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Torres P, Guitelman J, Lucio A, Rini C, Molina Y. Medical Advocacy among Latina Women Diagnosed with Breast Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:495. [PMID: 38673406 PMCID: PMC11049890 DOI: 10.3390/ijerph21040495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/06/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024]
Abstract
Medical advocacy has continued to significantly impact quality of life and survivorship outcomes among Latina breast cancer survivors in the United States. However, little is known about the unique experiences of Latina survivors, including the perceived value, process, and context in which they practice medical advocacy. To help address this gap, we conducted a qualitative, secondary analysis of semi-structured focus groups with 18 Latina breast cancer survivors from Chicago, Illinois. Eligible women had to self-identify as (1) female, (2) Latina, (3) 18 years or older, and (4) having a breast cancer diagnosis 5 years ago or more. In total, 61% of participants were 50-59 years old, 83% were born in Mexico, and 100% spoke Spanish. The three emergent themes from the focus groups were (1) the cultural need for Latina advocates and support groups; (2) the process and experiences of becoming a community advocate within Latine culture; and (3) the cultural contexts for advocacy by Latina breast cancer survivors. Latina survivor advocates share strengths of receiving ongoing health education, peer support, and access to resources when being linked to a support group furthering their exposure to role models, increasing their awareness of opportunities in medical advocacy, and providing an entry to participate in medical advocacy.
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Affiliation(s)
- Paola Torres
- University of Illinois Cancer Center, University of Illinois, Chicago, IL 60612, USA;
| | - Judith Guitelman
- Asociación Latina de Asistencia y Prevención del Cáncer de Mama (ALAS-WINGS), Chicago, IL 60657, USA;
| | | | - Christine Rini
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Yamilé Molina
- University of Illinois Cancer Center, University of Illinois, Chicago, IL 60612, USA;
- Division of Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
- Hospital & Health Sciences Systems Mile Square Health Center, University of Illinois, Chicago, IL 60612, USA
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2
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miR-28-5p's Targeting of GAGE12I Inhibits Proliferation, Migration, and Invasion of Gastric Cancer in Vitro. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:6946051. [PMID: 36212971 PMCID: PMC9546678 DOI: 10.1155/2022/6946051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/31/2022] [Accepted: 09/16/2022] [Indexed: 11/18/2022]
Abstract
GAGE12I is a tumor metastasis-promoting factor, which can induce gastric cancer cells to invade and migrate. We investigated the effect of miR-28-5p targeting GAGE12I on proliferation, invasion, and migration of human gastric cancer cell lines SGC-7901, AGS, and MGC-803. The expression levels of miR-28-5p and GAGE12I were detected by real-time PCR and western blot, respectively. Cell proliferation, migration, and invasion were measured by MTT and Transwell chamber. The interaction between miR-28-5p and GAGE12I was investigated by bioinformatics analysis and luciferase assay. Results showed that the expression of miR-28-5p in human gastric cancer cell lines was lower than that in normal gastric epithelial cells (P < 0.05). Overexpression of miR-28-5p suppressed cell proliferation, invasion, and migration (P < 0.05). GAGE12I was confirmed as a target of miR-28-5p. Cell proliferation, invasion, and migration were decreased in cells transfected with shGAGE12I compared with those of the scrambled group (P < 0.05). Collectively, miR-28-5p negatively regulated GAGE12I and reduced the proliferation, invasion, and migration of gastric cancer cells.
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Woodard N, Chen C, Huq MR, He X, Knott CL. Prior health promotion experience and intervention outcomes in a lay health advisor intervention. HEALTH EDUCATION RESEARCH 2022; 37:266-277. [PMID: 35726480 PMCID: PMC9340964 DOI: 10.1093/her/cyac015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 04/26/2022] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
Training lay community members to implement health promotion interventions is an effective method to educate medically underserved populations. Some trainings are designed for individuals who already have a health-related background; however, others are developed for those with no previous health promotion experience. It is unknown whether those with backgrounds in health promotion are more effective in this role than those without. This study assessed the relationship between health promotion experience among trained community health advisors (CHAs) and their self-efficacy to implement an evidence-based cancer control intervention, as well as cancer knowledge and screening behavior outcomes among intervention participants. Data were collected from 66 trained CHAs and 269 participants in CHA-led cancer awareness and early detection workshops. CHAs reported high self-efficacy to implement the intervention independent of their health promotion experience. CHA health promotion experience was neither indicative of differences in participant colorectal or breast cancer knowledge at 12 months, nor of changes in participant-reported cancer screening. However, participant prostate cancer knowledge at 12 months was greater when taught by CHAs with previous health promotion experience (P < 0.01). Prior health promotion experience of trained health advisors may not be pivotal across all contexts, but they may affect specific knowledge outcomes.
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Affiliation(s)
| | - Chang Chen
- Department of Epidemiology and Biostatistics, University of Maryland, SPH Building, 4200 Valley Drive, Rm 2234, College Park, MD 20742-2611, USA
| | - Maisha R Huq
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, SPH Building, 4200 Valley Drive, Rm 1234, College Park, MD 20742-2611, USA
| | - Xin He
- Department of Epidemiology and Biostatistics, University of Maryland, SPH Building, 4200 Valley Drive, Rm 2234, College Park, MD 20742-2611, USA
| | - Cheryl L Knott
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, SPH Building, 4200 Valley Drive, Rm 1234, College Park, MD 20742-2611, USA
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Almeida R, Lopez-Macha A, Dugatkin T, Joseph G, Duron Y, Hurtado de Mendoza A, D. Graves K, Fejerman L. Community research collaboration to develop a promotores-based hereditary breast cancer education program for Spanish-speaking Latinas. HEALTH EDUCATION RESEARCH 2021; 36:319-336. [PMID: 34113985 PMCID: PMC9115327 DOI: 10.1093/her/cyab011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Indexed: 06/12/2023]
Abstract
Breast cancer (BC) is the most common cancer in Latinas and the leading cause of cancer death. Latinas tend to be diagnosed at later stages, receive poorer quality care and have a higher risk of mortality than non-Latina White (NLW) women. Among women with a genetic predisposition to hereditary BC, genetic counseling can be beneficial. Latinas participate in genetic counseling at lower rates than NLW women. The goal of this study was to develop comprehensive, culturally appropriate materials for community health educators (promotores)-led hereditary BC education program for Spanish-speaking Latinas. We developed the curriculum through feedback from 7 focus groups, with a total of 68 participants (35 promotores and 33 community members). We used a mixed-methods approach that relied on quantitative analysis of survey questions and qualitative content analysis of the focus groups transcripts. Pre and post promotores' training survey responses suggested improvement in the promotores' cancer-related knowledge. Themes that emerged from the qualitative analyses were (i) barriers to health education and/or care; (ii) importance of educating the Latino community about BC and genetics and (iii) role of the promotores. Future research will further evaluate the impact of the program in promotores' knowledge and community members' screening behaviors.
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Affiliation(s)
| | | | | | - Galen Joseph
- University of California, San Francisco, CA, USA
| | | | | | | | - Laura Fejerman
- University of California, San Francisco, CA, USA
- University of California, Davis, San Francisco, CA, USA
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5
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Shah SK, Nakagawa M, Lieblong BJ. Examining aspects of successful community-based programs promoting cancer screening uptake to reduce cancer health disparity: A systematic review. Prev Med 2020; 141:106242. [PMID: 32882299 PMCID: PMC7704699 DOI: 10.1016/j.ypmed.2020.106242] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/17/2020] [Accepted: 08/25/2020] [Indexed: 01/27/2023]
Abstract
Certain minorities in the US are disproportionately burdened with higher cancer incidence and mortality rates. Programs encouraging timely uptake of cancer screening measures serve to reduce cancer health disparities. A systematic literature review was conducted to assess the effectiveness and the qualities of these programs, and to elucidate characteristics of success programs to aid in designing of future ones. We focused on community-based programs rather than clinic-based programs as the former are more likely to reach disadvantaged populations, and on prevention programs for breast, cervical, and/or colon cancers as longstanding screening recommendations for these cancers exist. PubMed, CINAHL and EBSCO databases were searched for articles that utilized community organizations and community health workers. Fourteen programs described in 34 manuscripts were identified. While 10 of 14 programs reported statistically significant increases in cancer prevention knowledge and/or increase in screening rates, only 7 of them enrolled large numbers of participants (defined as ≥1000). Only 7 programs had control groups, only 4 programs independently verified screening uptake, and 2 programs had long-term follow-up (defined as more than one screening cycle). Only one program demonstrated elimination of cancer health disparity at a population level. While most community-based cancer prevention programs have demonstrated efficacy in terms of increased knowledge and/or screening uptake, scalability and demonstration in reduction at a population level remain a challenge.
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Affiliation(s)
- Sumit K Shah
- University of Arkansas for Medical Sciences, College of Medicine, Department of Pathology, 4301 W. Markham St. Slot 845, Little Rock, AR 72205, United States of America
| | - Mayumi Nakagawa
- University of Arkansas for Medical Sciences, College of Medicine, Department of Pathology, 4301 W. Markham St. Slot 845, Little Rock, AR 72205, United States of America
| | - Benjamin J Lieblong
- University of Arkansas for Medical Sciences, College of Medicine, Department of Pathology, 4301 W. Markham St. Slot 845, Little Rock, AR 72205, United States of America.
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Portillo EM, Vasquez D, Brown LD. Promoting Hispanic Immigrant Health via Community Health Workers and Motivational Interviewing. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2020; 41:3-6. [PMID: 31924133 PMCID: PMC7347455 DOI: 10.1177/0272684x19896731] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Hispanic immigrant health disparities are among the highest in the nation, especially related to obesity and access to health services. Healthy Fit (En Forma Saludable) is a health promotion program that leverages public health department infrastructure to address these disparities through the use of three key innovations explored in this article: community health workers (CHWs), motivational interviewing (MI), and vouchers for free preventative health services. CHWs trained in MI conduct a health screening and then distribute preventive service vouchers and health resources as needed based on screening results. Vouchers cover breast, cervical, and colorectal cancer screening, and several vaccinations including flu and human papillomavirus. Resources to support exercise, to support a healthy diet, to quit smoking, and to reduce risky drinking are also distributed as needed. CHWs then use MI to address perceived barriers and strengthen intrinsic motivation to make use of the health resources. Integrating these strategies provides a low-cost approach to promote healthy behavior in an underserved immigrant population.
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Affiliation(s)
- Erin M. Portillo
- Department of Psychology, The University of Texas at El Paso, El Paso, TX 79968
| | - Denise Vasquez
- School of Public Health in El Paso, The University of Texas Health Science Center at Houston, El Paso, TX 79905
| | - Louis D. Brown
- School of Public Health in El Paso, The University of Texas Health Science Center at Houston, El Paso, TX 79905
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Adams C. Toward an institutional perspective on social capital health interventions: lay community health workers as social capital builders. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:95-110. [PMID: 31674684 DOI: 10.1111/1467-9566.12992] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This article argues that social capital health research should move beyond a mere focus on social cohesion and network perspectives to integrate an institutional approach into the development of social capital health interventions. An institutional perspective, which is unique in its emphasis on linking social capital in addition to the bonding and bridging forms, contextualises social capital, allowing researchers to confront the complexity of social relationships. This perspective allows for the construction of interventions that draw on the resources of diverse actors, particularly the state. One intervention strategy with the potential to create community linkages involves lay community health workers (LCHWs), individuals who are trained to perform a variety of health-related functions but lack a formal professional health education. This article begins with a review of the institutional social capital-building literature. It then goes on to briefly review the social capital and health literature and discuss the state of intervention research. Thereafter, it describes LCHWs and discusses studies that have utilised LCHWs to tackle community health problems. In doing so, this article presents an institutional-based systematic framework for how LCHWs can build social capital, including a discussion of the ways in which LCHWs can successfully promote bonding, bridging and linking social capital.
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Affiliation(s)
- Crystal Adams
- Department of Sociology and Anthropology, Muhlenberg College, Allentown, Pennsylvania, USA
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Disparities in Postmastectomy Breast Reconstruction: A Systematic Review of the Literature and Modified Framework for Advancing Research Toward Intervention. Ann Plast Surg 2019; 81:495-502. [PMID: 29851727 DOI: 10.1097/sap.0000000000001503] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND As the United States' population diversifies, eliminating disparities in health and healthcare has become increasingly important across all disciplines of medicine, including plastic and reconstructive surgery. This is evidenced by the growing body of literature in recent years focusing on disparities in postmastectomy breast reconstruction. No study to date has evaluated whether this research is progressing appropriately to promote tangible evidence-based interventions to reduce these disparities. METHODS A systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines was performed to identify studies focusing on disparities in postmastectomy breast reconstruction. A previously established public health framework for advancing health disparities research was used to inform analysis of the quality and progression of the included studies. This triphasic framework categorizes disparities research as follows: detecting (identifies and measures disparities in vulnerable populations), understanding (establishes determinants of disparities), or reducing (proposes and evaluates interventions for eliminating disparities). RESULTS Ninety-five studies were identified between 1979 and 2016, with 61 (64.2%) published after 2010. The majority of studies (51.6%) were retrospective cohort or case-control studies (American Society of Plastic Surgery level III evidence). Fifty-eight (63.7%), 31 (34.1%), and 2 (2.2%) studies provided detecting-, understanding- and reducing-phase disparities research, respectively. Non-plastic and reconstructive surgery journals accounted for 70.5% of all articles and for most higher phase research articles, publishing 83.9% and 100% of second and third phase studies, respectively. Disparity categories investigated included race/ethnicity, age, income, insurance status/type, geography, and education level, with race/ethnicity being the most common (73.7%). The most commonly measured outcome was percent of subpopulation receiving reconstruction (63, 66.3%), followed by reconstruction type (14, 16.7%). Patient-, provider-, system-, and research-level factors were all identified as potential targets for interventions to reduce disparities. CONCLUSIONS Despite a recent increase in literature focusing on postmastectomy breast reconstruction disparities, the majority focuses on identifying vulnerable populations with inadequate progression to second (understanding) and third (reducing) phases. Increasing research funding, availability of language-concordant and culturally concordant educational materials, and advocacy and sociopolitical awareness within the plastic surgery community is necessary to advance research on postmastectomy breast reconstruction and, ultimately, eliminate it.
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Molina Y, Watson KS, San Miguel LG, Aguirre K, Hernandez-Flores M, Giraldo TB, Lucio A, Coronado N, Matthews PA. Integrating multiple community perspectives in intervention development. HEALTH EDUCATION RESEARCH 2019; 34:357-371. [PMID: 31121040 PMCID: PMC6646948 DOI: 10.1093/her/cyz018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 04/29/2019] [Indexed: 06/09/2023]
Abstract
We offer a framework and exemplify how to integrate multiple community perspectives in research to develop breast cancer screening interventions among Latinas non-adherent to national guidelines. We leverage members of an academic institution's community consultative service [community engagement advisory board (CEAB) members]; study team members [community health workers (CHWs)] and study-eligible individuals (non-adherent Latinas). First, we asked what was needed from CEAB members (N=17), CHWs (N=14) and non-adherent Latinas (N=20) in one-time semi-structured group consultations and focus groups. Second, we drafted materials. Third, we conducted group consultations and focus groups with a new set of CEAB members (N=13), CHWs (N=17) and non-adherent Latinas (N=16) to reflect on our initial analysis and draft materials. Fourth, we finalized interventions. Certain recommendations were shared across stakeholders and simple to integrate (e.g. costs → access to free services). Some recommendations varied, but complementary integration was possible (e.g. location versus recruitment → multiple recruitment in multiple community areas). Others were distinct across stakeholders and resulted in strategies to recognize participants' agency and inform their choices about breast cancer screening (e.g. differences in preferred information about screening → personalized information and evidence about all screening options).
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Affiliation(s)
| | | | - Liliana G San Miguel
- Community Health Sciences Division, University of Illinois at Chicago, Chicago, IL, USA
| | - Karen Aguirre
- Community Health Sciences Division, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Tatiana B Giraldo
- Community Health Sciences Division, University of Illinois at Chicago, Chicago, IL, USA
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Mosavel M, Barker KL, Gardiner HM, Siminoff LA. Responsiveness and adaptability in community engaged biobanking research: experiences from a Hispanic community. J Community Genet 2019; 10:395-406. [PMID: 30610570 PMCID: PMC6591347 DOI: 10.1007/s12687-018-0397-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 11/07/2018] [Indexed: 10/27/2022] Open
Abstract
The success of biobanking research relies on the willingness of the public to provide biological and sociological information, donate tissue samples, and complete psychosocial questionnaires. Medical advances made through biobanking research have limited reach if tissues are not obtained from a diverse sample of individuals. Within, we describe the process of transitioning a small group of Hispanic community members who met regularly into a more formal Hispanic Community Advisory Board (HCAB) for the Genotype-Tissue Expression (GTEx) project. The sole purpose of the HCAB was to provide input and feedback on GTEx and, specifically, how researchers can best address the concerns of the Hispanic community related to tissue donation. This initial purpose was adapted to be responsive to the HCAB's request to include educating others in the Hispanic community who were not a part of the advisory board about genomic biobanking. While HCAB members' knowledge of biobanking was limited, a strong need for culturally tailored information about the impact of biobanking medical discoveries and their potential benefit to the Hispanic community was expressed. The HCAB's feedback guided revisions to GTEx study documents to specifically address concerns about language use, clarity, and context including the need for consent forms to address cultural concerns and fears. HCAB members also collaborated on the development of a walk-through exhibition which provided a visual, narrative-based explanation of GTEx and the process of tissue donation for research and biobanking purposes. The HCAB demonstrated the value of including community participation in scientific research projects, for both scientists and lay communities, and underscored the importance of developing community engagement approaches that are adaptable and responsive to community needs. Our experience with the HCAB serves as exemplar for a unique paradigm of community inclusiveness and education in research.
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Affiliation(s)
- Maghboeba Mosavel
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, 830 East Main Street, One Capitol Square, 4th floor, Richmond, VA 23219 USA
| | - K. Laura Barker
- College of Public Health, Temple University, 1700 N. Broad Street, Suite 417, Philadelphia, PA 19121 USA
| | - Heather M. Gardiner
- Department of Public Health, College of Public Health, Temple University, 1301 Cecil B. Moore Ave., Ritter Annex, 9th Floor, Philadelphia, PA 19122 USA
| | - Laura A. Siminoff
- College of Public Health (286-00), Bell Building (TECH CENTER), 1101 Montgomery Ave., Philadelphia, PA 19122 USA
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Educating Latinas about cervical cancer and HPV: a pilot randomized study. Cancer Causes Control 2019; 30:375-384. [PMID: 30830494 DOI: 10.1007/s10552-019-01150-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 02/22/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The purpose of this study was to assess effects of three different educational intervention arms on knowledge of and intention to receive Pap testing and HPV co-testing. METHODS Three active educational intervention arms were developed: a fotonovela, a radionovela, and a digital story. A pilot randomized controlled trial of 160 Latinas was conducted to assess the effectiveness of the intervention arms in increasing knowledge of cervical cancer and HPV and intention to be screened for cervical cancer compared to an attention control group (flu vaccination). RESULTS Women in all three treatment arms significantly increased knowledge about cervical cancer compared to control arm (p = 0.02). Knowledge about cervical cancer screening also increased in the active arms compared to control (p = 0.0003). Knowledge of HPV risk also increased relative to the control (p = 0.0001). There were no significant differences between the intervention arms in increased knowledge of cervical cancer or cervical cancer screening (p = 0.57 and 0.16, respectively). DISCUSSION This study supported the use of small media interventions in narrative education form as effective in increasing knowledge and intention to be screened for cervical cancer. The three culturally relevant interventions, built on qualitative data, were all successful in increasing knowledge.
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Santiago-Rivas M, Benjamin S, Andrews JZ, Jandorf L. Breast Density Awareness and Knowledge, and Intentions for Breast Cancer Screening in a Diverse Sample of Women Age Eligible for Mammography. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:90-97. [PMID: 28808894 PMCID: PMC5812844 DOI: 10.1007/s13187-017-1271-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The objectives of this study were to assess breast density knowledge and breast density awareness, and to identify information associated with intention to complete routine and supplemental screening for breast cancer in a diverse sample of women age eligible for mammography. We quantitatively (self-report) assessed breast density awareness and knowledge (N = 264) in black (47.7%), Latina (35.2%), and white (17%) women recruited online and in the community. Most participants reported having heard about breast density (69.2%); less than one third knew their own breast density status (30.4%). Knowing their own breast density, believing that women should be notified of their breast density in their mammogram report, and feeling informed if being provided this information are associated with likelihood of completing mammogram. Intending mammogram completion and knowledge regarding the impact of breast density on mammogram accuracy are associated with likelihood of completing supplemental ultrasound tests of the breast. These findings help inform practitioners and policy makers about information and communication factors that influence breast cancer screening concerns and decisions. Knowing this information should prepare practitioners to better identify women who may have not been exposed to breast density messages.
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Affiliation(s)
- Marimer Santiago-Rivas
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1130, New York, NY, 10029, USA.
| | - Shayna Benjamin
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1130, New York, NY, 10029, USA
| | - Janna Z Andrews
- Department of Radiation Medicine, Hofstra Northwell School of Medicine at Hofstra University, Hempstead, NY, 11549, USA
| | - Lina Jandorf
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1130, New York, NY, 10029, USA
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13
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Conley T, Enriquez M, Cheng AL, Jorge D, Meristal SY, Coe B, Logan PR, Stiles S, Beall G, Biggs A, McKinsey DS. The Jonas Hypertension Program: An Academic-Community Partnership to Address Hypertension in Four Dominican Bateyes. HISPANIC HEALTH CARE INTERNATIONAL 2018; 17:11-17. [PMID: 30590947 DOI: 10.1177/1540415318819487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Adults living in bateyes (i.e., sugarcane plantation villages) in the Dominican Republic have minimal access to health care services. Hypertension (HTN) is a serious and often unrecognized health problem among batey residents. The Jonas Batey Hypertension Program was built on existing social networks to address the detection and treatment of HTN. METHODS An ongoing community-based participatory research endeavor involves a partnership among three organizations and collaboration with promotoras who engage their batey communities in a mobile HTN screening and treatment program. Adults are screened and, if indicated, are treated with antihypertensive medications. Data collection includes project documentation, participant observation, demographic data, blood pressure (BP) measurements, and pill counts. RESULTS To date, 243 adults have received HTN treatment in four batey communities. A within-group, as-treated, repeated-measures, pre-/postanalysis showed that among participants who had been receiving antihypertensive treatment for 12 months ( n = 70), there was a significant decrease in BP ( p < .005). CONCLUSION Results of an interim data analysis indicate that the program model has been implemented successfully and is making a positive impact on BP control. Evaluation is ongoing with regard to the long-term HTN-related health outcomes of batey residents. Ensuring program sustainability is an important consideration for the future.
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Affiliation(s)
| | - Maithe Enriquez
- 1 University of Missouri, Columbia, MO, USA.,2 Dominican Republic Medical Partnership, Prairie Village, KS, USA
| | - An-Lin Cheng
- 3 University of Missouri-Kansas City, Kansas City, MO, USA
| | - Dorcas Jorge
- 4 Fundacion Enciende Una Luz (Light a Candle), La Romana, Dominican Republic
| | - Sandy Yan Meristal
- 4 Fundacion Enciende Una Luz (Light a Candle), La Romana, Dominican Republic
| | | | - Pamela R Logan
- 2 Dominican Republic Medical Partnership, Prairie Village, KS, USA
| | - Steven Stiles
- 2 Dominican Republic Medical Partnership, Prairie Village, KS, USA
| | - Ginny Beall
- 2 Dominican Republic Medical Partnership, Prairie Village, KS, USA
| | - Alfred Biggs
- 2 Dominican Republic Medical Partnership, Prairie Village, KS, USA
| | - David S McKinsey
- 2 Dominican Republic Medical Partnership, Prairie Village, KS, USA
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14
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Perez LG, Elder JP, Haughton J, Martinez ME, Arredondo EM. Socio-demographic Moderators of Associations Between Psychological Factors and Latinas' Breast Cancer Screening Behaviors. J Immigr Minor Health 2018; 20:823-830. [PMID: 28752364 PMCID: PMC5787042 DOI: 10.1007/s10903-017-0633-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This study tested whether socio-demographic factors moderated associations between psychological factors and Latinas' breast cancer screening behaviors. 222 churchgoing Latinas (40-65 years) in San Diego, CA completed surveys assessing socio-demographics (e.g., income and acculturation), psychological factors (e.g., perceived barriers to screening), and cancer screening behaviors. Multilevel models examined associations of socio-demographic and psychological factors (and their interactions) with adherence to annual mammography or clinical breast exam (CBE) screening. Although no main effects were found, there were moderation effects. Acculturation moderated associations between perceived barriers to screening and both screening outcomes, with inverse associations only among the high-acculturation group. Education moderated the relationship between perceived barriers to screening and CBE screening, with an inverse association only among the low-education group. Marital status moderated the relationship between depressive symptoms and CBE screening, with an inverse association only among single/non-partnered participants. Interventions are needed targeting psychological barriers to breast cancer screening among Latinas.
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Affiliation(s)
- L G Perez
- Joint Doctoral Program in Public Health, University of California, San Diego/San Diego State University, San Diego, CA, USA.
- Institute for Behavioral and Community Health, San Diego, CA, USA.
| | - J P Elder
- Institute for Behavioral and Community Health, San Diego, CA, USA
- Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA, USA
| | - J Haughton
- Institute for Behavioral and Community Health, San Diego, CA, USA
| | - M E Martinez
- Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - E M Arredondo
- Institute for Behavioral and Community Health, San Diego, CA, USA
- Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA, USA
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15
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Molina Y, San Miguel LG, Tamayo L, Robledo C, Díaz CS, Lucio A, Coronado N, Ferrans CE. The "Empowering Latinas to Obtain Breast Cancer Screenings" study: Rationale and design. Contemp Clin Trials 2018; 71:1-8. [PMID: 29803815 DOI: 10.1016/j.cct.2018.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/08/2018] [Accepted: 05/22/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Latinas suffer disproportionately from breast cancer (BC) in part due to lower guideline-concordant screening. Multiple intervention approaches have been developed to promote screening through direct patient education and empowerment approaches (i.e., training community members to share BC information). This study compares the relative effects of these approaches on: 1) women's BC screening; and, 2) women's dissemination of BC information within their social networks. DESIGN/METHODS Our quasi-experimental trial is being implemented in community venues in two predominantly Latino neighborhoods in South and West Chicago. Eligible participants: 1) are female; 2) are 52-74 years old; 3) have not obtained a mammogram in the past 2 years; and, 4) have not previously participated in health-related volunteerism. Based on their geographic location, participants are assigned to one of two group-based interventions. Both interventions consist of three two-hour sessions, which includes BC early detection education. The education intervention sessions also covers BC prevention (diet, physical activity), whereas the empowerment intervention covers sharing information with family/friends, and health volunteerism. Navigation is provided for all women who wish to obtain mammograms. Primary outcomes include: 1) receipt of BC screening; and, 2) participants' dissemination of BC information. Secondary outcomes include positive changes in 1) participants' self-reported psychosocial facilitators; and, 2) social network members' BC behaviors. DISCUSSION The design of our program allows for a preliminary comparison of the effectiveness of these two approaches. This work will inform larger comparativeness trials and offers a new approach to intervention evaluation via social network analysis.
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16
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Molina Y, McKell MS, Mendoza N, Barbour L, Berrios NM, Murray K, Ferrans CE. Health Volunteerism and Improved Cancer Health for Latina and African American Women and Their Social Networks: Potential Mechanisms. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:59-66. [PMID: 27328950 PMCID: PMC5179314 DOI: 10.1007/s13187-016-1061-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Health volunteerism has been associated with positive health outcomes for volunteers and the communities they serve. This work suggests that there may be an added value to providing underserved populations with information and skills to be agents of change. The current study is a first step toward testing this hypothesis. The purpose is to identify how volunteerism may result in improved cancer health among Latina and African American women volunteers. A purposive sample of 40 Latina and African American female adults who had participated in cancer volunteerism in the past 5 years was recruited by community advocates and flyers distributed throughout community venues in San Diego, CA. This qualitative study included semi-structured focus groups. Participants indicated that volunteerism not only improved their health but also the health of their family and friends. Such perceptions aligned with the high rates of self-report lifetime cancer screening rates among age-eligible patients (e.g., 83-93 % breast; 90-93 % cervical; 79-92 % colorectal). Identified mechanisms included exposure to evidence-based information, health-protective social norms and support, and pressure to be a healthy role model. Our findings suggest that train-the-trainer and volunteer-driven interventions may have unintended health-protective effects for participating staff, especially Latina and African American women.
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Affiliation(s)
- Yamile Molina
- University of Illinois at Chicago, Chicago, IL, USA.
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
| | | | | | - Lynda Barbour
- American Cancer Society Cancer Action Network, Washington, DC, USA
| | | | - Kate Murray
- University of California, San Diego, CA, USA
- Queensland University of Technology, Brisbane, Australia
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17
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Yoeli H, Cattan M. Insiders and incomers: how lay public health workers' knowledge might improve public health practice. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:1743-1751. [PMID: 28370767 DOI: 10.1111/hsc.12446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/19/2017] [Indexed: 06/07/2023]
Abstract
Since 2005, health trainers and other lay public health workers (LPHWs) have been increasingly active in the UK. Although elsewhere in the world LPHWs are expected to come from the communities within which they work and know that their knowledge is valued, neither is the case for LPHWs in the UK. This study sought to discover the lay knowledge of health trainers and other LPHWs, aiming to ascertain how this knowledge might more effectively be utilised within UK public health services. This paper describes a participatory and ethnographic case study research project undertaken on an anonymised urban estate in North East England. Findings were generated by a range of means including by participant observation and semi-structured interviews. Seven LPHWs took part, as did 32 other community members. This study found that the lay health knowledge of an individual UK LPHW is determined primarily by his or her position within, or in relation to, the community within which he or she works. Insider LPHWs possess an embodied knowledge and incomer LPHWs possess an experiential knowledge which, although different from one another, are essentially interpersonal in nature. Lay health knowledge can take different forms, and different LPHWs can provide different forms of lay health knowledge. Public health structures and services in the UK should make better use of all forms of LPHW knowledge, and should seek from LPHWs training on how to engage the most 'hard-to-reach' or 'difficult-to-engage' groups. Services recruiting LPHWs should decide whether they are seeking embodied insider LPHW knowledge, experiential incomer LPHW knowledge or a mixture of both.
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Affiliation(s)
- Heather Yoeli
- Volunteer lecturer in Qualitative Research Methods, Qualitative Research Methods, Northumbria University, Newcastle upon Tyne, UK
| | - Mima Cattan
- Professor Emeritus of Public Health & Wellbeing (Knowledge Translation), Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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18
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Elder JP, Haughton J, Perez LG, Martinez ME, De la Torre CL, Slymen DJ, Arredondo EM. Promoting cancer screening among churchgoing Latinas: Fe en Acción/faith in action. HEALTH EDUCATION RESEARCH 2017; 32:163-173. [PMID: 28380627 PMCID: PMC5914432 DOI: 10.1093/her/cyx033] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 01/30/2017] [Indexed: 06/07/2023]
Abstract
Cancer screening rates among Latinas are generally low, reducing the likelihood of early cancer detection in this population. This article examines the effects of a community intervention (Fe en Acción/Faith in Action) led by community health workers (promotoras) on promoting breast, cervical and colorectal cancer screening among churchgoing Latinas. Sixteen churches were randomly assigned to a cancer screening or a physical activity intervention. We examined cancer knowledge, barriers to screening and self-reported mammography, clinical breast exam, Pap test, fecal occult blood test and sigmoidoscopy or colonoscopy at baseline and 12 months follow-up. Participants were 436 adult Latinas, with 16 promotoras conducting a cancer screening intervention at 8 out of 16 churches. The cancer screening intervention had a significant positive impact on self-reported mammography (OR = 4.64, 95% CI: 2.00-10.75) and breast exams in the last year (OR= 2.82, 95% CI: 1.41-5.57) and corresponding reductions in perceived (87.6%) barriers to breast cancer screening (P < .008). Cervical and colorectal cancer screening did not improve with the intervention. These findings suggest Fe en Acción church-based promotoras had a significant impact on promoting breast cancer screening among Latinas. Colon cancer screening promotion, however, remains a challenge.
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Affiliation(s)
- J. P. Elder
- Institute for Behavioral and Community Health (IBACH), Graduate School of Public Health, San Diego State University, San Diego, CA 92123, USA
- Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, University of California, San Diego Moores Cancer Center, La Jolla, CA 92093, USA
| | - J. Haughton
- Institute for Behavioral and Community Health (IBACH), Graduate School of Public Health, San Diego State University, San Diego, CA 92123, USA
| | - L. G. Perez
- Institute for Behavioral and Community Health (IBACH), Graduate School of Public Health, San Diego State University, San Diego, CA 92123, USA
| | - M. E. Martinez
- Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, University of California, San Diego Moores Cancer Center, La Jolla, CA 92093, USA
| | - C. L. De la Torre
- Institute for Behavioral and Community Health (IBACH), Graduate School of Public Health, San Diego State University, San Diego, CA 92123, USA
| | - D. J. Slymen
- Institute for Behavioral and Community Health (IBACH), Graduate School of Public Health, San Diego State University, San Diego, CA 92123, USA
| | - E. M. Arredondo
- Institute for Behavioral and Community Health (IBACH), Graduate School of Public Health, San Diego State University, San Diego, CA 92123, USA
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19
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Montealegre JR, Mullen PD, L Jibaja-Weiss M, Vargas Mendez MM, Scheurer ME. Feasibility of Cervical Cancer Screening Utilizing Self-sample Human Papillomavirus Testing Among Mexican Immigrant Women in Harris County, Texas: A Pilot Study. J Immigr Minor Health 2016; 17:704-12. [PMID: 25358741 DOI: 10.1007/s10903-014-0125-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Here we evaluate the acceptability and feasibility of self-sample human papillomavirus (HPV) testing (self-HPV) among a sample of predominantly Mexican immigrant women who never or sporadically attend for Pap testing. Immigrant women who had not had a Pap test in the past 3 years (n = 100) were recruited. Participants self-collected a cervical sample for HPV testing. High-risk (HR) HPV-positive women were referred for clinical follow-up. Acceptability of self-HPV was high, with 99% reporting that they would be willing to use self-HPV regularly. Nineteen women (19%) tested positive for HR-HPV. Of these, 50% obtained clinical follow-up within 3 months. For those who did not, the primary barrier to follow-up was difficulty obtaining healthcare coverage. In conclusion, self-HPV is highly acceptable to Mexican immigrant women who otherwise do not attend for Pap testing. While the approach addresses critical barriers to primary screening, questions remain as to whether uninsured HR-HPV positive women are able to attend for clinical follow-up.
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Affiliation(s)
- Jane R Montealegre
- Department of Pediatrics, Baylor College of Medicine, One Baylor Plaza, MS: BCM 305, Houston, TX, 77030, USA,
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20
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Messias DKH, Parra-Medina D, Sharpe PA, Treviño L, Koskan AM, Morales-Campos D. Promotoras de Salud: roles, responsibilities, and contributions in a multisite community-based randomized controlled trial. HISPANIC HEALTH CARE INTERNATIONAL 2015; 11:62-71. [PMID: 24695944 DOI: 10.1891/1540-4153.11.2.62] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
There is widespread recognition of the cultural and linguistic appropriateness of (a Spanish term for community health workers [CHW]) in health education and outreach among Hispanic communities. Yet, there are significant gaps in the literature regarding the preparation, implementation, and evaluation of ' engagement in research. To address this gap, we examine ' research-related training, roles, responsibilities, and contributions in a community-based participatory research project involving a multisite randomized controlled trial (RCT) of a physical activity intervention for Mexican-origin women in Texas and South Carolina. We identify both benefits and challenges associated with ' engagement as community researchers; examine variations and differences in roles and responsibilities related to the research contexts, sites, settings, and individual characteristics; and discuss implications for research and practice.
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21
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Arredondo EM, Haughton J, Ayala GX, Slymen DJ, Sallis JF, Burke K, Holub C, Chanson D, Perez LG, Valdivia R, Ryan S, Elder J. Fe en Accion/Faith in Action: Design and implementation of a church-based randomized trial to promote physical activity and cancer screening among churchgoing Latinas. Contemp Clin Trials 2015; 45:404-415. [PMID: 26358535 PMCID: PMC4770876 DOI: 10.1016/j.cct.2015.09.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 09/01/2015] [Accepted: 09/03/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To describe both conditions of a two-group randomized trial, one that promotes physical activity and one that promotes cancer screening, among churchgoing Latinas. The trial involves promotoras (community health workers) targeting multiple levels of the Ecological Model. This trial builds on formative and pilot research findings. DESIGN Sixteen churches were randomly assigned to either the physical activity intervention or cancer screening comparison condition (approximately 27 women per church). In both conditions, promotoras from each church intervened at the individual- (e.g., beliefs), interpersonal- (e.g., social support), and environmental- (e.g., park features and access to health care) levels to affect change on target behaviors. MEASUREMENTS The study's primary outcome is min/wk of moderate-to-vigorous physical activity (MVPA) at baseline and 12 and 24 months following implementation of intervention activities. We enrolled 436 Latinas (aged 18-65 years) who engaged in less than 250 min/wk of MVPA at baseline as assessed by accelerometer, attended church at least four times per month, lived near their church, and did not have a health condition that could prevent them from participating in physical activity. Participants were asked to complete measures assessing physical activity and cancer screening as well as their correlates at 12- and 24-months. SUMMARY Findings from the current study will address gaps in research by showing the long term effectiveness of multi-level faith-based interventions promoting physical activity and cancer screening among Latino communities.
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Affiliation(s)
- Elva M Arredondo
- Graduate School of Public Health, San Diego State University, Institute for Behavioral and Community Health (IBACH), San Diego, CA, USA.
| | - Jessica Haughton
- Graduate School of Public Health, San Diego State University, Institute for Behavioral and Community Health (IBACH), San Diego, CA, USA
| | - Guadalupe X Ayala
- Graduate School of Public Health, San Diego State University, Institute for Behavioral and Community Health (IBACH), San Diego, CA, USA
| | - Donald J Slymen
- Graduate School of Public Health, San Diego State University, Institute for Behavioral and Community Health (IBACH), San Diego, CA, USA
| | - James F Sallis
- Department of Family Medicine and Public Health, University of California, San Diego, Active Living Research, San Diego, CA, USA
| | - Kari Burke
- Graduate School of Public Health, San Diego State University, Institute for Behavioral and Community Health (IBACH), San Diego, CA, USA
| | - Christina Holub
- Graduate School of Public Health, San Diego State University, Institute for Behavioral and Community Health (IBACH), San Diego, CA, USA
| | - Dayana Chanson
- Graduate School of Public Health, San Diego State University, Institute for Behavioral and Community Health (IBACH), San Diego, CA, USA
| | - Lilian G Perez
- Graduate School of Public Health, San Diego State University, Institute for Behavioral and Community Health (IBACH), San Diego, CA, USA
| | | | - Sherry Ryan
- School of Public Affairs, San Diego State University, San Diego, CA, USA
| | - John Elder
- Graduate School of Public Health, San Diego State University, Institute for Behavioral and Community Health (IBACH), San Diego, CA, USA
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22
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Haughton J, Ayala GX, Burke KH, Elder JP, Montañez J, Arredondo EM. Community Health Workers Promoting Physical Activity: Targeting Multiple Levels of the Social Ecological Model. J Ambul Care Manage 2015; 38:309-20. [PMID: 26280587 PMCID: PMC4565764 DOI: 10.1097/jac.0000000000000108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The effectiveness of community health workers (CHWs) as health educators and health promoters among Latino populations is widely recognized. The Affordable Care Act created important opportunities to increase the role of CHWs in preventive health. This article describes the implementation of CHW-led, culturally specific, faith-based program to increase physical activity among churchgoing Latinas. This study augments previous research by describing the recruitment, selection, training, and evaluation of CHWs for a physical activity intervention targeting multiple levels of the Social Ecological Model.
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Affiliation(s)
- Jessica Haughton
- College of Health and Human Services (Dr Ayala) and Graduate School of Public Health (Drs Elder and Arredondo), Institute for Behavioral and Community Health (Mss Haughton and Montañez), San Diego State University, San Diego, California; and Upstate University Hospital, SUNY Upstate Medical University, Syracuse, New York (Ms Burke)
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23
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Davis JL, Ramos R, Rivera-Colón V, Escobar M, Palencia J, Grant CG, Green BL. The Yo me cuido® Program: Addressing Breast Cancer Screening and Prevention Among Hispanic Women. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:439-446. [PMID: 25099235 DOI: 10.1007/s13187-014-0710-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Breast cancer is less likely to be diagnosed at the earliest stage in Hispanic/Latino (Hispanic) women compared to non-Hispanic White women, even after accounting for differences in age, socioeconomic status, and method of detection. Moffitt Cancer Center created a comprehensive health education program called Yo me cuido (®) (YMC) to address and reduce breast cancer disparities among Spanish- and English-speaking Hispanic women by providing breast cancer and healthy lifestyles awareness and education, and promoting breast cancer screenings, reminders, and referrals for women 40 years and older. The purpose of this paper is to showcase the innovative approaches and methods to cancer prevention and early detection of the YMC program, and to promote it as an effective tool for improving outcomes in community health education, outreach, and engagement activities with Hispanic populations. Key components of the program include educational workshops, mammogram referrals, and a multimedia campaign. The YMC program is unique because of its approaches in reaching the Hispanic population, such as delivering the program with compassionate services to empower participants to live a healthier lifestyle. Additionally, direct follow-up for mammography screenings is provided by program staff. From 2011 to 2013, YMC has educated 2,226 women and 165 men through 93 workshops. About 684 (52 %) women ages 40 and older have had a screening mammogram within their first year of participating in the program. The YMC program is an innovative cancer education and outreach program that has demonstrated a positive impact on the lives of the Hispanic community in the Tampa Bay region.
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Affiliation(s)
- Jenna L Davis
- Moffitt Cancer Center, Moffitt Diversity, 12902 Magnolia Drive-MBC Diversity, Tampa, FL, USA,
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24
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Mann L, Foley KL, Tanner AE, Sun CJ, Rhodes SD. Increasing Cervical Cancer Screening Among US Hispanics/Latinas: A Qualitative Systematic Review. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:374-387. [PMID: 25154515 PMCID: PMC4344418 DOI: 10.1007/s13187-014-0716-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Hispanic/Latina women experience the highest cervical cancer incidence rates of any racial/ethnic group in the USA and tend to present with more severe cases and experience higher mortality compared to most other populations. The goals of this qualitative systematic review were to explore existing interventions to increase cervical cancer screening among US Hispanics/Latinas and to identify characteristics of effective interventions and research gaps. Six online databases were searched from their inception through June 30, 2013, using designated search terms and keywords. Peer-reviewed articles that documented an intervention designed to improve screening for cervical cancer among Hispanics/Latinas ages 18 years and older living in the USA were reviewed. Data were abstracted using a standardized form to document intervention characteristics and results. Forty-five articles, describing 32 unique interventions, met inclusion criteria. Identified interventions consisted primarily of educational programs and/or provision of screening. Interventions used lay health advisors (LHAs), clinic-based outreach/delivery strategies, partnerships with churches, and mass media campaigns. Twelve interventions resulted in significant increases in cervical cancer screening rates. Interventions developed utilizing theory, applying community-based participatory research approaches, and using LHAs were identified as having the greatest potential for improving cervical cancer screening among Hispanics/Latinas. There continues to be a need for the development of interventions in geographic areas with new and emerging Hispanic/Latino populations and that are comprehensive, follow participants for longer periods of time, and broaden the roles and build the capacities of LHAs.
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Affiliation(s)
- Lilli Mann
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA,
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25
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Sly J, Jandorf L, Erwin DO. Who's Missing? Predictors of Attrition Following Participation in Culturally Targeted Educational Breast and Cervical Cancer Outreach Programs for Latinas. JOURNAL OF HEALTH COMMUNICATION 2015; 20:851-858. [PMID: 26010727 DOI: 10.1080/10810730.2015.1018596] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Rates of breast and cervical cancer screening among Latinas are suboptimal. The Esperanza y Vida program was developed to increase awareness of screening methods among Latinas. Lay health advisor cancer survivors are trained to deliver the program and use a narrative communication approach to promote breast and cervical cancer awareness and screening. This study aimed to identify characteristics of participants, within the larger study, who were lost, due to attrition, for follow-up assistance. Participants (N = 908) completed questionnaires that assessed knowledge, perceptions, and beliefs about breast and cervical cancer and were contacted after the program to assess screening and offer assistance in obtaining screening exams. Latinas who were younger than 40 years of age and who felt that the survivor's story would prompt them to make an appointment for screening were more likely to be lost to follow-up at 2 months. These findings have implications for future breast and cervical cancer outreach programs and interventions.
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Affiliation(s)
- Jamilia Sly
- a Department of Oncological Sciences , Icahn School of Medicine at Mount Sinai , New York , New York , USA
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26
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Hou SI, Roberson K. A systematic review on US-based community health navigator (CHN) interventions for cancer screening promotion--comparing community- versus clinic-based navigator models. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:173-86. [PMID: 25219543 DOI: 10.1007/s13187-014-0723-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
This study synthesized lessons learned from US-based community and clinic health navigator (CHN) interventions on cancer screening promotion to identify characteristics of models and approaches for addressing cancer disparities. The combination terms "cancer screening" and "community health workers or navigators" or "patient navigators" were used in searching Medline, CINAHL, and PsycInfo. A total of 27 articles published during January 2005∼April 2014 were included. Two CHN models were identified: community-based (15 studies) and clinic/hospital-based (12 studies). While both models used the term "navigators," most community-based programs referred them as community health workers/navigators/advisors, whereas clinic-based programs often called them patient navigators. Most community-based CHN interventions targeted specific racial/ethnic minority or rural groups, while clinic-based programs mostly targeted urban low income or mixed ethnic groups. Most community-based CHN programs outreached members from community networks, while clinic-based programs commonly worked with pre-identified in-service clients. Overall, regardless model type, CHNs had similar roles and responsibilities, and interventions demonstrated effective outcomes. Our review identified characteristics of CHN interventions with attention to different settings. Lessons learned have implication on the dissemination and implementation of CHN interventions for cancer screening promotion across setting and target groups.
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Affiliation(s)
- Su-I Hou
- Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, 309 Ramsey Center, Athens, GA, 30602, USA,
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27
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Jones M, Ross B, Cloth A, Heller L. Interventions to reach underscreened populations: a narrative review for planning cancer screening initiatives. Int J Public Health 2015; 60:437-47. [PMID: 25712244 DOI: 10.1007/s00038-015-0666-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 02/10/2015] [Accepted: 02/13/2015] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES This review was conducted to support knowledge translation (KT) and implementation of interventions to increase participation in organized cancer screening programs in the province of Ontario, Canada. METHODS A rigorously designed literature search yielded over 900 references which were then subjected to exclusion criteria. The remainder was organized according to type of intervention, based on the categories applied in two authoritative systematic reviews and an analysis of the level of evidence. Emerging themes in the literature were then identified to provide a bridge between high-level evidence and on-the-ground practice. RESULTS We identify three promising types of KT interventions: community-based health education; lay or peer health education; and targeted or tailored interventions. Each is summarized with illustrative examples and a summary of key themes and considerations. CONCLUSIONS The authors conclude with a summary the types and a decision tool designed to help KT and implementation teams select interventions which could be adapted to their own context.
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28
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Ortega AN, Rodriguez HP, Vargas Bustamante A. Policy dilemmas in Latino health care and implementation of the Affordable Care Act. Annu Rev Public Health 2015; 36:525-44. [PMID: 25581154 DOI: 10.1146/annurev-publhealth-031914-122421] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The changing Latino demographic in the United States presents a number of challenges to health care policy makers, clinicians, organizations, and other stakeholders. Studies have demonstrated that Latinos tend to have worse patterns of access to, and utilization of, health care than other ethnic and racial groups. The implementation of the Affordable Care Act (ACA) of 2010 may ameliorate some of these disparities. However, even with the ACA, it is expected that Latinos will continue to have problems accessing and using high-quality health care, especially in states that are not expanding Medicaid eligibility as provided by the ACA. We identify four current policy dilemmas relevant to Latinos' health and ACA implementation: (a) the need to extend coverage to the undocumented; (b) the growth of Latino populations in states with limited insurance expansion;
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Affiliation(s)
- Alexander N Ortega
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, California 90095-1772; ,
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29
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Jandorf L, Hecht MF, Winkel G, Thélémaque LD, Saad-Harfouche FG, Bursac Z, Greene P, Erwin DO, Jandorf L. Increasing Cancer Screening for Latinas: Examining the Impact of Health Messages and Navigation in a Cluster-Randomized Study. J Racial Ethn Health Disparities 2014. [DOI: 10.1007/s40615-014-0014-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Rothpletz-Puglia P, Jones VM, Storm DS, Parrott JS, O'Brien KA. Building social networks for health promotion: Shout-out Health, New Jersey, 2011. Prev Chronic Dis 2013; 10:E147. [PMID: 23987253 PMCID: PMC3760081 DOI: 10.5888/pcd10.130018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background Building social networks for health promotion in high-poverty areas may reduce health disparities. Community involvement provides a mechanism to reach at-risk people with culturally tailored health information. Shout-out Health was a feasibility project to provide opportunity and support for women at risk for or living with human immunodeficiency virus infection to carry out health promotion within their informal social networks. Community Context The Shout-out Health project was designed by an academic–community agency team. During 3 months, health promotion topics were chosen, developed, and delivered to community members within informal social networks by participants living in Paterson and Jersey City, New Jersey. Methods We recruited women from our community agency partner’s clients; 57 women participated in in-person or online meetings facilitated by our team. The participants identified and developed the health topics, and we discussed each topic and checked it for message accuracy before the participants provided health promotion within their informal social networks. The primary outcome for evaluating feasibility included the women’s feedback about their experiences and the number of times they provided health promotion in the community. Other data collection included participant questionnaires and community-recipient evaluations. Outcome More than half of the participants reported substantial life challenges, such as unemployment and housing problems, yet with technical support and a modest stipend, women in both groups successfully provided health promotion to 5,861 people within their informal social networks. Interpretation Shout-out Health was feasible and has implications for building social networks to disseminate health information and reduce health disparities in communities.
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Affiliation(s)
- Pamela Rothpletz-Puglia
- Francois-Xavier Bagnoud Center, Rutgers, The State University of New Jersey, Biomedical and Health Sciences, Department of Nutritional Sciences, School of Health Related Professions, 65 Bergen St, Suite 157, Newark, NJ 07107, USA.
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Rodriguez EM, Torres ET, Erwin DO. Awareness and interest in biospecimen donation for cancer research: views from gatekeepers and prospective participants in the Latino community. J Community Genet 2013. [PMID: 23733683 DOI: 10.1007/s12687-013-0152-2.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Latinos are one of the fastest-growing population groups in the USA, and are underrepresented in scientific research and even more so in genetic research. The disproportionately lower number of certain subpopulations participating in biomedical research has a significant impact on the representativeness of scientific outcomes. We established a collaboration with scientists at a designated National Cancer Institute comprehensive cancer center to test the feasibility of community-based approaches for engaging Latinos in biospecimen donation for cancer genomic research. A methods triangulation approach was applied to gain a deeper understanding from the community, that included key informant interviews with Latino community leaders (N = 6), four focus groups (N = 22) with members of the Latino community, and the use of an audience response system within the focus groups to capture quantitative data. Overall, the majority of participants had never participated in biospecimen donation; however, despite being unaware of the biobank, they expressed willingness to participate as a way to help advance research. Themes included: Confusion on what biospecimen donation process entails; Barriers to and incentives for participation; Strategies and locations for reaching the Latino community. Clear communication of the "public good" as it relates to biospecimen donation by healthy/non-patient participants is a less clearly conceptualized message; yet, the significance of delivering this message is important to gaining participation and increasing the diversity of samples available for cancer genomic studies from a broader community context.
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Affiliation(s)
- Elisa Marie Rodriguez
- Department of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY, 14263, USA,
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Rodriguez EM, Torres ET, Erwin DO. Awareness and interest in biospecimen donation for cancer research: views from gatekeepers and prospective participants in the Latino community. J Community Genet 2013; 4:461-8. [PMID: 23733683 DOI: 10.1007/s12687-013-0152-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 05/22/2013] [Indexed: 01/13/2023] Open
Abstract
Latinos are one of the fastest-growing population groups in the USA, and are underrepresented in scientific research and even more so in genetic research. The disproportionately lower number of certain subpopulations participating in biomedical research has a significant impact on the representativeness of scientific outcomes. We established a collaboration with scientists at a designated National Cancer Institute comprehensive cancer center to test the feasibility of community-based approaches for engaging Latinos in biospecimen donation for cancer genomic research. A methods triangulation approach was applied to gain a deeper understanding from the community, that included key informant interviews with Latino community leaders (N = 6), four focus groups (N = 22) with members of the Latino community, and the use of an audience response system within the focus groups to capture quantitative data. Overall, the majority of participants had never participated in biospecimen donation; however, despite being unaware of the biobank, they expressed willingness to participate as a way to help advance research. Themes included: Confusion on what biospecimen donation process entails; Barriers to and incentives for participation; Strategies and locations for reaching the Latino community. Clear communication of the "public good" as it relates to biospecimen donation by healthy/non-patient participants is a less clearly conceptualized message; yet, the significance of delivering this message is important to gaining participation and increasing the diversity of samples available for cancer genomic studies from a broader community context.
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Affiliation(s)
- Elisa Marie Rodriguez
- Department of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY, 14263, USA,
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Klimmek RK, Noyes E, Edington-Saunders K, Logue C, Jones R, Wenzel J. Training of community health workers to deliver cancer patient navigation to rural African American seniors. Prog Community Health Partnersh 2012; 6:167-74. [PMID: 22820226 DOI: 10.1353/cpr.2012.0017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Rural African American (AA) seniors may experience significant challenges during cancer treatment. Previous research suggests community health workers (CHWs) can provide effective cancer patient navigation (CPN) support. OBJECTIVES To develop a Train the Trainers (TTT) program for CHWs in rural Central Virginia who would navigate local AA seniors with cancer and train their support persons to provide similar types of assistance. METHODS We conducted focus groups with rural AA seniors, consulted with experienced CHW trainers, recruited and trained CHWs through a combination of online learning and distance education, evaluated the TTT via surveys and focus groups, and hired CHWs to the study team. RESULTS/LESSONS LEARNED: Lessons learned from our TTT experience include the value of incorporating CHW trainers and trainees as full members of the research team. CONCLUSIONS Training should be accessible and flexible, providing trainees community-level resources and enriched educational experiences. Findings have informed a culturally tailored support CHW intervention to address cancer diagnosis and treatment needs for older rural AAs.
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Abstract
The purpose of this article is to determine, through a community-based breast and cervical cancer intervention program, the impact Latino males may have on Latinas and their cancer screening behaviors. This report includes data collected from 163 Latino males recruited throughout rural Arkansas and four New York City boroughs for the Esperanza y Vida program, designed to evaluate cancer screening outcomes among Latinas and address their health care needs and cancer control challenges. Basic demographics and identical pre- and post-program knowledge surveys were collected and analyzed using SPSS 15.0 and SAS 9.2. Results from this study suggest Latino men have little knowledge about breast or cervical cancer screening and are unfamiliar with their partners' screening histories. Male participants were also less likely to complete program assessment forms (pre, post, demographic questionnaires) and more likely to commit response errors (i.e. multiple answers, illegible responses). These findings suggest that including males in education programs for Latinas may be a crucial component in decreasing cancers among this segment of the population. The further development of programs such as Esperanza y Vida, that empowers Latino males, will be important in reducing the unequal burden of breast and cervical cancers for Latinas. It is important to continue including Latino men in these types of studies because the impact of their role on Latina's health remains understudied, unknown, and misunderstood.
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