Improving the health of African American men: experiences from the Targeting Cancer in Blacks (TCiB) Project

Advancing the science of integrating multiple interventions by blending and bundling

Cancer prevention and control research has produced a variety of effective interventions over the years, though most are single disease focused. To meet the Cancer Moonshot goal to reduce the cancer death rate by 50% by 2047, it may be necessary to overcome the limitations of siloed interventions that do not meet people's multiple needs and limitations in system capacity to deliver the increasing number of interventions in parallel. In this article, we propose integrating multiple evidence-based interventions as a potential solution. We define 2 types of integrated interventions, blended and bundled, and provide examples to illustrate each. We then offer a schematic and outline considerations for how to assemble blended or bundled interventions including looking at the intervention need or opportunity along the cancer continuum as well as co-occurring behaviors or motivations. We also discuss delivery workflow integration considerations including social-ecological level(s), context or setting, implementer, and intended beneficiary. Finally, in assembling integrated interventions, we encourage consideration of practice-based expertise and community and/or patient input. After assembly, we share thoughts related to implementation and evaluation of blended or bundled interventions. To conclude the article, we present multiple research opportunities in this space. With swift progress on these research directions, cancer prevention and control interventionists and implementation scientists can contribute to achieving the promise of the reignited Cancer Moonshot.

Cultural and emotional determinants of cervical cancer screening among older Hispanic women

Older adults are at highest risk of cancer and yet have the lowest rates of cancer screening participation. Older minority adults bear the burden of cancer screening disparities leading to late stage cancer diagnoses. This investigation, utilization data from the 2008 wave of the Health and Retirement study examined the cultural and emotional factors thought to influence cervical cancer screening among older Hispanic women. We utilized logistic regression models to conduct the analyses. Findings indicate that the emotional factors were not significant but the cultural factor, time orientation was a significant predictor for older Hispanics' cervical cancer screening behaviors.

Social Determinants Associated with Colorectal Cancer Screening in an Urban Community Sample of African-American Men

Background

African-American men are disproportionately burdened with colorectal cancer (CRC). Research is scarce on the social determinants that may influence CRC screening as the primary strategy for early detection among African-American males.

Methods

African-American men over the age of 18 years (n = 558) were recruited from a community health fair and anonymously surveyed about their health and cancer screening behaviors. A social ecological theoretical framework was utilized to identify intrapersonal, interpersonal, organizational, and community predictors of CRC screening, which may be associated with social determinants of health and health behaviors. Analysis included correlations and logistic regression.

Results

The mean age of participants was 54.3 years with 85.8% of men being over 40 years of age. Regarding CRC screening: 50.5% (n = 282) of African-American male participants had received any type of CRC screening at any time. Positive predictors of CRC screening included: health insurance status, older age, having spoken with a health provider about family cancer risk, and having a regular doctor. However, employment status and poor self-rated health were negative predictors of the outcome.

Conclusions

Social determinants of health, such as healthcare access and interactions with health systems, along with employment play a critical role in facilitating CRC screening completion in high-risk underserved populations such as African-American men.

Examining the influence of social ecological factors on prostate cancer screening in urban African-American men

African-American men experience a disparate burden of prostate cancer (PC). Little is known about how social factors influence PC screening in this population.

METHODS

African-American men over the age of 18 (N = 229) were recruited from a community health fair and anonymously surveyed about their PC screening behavior and conditions of their social environment. Analysis included logistic regression.

FINDINGS

Fifty one percent of respondents reported receiving any form of PC screening within the past five years. Older age, higher levels of education, and access to a usual health care provider were associated with PC screening.

CONCLUSIONS

Social workers in preventive and community health settings should be increasingly attentive to the PC screening barriers facing African-American men, particularly those who may be undereducated and lack access to care.

Best Practices in the Reporting of Participatory Action Research: Embracing Both the Forest and the Trees 1Ψ7

Participatory action research (PAR) represents an approach that is deeply consonant with counseling psychology’s commitments to social equity and action. However, counseling psychologists who would like to study this literature, or who would like to write about a project of their own, may discover that the reporting of PAR is not straightforward: PAR is a fluid, multifaceted, co-created, idiosyncratic process that does not necessarily correspond to established report-writing conventions. In this article, the authors present best-practices suggestions for writing about PAR based on an analysis of PAR articles published between 2000 and 2008.