PREFACE

 Dear Friends:

   Welcome to the Lay Health Advisor (LHA) education program!  This program seeks to educate people to be Lay Health Advisors.  LHAs are “lay people” who know how to reach people where they live and work, and to whom others naturally turn to for advice, emotional support, and tangible aid.  Many projects have proven that LHAs help promote community health through establishing an effective link between formal and informal support systems.  LHAs are especially important agents of change in Asian communities because many non-English speaking and/or newly arrived immigrants are particularly challenged by access to the American health care system.  You will play an important role helping people overcome these difficulties and fight the battle against cancer.  We hope this education program will enrich your knowledge, improve your skills, and increase your self-efficacy to promote the United State's Asian population's health with a focus on increasing Asian women's breast cancer screening rates. As a trained LHA, you will be the leader in helping medically underserved Asian women get needed health care through overcoming cultural, linguistic, and economic barriers. 

   Funded by the Susan G. Komen Breast Cancer Foundation, this education program is being conducted by the Healthy Asian Americans Project (HAAP) at the University of Michigan School of Nursing.  Initiated in 1996, HAAP is devoted to researching and promoting Asian Americans’ health.  The short-term goal of this project is to educate approximately 100 LHAs residing in southeastern Michigan counties to have the knowledge, skills, and self-efficiency to promote breast cancer screening among medically underserved Asian women.  The long-term objective of the project is to organize the most effective support mechanism- a self-sustaining LHA infrastructure- within the Asian community. Each LHA is expected to recruit a minimum of 20 Chinese women to participate in breast cancer screening promotion events and help at least 2 women get breast cancer screening within six months of completing the education program.

   In consideration of your busy schedule, we have developed a short but comprehensive education program.  All nine chapters are designed to be rich in content, easily understandable, and vividly presented.  An important aspect of this education program is the number of case studies featuring women from the community sharing their experiences with the U.S. health care system, community work and other topics. A basic summary of the chapter contents is outlined below.

► Chapter 1 takes a look at Asian people’s health issues and population characteristics in the U.S.
          ► Chapter 2 focuses on breast cancer and the importance of early detection.
          ► Chapter 3 examines Asian women’s breast cancer screening behavior and the factors influencing their access to screening in the USA. 
          ► Chapter 4 discusses the critical role Lay Health Advisors play in helping their community gain better access to health services. 
            ►  Chapter 5 illustrates different outreach strategies. 
            ►  Chapter 6 outlines essential communication skills.
            ►  Chapter 7 draws attention to the importance of team building.
            ►  Chapter 8 provides background information about the Michigan Breast and Cervical Control Cancer Program (BCCCP)
            ►  Chapter 9 will guide the LHA to developing and defining goals.
          ►  An appendix provides important information.
            · How to contact HAAP
            · Frequently Asked Questions
            · Answer Key
            · Glossary of medical terms in English an Chinese  
            · How to use the program website
             ►  For those interested in reading further about the topics discussed in the manual, a reference section is included.    

    At the beginning of each chapter, the objectives and important points are outlined.  At the end of each chapter, a combination of case studies and questions are assigned to help you apply the information just learned.  A website, www.nursing.umich.edu/haap/lha.html  has been developed to aid with distance learning.  The contents of this manual are reproduced on our website but there are significant additional materials that we could not reproduce in a print format.  Power point presentations, audio recordings of chapter summaries and personal stories are but a few of the features on the web site.  You are strongly encouraged to visit the website, if possible, regularly.  Links to other sources of information about cancer and the Asian community are also there for reference.  Throughout the manual you will find internet addresses that can be accessed while online.  The appendix of this manual contains important information about registering to gain access to the web site.
    
    You should complete one chapter each week and finish the entire program in about two months.  Of course, you can finish in less time if you want.

    In this education program, the terms “Asian” and “Chinese” refer to people who are of these racial and ethnic groups.  They do not imply U.S. citizenship status.

      This education program focuses on breast cancer screening.  However, since many recent immigrants are without health insurance and have low incomes, we discuss Michigan’s Breast and Cervical Cancer Control Program (BCCCP) because it exists to aide women without insurance and with qualifying income levels to get both breast and cervical cancer screening.  Consequently, in discussing BCCCP, cervical cancer screening is also often mentioned.

      As more people become aware of the barriers Asians face in accessing American health care and realize the lack of information about the Asian population, the Asian community will be more empowered to demand greater resources from government.  You, as an LHA, are a critical part of this process.  While reading this manual, we invite you to consider how you will employ the contents of this manual in your work.  We commend your interest and desire to help others and make our community healthier.  If at any time you have questions or concerns, please contact our office.  HAAP looks forward to working closely with you for a successful and enjoyable education program.  Thank you for your participation and contribution.

 Sincerely,
Mei-yu Yu

Mei-yu Yu, PhD, MD
 Director of the HAAP

   
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