Sora Park Tanjisiri Uncovers Disparities among Pacific Islanders
Natalie Collins, M.S.W., Outreach and Technical Assistance Coordinator
The impact of breast cancer on underserved
communities is a central priority
for the CBCRP Community Research
Collaboration (CRC) awards. Investigators
funded under the CRC mechanism
reflect the diversity of communities
affected by breast cancer. Sora Park
Tanjisiri, of California State University,
Fullerton, has spent over a decade
looking at breast cancer screening
and cancer disparities among Pacific
Islander (PI) communities. Her work
started in 1992, while pursuing her doctorate
in Public Health at the University
of California, Los Angeles. During her
doctoral training, Dr. Tanjisiri worked
with Lola Sablan Santos, executive
director of the Guam Communications
Network, Inc. to address disproportionate
rates of cancer among PI, including
breast cancer.
Dr. Tanjisiri and Ms. Sablan Santos began
looking at screening rates among PIs and some of the unique cultural
characteristics such as culturally discordant
providers, language difficulties,
close knit communities, and feelings
of shame around breast cancer. Dr.
Tanjisiri realized that a scientist going
into the PI community would have
little impact and research must be done
collaboratively with equal input from
community partners in all aspects of the
research process. The CRC program is
based on this same research philosophy,
known as community based participatory
research (CBPR) where research
scientists and community partners work
together to answer issues of importance
to the community.
Dr. Tanjisiri received her first CBCRP
grant, a postdoctoral award in 1997 for
a study titled, Breast Cancer Knowledge/
Attitudes: Southern California
Pacific Islanders. This was a two-year
study that analyzed and assessed the
breast cancer knowledge, attitudes, and
screening behaviors among Tongan and
Chamorro women, age 40 and older
living in Los Angeles, Orange, and San
Diego counties. Dr. Tanjisiri collaborated
with both the Guam Communications
Network, Inc. and the Tongan
Community Service Center to recruit
530 women to complete surveys, which
highlighted striking differences in these
two communities related to screening.
For example, 25.7% of Tongans had
ever had a clinical breast exam compared
with 92.8% of Chamorros. Similarly,
25.1% Tongans had ever had a
mammogram while 76.8% of Chamorros
had. A similar finding for both communities
was low rates of breast self
exams with 40.4% in Tongan women
and 37.3% in Chamorros. Barriers to
screening such as cost, language, and
lack of knowledge for both populations
were elucidated in this study.
In 2001, both Dr. Tanjisiri and Ms. Sablan Santos were funded for a full Community Research Collaboration grant, for the study, A Network-Based Intervention for Chamorros in Southern California. This was a three-year study that attempted to increase screening rates among Chamorro women, age 50 and older living in Los Angeles and Orange counties. The study employed a quasi-experimental design with a comparison group of Chamorro women in Northern California. aseline data showed that only 54.9% of Chamorro women were getting yearly mammograms despite high rates of insurance coverage.
Investigators like Dr. Tanjisiri and Ms.
Sablan Santos have focused on specific
communities like Chamorros and
Tongans because Asian communities
tend to be lumped together for statistical
power, yet can have significantly
different rates of disease and health
education needs. Dr. Tanjisiri recommends
building bridges and networks to
epidemiologists and cancer registries to
get ethnic specific data. There is still a
paucity of health-related data available
for the PI population, such as breast
cancer stage at diagnosis, especially
compared with other ethnic minority
groups. Bridges must also be built with
funding agencies so that they carefully
consider funding studies assessing the needs of smaller or isolated
communities
in addition to those with communities
large enough to have adequate
sample sizes.
Dr. Tanjisiri’s work on breast cancer
among PI is extremely rewarding,
because she has observed a large
impact in this community in a small
amount of time. She attends community
forums where once invisible
Chamorran survivors voice their own
experiences with breast cancer and
serve as leaders in their communities.
She is also inspired by the work
of her community collaborators, like
Ms. Sablan Santos, who have been
successful in leveraging additional
funds, writing their own proposals,
and taking the lead on subsequent
collaborative research projects. Dr.
Tanjisiri is now focusing on additional
grants related to survivorship, lymphedema,
and social support among PIs,
and is involved in a project related to
mentoring junior researchers so they
may develop expertise in community
based participatory research, and
continue addressing the needs of PI
communities.
