Developing Materials for the Asian American (AA) and Pacific Islander (PI) Populations (Posted on June 08, 2012)

Asian American (AA) and Pacific Islander (PI) populations happen to be two of the fastest growing ethnic groups in the United States. As of 2010, there are 17.3 million Asian Americans living in the U.S., a 46 percent increase in population in the last decade, and 1.2 million Native Hawaiians and other Pacific Islanders (NHOPI) living in the U.S., a 40 percent increase in population in the last decade1. It is important to note that until recently, Asian American (AA) and Pacific Islander (NHOPI) populations were aggregated on census data. As people continue to learn that AA and NHOPI groups are culturally and ethnically dis-similar many continue to group these heterogeneous groups as Asian American and Pacific Islander. And, for the purposes of comparing data sets that are aggregated in this way, it is sometimes necessary for context.

California has the largest population of Asian Americans in the U.S., and it has the second largest population of Pacific Islanders (the largest in the U.S. belonging to Hawaii with 356,000 Pacific Islanders)2. In 2010, there were 286,145 Pacific Islanders living in California, which was a 29.2 percent increase since 20003. Also in 2010, there were 5.6 million Asian Americans living in California, a 1.5 million increase in population since 20003.

Both Asian American (AA) and Pacific Islander (PI) groups have been targeted by tobacco companies as potential new users. Documented tactics included:

  1. Product placement of cigarettes and their use in movies, which has high proportions of young viewers4.
  2. Using the values and beliefs of family, education, and strong work ethic to market cigarette brands as the “American” standard, which identifies with the desire to assimilate into U.S. culture and lifestyle.
  3. Using Asian and Pacific Islander models in advertising and promotions.
  4. Sponsorships and ads in publications or events that deal with a strong Asian and Pacific Islander market such as golf, motorsports, music, film, dance, and gambling.
  5. The sales force of tobacco companies routinely visit store owners to monitor retail promotional activity, displays, and inventory of their products.
  6. Offers of promotional materials made to store owners, along with monetary incentives5.

Keep in mind, the tobacco industry sends a large percent of their exports to Asia11. Also, tobacco companies have made a concerted effort to build relationships with AA and NHOPI communities by sponsoring festivals, newspapers, and community groups11. In addition, research shows that ethnic communities have a higher density of tobacco advertising.

You might be wondering how tobacco has affected AA and PI communities? It’s been estimated that each year, since 2000, 15,000 to 20,000 Asian Americans and Pacific Islanders (aggregately) would die from a tobacco-related illness7. In aggregated terms, smoking has been responsible for 27.9 per 100,000 deaths from lung cancer for AA and NHOPI men and 11.4 per 100,000 for AA and NHOPI women. The statistics and information provide a strong case for why countering tobacco influences with anti-tobacco messages and campaigns for the Asian American and Native Hawaiians and other Pacific Islander communities are needed.

Here are some general things to keep in mind when developing educational materials for and about Asian American and Native Hawaiians and other Pacific Islander communities’ prevention:

  1. Know your audience
    • Target specific genders because prevalence is different. For instance, smoking is more prevalent in AA and NHOPI males compared to females. Smoking rates for AA and NHOPI women have been reported to increase with age7,8.
    • The major tobacco-related cause of death is lung cancer. Thus, it is important to make the information educational and informative, but not too academic.
  2. Strategize how to present the information to this population
    • Try to keep main points to a minimum; 3 to 5 points10
    • Present compelling and most important points either first or last among the material10
    • Utilize attention grabbers, pictures and images10
  3. Develop the content:
    • Organize the content in a logical manner (numerical order, chronological order, topical order)
    • Choose words carefully considering the appropriate reading level
    • Keep it simple (simple, short, and direct sentences and paragraphs are the most effective)
    • Use active voice
  4. Develop the visuals:
    • The format is the overall physical appearance of your material.
    • Think about how and where your material will be displayed (ex. clinic waiting room, malls, handouts, presentations, etc.)
    • Use graphics to grab the viewer’s attention, especially ones that resonate with different AA and PI cultures Organize the material in a way that allows for maximum visual appeal. Try not to clutter your material with images. Present one image that has a direct and simple message.
    • Position graphic elements with purpose. Having clear and precise graphics allows the material to be reinforced and improves understanding for the viewer. In addition, choose an appropriate font size and text style that the viewer can easily read.
  5. Let the message of tobacco be the main topic in the material
    • Stress the importance of an anti-tobacco lifestyle by highlighting the negative effects of tobacco.
    • Introduce warning labels by providing examples that individuals can look for, helping inform smokers about the health hazards of smoking9.
  6. Field test your materials
    • Watch our Field Testing Webisodes series. There are five webisodes that are each about 10-20 minutes in length. Topics include: setting up pretests, readability testing and suitability assessment of materials, focus groups, and intercept and individual interviews.
    • You can also find more tips and resources by visiting the Learn How section, Step 8: Testing Your Materials.
    • Interview and consult with members of the target population to see if your materials are appealing and appropriate.

Given that the Asian American. Native Hawaiians and other Pacific Islander populations are ethnically separate; it is crucial to develop materials that are culturally and community competent for each population. Depending on which ethnic group your material is focused on, these populations have their own unique understanding of tobacco, which would be useful to take into account when developing your materials. For example, in the Hmong community, tobacco serves as a specific social function and is given as a gift during weddings6. Furthermore, materials can use cultural symbols specific to their ethnic target as metaphors or centerpieces to convey a message that will resonate with their target community. For example, bamboo represents strength, character, and longevity for Chinese, Japanese, and other Asian groups. Another way that your materials can resonate with a specific community is to promote a figurehead or key leader of that community who is speaking out on tobacco use and calling for change in the community. For example, the King of Tonga, a small island in the South Pacific, has developed health into a public campaign, focusing on the health impact of tobacco and withdrawing tobacco sponsorship from a national boat race11. Within the Asian American and Native Hawaiians and other Pacific Islander populations, each ethnic community has its own culture and understanding on tobacco. It is important to do intensive research and collaborate with community members so that your materials are culturally sensitive and address your target community.

1 US Census Bureau: Facts for Features: Asian/Pacific American Heritage
2 US Census Bureau: Facts for Features: Asian/Pacific American Heritage
3 The Sacramento Bee “Californa has second largest Pacific Islander population
4 CHEST Journal The Master Settlement Agreement and Its Impact on Tobacco Use 10 Years Later
5 Tobacco Control “Targeting of Asian Americans and Pacific Islanders by the tobacco industry”
6 APPEAL for Communities “Cultural Competence”
7 APPEAL for Communities “Enhancing Cultural and Community Competence for Tobacco Control for Asian Americans and Pacific Islanders”
8 Demographics for Tobacco Use
9 Tobacco-Free Kids “Tobacco Warning Labels: Evidence of Effectiveness”
10 Susan G. Komen for the Cure”
11 APPEAL for Communities “Making Tobacco Relevant for Asian American and Pacific Islander Communities”