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Salinas JJ, Valenzuela R. Using the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) Framework to Evaluate a Tailored Education Program to Reduce Obesity-Related Cancers in El Paso, Texas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1051. [PMID: 39200661 DOI: 10.3390/ijerph21081051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 07/27/2024] [Accepted: 08/02/2024] [Indexed: 09/02/2024]
Abstract
Background: Pasos Para Prevenir Cancer is a tailored lifestyle program that focuses on behavioral modification through knowledge and behavioral strategy education, which was delivered in El Paso, Texas, on the U.S.-Mexico border. Methods: Using the RE-AIM framework, we assessed Pasos Para Prevenir Cancer for efficacy and potential for sustainability. Survey, administrative, and observational data were collected between 2018 and 2022. The program was evaluated to determine reach, effectiveness, adoption, implementation, and maintenance. Results: Tailoring and adapting to the U.S.-Mexico border context is feasible and necessary to deliver evidence-based healthy eating and active living education content. Pasos Para Prevenir Cancer was well received and delivered in diverse settings with varying linguistic needs. Components of the program were adopted by other organizations and integrated into existing programming. Conclusions: Adapting and tailoring evidence-based programs to improve healthy eating and active living is required to meet the needs of Latino subgroup populations, like those on the U.S.-Mexico border.
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Affiliation(s)
- Jennifer J Salinas
- Department of Social Work, College of Health Sciences, University of Texas at El Paso, El Paso, TX 79912, USA
| | - Roy Valenzuela
- Department of Social Work, College of Health Sciences, University of Texas at El Paso, El Paso, TX 79912, USA
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Sarria GR, Martinez DA, Li B, Castillo RD, Salgado A, Pinillos L, Felix A, Bobadilla I, Ferraris G, Castilho M, Carmona J, Leon B, Aviles L, Ricagni L, Isa N, Flores C, Giordano FA, Zubizarreta EH, Polo A, Sarria GJ. Leveling Up the Access to Radiation Therapy in Latin America: Economic Analysis of Investment, Equity, and Inclusion Opportunities Up to 2030. Int J Radiat Oncol Biol Phys 2022; 116:448-458. [PMID: 36549348 DOI: 10.1016/j.ijrobp.2022.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/30/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Latin America faces a shortage in radiation therapy (RT) units and qualified personnel for timely and high-quality treatment of patients with cancer. Investing in equitable and inclusive access to RT over the next decade would prevent thousands of deaths. Measuring the investment gap and payoff is necessary for stakeholder discussions and capacity planning efforts. METHODS AND MATERIALS Data were collected from the International Atomic Energy Agency's Directory of Radiotherapy Centers, industry stakeholders, and individual surveys sent to national scientific societies. Nationwide data on available devices and personnel were compiled. The 10 most common cancers in 2020 with RT indication and their respective incidence rates were considered for gap calculations. The gross 2-year financial return on investment was calculated based on an average monthly salary across Latin America. A 10-year cost projection was calculated according to the estimated population dynamics for the period until 2030. RESULTS Eleven countries were included in the study, accounting for 557,213,447 people in 2020 and 561 RT facilities. Approximately 1,065,684 new cancer cases were diagnosed, and a mean density of 768,469 (standard deviation ±392,778) people per available unit was found. By projecting the currently available treatment fractions to determine those required in 2030, it was found that 62.3% and 130.8% increases in external beam RT and brachytherapy units are needed from the baseline, respectively. An overall regional investment of approximately United States (US) $349,650,480 in 2020 would have covered the existing demand. An investment of US $872,889,949 will be necessary by 2030, with the expectation of a 2-year posttreatment gross return on investment of more than US $2.1 billion from patients treated in 2030 only. CONCLUSIONS Investment in RT services is lagging in Latin America in terms of the population's needs. An accelerated outlay could save additional lives during the next decade, create a self-sustaining system, and reduce region-wide inequities in cancer care access. Cash flow analyses are warranted to tailor precise national-level intervention strategies.
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Affiliation(s)
- Gustavo R Sarria
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany; Rayos Contra Cancer, Inc, Nashville, Tennessee.
| | - David A Martinez
- Rayos Contra Cancer, Inc, Nashville, Tennessee; Department of Radiation Oncology, Oncosalud-Auna, Lima, Peru
| | - Benjamin Li
- Rayos Contra Cancer, Inc, Nashville, Tennessee; Department of Radiation Oncology, University of California, San Francisco, California
| | | | - Apolo Salgado
- Department of Radiation Oncology, Instituto Nacional del Cancer, Santiago de Chile, Chile
| | - Luis Pinillos
- Department of Radiation Oncology, Oncosalud-Auna, Lima, Peru
| | - Armando Felix
- Department of Radiation Oncology, Hospital de Oncologia Centro Medico Nacional Siglo XXI - IMSS, Mexico City, Mexico
| | - Ivan Bobadilla
- Radiotherapy Unit, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center - CTIC, Bogota, Colombia
| | - Gustavo Ferraris
- Radiotherapy Unit, Centro de Radioterapia Dean Funes, Cordoba, Argentina
| | - Marcus Castilho
- Radiotherapy Center, Hospital Felicio Rocho, Belo Horizonte, Brazil
| | - Jorge Carmona
- Radiotherapy Unit, Oncoserv, Santiago de los Caballeros, Dominican Republic
| | - Barbara Leon
- Radiotherapy Technical Unit, Hospital Carlos Andrade Marín, Quito, Ecuador
| | | | - Leandro Ricagni
- Department of Radiation Oncology, Hospital de Clinicas, Montevideo, Uruguay
| | - Nicolas Isa
- Department of Radiation Oncology, Clinica IRAM, Santiago de Chile, Chile
| | - Claudio Flores
- Department of Epidemiology and Applied Research, Auna Ideas, Lima, Peru
| | - Frank A Giordano
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | | | - Alfredo Polo
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Gustavo J Sarria
- Department of Radiation Oncology, Oncosalud-Auna, Lima, Peru; Department of Radiotherapy, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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Valenzuela R, Saadiq S, Cobos S, Salinas JJ. Engagement in Physical Activity Improves after Participation in Pasos Para Prevenir Cancer-An Obesity-Related Cancer Prevention Program in El Paso, Texas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11607. [PMID: 36141878 PMCID: PMC9517185 DOI: 10.3390/ijerph191811607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/02/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND This present study experimentally evaluated the Pasos Para Prevenir Cancer (PPPC) program to determine whether participation was associated with improved physical activity engagement. Evidence suggests that obesity prevention programs improve physical activity (PA) engagement and lead to healthier weights, which substantially impacts cancer and cardiometabolic disease risk. There is a shortage of knowledge on the effectiveness of programs tailored to populations along the U.S.-Mexico border. METHODS We collected demographic, nutrition, and physical activity data at baseline, 6 months, and 12 months using the Research Electronic Data Capture (REDCap) for 209 participants. We analyzed the average metabolic equivalents (METS) per week for all physical activity levels and types and the achievement of the recommended METS per week to determine the demographic characteristics most associated with a change between baseline, 6 months, and 12 months. RESULTS Light activity was the most common activity at all three points, and it slightly increased at 6 months in work settings. Subjects conducted moderate physical activity primarily at home and work, and moderate physical activity increased more compared to vigorous physical activity. CONCLUSIONS Intervention tailoring might improve PA engagement in Mexican Americans residing on the U.S.-Mexico border; however, larger studies that are more diverse are required.
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Affiliation(s)
- Roy Valenzuela
- Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA
| | - Stefan Saadiq
- Francis Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA
| | - Sandra Cobos
- Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA
| | - Jennifer J. Salinas
- Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA
- Francis Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA
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LaPelusa M, Diaz F, Machiorlatti M. Patterns of Colorectal Cancer in Texas Counties From 2000 to 2017. JCO Oncol Pract 2022; 18:e770-e779. [PMID: 35544648 DOI: 10.1200/op.22.00093] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
PURPOSE Residents living in Texas counties along the United States-Mexico border make up a unique demographic. These counties consist of a large proportion of Hispanic-Latinx people who experience a high rate of health uninsurance and underinsurance, low household income averages, and, as a whole, exhibiting relatively poor health outcomes compared to the US general population. Limited information exists regarding the effects of these characteristics on the incidence of colorectal cancer (CRC). METHODS Using data from the Texas Department of State Health Service, we calculated that the overall age-adjusted incidence rate (AAIR) of CRC was lower and decreased at a slower rate over time in Texas border counties compared with nonborder counties in Texas. RESULTS The AAIR of CRC was lower and decreased at a slower rate over time in Texas border counties compared with nonborder counties in Texas. Conversely to other groups analyzed, the AAIR of CRC in individuals age 50-64 years in border counties increased. CONCLUSION These findings are likely a reflection of less utilization of cancer screening in border counties than in nonborder counties. The increase in AAIR of CRC among individuals age 50-64 years in border counties warrants further investigation.
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Affiliation(s)
- Michael LaPelusa
- Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Fernando Diaz
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Michael Machiorlatti
- Department of Population Health and Biostatistics, University of Texas Rio Grande Valley School of Medicine, Edinburg, TX
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