Haeok Lee
FAAN PhD RN
Professor
hl5209@nyu.edu
1 212 998 5714
Professor
433 FIRST AVENUE
NEW YORK, NY 10010
United States
Haeok Lee's additional information
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Haeok Lee, FAAN, PhD, RN, is a professor at NYU Rory Meyers College of Nursing. She is an experienced nurse behavioral scientist with extensive clinical and research experience with populations affected by health disparities. Her research has played a critical role in the national and global recognition of health disparities, especially related to cervical and liver cancers among Asians and Africans. Prof. Lee is currently the site PI on an NIH/NIA-funded grant (R56 AG069130) for the Asian Ancestry Cohort for Alzheimer's Disease Study. Lee is particularly interested in culturally linguistically responsive and theory-based storytelling narrative interventions tailored to targeted racial/ethnic minority populations. Her research, which is noteworthy for its theoretical base, holds considerable promise for the development of practice guidelines and interventions for improving health communication and changing health behaviors to move toward global health equity. She has conducted her studies globally with colleges in several countries.
Before joining the faculty at NYU Meyers, she was a nursing professor at the University of Massachusetts Boston from 2008–2022. She was also on faculty at the University of Colorado Health Sciences Center and Case Western Reserve University. She mentors faculty, postdoctoral scholars, PhD students, and undergraduate students from diverse racial/ethnic backgrounds from diverse disciplines. She has sponsored overseas visiting scholars.
Among her many honors, Lee received the 2022 American Nurses Association, Massachusetts Excellence in Nursing Research Awards. She was honored by Choson University, South Korea as the 2012 Excellent Chosun Alumni for Contributions in Education and Social Justice. She has provided advice to the Korean Nurses Association as a Senior Advisor in Global Health as well as has served on several NIH review panels in the areas of vaccination behavior, HIV/AIDs, and global health.
Lee earned her PhD from the University of California San Francisco, a Master in Nursing Education from Yonsei University, and a BSN from Chosun University. She received a postdoctoral fellowship from the University of California San Francisco, Clinical Cardiology.
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Publications
Human papillomavirus: A qualitative study of Korean American female college students’ attitudes toward vaccination
AbstractKim, M., Lee, H., Kiang, P., & Kim, D. (2017). Clinical Journal of Oncology Nursing, 21(5), E239-E247. 10.1188/17.CJON.E239-E247AbstractBACKGROUND: Human papillomavirus (HPV) vaccines have the potential to reduce Korean American women’s high burden of cervical cancer, but information is limited about their awareness of HPV and its vaccine. OBJECTIVES: This study aimed to explore Korean American female college students’ awareness of and attitudes toward HPV vaccination. METHODS: A qualitative descriptive study was used. Five focus group interviews were conducted with 20 Korean American female college students aged 18–26 years from Massachusetts. Data were analyzed using inductive content analysis. FINDINGS: Major themes were awareness, misunderstandings, attitudes, social influences, and cultural influence. A critical need exists to develop and implement culturally and linguistically appropriate HPV prevention education programs to promote HPV vaccination in this population.Cervical cancer screening in developing countries: Using visual inspection methods
AbstractLee, H., Kang, Y., & Ju, W. (2016). Clinical Journal of Oncology Nursing, 20(1), 79-84. 10.1188/16.CJON.79-83AbstractBackground: Cervical cancer is the fourth most common cancer among women worldwide. Most diagnoses occur in developing countries where cases are detected in later stages with poorer prognoses. Cervical cancer is a preventable disease; however, most women in developing and resource-limited countries do not have the access to the same methods of cervical cancer screening as women in developed countries. Objectives: The objectives of this review are to examine and discuss (a) the burden of cervical cancer in developing countries, (b) the socioeconomic determinants of primary and secondary prevention of cervical cancer, and (c) the use of visual inspection methods of screening with acetic acid (VIA) and Lugol’s iodine (VILI) as alternative strategies for cervical cancer screening in areas with limited resources. Methods: A critical review was conducted of the literature and recommendations on the role of VIA in cervical cancer prevention in developing countries. Findings: Visual inspection methods of screening for cervical cancer have emerged as a low-cost, safe, and effective alternative to cytology screening and can be administered to a large proportion of targeted women in developing countries. VIA and VILI can be performed by nurses, midwives, and paramedic staff after a short competency-based training program. In addition, visual screening provides immediate results in real time, permitting a single-visit, screen-and-treat approach, which is an effective strategy to overcome issues of nonadherence to follow-up visits among women in developing countries.Factors Associated with HPV Vaccination among Cambodian American Teenagers
AbstractLee, H., Kim, M., Kiang, P., Shi, L., Tan, K., Chea, P., Peou, S., & Grigg-Saito, D. C. (2016). Public Health Nursing, 33(6), 493-501. 10.1111/phn.12294AbstractObjectives: Parents have general influence over their children's health and health behavior. However, given the dearth of specific literature regarding knowledge level and social and cultural factors influencing HPV vaccination behaviors among Cambodian American (CA) parent, it is difficult to develop an effective, evidence-based public health HPV vaccination program. Therefore, the objectives of this study were to determine the HPV vaccine uptakes among CA teenagers and to examine factors influencing HPV vaccine uptakes. Design and Sample: A descriptive, cross-sectional survey design and a combination of network and targeted sampling methods were used. Results: CA mothers (n = 130) completed a health survey through face-to-face interviews in either English or Khmer language. Girls vaccination rates were 29% while that of boys was 16%. Awareness and knowledge of HPV among CA mothers was very low, and many believed that their daughters, who speak English and were educated in the U.S., had more knowledge about health than they did. Logistic regression analysis showed that CA girls had significantly higher odds of vaccination when their mothers possessed a higher level of English reading ability and had greater awareness and knowledge of HPV. Conclusions: The strikingly low rates of HPV vaccination among CA girls and boys underscore the need to improve vaccination outreach, education, and uptake. The findings can be used to develop targeted public health HPV vaccination programs for CAs, which will reduce cervical cancer disparities.Storytelling/narrative theory to address health communication with minority populations
AbstractLee, H., Fawcett, J., & DeMarco, R. (2016). Applied Nursing Research, 30, 58-60. 10.1016/j.apnr.2015.09.004AbstractPurpose: To explain the development and application of storytelling/narrative theory in health disparities intervention research as a way to promote health communication and behavior change among racial, ethnic, and minority populations. Findings: The proposed storytelling theory helps explain that storytelling affects changes in attitude and health behavior of the viewer through realism, identification, and transportation. Conclusions: The proposed storytelling/narrative theory can be a guide to develop culturally grounded narrative interventions that have the ability to connect with hard-to-reach populations. Clinical Relevance: Narrative communication is context-dependent because it derives meaning from the surrounding situation and provides situation-based stories that are a pathway to processing story content. Although storytelling is grounded in nursing practice and education, it is underutilized in nursing interventional research. Future efforts are needed to extend theory-based narrative intervention studies designed to change attitude and behaviors that will reduce health disparities among minorities.Khmer American Mothers' Knowledge about HPV and HBV Infection and Their Perceptions of Parenting: My English Speaking Daughter Knows More
AbstractLee, H., Kiang, P., Tang, S. S., Chea, P., Peou, S., Semino-Asaro, S., & Grigg-Saito, D. C. (2015). Asian Nursing Research, 9(2), 168-174. 10.1016/j.anr.2015.03.001AbstractSummary Purpose The purpose of this study is to explore and describe Khmer mothers' understanding of HBV and HPV prevention as well as their perception of parenting on health and health education of their daughters in the US. Methods The qualitative pilot study guided by the revised Network Episode Model and informed by ethnographic analysis and community-based purposive sampling method were used. Face-to-face audiotaped interviews with eight Khmer mothers were conducted by bilingual female middle-aged community health leaders who spoke Khmer. Results The findings revealed that Khmer mothers clearly lacked knowledge about HBV and HPV infection prevention and had difficulty understanding and educating their daughters about health behavior, especially on sex-related topics. The findings showed that histo-sociocultural factors are integrated with the individual factor, and these factors influenced the HBV and HPV knowledge and perspective of Khmer mothers' parenting. Conclusions The study suggests that situation-specific conceptual and methodological approaches that take into account the uniqueness of the sociocultural context of CAs is a novel method for identifying factors that are significant in shaping the perception of Khmer mothers' health education related to HBV and HPV prevention among their daughters. The communication between mother and daughter about sex and the risk involved in contracting HBV and HPV has been limited, partly because it is seen as a "taboo subject" and partly because mothers think that schools educate their children regarding sexuality and health.Recognizing global disparities in health and in health transitions in the 21st century: What can nurses do?
AbstractLee, H., Kim, S., DeMarco, R., Aronowitz, T., Mtengezo, J., Kang, Y., Yang, Y., Touch, C., & Fitzpatrick, J. J. (2015). Applied Nursing Research, 28(1), 60-65. 10.1016/j.apnr.2014.09.004AbstractPurpose: To examine changes in patterns of health and disease in global context between rich countries (USA, Korea, South Africa) and poor countries (Cambodia, Malawi) by using the framework of epidemiology theory developed by Orman (1971, 2005), and to raise awareness of global health disparities thereby prompting actions to reduce such disparities. Findings: 1) Life expectancy has increased across all selected countries except South Africa; 2) Korea and the USA have substantially lower mortality rates than other countries; 3) Infant and maternal mortality are still high in the poor countries; 4) The major cause of mortality in the poor countries is still communicable disease with evidence of the onset of non-communicable disease; and 5) The health transition theory provides a description and explanation of the differences in progress in economic development between countries but fails to explain differences in health status within and between countries. Conclusions: Life expectancy and mortality are enormously different among the five selected countries. This excessive health disparity is primarily due to the higher risk of communicable diseases in low-income countries. Social determinants of health are mainly responsible for the health disparities observed within and between countries. Clinical relevance: Future health care development and global research priorities will not be the same for all countries because the pattern of health transitions in the developing countries is not the same as the developed countries. Actions to reduce global health disparities need to recognize the conditions and social context in which persons live. An effective strategic approach to global health equality should develop a shared system of values, priorities, and delivery infrastructures with the populations who are targeted, aligning delivery within the local social contexts.Asian flushing: Genetic and sociocultural factors of alcoholism among East Asians
AbstractLee, H., Kim, S. S., You, K. S., Park, W., Yang, J. H., Kim, M., & Hayman, L. L. (2014). Gastroenterology Nursing, 37(5), 327-336. 10.1097/SGA.0000000000000062AbstractAlcoholuse can lead to a cascade of problems such as increased chances of risky behavior and negative health consequences, including alcoholic liver disease and upper gastric and liver cancer. Ethanol is metabolized mainly by 2 major enzymes: alcohol dehydrogenase (ADH) and acetaldehyde dehydrogenase (ALDH). Genetic variations of genes encoding the 2 enzymes are very common among East Asians but relatively rare for most other populations. Facial flushing and other physical discomforts after alcohol drinking triggered by accumulation of acetaldehyde through defective genes for ADH and ALDH have been reported. Approximately 40% of East Asians (Chinese, Japanese, and Korean) show facial flushing after drinking alcohol, known as "Asian flush," which is characterized by adverse reactions on alcohol drinking in individuals possessing the fasting metabolizing alleles for ADH, ADH1B∗2, and ADH1C∗1, and the null allele for ALDH and ALDH2∗2. Alcoholism is determined not only by the genetic deficiency but also by behaviors that involve complex interactions between genetic and sociocultural factors. The purpose of this article was to provide nurses with the most current information about genetic and sociocultural influences on alcoholism and alcohol-related health problems specifically for East Asians and implications of this knowledge to nursing practice. The physiological phenomenon of genes and genetics in relation to alcohol metabolism in this special population is emphasized.Factors associated with alcohol problems among Asian American college students: Gender, ethnicity, smoking and depressed mood
AbstractKim, S. S., Lee, H. O., Kiang, P., Kalman, D., & Ziedonis, D. M. (2014). Journal of Substance Use, 19(1), 12-17. 10.3109/14659891.2012.709912AbstractObjective: This study examined gender, ethnicity and psychological factors associated with alcohol problems among Asian American college students, using the CAGE questionnaire. Method: The study is a cross-sectional, school-based survey. College students who self-identified as Asian, participated. Results: The sample comprised 258 Asian American college students (132 men and 126 women). In all, 17.7% of males and 8.9% of females had alcohol problems based on CAGE score of 2 or more; yet, the difference was marginally significant (χ2 [1, N = 225] = 3.7, p = 0.08). Chinese and Vietnamese males tended to have more alcohol problems than females in their respective ethnic subgroups. Among Koreans, more females (33%) had the problems than males (11%). Male students did not differ in alcohol problems by ethnicity, whereas Korean females were more likely to have the problems (χ2 [4, N = 112] = 13.0, p = 0.01) than females in the other groups. After controlling for gender, Asian American college students who were older (≥25), smoking currently and reporting depressed mood were more likely to have alcohol problems. Conclusions: College health center workers should monitor more closely Asian students who have the risk factors for early detection of and treatment for alcohol problems.HBV-related health behaviors in a socio-cultural context: Perspectives from Khmers and Koreans
AbstractLee, H., Kiang, P., Chea, P., Peou, S., Tang, S. S., Yang, J. H., Fawcett, J., & Hann, H. W. (2014). Applied Nursing Research, 27(2), 127-132. 10.1016/j.apnr.2013.11.012AbstractPurpose: The aim of this study is to explore factors influencing health and health care within the sociocultural context of Cambodian Americans (CAs or Khmers) and Korean Americans (KA) and to examine intergroup similarities and differences between CAs and KAs, focusing on hepatitis B virus (HBV) and liver cancer prevention behaviors. Methods: The study used a qualitative design guided by the revised Network Episode Model (NEM) and informed by ethnographic analysis. Focus group interviews with key informants among CA community health leaders (CHLs, n= 14) and individual interviews with key informants of KA CHLs (n= 9) were audiotaped and transcribed. Results: Three categories that influenced HBV and liver cancer prevention emerged from both CAs and KAs: the socio-cultural, individual, and behavioral. Four additional subcategories (sub-themes) of sociocultural were identified as socio-history, socio-medicine, socio-linguistic, and socio-health resources. Both CAs and KAs, however, have low levels of knowledge and significant misunderstandings about HBV infection. Conclusions: The study identifies and compares the social-cultural determinant for HBV and liver cancer and highlights the factors of education, intercultural communication, and interactions within socio-cultural contexts of CA and KA subgroups. In general, conceptual overlaps are apparent between Khmers (from now on, the terms, CA and Khmer, will be used interchangeably) and Koreans except for the sub-theme of socio-history. However, differences in concept-specific attributes point to the need to account for differing conceptualizations and implications of specific ethnic groups' sociocultural contexts, and to design contextually-relevant outreach and educational interventions for targeted AAPI subgroups.Hepatitis B virus infection and immunizations among Asian American college students: Infection, exposure, and immunity rates
AbstractLee, H., Kiang, P., Watanabe, P., Halon, P., Shi, L., & Church, D. R. (2013). Journal of American College Health, 61(2), 67-74. 10.1080/07448481.2012.753891AbstractObjectives: To evaluate the prevalence of hepatitis B virus (HBV) infection, exposure, and immunity among Asian American college students as a basis for evaluating HBV screening and vaccination policy. Participants and Methods: Self-identified Asian American college students aged 18 years or older were examined. Serological tests of HBV surface antigens, antibodies to HBV core antigens (anti-HBc), and antibodies to HBV surface antigens (anti-HBs) were used to determine HBV infection and immunization prevalence. Results: Among US-born students (n = 66), none was infected with HBV, 68% (n = 45) had immunity from vaccination, and 1 student had evidence of past exposure to HBV. Among foreign-born students (n = 142), 4% (n = 5) had evidence of chronic HBV infection, 62% (n = 88) had immunity from vaccination, and 19% (n = 27) had results indicating past exposure to HBV. Asian American college students showed very little knowledge of HBV vaccination; 43% reported that they had received vaccination, whereas 50% did not know whether they had received it or not. Conclusions: The prevalence of current and past HBV infection among foreign-born Asian American college students is significantly higher (p <.01), than US-born students. The lack of awareness of their HBV-infected status points out the importance of routine HBV screening of high-risk populations such as Asian students.