The story of how the Sacramento Asian American Network for Cancer Awareness Research and Training (AANCART) developed is really a tale of how personal friendships and relationships have woven into a synergistic partnership to reach Sacramento's Asian American community initially in cancer awareness, currently in community capacity building for cancer control, and, in the near future, as a collaborative partnership for community-based participatory cancer control research for, by, and with Sacramento's Asian American community. As Judy Heary, Executive Director of Sacramento's Asian Pacific Community Counseling reflected, &ldquote;Our best practice is building upon the Asian values of friendships and relationships that have traditionally been applied to social advancement for a family's welfare to applying the practice to health and social advancement for all of Sacramento's Asian American community.&rdquote; This brief report traces the history of Sacramento AANCART's beginnings and illustrates the application of these values to our work in creating a synergistic model involving public health/cancer control professionals working in concert with Asian American community leaders, the American Cancer Society, Council of Asian Pacific Islanders Together for Advocacy and Leadership (CAPITAL), Hmong Women's Heritage Association, Paul Hom Asian Clinic, and a growing constituency of Asian American and Pacific Islander community leaders and organizations.
The best practice of Sacramento's Asian American Network for Cancer Awareness Research and Training program is friendships and relationships. Cancer 2005. © 2005 American Cancer Society.
Sacramento AANCART began in January 2002 when Moon Chen, Jr., Ph.D., M.P.H., National Principal Investigator, decided to move the National AANCART headquarters to Sacramento because of his desire to work in a larger Asian American community than Columbus, Ohio. Dr. Chen accepted a faculty position at the University of California, Davis (UCD), and established Sacramento as his base. Sacramento was also the home base for Dileep G. Bal, M.D., M.P.H., Chief, Cancer Control Branch for the California Department of Health Services and a member of National AANCART's Steering Committee. Thus, Dr. Chen appointed Dr. Bal as the Regional Principal Investigator for Sacramento AANCART, making Sacramento an AANCART region equivalent to the other AANCART regions of New York, Houston, Seattle, San Francisco, Los Angeles, and Hawaii. However, the major difference between Dr. Bal and the other Regional Principal Investigators is that he and his principal deputies enlisted at the California Department of Health Services: Robin Shimizu, Assistant Chief, Tobacco Control Section as Community Director, and Kurt Snipes, Ph.D., Chief, Cancer Planning, Research, and Disparities Section, as Research Director, to volunteer their services. Along with the volunteer infrastructure at the Cancer Control Branch (CCB) came the access and resources of the entire branch. The CCB includes: the Tobacco Control Section, the Cancer Prevention and Nutrition Section, the Cancer Detection Section, the Cancer Surveillance Section, and the Cancer Planning, Research, and Disparities Section. All five sections have previously devoted considerable efforts to cancer control in Asian American communities statewide, such as developing the nation's first antitobacco media messages in Asian languages, a toll-free smokers' Quitline in Asian languages, tobacco control materials in Asian languages, establishing a cancer registry with ethnically specific data on cancer incidence and mortality for various Asian American groups, developing a Five-A-Day for better nutritional health program for Asian Americans, and offering a breast and cervical cancer early detection program for underinsured women, including Asian women. The designation of Sacramento as an AANCART region resulted in the targeting of the nation's most extensive state-based cancer control efforts to be focused on Sacramento. We attribute the beginning of this foundation to the years of friendship among friends.
Friendship was also the basis for involving Mr. Gary Wilson, Cancer Control Director for the local American Cancer Society through Dr. Bal and Ms. Alice Chan of CAPITAL through Dr. Chen. Dr. Bal introduced Dr. Chen to Mr. Wilson and Dr. Chen introduced Dr. Bal to Ms. Chan, who in turn introduced the CAPITAL leaders, Dr. Sonney Chong, Chair, and Mr. Jerry Chong, Esq., Chief Legal Counsel of CAPITAL. CAPITAL, established in 1995, is the lead entity for more than 90 Asian Pacific Islander (API) community-based organizations throughout Sacramento and its surrounding counties for a variety of civic, cultural, political, social, and health and human services concerns that affect Asian Americans and Pacific Islanders. Under the founding leadership of Dr. Sonny Chong and Jerry Chong, Esq., CAPITAL provides a forum for the API community leaders and representatives to interact with and influence local political figures and their staff on a broad range of issues and concerns. CAPITAL holds regular bi-monthly meetings where representatives from the community have an opportunity to seek guidance and assistance from the coalition of their specific issues or to address issues generally affecting API communities. CAPITAL has an extensive listserve that disseminates regular information and updates and provides the mechanism when the community needs to be mobilized to expose and advocate on various issues affecting all communities of color, but especially the API community.
Creating a Synergistic Partnership
Through CAPITAL's membership and their leadership, Sacramento AANCART has been able to seek guidance and input on program development, training topics, and future program activities. It was through consensus that Sacramento AANCART developed the idea to hold quarterly training sessions for health professionals, community leaders, and advocates and students, as well as the decision to focus on the Hmong population as Sacramento's population of emphasis. During its normal course of business, CCB already had a strong relationship and partnership with the California Division of the American Cancer Society (ACS), so it was natural to include the leadership of ACS in the group. ACS has been an invaluable member organization and has dedicated its staff and volunteer resources to the overall efforts. ACS is committed to continue to build a robust and sustainable infrastructure to address API cancer concerns; integrate ACS programs and services into the delivery of Sacramento AANCART's programs; advocate to reduce health disparities among the diverse API communities; and participate in the training and education of API outreach workers and community-based cancer researchers.
Over the course of the last 2 years, the partnership of Sacramento AANCART has been transformed into a community-based driven collaboration. The original host organizations (CCB, UCD, and ACS) have switched the responsibilities of identifying program direction and activities with CAPITAL. For instance, the last three quarterly training sessions topics and expert speakers have been identified by the membership of CAPITAL. Consequently, an anecdotal review of these training sessions has shown that participants found them more helpful, relevant, and memorable than previous trainings that were held earlier in the program. In addition, attendance at these trainings rose from an average of 35–50 participants to more than 100 participants without any additional recruitment efforts by the CCB staff. The commitment of the partner organizations continues to grow stronger with each training session, while at the same time UCD, CCB, and ACS support and participate in activities sponsored by CAPITAL and its membership. This model appears to have national implications as other community-based projects focusing on capacity building, training, and research for communities of color are pursued in other funding opportunities.
At the same time, what began as a UCD-led effort to reach out to the Hmong community through a Cancer Awareness 101 series has now been entirely run by the Hmong Women's Heritage Association (May Ying Ly, Executive Director, and Dao Moua, Staff). Cancer Awareness 101 is offered by Hmong to the Hmong in Hmong, a feat that all of us are proud of. The Hmong Women's Heritage Association was also instrumental in assuring that the most recently completed National Asian American Cancer Control Academy held in Sacramento had correctly and appropriately emphasized Hmong cultural themes. The Hmong Women's Heritage Association and Dr. Serge Lee, Professor of Social Work at California State University, Sacramento, contributed their cultural and professional insights for outreach to the growing Hmong community. Again, the best practice of friendships and relationships is key.
Another result of friendships and relationships is the long-term friendship between Dr. Moon Chen and Dr. Lindy Kumagai, Founding Medical Director of the Paul Hom Asian Clinic at UCD. Dr. Kumagai, along with UCD medical students, established in 1992 the nation's first free medical clinic serving Asian Americans. This clinic most recently became known as the Paul Hom Asian Clinic in memory of its medical student founder, Paul Hom, M.D., J.D., who cofounded the clinic with Dr. Kumagai. This clinic continues to operate as a labor of love by volunteer physicians, UCD medical students, and undergraduate UCD students. Sacramento AANCART is fortunate to have the clinic as a partner that serves the medical needs of the community very tangibly and pragmatically. Furthermore, all who have been to the clinic cannot help but be inspired.
In summary, Sacramento AANCART is an example of applying Asian values of friendships and relationships for the health and well being of the community. Starting from four entities (UCD, CCB, ACS, CAPITAL; Fig. 1) that retain their identity and niche, we continue to accrue other entities, e.g., the Hmong Women's Heritage Association and a growing Asian American constituency, to make one synergistic entity.
We believe it exemplifies synergy, where the whole is truly greater than the sum of its parts, and is the foundation for the next phase of initiating a base for community-based participatory research of, by, for, and with Sacramento's Asian American community.