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Kawabata Y, Dalisay F, Pokhrel P. Resistance to peer influence, smoking friends, cigarette and betel nut use, and gender among Pacific Islander youth. J Ethn Subst Abuse 2024:1-19. [PMID: 38206103 PMCID: PMC11236956 DOI: 10.1080/15332640.2023.2295933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
The present study examined the relationships between resistance to peer influence and cigarette and betel nut use, as well as the potential mediating role of friends who use cigarettes and betel nut, among boys and girls in Guam. This study included 673 ethnically diverse students (49% female; M age = 12.7, SD = 0.89) from eight public middle schools. The mediation analysis demonstrated that higher resistance to peer influence for both cigarette and betel nut use was associated with lower cigarette and betel nut use directly and that this association was mediated by friends who used cigarette and betel nut products. That is, low resistance to peer influence for both cigarette and betel nut use was associated with a greater number of friends who smoke and use betel nut, which was linked with more cigarette and betel nut use. The moderated mediation analysis revealed no gender difference in the indirect effect (i.e., the mediation of friends who used cigarettes and betel nut). These findings can be used to inform the design and implementation of intervention and prevention programs for at-risk youth, regardless of gender, who are vulnerable to substance use in the Pacific.
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Affiliation(s)
- Yoshito Kawabata
- Division of Social and Behavioral Sciences, College of Liberal Arts and Social Sciences, University of Guam, UOG Station, Mangilao, Guam
| | - Francis Dalisay
- Division of Communication, Media and Fine Arts, College of Liberal Arts and Social Sciences, University of Guam, UOG Station, Mangilao, Guam
| | - Pallav Pokhrel
- Population Sciences Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, Hawaii
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Dalisay F, Okamoto SK, Teneza J, Dalton C, Lizama K, Pokhrel P, Kawabata Y. Types of Offers of Combustible Cigarettes, E-Cigarettes, and Betel Nut Experienced by Guam Youths. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6832. [PMID: 37835102 PMCID: PMC10572108 DOI: 10.3390/ijerph20196832] [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: 07/23/2023] [Revised: 09/07/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023]
Abstract
The present study examined types of scenarios in which Guam youths are offered tobacco-namely, combustible cigarettes and e-cigarettes-and betel (areca) nut. We conducted 10 focus groups with public middle school students (n = 34) from Guam. Results suggested that the types of offer scenarios of combustible cigarettes, e-cigarettes, and betel nut referenced by the students fall into two categories-direct-relational offers and indirect-contextual offers. The results also suggested that both categories of offer scenarios were more likely to occur in school rather than in other locations such as the home. Family members were more likely to make offers than other types of people. Indirect-contextual offers were more easily avoidable depending on the substance offered, the location where the offer took place, and the person making the offer. Based on the findings, we provide brief suggestions on developing a school-based prevention curriculum focused on training young adolescents from Guam on ways to resist offers of cigarettes, e-cigarettes, and betel nut.
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Affiliation(s)
- Francis Dalisay
- College of Liberal Arts and Social Sciences, University of Guam, Mangilao, GU 96923, USA;
| | - Scott K. Okamoto
- Population Sciences in the Pacific Program (Cancer Prevention in the Pacific), University of Hawai’i Cancer Center, Oahu, HI 96813, USA; (S.K.O.); (P.P.)
| | - Jane Teneza
- Minority Health Research Training Program, Department of Tropical Medicine Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI 96813, USA; (J.T.); (C.D.)
| | - Christina Dalton
- Minority Health Research Training Program, Department of Tropical Medicine Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI 96813, USA; (J.T.); (C.D.)
| | - Kayli Lizama
- Pacific Island Partnership for Cancer Health Equity, University of Guam Cancer Research Center, Mangilao, GU 96913, USA;
| | - Pallav Pokhrel
- Population Sciences in the Pacific Program (Cancer Prevention in the Pacific), University of Hawai’i Cancer Center, Oahu, HI 96813, USA; (S.K.O.); (P.P.)
| | - Yoshito Kawabata
- College of Liberal Arts and Social Sciences, University of Guam, Mangilao, GU 96923, USA;
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Kawabata Y, Dalisay F, Santos JM, Pokhrel P. A Mediation Model for Biculturalism and Cigarette and Betel Nut Use: The Case of Adolescents in Guam. ASIAN AMERICAN JOURNAL OF PSYCHOLOGY 2023; 14:297-305. [PMID: 37869473 PMCID: PMC10588809 DOI: 10.1037/aap0000303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
The present study examined the associations between biculturalism and cigarette and betel nut use and the potential mediating roles of cigarette and betel nut use risk perception and resistance to peer and adult influence among adolescents in Guam. Participants were 673 ethnically diverse students (49% female; Mage = 12.7, SD = .89) from eight public middle schools. The results showed that biculturalism was not associated with cigarette use directly; however, this association was mediated by cigarette use risk perception and resistance to peer and adult influence. In other words, higher biculturalism was associated with more risk perception and then more resistance to peer and adult influence, which sequentially predicted less cigarette use. Similarly, the association between biculturalism and betel nut use was mediated by betel nut use risk perception and resistance to peer and adult influence. Higher biculturalism was associated with greater risk perception and then more resistance to peer and adult influence, which in turn resulted in less betel nut use. These findings can be used to inform the design and implementation of intervention and prevention programs targeting youth who are vulnerable to substance use.
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Affiliation(s)
| | - Francis Dalisay
- College of Liberal Arts and Social Sciences, University of Guam
| | | | - Pallav Pokhrel
- Population Sciences in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa
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Dalisay F, Pokhrel P, Santos J, Mori E, Kawabata Y, Beltran Z, Ooka G, Okamoto SK. Guam Adolescents' Use of Strategies to Resist Cigarette, e-Cigarette, and Betel Nut Offers: Findings from a Focus Group Study. Subst Use Misuse 2023; 58:1580-1586. [PMID: 37488091 PMCID: PMC10861142 DOI: 10.1080/10826084.2023.2236205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
Background: This study examined resistance strategies used by predominantly Pacific Islander young adolescents in response to offers of tobacco, e-cigarettes, and betel [areca] nuts. This study was intended to inform the development of a prevention curriculum focused on training young adolescents from the U.S.-Affiliated Pacific Islands (USAPI) on culturally appropriate strategies to resist substance use offers. Currently, very little is understood in terms of how Pacific Islander youths deal with tobacco and other substance use offers, although the use of tobacco products among Pacific Islander youths is high. Specifically, given the collectivist sociocultural orientation of the Pacific Islander communities, it is unclear whether the direct (overt) confrontational style of resistance is a viable mode of resistance for youths to practice when faced with a substance use offer. Methods: We conducted 10 focus groups with public middle school students (N = 34) from Guam, which is part of the USAPI. Results: Results suggested that, as with other communities in the U.S., the resistance strategies fall into two categories-overt/confrontational and non-confrontational resistance strategies. Overt/confrontational strategies included (a) saying "no" and (b) verbally confronting the offeror. Non-confrontational strategies included (a) avoiding or leaving the situation and (b) telling an adult. Conclusions: Our findings have implications for the development of culturally grounded interventions aimed at preventing youth tobacco and other substance use in Guam, the USAPI, and the Pacific region.
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Affiliation(s)
- Francis Dalisay
- College of Liberal Arts & Social Sciences, University of Guam, UOG Station, Mangilao, Guam, USA
| | - Pallav Pokhrel
- Population Sciences in the Pacific Program, University of Hawai’i Cancer Center, University of Hawai’i at Mānoa, Honolulu, Hawai’i, USA
| | - Jean Santos
- College of Liberal Arts & Social Sciences, University of Guam, UOG Station, Mangilao, Guam, USA
| | - Elua Mori
- College of Liberal Arts & Social Sciences, University of Guam, UOG Station, Mangilao, Guam, USA
| | - Yoshito Kawabata
- College of Liberal Arts & Social Sciences, University of Guam, UOG Station, Mangilao, Guam, USA
| | - Zhantelle Beltran
- College of Liberal Arts & Social Sciences, University of Guam, UOG Station, Mangilao, Guam, USA
| | - Gabrielle Ooka
- College of Liberal Arts & Social Sciences, University of Guam, UOG Station, Mangilao, Guam, USA
| | - Scott K. Okamoto
- Population Sciences in the Pacific Program, University of Hawai’i Cancer Center, University of Hawai’i at Mānoa, Honolulu, Hawai’i, USA
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Rosario MH, Johnson DL, Manglallan KS, Phillips KT, Pokhrel P, Okamoto SK. Tobacco use among native Hawaiian and Pacific Islander youth in the U.S. and USAPI: a systematic review of the literature. J Ethn Subst Abuse 2023; 22:500-515. [PMID: 34424138 PMCID: PMC8863994 DOI: 10.1080/15332640.2021.1965934] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
With rates of tobacco use among youth in the United States on the rise, further analysis of disproportionately impacted populations, like Native Hawaiian and other Pacific Islanders (NHPIs), is needed. NHPIs face a unique set of challenges compared to other ethnic minorities that contribute to their health disparities from tobacco use. This systematic literature review investigated empirical studies published between 2010-2020 on tobacco use among NHPI youth and young adults. Using comprehensive literature search engines and focused author searches of tobacco researchers in NHPI communities, 7,208 article abstracts were extracted for potential inclusion. Explicit inclusionary and exclusionary criteria were used to identify peer-reviewed articles related to tobacco use correlates and interventions for NHPI youth populations. A total of 17 articles met our criteria for inclusion in this study. Community influences, peer pressure, social status, variety of flavors, craving, and stimulation were correlates found in smoking and vaping for NHPI youth. There were also few published tobacco use prevention and intervention studies focused specifically on NHPI youth. Our study addresses the needs of an under-researched population that is heavily affected by the adverse consequences of short-term and long-term use of cigarettes and e-cigarettes. Additional research should focus on developing effective and culturally relevant interventions to reduce NHPI health disparities.
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Affiliation(s)
| | | | | | | | - Pallav Pokhrel
- Cancer Prevention in the Pacific Program, University of Hawai‘i Cancer Center
| | - Scott K. Okamoto
- School of Social Work, Hawai‘i Pacific University
- Cancer Prevention in the Pacific Program, University of Hawai‘i Cancer Center
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Johnson DL, Okamoto SK, Rosario MH, Pokhrel P. Tobacco product use and cultural connectedness among Native Hawaiian/Pacific Islander, Asian American, and Filipino American young adults in Hawai'i. J Ethn Subst Abuse 2022:1-15. [PMID: 36579697 PMCID: PMC10307923 DOI: 10.1080/15332640.2022.2161082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Tobacco product use rates among Native Hawaiian/Pacific Islander (NHPI), Asian American, and Filipino American young adults in Hawai'i have risen rapidly in recent years following the introduction of electronic nicotine delivery systems. Though some research has examined tobacco use correlates for these demographics of young adults, research examining protective factors, such as cultural connectedness, is lacking. Additionally, research that disaggregates Asian Americans from Pacific Islanders is scarce, despite the differing risk and protective factors that have been determined for each group. This study separately examined cultural connectedness among NHPIs, Asian Americans, and Filipino Americans to help fill the gaps in the current tobacco product literature. The findings indicated that Asian Americans and Filipino Americans who identify more with their own cultures are less likely to use e-cigarettes; however, this relationship was not supported for NHPIs. No significant evidence was found to indicate a relationship between cultural connectedness and combustible cigarette use among any of the sampled groups. The lack of relationship between cultural connectedness and e-cigarette use among Native Hawaiians may be explained by measurement limitations in the study, and suggest the need for more culturally competent scales (e.g., an enculturation scale) that account for Indigenous status.
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Affiliation(s)
| | - Scott K. Okamoto
- School of Social Work, Hawai‘i Pacific University
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center
| | | | - Pallav Pokhrel
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center
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Dalisay F, Kawabata Y, Buente W, Pokhrel P, Benitez C, Herzog T. Social media, peer norms, and betel nut susceptibility and use: Evidence from early adolescents in Guam. FRONTIERS IN COMMUNICATION 2022; 7:960093. [PMID: 37207255 PMCID: PMC10194842 DOI: 10.3389/fcomm.2022.960093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Betel (areca) nut is an addictive psychoactive substance considered to be carcinogenic. Yet not much is known about factors that may be promoting betel nut use. To fill this void, the present study examines the roles of exposure to betel nut-related posts on social media and peer norms regarding betel nut use in explaining betel nut susceptibility and use among adolescents. We conducted a representative survey of early adolescents (N = 673) attending all public middle schools on Guam, a United States-Affiliated Pacific Island in the Western Pacific. Results showed that exposure to betel nut-related posts on social media was positively associated with peer descriptive norms regarding betel nut use. Specifically, the more frequent early adolescents were exposed to betel nut posts on social media, the more likely they were to perceive betel nut use to be more prevalent among their general peers and close friends. Additionally, early adolescents' exposure to betel nut-related posts on social media was positively associated with both their susceptibility to use betel nut and reported use. Descriptive norms regarding close friends' betel nut use was also positively associated with both susceptibility to and use of betel nut. However, descriptive norms regarding general peers' betel nut use was unrelated with either betel nut susceptibility or use. Descriptive norms regarding close friends' betel nut use mediated the relationships that exposure to betel nut posts on social media had with both betel nut susceptibility and betel nut use. Implications are discussed.
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Affiliation(s)
- Francis Dalisay
- College of Liberal Arts and Social Sciences, University of Guam, Mangilao, GU, United States
| | - Yoshito Kawabata
- College of Liberal Arts and Social Sciences, University of Guam, Mangilao, GU, United States
| | - Wayne Buente
- School of Communications, University of Hawai’i at Mānoa, Honolulu, HI, United States
| | - Pallav Pokhrel
- Population Sciences in the Pacific (Cancer Prevention in the Pacific) University of Hawai’i Cancer Center, Honolulu, HI, United States
| | - Chantay Benitez
- College of Liberal Arts and Social Sciences, University of Guam, Mangilao, GU, United States
| | - Thaddeus Herzog
- Population Sciences in the Pacific (Cancer Prevention in the Pacific) University of Hawai’i Cancer Center, Honolulu, HI, United States
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Dalisay F, Pokhrel P, Buente W, Kawabata Y. Exposure to tobacco and betel nut content on social media, risk perceptions, and susceptibility to peer influence among early adolescents in Guam. Addict Behav Rep 2022; 15:100405. [PMID: 35434250 PMCID: PMC9006756 DOI: 10.1016/j.abrep.2021.100405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/30/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction This study aimed to examine the associations between exposure to tobacco and betel nut-related content on social media, perceived risks of tobacco and betel nut use, and susceptibility to peer influence for tobacco and betel nut use among adolescents living in Guam, a United States-Affiliated Pacific Island in the Western Pacific. Methods A representative survey of adolescents (N = 670) attending public middle schools on Guam was conducted. The survey measured exposure to tobacco and betel nut content on the following social media platforms: (a) Facebook, (b) Twitter, (c) Instagram, (d) Snapchat, and (e) WhatsApp. The survey also measured perceived risks of tobacco and betel nut use and susceptibility to peer influence for tobacco and betel nut use. Results Guam adolescents' exposure to tobacco-related content on social media was found to be associated with lower perceived risks toward the use of tobacco (β = -0.18, p < 0.001) and betel nut (β = -0.16, p < 0.001). Also, exposure to tobacco-related content on social media was found to be associated with higher levels of susceptibility to peer influence for uses of both tobacco (β = 0.10, p < 0.05) and betel nut (β = 0.15, p < 0.001). Similarly, exposure to betel nut-related content on social media was associated with lower perceived risks of using betel nut (β = -0.20, p < 0.001) and tobacco (β = -0.24, p < 0.001). Also, exposure to betel nut-related content on social media was associated with increased susceptibility to peer influence for use of both betel nut (β = 0.35, p < 0.001) and tobacco (β = 0.29, p < 0.001). Conclusions Adolescents' exposure to tobacco- and betel nut-related content on social media may influence attitudinal risk factors associated with tobacco and betel nut use.
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Affiliation(s)
- Francis Dalisay
- College of Liberal Arts & Social Sciences, University of Guam, UOG Station, Mangilao, Guam 96923, United States
| | - Pallav Pokhrel
- Population Sciences in the Pacific Program (Cancer Prevention in the Pacific), University of Hawaiʻi Cancer Center, 701 Ilalo St., Honolulu, HI 96813, United States
| | - Wayne Buente
- School of Communications, University of Hawai’i at Manoa, 2550 Campus Road #304, Honolulu, HI 96822, United States
| | - Yoshito Kawabata
- College of Liberal Arts & Social Sciences, University of Guam, UOG Station, Mangilao, Guam 96923, United States
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Tami-Maury I, Nethan S, Feng J, Miao H, Delclos G, Mehrotra R. Evidence of areca nut consumption in the United States mainland: a cross-sectional study. BMC Public Health 2022; 22:912. [PMID: 35525926 PMCID: PMC9078632 DOI: 10.1186/s12889-022-13262-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 04/13/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Areca nut (AN) is an addictive substance consumed in the Southeast region and is highly associated with oral premalignant lesions and oral cancer. The impact of AN use in the United States (US) is largely unknown, but the products are readily available and probably used by a significant fraction of Asian immigrants or descendants living in the US. We aimed at assessing AN use prevalence among the Asian community in Houston, Texas. METHODS A cross-sectional questionnaire was used to interview adult individuals (≥ 18 years of age) who self-identified as Asian immigrants or descendants residing in Houston. Means, frequencies, and proportions were reported. Factors associated with AN use were evaluated using logistic regression. RESULTS We surveyed 275 individuals (58% women, 43% between 35-54 years old, 67% born outside of the US, and 6% concurrent smokers). Among respondents, 91% were familiar with AN products, 17% self-reported ever use of AN products in the US, and 31% had friends/family members who were AN ever users. AN use was significantly associated with being Indian Subcontinent immigrants or descendants (ISID) (OR = 3·9; CI: 1·10,13·81; p = 0·035) and having friends/family members using AN products (OR = 6·2; CI: 1·69, 22·69; p = 0·006). CONCLUSIONS Our findings provide quantitative data on the prevalence of AN ever use and context for future AN prevention and cessation interventions specific to the Southeast Asian groups living in the US mainland. This is crucial for the prevention and control of oral cancer and other detrimental conditions related to AN consumption.
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Affiliation(s)
- Irene Tami-Maury
- The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA.
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Suzanne Nethan
- National Institute of Cancer Prevention & Research, Noida, India
| | - Jessy Feng
- University of Texas Rio Grande Valley School of Medicine, Edinburg, TX, USA
| | - Hongyu Miao
- The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - George Delclos
- The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
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Sun J, Xi B, Ma C, Zhao M, Bovet P. Prevalence of E-Cigarette Use and Its Associated Factors Among Youths Aged 12 to 16 Years in 68 Countries and Territories: Global Youth Tobacco Survey, 2012‒2019. Am J Public Health 2022; 112:650-661. [PMID: 35319939 PMCID: PMC8961851 DOI: 10.2105/ajph.2021.306686] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 11/04/2022]
Abstract
Objectives. To describe the recent global prevalence of e-cigarette use and to investigate its associated factors among youths aged 12 to 16 years in 68 countries and territories (hereafter "countries"). Methods. We analyzed 485 746 youths aged 12 to 16 years from the population-based cross-sectional Global Youth Tobacco Survey conducted in 67 countries between 2012 and 2019 and the 2019 National Youth Tobacco Survey in the United States. We defined past-30-day e-cigarette use as using e-cigarettes on 1 or more days during the past 30 days. Results. The global prevalence of past-30-day e-cigarette use among youths was 9.2%, ranging from 1.9% in Kazakhstan to 33.2% in Guam. Maternal smoking (adjusted odds ratio [AOR] = 1.40; 95% confidence interval [CI] = 1.29, 1.52), paternal smoking (AOR = 1.13; 95% CI = 1.07, 1.19), secondhand smoke exposure (AOR = 1.74; 95% CI = 1.64, 1.84), youth cigarette smoking (AOR = 7.18; 95% CI = 6.84, 7.54), and youth other tobacco use (AOR = 3.88; 95% CI = 3.62, 4.15) were positively associated with e-cigarette use. Conclusions. E-cigarette use was moderately frequent among youths aged 12 to 16 years globally. Several important factors were associated with youth e-cigarette use. Public Health Implications. Our findings highlight the need for countries worldwide to develop policies to address e-cigarette use among youths. (Am J Public Health. 2022;112(4):650-661. https://doi.org/10.2105/AJPH.2021.306686).
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Affiliation(s)
- Jiahong Sun
- Jiahong Sun, Bo Xi, and Chuanwei Ma are with the Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China. Min Zhao is with the Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine. Pascal Bovet is with the Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Bo Xi
- Jiahong Sun, Bo Xi, and Chuanwei Ma are with the Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China. Min Zhao is with the Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine. Pascal Bovet is with the Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Chuanwei Ma
- Jiahong Sun, Bo Xi, and Chuanwei Ma are with the Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China. Min Zhao is with the Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine. Pascal Bovet is with the Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Min Zhao
- Jiahong Sun, Bo Xi, and Chuanwei Ma are with the Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China. Min Zhao is with the Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine. Pascal Bovet is with the Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Pascal Bovet
- Jiahong Sun, Bo Xi, and Chuanwei Ma are with the Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China. Min Zhao is with the Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine. Pascal Bovet is with the Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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Paulino YC, Ada A, Dizon J, Benavente ERJ, Campbell KMDL, Cristobal B, Daughtry A, Estabillo LMO, Flisco VDC, Badowski G, Hattori-Uchima M. Development and evaluation of an undergraduate curriculum on non-communicable disease research in Guam: The Pacific Islands Cohort of College Students (PICCS). BMC Public Health 2021; 21:1994. [PMID: 34732169 PMCID: PMC8567551 DOI: 10.1186/s12889-021-12078-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 10/05/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The non-communicable disease (NCD) epidemic among Pacific Islanders prompted the declaration of a regional state of NCD emergency throughout the United States-Affiliated Pacific Islands (USAPIs) in 2010. Subsequently, the University of Guam Health Science Program launched a pilot study on NCD research in its undergraduate curriculum modeled after the Pacific Data for Decision Making (DDM) framework - a field epidemiology training program employed in the USAPIs. The primary objective of the research is to conduct annual assessments of student health indicators with plans for longitudinal follow-up. Here, development and evaluation of the undergraduate research curriculum are described. METHODS The Pacific DDM framework covering knowledge and skills in resourcing, types of data and indicators, data sources, data management, information products, and data dissemination and use were incorporated in undergraduate core courses of the Health Science Program. During the data collection pilot years, 2013 and 2014, a survey containing questions predominantly on NCD risk factors was launched at the university. The survey was administered by upperclassmen in the Health Science Program and evolved into the Pacific Islands Cohort of College Students (PICCS) research study. The initial years were spent developing the infrastructure. Program outputs were tracked annually to measure program success. RESULTS Students in the Health Science Program obtained research knowledge and skills through various courses while enrolled in the program. The PICCS data collection continued annually as a cross-sectional survey from 2015 to current. Numerous successes have resulted including student abstracts and publications, acceptances to summer programs and fellowships, a sustained annual health fair for college students, a grant award, and other program-related impacts. CONCLUSION The PICCS framework provided the organizational structure and documented tools, protocols, roles, and responsibilities to enhance consistency and reproducibility. Undergraduate students applied their knowledge and skills to an ongoing study focused on NCD risk factor surveillance of college students. Additionally, multiple research successes have been achieved through the PICCS curriculum. Plans are underway to begin the longitudinal design of the PICCS research study and sustain it through the curriculum, with room for adaptation as courses are updated over time.
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Affiliation(s)
- Yvette C Paulino
- University of Guam, School of Health, University Drive, Mangilao, GU, 96923, USA.
| | - Anthony Ada
- University of Guam, School of Health, University Drive, Mangilao, GU, 96923, USA
| | - John Dizon
- University of Guam, School of Health, University Drive, Mangilao, GU, 96923, USA
| | | | | | - Breinard Cristobal
- University of Guam, School of Health, University Drive, Mangilao, GU, 96923, USA
| | - Alexandria Daughtry
- University of Guam, School of Health, University Drive, Mangilao, GU, 96923, USA
| | | | - Victoria Diana Cruz Flisco
- University of Guam, College of Natural & Applied Sciences, Biology Program, University Drive, Mangilao, GU, 96923, USA
| | - Grazyna Badowski
- University of Guam, College of Natural & Applied Sciences, Mathematics Program, University Drive, Mangilao, GU, 96923, USA
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12
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Cash HL, De Jesus S, Durand AM, Tin STW, Shelton D, Robles R, Mendiola AR, Brikul S, Ipil M, Murphy M, Hunt LSS, Nielsen Lesa F, Sigrah CA, Waguk R, Abraham D, Kapiriel SF, Camacho J, Chutaro E. 'Hybrid Survey' approach to non-communicable disease surveillance in the US-Affiliated Pacific Islands. BMJ Glob Health 2021; 6:bmjgh-2021-006971. [PMID: 34706881 PMCID: PMC8552153 DOI: 10.1136/bmjgh-2021-006971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/08/2021] [Indexed: 11/12/2022] Open
Abstract
In 2010 the US-Affiliated Pacific Islands (USAPI) declared a regional state of health emergency due to the epidemic of non-communicable disease (NCD) and an NCD monitoring and surveillance framework was developed that includes adult NCD risk factor and disease prevalence indicators to be collected every 5 years using a population-based survey. On evaluation of existing data from adult population-based NCD surveys, it was found that there was a lack of valid, available and consistently collected data. Therefore, a new model was developed to combine various indicators and survey tools from different partner agencies into one survey. After the report was endorsed by local health leadership, a dissemination workshop was conducted. In 2015 (baseline for Hybrid Survey implementation), three out of nine jurisdictions (33.3%) had completed a population-based survey in the past 5 years. Four (44.4%) had no adult prevalence data at all, two (22.2%) had data sets from their surveys and four (44.4%) had at least two surveys ever collected that could be used for comparison. As of 2020, all nine jurisdictions have, or are in the process of completing an adult population-based survey. Eight (88.9%) have data sets from their surveys, and five (55.6%) have at least two surveys collected that can be used for comparison. This Hybrid Survey model has helped to improve adult NCD surveillance in the USAPI by more efficiently using limited resources. This model could be considered in other small island nations, or rural areas where adult NCD surveillance is challenging.
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Affiliation(s)
- Haley L Cash
- Pacific Island Health Officers Association, Honolulu, Hawaii, USA
| | - Stacy De Jesus
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - A Mark Durand
- Pacific Island Health Officers Association, Honolulu, Hawaii, USA
| | - Si Thu Win Tin
- Public Health Division, Secretariat of the Pacific Community Suva Regional Office, Suva, Fiji
| | - Dana Shelton
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rebecca Robles
- Division of Public Health, Commonwealth Healthcare Corporation, Saipan, Northern Mariana Islands
| | - Amber R Mendiola
- Public Health Division, Commonwealth Healthcare Corporation, Saipan, Northern Mariana Islands
| | - Suzette Brikul
- Non-Communicable Disease Unit, Republic of Palau Ministry of Health, Koror, Palau
| | - Maybelline Ipil
- Marshall Islands Epidemiology and Prevention Initiatives, Majuro, Marshall Islands
| | - Molly Murphy
- Marshall Islands Epidemiology and Prevention Initiatives, Majuro, Marshall Islands
| | - Leiema S S Hunt
- American Samoa Department of Health, Pago Pago, American Samoa
| | | | | | - Robina Waguk
- Kosrae State Department of Health, Tofol, Micronesia
| | - Delpihn Abraham
- Pohnpei State Department of Health and Social Services, Palikir, Micronesia
| | | | - Janet Camacho
- Pacific Island Health Officers Association, Honolulu, Hawaii, USA
| | - Emi Chutaro
- Pacific Island Health Officers Association, Honolulu, Hawaii, USA
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13
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Buente W, Dalisay F, Pokhrel P, Kramer HK, Pagano I. An Instagram-Based Study to Understand Betel Nut Use Culture in Micronesia: Exploratory Content Analysis. J Med Internet Res 2020; 22:e13954. [PMID: 32673220 PMCID: PMC7381034 DOI: 10.2196/13954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/27/2020] [Accepted: 04/30/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND A 2012 World Health Organization report recognizes betel nut use as an urgent public health threat faced by the Western Pacific region. However, compared with other addictive substances, little is known about how betel nuts are depicted on social media platforms. In particular, image-based social media platforms can be powerful tools for health communication. Studying the content of substance use on visual social media may provide valuable insights into public health interventions. OBJECTIVE This study aimed to explore and document the ways that betel nut is portrayed on the photo-sharing site Instagram. The analysis focuses on the hashtag #pugua, which refers to the local term for betel nut in Guam and other parts of Micronesia. METHODS An exploratory content analysis of 242 Instagram posts tagged #pugua was conducted based on previous research on substance use and Instagram and betel nut practices in Micronesia. In addition, the study examined the social engagement of betel nut content on the image-based platform. RESULTS The study findings revealed content themes referencing the betel nut or betel nut tree, betel nut preparation practices, and the unique social and cultural context surrounding betel nut activity in Guam and Micronesia. In addition, certain practices and cultural themes encouraged social engagement on Instagram. CONCLUSIONS The findings from this study emphasize the cultural relevance of betel nut use in Micronesia. These findings provide a basis for empirically testing hypotheses related to the etiological roles of cultural identity and pride in shaping betel nut use behavior among Micronesians, particularly youths and young adults. Such research is likely to inform the development of culturally relevant betel nut prevention and cessation programs.
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Affiliation(s)
- Wayne Buente
- School of Communications, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Francis Dalisay
- Communication and Fine Arts Division, College of Liberal Arts & Social Sciences, University of Guam, Mangilao, Guam
| | - Pallav Pokhrel
- Population Sciences in the Pacific Program (Cancer Prevention in the Pacific), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Hanae Kurihara Kramer
- School of Communications, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Ian Pagano
- Population Sciences in the Pacific Program (Cancer Prevention in the Pacific), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States
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Joo YJ, Newcombe D, Nosa V, Bullen C. Investigating Betel Nut Use, Antecedents and Consequences: A Review of Literature. Subst Use Misuse 2020; 55:1422-1442. [PMID: 31549570 DOI: 10.1080/10826084.2019.1666144] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: Betel nut use is a public health issue in the Asia-Pacific region that is often neglected. To control betel nut use, understanding of the adverse effects of betel nut use and evidence-based policies and strategies is necessary. Objectives: This narrative review aims to characterize the current situation on betel nut use at a global level regarding the epidemiology, pharmacology and toxicology, health effects, treatment options, policies and strategies. Methods: We found 139 existing literature published between 1970-2019 on the Web of Science database and other technical documents to collate the most relevant information on betel nut use. Data were categorized into appropriate themes. Results: The literature demonstrates that there is a lack of up to date statistics on betel nut use. There is limited research on the effect of policies and strategies to control betel nut use. Conclusion: Betel nut-chewing countries should focus on understanding which populations chew betel nut and implement appropriate policies, educational and cessation programs to help control betel nut use.
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Affiliation(s)
- Ye Jin Joo
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - David Newcombe
- Centre for Addiction Research, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Vili Nosa
- Pacific Health Section, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Chris Bullen
- National Institute for Health Innovation (NIHI), School of Population Health, The University of Auckland, Auckland, New Zealand
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