Connecting With the Asian Community

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Kim Ribbink

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Connecting with the Community BY KIM RIBBINK The Asian-American community is truly an untapped market for pharmaceutical companies. But to be successful, marketers have to understanD the diverse cultural mores of the many groups referred to as Asian. Hiroko Hatanaka The Epivir campaign continues to mobilize health organizations and chinese physician associations to educate asian americans about hbv. ASIAN AMERICAN diversity The pharmaceutical industry has been hesitant to approach an Asian-American audience. But experts say there is an opportunity to reach a loyal audience that is in need of health information. Companies that make the effort to reach Asian Americans in a culturally sensitive way will reap the rewards. The term Asian American is, in many respects, a misnomer. It is a general term used to refer to people from widely varied backgrounds who regard themselves as Chinese American, or Indian American, or Vietnamese American, and so forth. Asian Americans come from more than 20 different countries, represent more than 60 different ethnicities, and speak more than 100 different languages. It is this very diversity that often intimidates the pharmaceutical industry when it comes to targeting these many communities, some experts say. “Companies fear if they initiate a campaign they will make mistakes,” says Michael W. Wong, J.D., a consultant to the pharmaceutical industry who works on health programs that reach out to Asian Americans. “This can be pretty daunting. But if companies speak to someone in the community, the issues that need to be navigated can be explained fairly easily.” Reaching the Audience Experts say if a program directed toward Asian Americans is to be successful, the company must be committed to tapping into local experts and have a long-term strategy. “About 800,000 Asian Americans live in the greater metropolitan area of New York City,” says William Hsu, M.D., codirector of the Asian American Diabetes Initiative at the Joslin Diabetes Center, an institution affiliated with Harvard Medical School. “That’s significant in terms of regional business.” The ROI for a campaign targeting Asian Americans is clear, says Larry Moskowitz,VP of strategic marketing services at Kang & Lee Advertising Inc. “A typical New York Times full-page ad is more than $100,000,” he says. “A full-page ad in the biggest Chinese newspaper in New York, which will enable marketers to reach a much higher percentage of potential Chinese customers, will cost about $3,000.” Healthcare campaigns need to begin at the grassroots level, involving local community leaders and spokespeople. A program should tap into, and be sensitive to, all issues facing an Asian-American community. “In terms of talking to an Asian audience, companies need to find out the motivations, fears, barriers, baggage – good or bad – that they bring with them from their native cultures and how does that translate into attitudes and behaviors,” says Wanla Cheng, president of the Asia Link Consulting Group. Healthcare providers should be the first port of call for health campaigns, according to Mr. Wong. “In Asian culture, it is important to ensure that community healthcare leaders – doctors, dentists, and pharmacists – know about a program before going to the public,” he says. There are numerous physician organizations that companies can reach out to, including the American Association of Physicians of Indian Origin, the Chinese American Medical Society (CAMS), and the Vietnamese Medical Association of the USA. Pharmaceutical marketers also can leverage their promotions to a large number of Asian-American healthcare professionals. Asian American/Pacific Islanders (AAPI) account for about 11% of the nation’s physicians and 4% of nurses, notes The Provider’s Guide to Quality and Culture, a joint project of Management Sciences for Health, the U.S. Department of Health and Human Services, Health Resources and Services Administration, and the Bureau of Primary Health Care. And, according to Multi-Cultural Marketing Concepts (MC2), AAPIs represented 19.7% of the nation’s medical-school graduates in 2002. “There is a very real need to provide education targeted to these special populations in the United States, especially to physicians, on various healthcare-related topics that take into consideration cultural and philosophical differences,” says Donna Fucello, executive director of Innovia Education Institute. “I believe that the organizations that choose to support comprehensive educational initiatives for these populations will be recognized as leaders within their fields.” Erin Edgley, senior specialist, public affairs at Gilead Sciences says her company is working toward this goal with its hepatitis B program. “Working directly in the community creates opportunities that can’t be accessed through long-distance activities such as mass communications,” she says. “It allows us to form partnerships with people who are dedicated to the welfare of the local community and who can reach patients directly through services, activities, and special events. This gives the campaign a longer and more meaningful life, since it can be sustained in some form on an ongoing basis. For example, some of the groups we have worked with have distributed the educational materials at their own cultural festivals and health fairs. Others are considering holding regular hepatitis B seminars.” In tapping the large Asian-American physician population, experts say companies need to ensure that they get advice from those who know the market as well as those who understand the local scene. Mr. Wong suggests that pharma companies use an older male physician as a spokesman, even if a woman physician might be more highly qualified. “This is a traditional, male-dominated culture,” he says. “Men and age are still culturally dominant factors. For example, there is some rise in teenage Asian girls smoking, and some people believe that they can target the teenage girls and get to their fathers who also smoke. But that won’t work. By all means, give literature and information to the teenage girl, but she can’t take it home and give it to her father. In Asian culture, someone from the younger generation can’t teach someone from an older generation.” There are also some potentially volatile political issues to consider in selecting a spokesperson. “It’s not advisable to run Chinese and Vietnamese programs together because of historical issues that might offend Vietnamese patients,” Mr. Wong says. “And, within the Vietnamese community, physicians often are split along political lines: those who are anti-Communist and those who believe there should be political and economic ties to the current regime in Vietnam. In selecting a spokesperson, it is critical to ensure that whoever is speaking is regarded as neutral. The only way to know is to develop a relationship with community-based organizations because they will know who in their own community can speak to both groups of people.” Acculturation is another important consideration: 70% who are foreign born will hold different views and attitudes than American-born Asians. “I’m an American-born Chinese, and I’m referred to as Asian American in the same way that someone who came over from Hong Kong two months ago would be,” says Beverly J. Gor, Ed.D., associate program director of community relations and Asian American outreach coordinator at the Center for Research on Minority Health, University of Texas M.D. Anderson Cancer Center. “But we’re very different. It’s not possible to paint a broad brushstroke that encompasses all Asian Americans.” Even among populations from the same country there can be huge variations, says Ryan Nguyen, Pharm.D., manager of scientific and clinical affairs at Innovia Education Institute. “China, for example, has many different languages, and each language belongs to a different group and/or region,” he says. “Because of this, making healthcare education culturally relevant for Chinese Americans is challenging. The key here is that healthcare providers as well as pharmaceutical companies must be diligent about culture when dealing with this patient population.” While the huge spread of sub-segments in the Asian-American community might be discouraging to companies initiating an outreach or marketing campaign, experts in the field point out that it is not as daunting as it appears. According to MC2, 88% of all Asian Americans are Chinese, Filipino, Asian Indian, Vietnamese, Korean, or Japanese. Furthermore, opportunities for reaching an Asian audience are extensive and include grassroots organizations, healthcare professionals, and numerous media. “There are nearly 600 viable active Asian-American media in the United States, including satellite cable, terrestrial television, radio, magazines, and newspapers,” Mr. Moskowitz says. “Across the nation each day Asian immigrants turn to these media to find healthcare information. Doctors, hospitals, and insurance providers are already making profitable use of this media. Only the pharmaceutical industry is conspicuous by its absence.” In reaching an audience of Indian origin, for example, Rupa Ranganathan, ethnic strategist, leader ethnic and multicultural conference practice, at Strategic Research Institute, suggests tapping into IndiRap or Bhangra exercise videos, which are thriving in South-Asian youth cultures. “Companies could look to emerging Bollywood or other Asian film and media icons to build high-profile health-educational campaigns,” she says. “With the plethora of ethnic cable networks flourishing in Asian and other ethnic neighborhoods, this is a hugely untapped avenue for pharmaceutical companies to build relationships with Asian consumers and communities.” Much remains to be done. While several grassroots initiatives reach out to Asian patients, pharma has largely ignored the marketing potential. “Pharmaceutical companies often have someone in charge of ethnic outreach, but they usually tap into corporate funds as opposed to brand-marketing budgets,” Mr. Moskowitz says. “Although the nonbranded activities resulting from these efforts lead to good healthcare outcomes, the reach, impact, and ROI of the campaigns can’t begin to compare with what is possible if they were more integrated into the brand activities.” Anatomy of Health Cancer, heart disease, and cerebrovascular diseases are the leading causes of death in Asian Americans, as they are in white and black populations. Other diseases have much higher rates in Asian Americans than in non-Hispanic whites, including tuberculosis, osteoporosis, and Hepatitis B. (See box on page 25 for more information.) Depression is a leading concern for Asian-American women. According to The Office on Women’s Health, U.S. Department of Health and Human Services, Asian-American/Pacific-Islander women of all ages had the second-highest mortality rate from suicide among minority women in 2000. Among all women over the age of 65, Asian-American/Pacific-Islander women had the highest mortality rate from suicide in 2000. The National Women’s Health Information Center attributes this in part to the fact that counseling and psychotherapy are not socially acceptable in Asian cultures. Disease risks vary among the various groups of Asians. For example, the incidence of cervical cancer is five times higher among Vietnamese women than white women. And, on average, Asian-American/Pacific-Islander women have much lower rates of Pap test screening than other groups, the National Women’s Health Information Center notes. Diabetes is a leading cause of concern among Asians. According to Dr. W. Hsu, more than half the new cases in diabetes in the next two decades will come from the Pacific Rim. Dr. W. Hsu points to a number of findings on diabetes in Asians. Firstly, he says, Asians who have been in the United States for many years have about twice as high a risk for diabetes as those who live in Asia. This is particularly true for second- and third-generation immigrants. Secondly, those who come from urban areas in Asia are more likely to have diabetes than those from rural areas. “The incidence of diabetes in rural areas is about 1% to 2% compared with 8% to 10% in cities such as Hong Kong and Shanghai,” he notes. When these factors are combined, diabetes becomes an even greater issue. “For example, the Japanese in Seattle have a much higher rate of diabetes,” he says. “Up to 20% have the disease, compared with Tokyo, where the rate of diabetes is about 7%.” It is feared that the rate of diabetes among Asians is far higher than those diagnosed. Dr. W. Hsu says about 50% of diabetes sufferers in certain parts of Asia are unaware that they have the disease. Western diet plays a role in the development of Type 2 diabetes mellitus and cardiovascular disease in this population, Dr. Nguyen says. “Asian Americans develop Type 2 diabetes mellitus at lower weights than do Caucasians,” says Stephanie Hsu, M.D., medical writer at Innovia Education Institute. “Thus, although they may not be overweight, they may still be at risk for Type 2 diabetes.” Research published in the The Lancet indicates that the standards for body mass index (BMI) might not be appropriate for some Asian populations and that Asians are at risk for developing diabetes at a much lower BMI. Hepatitis is another key risk. About 1.25 million people in the United States are chronically infected with the hepatitis B virus (HBV), and 5,000 die each year from HBV-induced liver failure, the Management Sciences for Health report notes, quoting other sources. AAPIs account for about 50% of HBV infections and 50% of deaths caused by HBV-induced liver failure, the report notes. According to Ms. Edgley, Gilead Science’s program, Blocking the Invisible Enemy, was designed to raise awareness among hepatitis B sufferers in both the general and Asian-American populations. (See box on page 26 for more information.) Still, there are scant studies on Asian-American health, and the Management Sciences for Health notes that health data are of limited value because Asian Americans are such a diverse group. In an effort to redress the situation, Dr. Gor and her colleagues will initiate a survey in June to collect health data on the Chinese and Vietnamese community in Houston. “My goal is to do an Asian-language behavioral risk factors surveillance survey,” Dr. Gor says. Cultural Competency Aside from disease-specific issues, Asian Americans face healthcare barriers because of language and cultural issues. “A Korean, Chinese, or Vietnamese person can come to this country and won’t ever have to step out of his or her own community,” Ms. Cheng says. “These are isolated communities. But sometimes they are not isolated by choice. There may be anxiety about overcoming cultural and language barriers.” Trust and comfort with the American healthcare system then becomes an issue. “The first and foremost issue is trust and/or belief in Western medicine,” Dr. Nguyen says. “Given their culture and background, this group is more inclined to use home remedies or herbal medicine than Western medicine to treat their diseases. The second challenge is communication. This includes both the language barriers – between patients and physicians even though they might speak the same language – and patients’ lack of basic understanding of their illness.” One problem is the issue of access to care. Experts say many recent immigrants who have limited English are confused about their eligibility for services and have difficulty navigating the healthcare system. That becomes particularly notable given that 70% of Asian Americans are foreign born, according to the Management Sciences for Health. “First-generation Asian Americans are not as knowledgeable about latest breakthrough pharmaceuticals, and they don’t take advantage of the screening and diagnostics systems that are in place in this country,” Ms. Cheng says. Diagnosis can also be difficult, particularly with the types of cancer Asians can be susceptible to. “A lot of cancers that impact Asian Americans aren’t ones we have screenings for, so we can’t do a lot of early detection,” Dr. Gor says. “Those include liver cancer, which is more common among Asian Americans, stomach cancer, and nasopharyngeal cancer.” The lack of health insurance also is an issue for many Asian Americans. A report compiled by the Henry J. Kaiser Family Foundation and UCLA Center for Health Policy Research notes that overall 21% of AAPIs are uninsured compared with 14% of whites. Uninsured rates range from 8% for third-plus-generation AAPIs to 13% for Japanese to 34% for Koreans. “Health insurance is a new concept to many immigrants who are used to paying a fee to see their doctor only when they’re sick,” says Nita Song, president and chief operating officer at the IW Group Inc. “Many Asians are small business owners. So many Asians don’t work in companies that offer health insurance. Many employees at these businesses would prefer cash and other benefits instead of health insurance.” Asian Americans are, generally, more affluent and have a higher level of education than other ethnic groups. But poverty is a factor for certain subgroups of Asian Americans, particularly those from Southeast Asia. The Management Sciences for Health, quoting data from other reports, notes that 53% of Hmong, 41% of Cambodians, and 33% of Laotians have household incomes of less than $15,000, compared with 22% of non-Hispanic whites. In addition, there are other little-considered cultural issues that might impact the health of Asian Americans. “Many nail salons are owned by Asian women, and many of the chemicals are very strong and may be carcinogenic,” Dr. Gor says. “We’re trying to find out how many women are actually being exposed to these potential carcinogens. Also, Asians tend to eat a lot of fish, and the mercury level in some fish is a big FDA concern.” Experts note that it is important that companies, organizations, and healthcare providers develop a relationship based on trust and be sensitive to this audience’s cultural perspective when developing outreach programs for even basic health information. “For example, when providing information about a balanced diet, it is important to understand that while we might consider a balanced diet to refer to the food pyramid, foreign-born Asians might think of balance in terms of yin and yang philosophies,” Dr. Gor explains. Additionally, Asian cultures think of medicine as a way to restore the body as a whole, whereas the Western view is to dissect the condition and treat small pieces, Dr. W. Hsu says. “The approach a pharmaceutical company or healthcare professional takes in speaking with an Asian-American patient has to be sympathetic to that view,” he says. “For example with insulin, it is better to tell an Asian patient that an insulin replacement therapy restores the body’s natural insulin, rather than a product is the latest therapy. Pharmaceutical company outreach programs have to be tailored to that type of sensitivity.” Culture, philosophy, and diet define the Asian way of life and strongly influence health outlook as well as patient-compliance behavior, Ms. Ranganathan says. “An appreciation and respect for various alternate channels and systems, such as meditation, prayer and religious chanting, and feng-shui observances, will go a long way in making Asian consumers feel more secure with pharmaceutical companies, hospitals, and health-insurance companies,” she says. F PharmaVoice welcomes comments about this article. E-mail us at Nita Song In many parts of Asia, the staple diet is traditionally vegetable and fish based. But in the United States, Asians are adopting diets with a high level of animal proteins, animal fats, processed carbohydrates, and their bodies react strongly. The leading causes of death in the United States in 2001 for Asian Americans or Pacific Islanders Cancer Heart disease Stroke Unintentional injuries Diabetes Chronic lower respiratory disease Influenza and pneumonia Suicide Nephritis, nephrotic syndrome, and nephrosis Homicide In addition, Asian Americans have a disproportionately high prevalence of the following conditions and risk factors Chronic Obstructive Pulmonary Diseases (COPD) Hepatitis B HIV/AIDS Tobacco smoke Tuberculosis (TB) Source: The Office of Minority Health, U.S. Department of Health and Human Services. For more information visit Pharmaceutical Companies Reaching Out to Communities at Risk Healthcare experts have noted that incidences of chronic disease, such as diabetes, heart disease, and cancer, increase as Asians migrate from various countries in the East. Beyond that, certain Asians are already at high risk of diseases such as hepatitis B virus (HBV) and account for about 50% of HBV infections and 50% of deaths caused by HBV-induced liver failure in the United States, a report from Management Sciences for Health (MSH) notes, quoting other sources. Diabetes The incidence of diabetes is rising in Asians. According to the World Health Organization, 300 million people will have diabetes by 2025, up from 135.3 million in 1995. Of those 79.5 million will come from Southeast Asia and 56 million from the Western Pacific. Furthermore, experts at the Asian American Diabetes Initiative at Joslin Diabetes Center, which is affiliated with Harvard Medical School, say Asian Americans are at greater risk from the disease than those living in Asia. Joslin has ongoing studies investigating the relationship between heart disease, or the responsiveness of the blood vessels and how that relates to the degree of obesity in that population versus the degree of insulin sensitivity, says William Hsu, M.D., codirector of the Asian American Diabetes Initiative at Joslin and a board-certified endocrinologist. “We have studies looking at how Asian immigrant families understand medical information,” he says. “We’ve written a book in Chinese and English, Staying Healthy with Diabetes: A Guide for the Chinese American Community. We also have a bilingual Website – – to disseminate diabetes information. Our Website is being funded by Novo Nordisk, and Novo China helped with the translation of materials,” he says. Dr. Hsu says the center has worked closely with the pharmaceutical industry in its outreach campaigns. “For example, Takeda has ordered 12,000 copies of the second edition of our book because the pharmaceutical company realizes diabetes is of great concern to the community,” Dr. Hsu says. Takeda recognizes that education is a great tool and that coming into a new community it must represent itself as a pharmaceutical company that cares about the community. Elsewhere, pharmaceutical companies have been working to develop in-language, in-culture campaigns to reach this patient group. GlaxoSmithKline hired the IW Group, a marketing communications firm that specializes in reaching Asian-American communities, to educate Chinese-American consumers about Type 2 diabetes and how Avandia works. It was important that the campaign create breakthrough visuals without violating branding rules. IW Group came up with a cartoon character, Avandia Man, to reach the audience since cartoons are a popular communication form in Asia. The cartoon tells a story of how diabetes thrives on the food people consume and how Avandia can come to the rescue. The campaign, which was conducted in California and New York, placed an emphasis on community outreach, media relationships, and partnerships. “The Avandia campaign was national but with a focus on the key metro areas of San Francisco, Los Angeles, and New York,” says Nita Song, president and chief operating officer of the IW Group Inc. IW Group took the campaign to such events as the Annual Women’s Health Day, festivals, seminars and health fairs, and a healthy cooking contest. The cooking contest attracted 245 Chinese diabetes patients. Six finalists took part in a cook-off, which attracted more than 100,000 visitors. After the event, the cookbook was published. The Fourth Annual Women’s Health Day attracted about 800 visitors, many of whom visited the Avandia exhibit booth where a certified diabetes educator offered consultation. Other events where the Avandia campaign was highlighted included the San Francisco Lunar New Year Parade, the Los Angeles Summer Festival, the New York Summer Festival, the San Francisco Moon Festival, and the LA Harvest Moon Festival. Ms. Song says because GlaxoSmithKline is launching a new diabetes product, the Avandia campaign is on hold and information about prescription numbers has been hard to track. “We know that there were hundreds and thousands who came to the booth and signed forms and did surveys, but in terms of prescriptions written we don’t have a number,” she says. Hepatitis B The Asian Liver Center at Stanford University notes that Asians have the highest rate of hepatitis B of all ethnic groups, with rates of up to 15%, compared with 0.3% among the general U.S. population. The center notes that one out of four hepatitis B carriers die from liver cancer or cirrhosis. These high rates prompted Gilead Sciences, with its Blocking the Invisible Enemy program, to develop educational materials with an Asian-American focus, and translate these into various languages, including Chinese, Vietnamese, Korean, and Tagalog. “In Houston, which has one of the largest and fastest-growing Asian-American populations in the country, we partnered with local physicians and more than a dozen Asian community groups to pilot the program,” says Erin Edgley, senior specialist, public affairs, at Gilead Sciences. “In addition to hosting a launch event, we participated in Asian Lunar New Year activities and visited a Vietnamese health fair at a local Buddhist temple. Through our partners, we were able to directly reach hundreds of at-risk individuals; through their continuing activities, the program will likely reach many more.” Elsewhere, GlaxoSmithKline once again approached the IW Group to reach Asian Americans with information about HBV with relation to its product Epivir. “The goal of the Epivir campaign was to expand the prescription base for Epivir-HBV throughout the Asian-American population in United States,” says Hiroko Hatanaka, VP, management supervisor/general manager, at IW Group Inc. in New York. “If untreated chronic hepatitis B leads to liver cancer.” Ms. Song says the goal of the Epivir campaign was to educate people about hepatitis B and drive them to get blood tests. “Once they received blood tests, we directed them to a doctor in their area, based on their zip codes, who spoke their language,” Ms. Song says. “The other component of the campaign was to educate the physician community about Epivir and to inform them about the education campaign we were conducting with the consumer. The expectation was that the doctors would probably identify Epivir as one of the first remedies that they would recommend.” The pilot program was conducted in the Chinese-American community in New York in 2000, Ms. Hatanaka says. “Since then the program has been expanded to San Francisco, San Jose, Los Angeles, Orange County, Seattle, Chicago, and Houston targeting Chinese, Korean, and Vietnamese Americans who tend to have high prevalence rates of chronic hepatitis B,” she notes. The program encouraged a number of initiatives such as American Cancer Society-Asian Units Hepatitis B prevention campaign, Lower Manhattan Hepatitis B Project, Ms. Hatanaka says. “It continues to mobilize various community health organizations and Chinese physicians’ associations to educate Asian Americans on this issue,” she says. Dr. William Hsu While on a national basis Asian Americans may not comprise a huge market, on a regional basis they comprise a significant market share. Larry Moskowitz Ignorance of screening opportunities and new treatment protocols is the greatest barrier to treatment, and a simple one for direct-to-consumer marketers to overcome. An Untapped Market In March 2002, 12.5 million Asians and Pacific Islanders lived in the United States, comprising 4.4% of the population, according to 2002 Census data. The Census Bureau projects that the Asian-American population will grow to 37.6 million individuals by the year 2050, making up 9.3% of the population. While currently not a large segment of the market, the Asian-American market is particularly interesting in terms of regional campaigns. The western part of the United States had the highest proportion of Asians in its total population in 2000, according to Census data. Data also show 95% of Asians Americans and Pacific Islanders (AAPIs) live predominantly in metropolitan areas. And 51% of all AAPIs reside in just three states: California, Hawaii, and New York. Ten states – California, Florida, Hawaii, Illinois, Massachusetts, New Jersey, New York, Texas, Virginia, and Washington – account for 75% of the Asian population, according to the 2000 Census. New York City has the largest Asian population, 872,777, followed by Los Angeles with 407,444. Michael Wong The Asian-American community is nearly 5% of the population and in about 50 years will be about 10%. this population base, which already is well educated and has the highest average household income, will be a force to be reckoned with. Donna Fucello There is a very real need to provide education targeted to these special populations in the United States. Dr. Beverly Gor It’s important to develop a sense of trust within the community and not just do a quick campaign and leave. Rupa Ranganathan Asian-American access to the Internet and computers is significantly higher than the average, yet marketers have not fully exploited Asian-American portals or the Internet marketing space. Dr. Stephanie Hsu Asian Americans develop type 2 diabetes mellitus at lower weights than do Caucasians. Thus, although they may not be overweight, they may still be at risk for Type 2 diabetes mellitus. Experts on this topic Wanla Cheng. President, Asia Link Consulting Group, New York; Asia Link is a full-service multicultural marketing research and consulting company focused on the Asian-American market. For more information, visit Erin Edgley. Senior Specialist, Public Affairs, Gilead Sciences, Foster City, Calif.; Gilead Sciences is a biopharmaceutical company with six marketed products and a clinical, preclinical, and research pipeline focused on developing anti-infectives. For more information, visit Donna Fucello. Executive Director; stephanie hsu, m.d. Medical Writer; ryan nguyen, pharm.d. Manger of Scientific and Clinical Affairs, INNOVIA Education Institute; INNOVIA Education Institute, Columbia, Md., part of the Columbia MedCom Group, provides CME activities for physicians by blending high-caliber science with strategic marketing campaigns to help ensure the success of educational activities. For more information, visit Beverly J. Gor, Ed.D. Associate Program Director of Community Relations and Asian American Outreach Coordinator at the Center for Research on Minority Health, University of Texas M.D. Anderson Cancer Center, Houston; The mission of The University of Texas M.D. Anderson Cancer Center is to eliminate cancer in Texas, the nation, and the world through integrated programs in patient care, research, education, and prevention. For more information, visit Hiroko Hatanaka. VP, Account Management, General Manager, IW Group Inc., New York; IW Group is a fully integrated, full-service marketing communications firm that specializes in reaching the growing Asian communities in the United States. For more information, visit William Hsu, M.D. Codirector of the Asian American Diabetes Initiative, Joslin Diabetes Center, Boston; Joslin Diabetes Center is an internationally recognized diabetes treatment, research, and education institution affiliated with Harvard Medical School. For more information, visit Larry Moskowitz. VP, Strategic Marketing Services, Kang & Lee Advertising, New York; Kang & Lee Advertising is a marketing and communications agency specializing in the Asian-American market. For more information, visit Rupa Ranganathan. Ethnic Strategist, Leader Ethnic and Multicultural Conference Practice, Strategic Research Institute, New York; The Strategic Research Institute creates, produces, and manages conferences covering industry specific business-to-business topics. For more information, visit Nita Song. President and Chief Operating Officer, IW Group Inc., Los Angeles; IW Group is a fully integrated, full-service marketing communications firm that specializes in reaching the growing Asian communities in the United States. For more information, visit Michael W. Wong, J.D. Multicultural Consultant, Vancouver; Mr. Wong offers advice to pharma companies embarking on campaigns that target the Asian- American community. For more information, e-mail

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