuries. Research studies offering financial compensation or the possibility of treatment often attract more of the working poor who are less likely to have health insurance. Thus uninsured or underinsured participants face a heavier burden and greater risk than those with insurance. Based on a theoretical examination of the Belmont principles of beneficence and justice, the authors' IRB analysis, and an analysis of the changing health care and research arenas, the authors provide reasons to amend the Federal Code of Regulations
— id: 90133, year: 2000, vol: 6, page: 37, stat: Journal Article,