Project Summary The proposed NHLBI Diversity Supplement, Medication Adherence among Vietnamese immigrants to the US, will explore the interrelationships among social support, health literacy, and medication adherence in Vietnamese immigrants with hypertension in Springfield, MA. The parent study, Pharmacist-CHW Team to Improve Medication Adherence and Reduce Hypertension Disparities, will test an interprofessional care team intervention to identify and address individual, clinical, social-cultural and structural barriers to medication adherence among high-risk minority patients with hypertension, polypharmacy use and nonadherence. The proposed Diversity Supplement will support Ms. Thupten Phuntsog (Dorney), MPH, a second-generation daughter of Tibetan refugees to the U.S., as she gains mixed-method research experience and skills in qualitative and quantitative data collection and analysis to complete her PhD in Community Health Education at the University of Massachusetts. The proposed research will expand Ms. Phuntsog’s expertise in refugee and immigrant health by focusing on Vietnamese immigrant patients, one of the 3 targeted subgroups in the parent study, at Caring Health Center, and will provide a multidimensional (quantitative and qualitative) understanding of the cultural and structural facilitators and barriers to medication adherence among Vietnamese patients with hypertension. Research conducted for this supplement is complementary to the parent project as it provides greater depth of information about social factors in medication adherence among Vietnamese participants than is allowed by resource constraints in the parent project. The candidate will complete additional analyses of the quantitative data from the parent study to examine the interrelationships among social support, health literacy, and medication adherence among Vietnamese participants in the parent study (Aim 1). With the help of a bilingual, bicultural CHW, Ms. Phuntsog will conduct focus groups with Vietnamese participants to explore their understanding of three translated instruments: two social support scales (the MOS-Social Support Survey and two social support items from the PRAPARE tool) and the Beliefs about Medicines Questionnaire (Aim 2). Findings from these focus groups will improve the translations of these scales used in the parent study. In addition, a sub-sample of Vietnamese participants in the parent study will complete in-depth interviews to better understand the relationships between social support, health literacy, and medication adherence (Aim 3). By focusing on an in-depth understanding of the role of social support and health literacy among Vietnamese immigrants, this project will identify barriers experienced by immigrant and refugee groups and contribute to the development of tailored resources and other facilitators for chronic disease management.

Narrative The parent study, Pharmacist-CHW Team to Improve Medication Adherence and Reduce Hypertension Disparities, will identify and address individual, clinical, social-cultural and structural barriers to medication adherence among high-risk minority patients with hypertension, polypharmacy use and nonadherence at a Springfield, MA, community health center. The proposed NHLBI Diversity Supplement, Medication Adherence among Vietnamese immigrants to the US, will support Ms. Thupten Phuntsog (Dorney), MPH, a first- generation daughter of Tibetan refugees to the U.S., as she gains mixed-method research experience and skills in qualitative and quantitative data analysis to earn her PhD in Community Health Education at the University of Massachusetts. The proposed research will explore the interrelationships among social support, health literacy, and medication adherence in Vietnamese participants in the parent study and will inform broader efforts to improve primary health care for refugee and immigrant populations.