ChristianaCare Brings Cancer Screenings, Preventive Care to Delaware’s Chinese Community

Xiangfen “Fen” Gu remembers clearly her first days on the job as a community health educator more than a decade ago. Newly arrived from China herself, Gu visited every Chinese restaurant she could find across New Castle County, Delaware. Her message to the other Mandarin speakers there was simple yet essential: “I’m here to help.”

Gu, now in her 14th year at ChristianaCare’s Helen F. Graham Cancer Center & Research Institute, understood firsthand how overwhelming the American health system could be, especially for recent immigrants. Provider networks, insurance plans, referrals and preventive care protocols often differ dramatically from health care systems in Mandarin speakers’ countries of origin. This complexity frequently leads to confusion and delayed care, even when services are just minutes away.

For many in Delaware’s Mandarin-speaking community, important but non-urgent matters like completing preventive screenings and establishing a primary care provider stay on the back burner as they navigate life in a new country. Gu was determined to bridge these gaps, one relationship at a time.

Binh Pham, a chef at a local hibachi restaurant, was among those Fen approached early on. Pham had lived in Delaware for over 20 years but, like many in his community, he and his wife were isolated by language barriers and a deep unfamiliarity with U.S. health care system. Before meeting Gu, getting medical attention meant driving to Philadelphia’s Chinatown, even though ChristianaCare was just minutes away.

“Before I met Fen, I didn’t know how to get care,” Pham said in Mandarin, his native language. “I didn’t know who to ask or where to go.”

Mandarin speakers, understand your risk of cancer and find the right cancer screening program for you.

Gu stepped in, assisting Pham and his family with enrolling in health insurance, establishing primary care and scheduling critical cancer screenings. Recognizing their financial concerns, she also helped them enroll in Delaware’s Screening for Life program, which provides free cancer screening tests to qualified residents. Through this program, the Phams were able to access essential screenings at little to no cost, ensuring they received timely preventive care.

Additionally, Gu helped Pham manage heart-related health issues and connected his wife with a specialist for stomach problems. Gu’s guidance gave the family confidence to navigate care close to home.

Now, Pham strongly encourages others in the Mandarin-speaking community to seek help from “the teacher.”

“Just go to Fen,” he advises. “She will help you.”

Building trust as the first step

Trust is at the heart of Gu’s work. Many people she meets come from a culture where a doctor is consulted only in emergencies, not for prevention. Gu patiently explains the importance of early detection, especially for colorectal, cervical and breast cancers. Through persistent, respectful outreach, Gu turns skepticism into action.

“When one person gets help and trusts you, they tell their families and friends,” she said. “Trust spreads through the whole community.”

Gu stays connected through WeChat — an app widely used in the Chinese community — and organizes annual Community Health Days with the Chinese American Medical Association, creating welcoming spaces where people can ask questions in their native languages.

Nora Katurakes, MSN, RN, OCN, manager of Community Health Outreach and Education at the Graham Cancer Center, has watched Gu’s role expand from basic awareness to a robust navigation model tailored to overcome cultural, linguistic and structural barriers.

“Fen understands exactly what her community faces,” Katurakes said. “She reminds me all the time that the health system here is different, and she helps people understand insurance, appointments and everything in between.”

Gu’s work represents one component of ChristianaCare’s broader strategy to address social drivers of health and eliminate disparities in health care access and outcomes. By developing culturally responsive approaches for specific communities, ChristianaCare is creating models that can be adapted for historically underserved populations throughout Delaware.

“Excellent cancer care depends on clinical quality and ensuring every community can access it with confidence,” said Carolmarie Mahoney, MBA, corporate director, Medical Group, Graham Cancer Center. “Our outreach efforts help reduce disparities by building trust, sharing information, and connecting people to support through trusted advocates like our community health educators. When we understand what people need and what they’re experiencing, we can deliver care that leads to better outcomes and works better for each person.”

A force in the community

Chinese American adults generally have lower cancer screening rates than white adults, according to a 2024 American Cancer Society report. Nationally, only 51% of Chinese adults age 45 and older are up-to-date with colorectal cancer screening, compared to 57% of white adults. Breast and cervical cancer screening rates among Chinese women also trail those of other groups, contributing to delayed diagnoses and missed opportunities for early treatment.

In Delaware, Gu is helping to close those gaps one patient at a time. Since 2013, she has guided hundreds of residents through screenings and primary-care visits, including about 50 new clients over the past year.

Appointments, tests and checkups now happen close to home for the Pham family and others. A neighbor hears about Gu. A friend shares her WeChat. Little by little, more people ask questions about obtaining health insurance, schedule screenings and access other services.

“When someone tells me their life was saved because of this work,” Gu said, “it reminds me why my job matters.”

Are you or someone you know facing challenges accessing health care due to language barriers or unfamiliarity with the system? ChristianaCare’s community health educators can help connect you with appropriate screenings, primary care providers, and support services. Don’t wait for symptoms to appear — preventive care saves lives. Reach out today to learn how we can support your health journey.