UW Hmong: American Nurse Brings her Community to the Doctor’s Office

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Originally posted in WiscNews

MADISON – Nursing student Maichou Lor wanted to bring her fellow Hmong community members out of the shadows and into the doctor’s office.
Lor, who recently received her Ph.D. from the University of Wisconsin-Madison School of Nursing, was born in a refugee camp in Thailand before her family immigrated to Madison. As she pursued nursing, starting in high school, Lor discovered that the Hmong immigrant community lacked access to major medical care because low rates of literacy and English proficiency kept their health status murky. In an interdisciplinary research program, Lor developed new survey tools that respond to the needs of the Hmong, which she hopes can help close gaps in access to care among her own community and other underserved populations.

Along the way, she became the first Hmong-American nurse to earn a Ph.D. in the United States.

“Throughout my whole life, I saw a lot of inequalities and injustice in issues surrounding health care,” says Lor, “not just among the Hmong population. It’s the Cambodian population, the Laotian population, a lot of Southeast Asian populations who have gone through the same kind of history that we have are also struggling.”

Following the Vietnam War, Wisconsin became a hub for displaced Hmong from Southeast Asia immigrating to the United States. The Hmong community is the largest Asian population in Wisconsin, which has the third-largest Hmong population, behind California and Minnesota. According to the U.S. Census Bureau, more than 54,000 Hmong lived in Wisconsin in 2015, nearly 20 percent of all Hmong in the country.

As an undergraduate nursing student at the UW, Lor partnered with three other Hmong students to try to survey the local Hmong population about cancer screening. But the group found that written surveys, even if they only asked for true-false answers, resulted in mostly blank responses.

“We ended up just reading the questions and having people raise their hands to respond, but we realized there’s contamination, because they just looked around at how others were responding,” says Lor. “That was an ‘aha’ moment for me, to realize we can’t collect data from this population, and I’m sure there are other populations experiencing the same thing.”

Lor saw that without an effective way to ask Hmong about their health, there was no way to fully integrate them into the health care system. In graduate school, she worked with an interdisciplinary group of mentors to create a data collection tool that responded to the needs of the Hmong community.

She adapted a survey system from sociology that combines prerecorded oral translations in the Hmong language, written text in English and color-coded responses to facilitate communication and to accommodate any level of language proficiency. In addition, a family helper was included to assist with the survey completion process. The tool allowed Lor to successfully survey all of her study participants on their health status, without missing responses.

One concern was that respondents might be reluctant to answer a question that may be sensitive or potentially embarrassing in the presence of family members. To test this, Lor included a question about frequent urination.

“What I realized is because I translated the question in a culturally sensitive way, people were fine answering it, and they didn’t see any question as being too sensitive or embarrassing to answer,” says Lor.

“She’s just tenacious. She’s the most curious student I’ve ever had,” says Barbara Bowers, the associate dean for research at the School of Nursing and Lor’s advisor. “She ends up being a cultural broker for a lot of people in the Hmong community.”

“I’m hoping she comes back here and establishes her own center for Hmong health at the university,” says Bowers.

Lor is leaving Madison in August to train in informatics and data visualization at Columbia University. She wants to find ways to communicate with her patients about their health that bypass linguistic and cultural barriers. But Wisconsin remains her home.

“My family threw me a graduation party back in May, and I had some of my research participants come — they were sad I’m leaving. They’re often forgotten in research, in health, in everything, and they felt like I was a voice for them,” says Lor.

“I told people I will come back; I just have to go get another kind of tool to help me develop as a researcher and make a greater impact.”

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Communications intern position open at GHI

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The Global Health Institute is looking for a communications intern who is savvy in social media and has the skills to perform other communications duties.

The intern works directly with the GHI communications manager and GHI’s administrator on a variety of tasks, including website posts, social media outreach, infographics, news writing, newsletter creation and other tasks as assigned.

Apply by August 11, 2017.

Responsibilities:

  • Take a lead role in the planning and execution of a social media platform (Twitter, Facebook, Instagram and Vimeo)
  • Assist with website, including posting new content and making existing content more user friendly
  • Take a lead role in producing the weekly Events+ newsletter; assist with e-newsletter and annual report
  • Write and edit content, including news stories, feature articles, news releases and development and website materials
  • Perform administrative services such as word processing, proofreading, fact checking, organizing photo files, preparing information for distribution, creating graphics, etc.
  • Work at GHI events through set-up, cleanup and assistance throughout the event
  • Other ad hoc projects assigned by communications or administration that ensure that GHI communications run smoothly

Qualifications:

  • Excellent communication skills, especially listening, writing, editing and design capabilities
  • Hands on experience with social media, including Twitter, Facebook, Instagram and LinkedIn
  • Must be graduating no sooner than May 2018
  • Ideally, be able to work starting in late August/ September start date possible
  • Preferred: global health/ environmental health students with experience in Journalism and/or Mass Communications/Life Sciences Communication
  • Hands on experience with a variety of electronic tools including MailChimp, Adobe Creative Suite (InDesign, Photoshop, Illustrator), Microsoft Office, WordPress
  • Working knowledge of AP style
  • Demonstrated ability to work independently within deadlines
  • Curiosity and enthusiasm for global health and GHI, and a desire to share the mission and vision to attract support for the Institute

Other Details:

  • Wage: $10.00 per hour
  • 10-12 hours per week depending on workload and class schedule. Most hours will be spent at the Medical Sciences Center office. More hours may be available during the summer.

How to apply:

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