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Altun A, Brown H, Sturgiss E, Russell G. Experiences of Assyrian refugee women seeking care for chronic pain: a qualitative study. Int J Equity Health 2023; 22:83. [PMID: 37158876 PMCID: PMC10169379 DOI: 10.1186/s12939-023-01891-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/11/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Refugee women exhibit some of the highest rates of chronic pain yet the diversity and challenges of health care systems across countries pose numerous challenges for refugee women trying to access quality health care. OBJECTIVE We sought to explore the experiences of Assyrian refugee women seeking care for chronic pain. METHODS Semi-structured interviews (face-to-face and virtual) were undertaken with 10 Assyrian women of refugee background living in Melbourne, Australia. Audio recordings and field notes of interviews were collected and themes were identified using a phenomenological approach. Women were required to be conversant in English or Arabic and willing to use a translator if necessary. RESULTS We identified five major themes of women's experiences accessing care for chronic pain: (1) the story of pain; (2) the experience of help seeking in Australia and home country; (3) factors shaping the ability to access appropriate care; (4) support seeking systems; and (5) influence of culture and gender roles. CONCLUSION Exploring refugee women's experience of seeking care for chronic pain reinforces the need to explore hard to reach population's perspectives in research and helps to understand how vectors of disadvantage may intersect. For successful integration into health care systems of host countries, particularly for complex conditions such as chronic pain, there is a need to work with women community members to develop programs that are culturally aligned to enhance access pathways to care.
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Affiliation(s)
- Areni Altun
- Department of General Practice, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
| | | | - Elizabeth Sturgiss
- Department of General Practice, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Academic Unit of General Practice, Australian National University, Canberra, Australia
| | - Grant Russell
- Department of General Practice, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
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Maryam D, Wu LM, Su YC, Hsu MT, Harianto S. The journey of embracing life: Mothers' perspectives of living with their children with retinoblastoma. J Pediatr Nurs 2022; 66:e46-e53. [PMID: 35718669 DOI: 10.1016/j.pedn.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aimed to explore the experience and views of mothers with children who have been diagnosed with retinoblastoma. DESIGN AND METHODS A descriptive qualitative study was conducted in the period of 2019-2021. Interviews were conducted with 21 mothers of children diagnosed with retinoblastoma in Indonesia. Data were collected by semi-structured interviews and examined by content analysis. RESULTS Mothers evolved from a sense of unacceptability to accepting challenges and gaining inner strength. Three themes were identified: 1) physical and psychological suffering, 2) awareness of changes and demands, and 3) keep moving forward. Mothers developed positive adaptive mechanisms for coping with the problems associated with having a child with retinoblastoma. Psychological adjustment and religious beliefs were key elements in their journeys toward embracing life in the moment. CONCLUSION Findings illuminated psychological adaptation and coping strategies of mothers with seriously ill children and highlighted how difficulties and cultural norms shaped the adaptative process. Religion and health beliefs played varied and important roles in helping mothers to manage their stress and enhance their coping strategies. PRACTICE IMPLICATIONS Our findings revealed that it is important to routinely assess social support, traditional health beliefs, and spirituality on mothers, facilitate mentoring to help mothers find their inner strengths, and develop intervention programs designed to promote psychological adjustment without delaying treatment.
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Affiliation(s)
- Dewi Maryam
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC, and Dr Soetomo Hospital, Surabaya, Indonesia.
| | - Li-Min Wu
- School of Nursing, Kaohsiung Medical University, and Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC.
| | - Yi-Ching Su
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
| | - Min-Tao Hsu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
| | - Susilo Harianto
- Faculty of Nursing, Airlangga University, Surabaya Indonesia, Faculty of Vocational, Airlangga Indonesia, Mulyorejo, Surabaya 60115, Indonesia.
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Huang YC, Garcia AA. Culturally-tailored interventions for chronic disease self-management among Chinese Americans: a systematic review. ETHNICITY & HEALTH 2020; 25:465-484. [PMID: 29385815 DOI: 10.1080/13557858.2018.1432752] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 12/21/2017] [Indexed: 06/07/2023]
Abstract
Objectives: Literature review evaluating the effectiveness and cultural surface and deep structures of interventions designed to improve Chinese Americans' chronic disease self-management.Method: PubMed, PsycINFO, CINAHL, and Health Source databases were searched for research conducted from 1990 to 2016 on self-management interventions for Chinese Americans with chronic disease.Results: Ten articles comprised eight interventions, which each addressed a dimension of cultural surface structure, all providing linguistically appropriate messages delivered via bilingual staff. Five interventions also addressed cultural deep structure dimensions by providing culturally congruent counsellors or educators, or incorporating Chinese cultural values and social customs. Six interventions resulted in significant improvements in major outcome variables. Participants also reported high satisfaction and retention rates were high.Conclusion: Culturally-tailored interventions that incorporate surface and deep structural elements of culture are sensitive and generally effective for Chinese Americans to improve access to health care, disease awareness, social environment, and participants' ability to practice self-management skills.
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Affiliation(s)
- Ya-Ching Huang
- The School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Alexandra A Garcia
- Dell Medical School, The School of Nursing, The University of Texas at Austin, Austin, TX, USA
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Yang L, Mao Y, Jansz J. Understanding the Chinese Hui Ethnic Minority's Information Seeking on Cardiovascular Diseases: A Focus Group Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152784. [PMID: 31382662 PMCID: PMC6696336 DOI: 10.3390/ijerph16152784] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 07/26/2019] [Accepted: 07/30/2019] [Indexed: 12/02/2022]
Abstract
The Chinese Hui ethnic minority group is an Islamic minority. The Hui people comprise the third largest minority population in China and are widely distributed throughout the country. Previous research shows that the Hui had a higher prevalence of cardiovascular risk factors (CVRFs) than most other ethnic groups. Therefore, the availability of health information relating to these factors is especially important for the Hui minority’s preventive healthcare. They do, however, experience difficulties in obtaining health-related information. The current research aims to identify the needs of the Hui people on where and how they obtain cardiovascular disease (CVD) related information from the media and other sources. Six focus groups were conducted in Shenyang City. The results revealed that the participants relied on different sources to get advice about CVDs, of which the internet and television were the most prominent ones. The participants expressed a desire for credible and professional information from different sources and asked for mediated health communication programs specifically targeted at the Hui. In addition, the participants felt ignored by the Chinese mainstream media at large, which created barriers for them to get health information.
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Affiliation(s)
- Lei Yang
- Erasmus Research Centre for Media, Communication and Culture, Erasmus School of History, Culture and Communication, Erasmus University Rotterdam, 3062 PA Rotterdam, The Netherlands.
| | - Yuping Mao
- Department of Communication Studies, College of Liberal Arts, California State University Long Beach, Long Beach, CA 90840, USA
| | - Jeroen Jansz
- Erasmus Research Centre for Media, Communication and Culture, Erasmus School of History, Culture and Communication, Erasmus University Rotterdam, 3062 PA Rotterdam, The Netherlands
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Lutkenhaus RO, Jansz J, Bouman MP. Tailoring in the digital era: Stimulating dialogues on health topics in collaboration with social media influencers. Digit Health 2019; 5:2055207618821521. [PMID: 30729023 PMCID: PMC6350129 DOI: 10.1177/2055207618821521] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 12/04/2018] [Indexed: 11/30/2022] Open
Abstract
In today’s media landscape, audiences increasingly turn to online communities for media consumption and to exchange information about specific niche interests such as health-related topics. This calls for a segmented approach in which interventions are targeted at online communities, tailored to their specific cultures and health-related perceptions, and leverage the dynamics of conversation and social influence in online networks. Strategies drawn from the field of influencer marketing provide interesting opportunities to reach and engage with audiences in a personally relevant manner, including with those who may disagree with an intervention’s message. This article reflects on what health communicators might learn from influencer strategies and proposes digital methods to target and tailor health communication in the digital era. More concretely, we present methods to: (a) identify online communities engaging on a specific health issue; (b) map community specific cultures and health-related perceptions; and (c) identify influencers as potential collaboration partners. As such, we adopt a slightly different take on tailoring by putting the creative and cultural competences of social influencers central, and by aligning our methods with a media mapping protocol to create influencer strategies that are tailored to the cultures and health-related perceptions of multiple online audience segments. We illustrate the potential of these methods with a study of how vaccination is discussed among Dutch Twitter users.
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Affiliation(s)
- Roel O Lutkenhaus
- Center for Media & Health, Gouda, the Netherlands.,Erasmus Research Centre for Media, Communication and Culture, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Jeroen Jansz
- Erasmus Research Centre for Media, Communication and Culture, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Martine Pa Bouman
- Center for Media & Health, Gouda, the Netherlands.,Erasmus Research Centre for Media, Communication and Culture, Erasmus University Rotterdam, Rotterdam, the Netherlands
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Effects of cultural cues on perceptions of HPV vaccination messages among parents and guardians of American Indian youth. Prev Med 2018; 115:104-109. [PMID: 30153440 PMCID: PMC6608571 DOI: 10.1016/j.ypmed.2018.08.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 08/10/2018] [Accepted: 08/21/2018] [Indexed: 12/15/2022]
Abstract
The encouragement of human papillomavirus (HPV) vaccination is an important goal for interventions among American Indians (AIs), given the significant disparities AIs face with respect to HPV cancers. Tailoring intervention messages to the culture of message recipients has been proposed as a potentially useful intervention approach, yet cultural tailoring of HPV messages has never been tested among AIs. The objective of this research was to test the effectiveness of cultural tailoring in positively affecting two variables that have been proposed as mechanisms of tailoring effects, namely identification with the message and perceptions of message effectiveness. We conducted a between subjects randomized experiment among 300 parents of AI children. Participants saw one of three messages that differed in the extent to which the message contained cues to AI culture. Analysis of variance (anova) showed that participants identified more strongly (partial eta2 = 0.10) with messages that included stronger AI cultural features and thought these messages were more convincing (partial eta2 = 0.14) and pleasant (partial eta2 = 0.11) compared to messages that included weaker cultural cues. Effects on message identification and convincingness were moderated by AI identity, such that the more participants identified themselves with AI culture, the stronger the effects of the culturally-tailored messages were (R2change = 0.043 and 0.020 in hierarchical regression analyses). These findings suggest good potential for cultural tailoring to encourage HPV vaccination among AIs.
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Baskerville NB, Shuh A, Wong-Francq K, Dash D, Abramowicz A. LGBTQ Youth and Young Adult Perspectives on a Culturally Tailored Group Smoking Cessation Program. Nicotine Tob Res 2018; 19:960-967. [PMID: 28339649 PMCID: PMC5896477 DOI: 10.1093/ntr/ntx011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 01/13/2017] [Indexed: 11/12/2022]
Abstract
Introduction The prevalence of smoking among LGBTQ youth and young adults (YYAs) is much higher than that of non-LGBTQ young people. The current study explored LGBTQ YYA perceptions of a culturally tailored group smoking cessation counselling program, along with how the intervention could be improved. Methods We conducted focus groups (n = 24) with 204 LGBTQ YYAs in Toronto and Ottawa, Canada. Open-ended questions focused on their feelings, likes and dislikes, concerns and additional ideas for a culturally tailored group cessation counselling intervention. Focus group transcripts were coded thematically and analyzed. Results Overall, YYAs were ambivalent towards the concept of a culturally tailored, group cessation counselling program. Although several participants were attracted to the LGBTQ friendly and social benefits of such a program (eg, good support system), many also had concerns. Particularly, the possibility that other group members might trigger them to smoke was a frequently stated issue. Focus group members also noted lack of motivation to attend the group, and that the group program may be inaccessible depending on where and when the program was offered. Several suggestions were made as to how to ameliorate the expressed issues related to inaccessibility or lack of attractiveness. Conclusions This study is among the first to gain the perspectives of LGBTQ YYAs on culturally tailored group cessation strategies in Canada. We identified components of group cessation programs that are both favored and not favored among LGBTQ YYAs, as well as suggestions as to how to make group cessation programs more appealing. Implications This study is particularly relevant as smoking cessation programs are one of the most commonly offered and published cessation interventions for the LGBTQ community, yet little is understood in terms of preferences of LGBTQ YYA smokers. Given the disparity in the prevalence of smoking among LGBTQ young people compared to their non-LGBTQ peers, research on effective intervention strategies for this population is needed. Findings from this study can assist practitioners and researchers in designing interventions.
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Affiliation(s)
| | - Alanna Shuh
- Propel Centre for Population Health Impact, University of Waterloo,Waterloo, Canada
| | - Katy Wong-Francq
- Propel Centre for Population Health Impact, University of Waterloo,Waterloo, Canada
| | - Darly Dash
- Propel Centre for Population Health Impact, University of Waterloo,Waterloo, Canada
| | - Aneta Abramowicz
- Propel Centre for Population Health Impact, University of Waterloo,Waterloo, Canada
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Heard EM, Auvaa L, Conway BA. Culture X: addressing barriers to physical activity in Samoa. Health Promot Int 2018; 32:734-742. [PMID: 26825998 DOI: 10.1093/heapro/dav119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
There is an urgent need to address the epidemic rates of non-communicable diseases globally, and the Pacific Island region is of particular concern. Increasing physical activity participation plays an important role in reducing some of the key risk factors for non-communicable diseases including obesity and being overweight. In order to address low levels of physical activity, it is essential to understand the key barriers and facilitating factors experienced by specific population groups. The purpose of this study is to investigate key facilitating factors for participation in a dance aerobic initiative, Culture X, developed in the Pacific Island country, Samoa. The study further aims to understand ways in which the programme assists participants in addressing barriers to physical activity. Face-to-face interviews running from 10 to 20 min were conducted with 28 Culture X participants in order to gain a deep understanding of participants' personal perspectives with regard to barriers and facilitating factors to physical activity. Findings suggest the inclusion of key cultural components (including, traditional dance moves and music, prayer, community orientation and family inclusiveness) were integral for supporting ongoing participation in Culture X. These components further assisted participants in addressing important personal and social barriers to physical activity (including lack of motivation and enjoyment, lack of confidence, time management, family and social commitments and lack of support). This study highlights creative ways that health promotion in the Pacific Island region can encourage physical activity and informs health promotion literature regarding the importance of placing local culture at the heart of behaviour change initiatives.
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Affiliation(s)
- Emma Marie Heard
- School of Nursing and Health Sciences, National University of Samoa, Apia, Samoa
| | - Leveti Auvaa
- School of Nursing and Health Sciences, National University of Samoa, Apia, Samoa
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Ornelas IJ, Ho K, Jackson JC, Moo-Young J, Le A, Do HH, Lor B, Magarati M, Zhang Y, Taylor VM. Results From a Pilot Video Intervention to Increase Cervical Cancer Screening in Refugee Women. HEALTH EDUCATION & BEHAVIOR 2017; 45:559-568. [PMID: 29202606 DOI: 10.1177/1090198117742153] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Many refugee women emigrate from countries with high cervical cancer incidence rates and have low rates of cervical cancer screening both before and after resettlement. Refugee women face many barriers to cervical cancer screening, including limited knowledge of cervical cancer and screening recommendations and cultural and linguistic barriers to being screened. Our pilot study aimed to develop and evaluate educational videos to promote cervical cancer screening among Karen-Burmese and Nepali-Bhutanese refugees, two of the largest groups of refugees arriving to the United States in recent years. We developed culturally tailored narrative videos for each ethnic group. Karen-Burmese and Nepali-Bhutanese women ( N = 40) were recruited through community health educators to participate in a pre- and posttest study. We assessed changes in cervical cancer knowledge and intentions to be screened, and satisfaction with the videos. We found that women were significantly more likely to report having heard of a test for cervical cancer and indicated significantly greater intentions to be screened after watching the video. Their knowledge about cervical cancer and screening also improved significantly, and they reported high levels of acceptability with the video. Our results suggest that culturally tailored narrative educational videos were acceptable to the target audiences and may be effective in increasing cervical cancer screening among refugee women. Further research should assess how health care and social service providers could implement video-based interventions to encourage women to be screened for cervical cancer during early resettlement.
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Affiliation(s)
- India J Ornelas
- 1 University of Washington, Seattle, WA, USA.,2 Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Khanh Ho
- 1 University of Washington, Seattle, WA, USA
| | | | | | - Anh Le
- 1 University of Washington, Seattle, WA, USA
| | - H Hoai Do
- 2 Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | | | - Ying Zhang
- 1 University of Washington, Seattle, WA, USA
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Choi TST, Walker KZ, Palermo C. Culturally Tailored Diabetes Education for Chinese Patients: A Qualitative Case Study. J Transcult Nurs 2016; 28:315-323. [DOI: 10.1177/1043659616677641] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: To explore the range of teaching approaches and cultural-tailoring elements used in diabetes educations directed at Chinese patients and to determine the strategies that appeared to best address Chinese patients’ needs. Design: A case study approach in three countries was employed, using multiple ethnographic data collection methods including participant observations and qualitative interviews. Findings: Data were collected from 39 participant observations and 22 interviews across seven cases. Collective didactic education was most common. Individual clarification at the end of an education session was used to allow patients to derive their own management plan. Clinicians mainly provided information and used knowledge reinforcement to facilitate behavioral change. Participatory diabetes education models borrowed from the West did not translate well culturally and did not appear to meet Chinese patients’ needs. Conclusion and Practical Implications: Diabetes education for the Chinese may be enhanced by building on traditional Confucian education strategies.
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Torres MI, Weeks MR. Sexual Health Protection, Culture and Community: Contributions of Anthropology to Community Health Education Approaches: An Introduction. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2016. [DOI: 10.2190/d6b6-r1at-xywq-00n4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Stanton CA, Papandonatos GD, Shuter J, Bicki A, Lloyd-Richardson EE, de Dios MA, Morrow KM, Makgoeng SB, Tashima KT, Niaura RS. Outcomes of a Tailored Intervention for Cigarette Smoking Cessation Among Latinos Living With HIV/AIDS. Nicotine Tob Res 2016; 17:975-82. [PMID: 26180222 DOI: 10.1093/ntr/ntv014] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Tobacco use has emerged as a leading killer among persons living with HIV, with effective approaches to tobacco treatment still unknown. HIV infection is nearly 3 times as prevalent in Latinos than in non-Latino Whites. This study reports the results of a randomized trial comparing a tailored intervention to brief counseling for smoking cessation among Latino smokers living with HIV (LSLWH). METHODS LSLWH (N = 302; 36% female, 10% employed full-time, 49% born in United States) were randomized to 4 in-person sessions of a tailored intervention (Aurora) or 2 in-person sessions of brief advice (enhanced standard care [ESC]). Both groups received 8 weeks of nicotine replacement therapy (NRT) patch. Biochemically validated 6- and 12-month 7-day point-prevalence abstinence (PPA) rates were compared, along with secondary outcomes (e.g., reduction to light smoking, NRT adherence). RESULTS Seven-day PPA rates reached 8% versus 11% at 6 months and 6% versus 7% at 12 months, for Aurora and ESC, respectively, with no between-group differences (p values > .40). Significant changes from baseline to 6 and 12 months among intervention targets were noted (percentage reduction in heavy smoking and dependence; increases in knowledge and self-efficacy). Baseline smoking frequency, older age, and higher intensity of patch use during the trial emerged as significant predictors of abstinence at 6 months. CONCLUSIONS There was no evidence that the tailored intervention improved cessation rates. Interventions that encourage use of, and adherence to, empirically validated cessation aids require further development to reduce tobacco-related death and disease in this vulnerable population.
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Affiliation(s)
- Cassandra A Stanton
- Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center; Schroeder Institute for Tobacco Research and Policy Studies, American Legacy Foundation; Westat, Behavioral Health Group; Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University;
| | | | - Jonathan Shuter
- Montefiore Medical Center, Albert Einstein College of Medicine
| | - Alexandra Bicki
- Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center
| | - Elizabeth E Lloyd-Richardson
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University; Department of Psychology, University of Massachusetts
| | - Marcel A de Dios
- Department of Health Disparities Research, MD Anderson Cancer Center
| | - Kathleen M Morrow
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University
| | - Solomon B Makgoeng
- Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center
| | - Karen T Tashima
- Department of Medicine, The Miriam Hospital, The Warren Alpert Medical School of Brown University
| | - Raymond S Niaura
- Schroeder Institute for Tobacco Research and Policy Studies, American Legacy Foundation
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Martinez M, Prabhakar N, Drake K, Coull B, Chong J, Ritter L, Kidwell C. Identification of Barriers to Stroke Awareness and Risk Factor Management Unique to Hispanics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 13:ijerph13010023. [PMID: 26703690 PMCID: PMC4730414 DOI: 10.3390/ijerph13010023] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 09/26/2015] [Accepted: 09/29/2015] [Indexed: 11/26/2022]
Abstract
Barriers to risk factor control may differ by race/ethnicity. The goal of this study was to identify barriers to stroke awareness and risk factor management unique to Hispanics as compared to non-Hispanic whites (NHWs). We performed a prospective study of stroke patients from an academic Stroke Center in Arizona and surveyed members of the general community. Questionnaires included: the Duke Social Support Index (DSSI), the Multidimensional Health Locus of Control (MHLC) Scale, a stroke barriers questionnaire, and a Stroke Awareness Test. Of 145 stroke patients surveyed (72 Hispanic; 73 NHW), Hispanics scored lower on the Stroke Awareness Test compared to NHWs (72.5% vs. 79.1%, p = 0.029). Hispanic stroke patients also reported greater barriers related to medical knowledge, medication adherence, and healthcare access (p < 0.05 for all). Hispanics scored higher on the "powerful others" sub-scale (11.3 vs. 10, p < 0.05) of the MHLC. Of 177 members of the general public surveyed, Hispanics had lower stroke awareness compared to NHWs and tended to have lower awareness than Hispanic stroke patients. These results suggest that Hispanic stroke patients perceive less control over their health, experience more healthcare barriers, and demonstrate lower rates of stroke literacy. Interventions for stroke prevention and education in Hispanics should address these racial/ethnic differences in stroke awareness and barriers to risk factor control.
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Affiliation(s)
- Marina Martinez
- Department of Neurology, University of Arizona College of Medicine, 1501 N. Campbell Avenue Tucson, AZ 85724, USA.
| | - Nitin Prabhakar
- Department of Neurology, University of Arizona College of Medicine, 1501 N. Campbell Avenue Tucson, AZ 85724, USA.
| | - Kendra Drake
- Department of Neurology, University of Arizona College of Medicine, 1501 N. Campbell Avenue Tucson, AZ 85724, USA.
| | - Bruce Coull
- Department of Neurology, University of Arizona College of Medicine, 1501 N. Campbell Avenue Tucson, AZ 85724, USA.
| | - Jenny Chong
- Department of Neurology, University of Arizona College of Medicine, 1501 N. Campbell Avenue Tucson, AZ 85724, USA.
| | - Leslie Ritter
- Department of Neurology, University of Arizona College of Medicine, 1501 N. Campbell Avenue Tucson, AZ 85724, USA.
| | - Chelsea Kidwell
- Department of Neurology, University of Arizona College of Medicine, 1501 N. Campbell Avenue Tucson, AZ 85724, USA.
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Lau EY, Lau PWC, Cai B, Archer E. The Effects of Text Message Content on the Use of an Internet-Based Physical Activity Intervention in Hong Kong Chinese Adolescents. JOURNAL OF HEALTH COMMUNICATION 2015; 20:1041-1051. [PMID: 25996371 DOI: 10.1080/10810730.2015.1018580] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study examined the effects of text message content (generic vs. culturally tailored) on the login rate of an Internet physical activity program in Hong Kong Chinese adolescent school children. A convenience sample of 252 Hong Kong secondary school adolescents (51% female, 49% male; M age = 13.17 years, SD = 1.28 years) were assigned to one of 3 treatments for 8 weeks. The control group consisted of an Internet physical activity program. The Internet plus generic text message group consisted of the same Internet physical activity program and included daily generic text messages. The Internet plus culturally tailored text message group consisted of the Internet physical activity program and included daily culturally tailored text messages. Zero-inflated Poisson mixed models showed that the overall effect of the treatment group on the login rates varied significantly across individuals. The login rates over time were significantly higher in the Internet plus culturally tailored text message group than the control group (β = 46.06, 95% CI 13.60, 156.02; p = .002) and the Internet plus generic text message group (β = 15.80, 95% CI 4.81, 51.9; p = .021) after adjusting for covariates. These findings suggest that culturally tailored text messages may be more advantageous than generic text messages on improving adolescents' website login rate, but effects varied significantly across individuals. Our results support the inclusion of culturally tailored messaging in future online physical activity interventions.
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Affiliation(s)
- Erica Y Lau
- a Department of Exercise Science, Arnold School of Public Health , University of South Carolina , Columbia , South Carolina , USA
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Baskin ML, Dulin-Keita A, Thind H, Godsey E. Social and cultural environment factors influencing physical activity among african-american adolescents. J Adolesc Health 2015; 56:536-42. [PMID: 25907652 DOI: 10.1016/j.jadohealth.2015.01.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 12/15/2014] [Accepted: 01/20/2015] [Indexed: 11/18/2022]
Abstract
PURPOSE African-American youth are at high risk for physical inactivity. This study explored social and cultural environment facilitators of physical activity among 12- to 14-year-old African-American adolescents living in a metropolitan area in the Southeast. METHODS Youth (n = 51; 45% male) participated in brainstorming focus groups responding to the prompt, "What about your family, friends, and community, encourages you to be physically active?" In a second meeting, participants (n = 56; 37.5% male) sorted statements (n = 84) based on similarity in meaning and rated statements on relative importance. Statement groups and ratings were entered into Concept Systems software where multidimensional scaling and hierarchical cluster analysis were used to create graphical representation of ideas. Finally, researchers named clusters according to the gestalt of grouped statements. RESULTS The total sample included 28.9% of youth with household incomes ≤$30,000 (area median income = $30,701), 29% who perceived themselves as overweight, and 14.5% who reported being active for 60+ minutes everyday. Nine clusters, in rank order, emerged as follows: access/availability of physical activity resources; family and friend support; physical activity with friends; physical activity with family members; inspiration to/from others; parental reinforcement; opportunities in daily routine; pressure from social networks; and seeing consequences of activity/inactivity. Themes analyzed by gender were very similar (r = .90); however, "pressure from social networks" was more important for girls than boys (r = .10). CONCLUSIONS Clear patterns of social and cultural facilitators of physical activity are perceived by African-American adolescents. Interventions targeting this group may benefit by incorporating these themes.
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Affiliation(s)
- Monica L Baskin
- Department of Medicine, Division of Preventive Medicine, UAB School of Medicine, Birmingham, Alabama.
| | - Akilah Dulin-Keita
- Department of Behavioral and Social Sciences, Institute for Community Health Promotion, Brown University, Providence, Rhode Island
| | - Herpreet Thind
- Department of Psychiatry and Human Behavior, Centers for Behavioral and Preventive Medicine, Brown Alpert Medical School and the Miriam Hospital, Providence, Rhode Island
| | - Emily Godsey
- Department of Sociology, University of Alabama at Birmingham, Birmingham, Alabama
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Williams NJ, Grandne MA, Snipes A, Rogers A, Williams O, Airhihenbuwa C, Jean-Louis G. Racial/ethnic disparities in sleep health and health care: importance of the sociocultural context. Sleep Health 2015; 1:28-35. [PMID: 26229976 PMCID: PMC4517599 DOI: 10.1016/j.sleh.2014.12.004] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Natasha J. Williams
- Center for Healthful Behavior Change, Division of Health and Behavior, Department of Population Health, NYU Medical Center, 227 East 30th St, New York, NY 10016
| | - Michael A. Grandne
- Department of Psychiatry, Behavioral Sleep Medicine Program, University of Pennsylvania, 3535 Market St, Philadelphia, PA 19104
| | - Amy Snipes
- Department of Biobehavioral Health, The Penn State University, 219 Biobehavioral Health Building, University Park, PA, 16802
| | - April Rogers
- Center for Healthful Behavior Change, Division of Health and Behavior, Department of Population Health, NYU Medical Center, 227 East 30th St, New York, NY 10016
| | - Olajide Williams
- Columbia University, Department of Neurology, 710 West 168th St, New York, NY 10032
| | - Collins Airhihenbuwa
- Department of Biobehavioral Health, The Penn State University, 219 Biobehavioral Health Building, University Park, PA, 16802
| | - Girardin Jean-Louis
- Center for Healthful Behavior Change, Division of Health and Behavior, Department of Population Health, NYU Medical Center, 227 East 30th St, New York, NY 10016
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Knowledge and willingness to provide research biospecimens among foreign-born Latinos using safety-net clinics. J Community Health 2014; 38:652-9. [PMID: 23543371 DOI: 10.1007/s10900-013-9660-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Latinos tend to be under-represented in cancer research and in bio-repositories. We conducted a Spanish-language, interviewer-administered cross-sectional survey of 331 foreign-born Latinos from Central and South America attending safety-net clinics in order to describe factors associated with knowledge about and intention to provide bio-specimens for research purposes. We used logistic regression and multiple imputation methods to evaluate associations between socio-cultural measures, medical trust, demographics, as well as knowledge about and intentions to provide bio-specimens. Almost half (47 %) of respondents knew what bio-specimens were, and 67 % said that they would provide a specimen after being given information about what this involved; this increased to 72 % among those with prior knowledge. Controlling for covariates, Latinos with a high school education and above were more likely to know what a bio-specimen was and to say they would provide bio-specimens than were those with lower levels of education [adjusted OR (aOR) 2.85, 95 % CI 1.37-5.96; and 3.49, 95 % CI 1.41-8.63, p ≤ 0.01, respectively]. Those with greater social integration were more likely to know about bio-specimens than those with less integration (aOR 2.54, 95 % CI 1.45-4.46, p = 0.001). Higher endorsement of family values was independently associated with intent to give bio-specimens (aOR 1.11, 95 % CI 1.02-1.20, p = 0.017 per five-point increase in "familism" score). Medical mistrust was not related to intentions to provide specimens. Our results suggest that interventions to increase willingness to provide bio-specimens could leverage trusted clinics or social networks and should consider individuals' education and socio-cultural perspectives.
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Wang-Schweig M, Kviz FJ, Altfeld SJ, Miller AM, Miller BA. Building a conceptual framework to culturally adapt health promotion and prevention programs at the deep structural level. Health Promot Pract 2014; 15:575-84. [PMID: 24396122 DOI: 10.1177/1524839913518176] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The debate on the effectiveness and merit for the amount of time, effort, and resources to culturally adapt health promotion and prevention programs continues. This may be due, in large part, to the lack of theory in commonly used methods to match programmatic content and delivery to the culture of a population, particularly at the deep structural level. This paper asserts that prior to the cultural adaptation of prevention programs, it is necessary to first develop a conceptual framework. We propose a multiphase approach to address key challenges in the science of cultural adaptation by first identifying and exploring relevant cultural factors that may affect the targeted health-related behavior prior to proceeding through steps of a stage model. The first phase involves developing an underlying conceptual framework that integrates cultural factors to ground this process. The second phase employs the different steps of a stage model. For Phase I of our approach, we offer four key steps and use our research study as an example of how these steps were applied to build a framework for the cultural adaptation of a family-based intervention to prevent adolescent alcohol use, Guiding Good Choices (GGC), to Chinese American families. We then provide a summary of the preliminary evidence from a few key relationships that were tested among our sample with the greater purpose of discussing how these findings might be used to culturally adapt GGC.
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Affiliation(s)
- Meme Wang-Schweig
- University of California, Berkeley, CA, USA Prevention Research Center of the Pacific Institute for Research and Evaluation, Oakland, CA, USA
| | | | | | | | - Brenda A Miller
- Prevention Research Center of the Pacific Institute for Research and Evaluation, Oakland, CA, USA
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Garbuzova‐Schlifter M, Madlener R. Prospects and barriers for Russia's emerging ESCO market. INTERNATIONAL JOURNAL OF ENERGY SECTOR MANAGEMENT 2013. [DOI: 10.1108/17506221311316506] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Tanjasiri SP. Shared Responsibility: California's State and Community Partnerships to Promote Physical Activity among Diverse Populations. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/10556699.1999.10603435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Sora Park Tanjasiri
- a Department of Environmental Analysis and Design , School of Social Ecology, University of California , Irvine , USA
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21
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Stellefson ML, Hanik BW, Chaney BH, Chaney DJ. Challenges for Tailored Messaging in Health Education. AMERICAN JOURNAL OF HEALTH EDUCATION 2013. [DOI: 10.1080/19325037.2008.10599054] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Michael L. Stellefson
- a Department of Health and Kinesiology , Texas A∓M University , MS 4243, College Station , TX , 77843
| | - Bruce W. Hanik
- b Department of Health and Kinesiology , Texas A&M University , MS 4243, College Station , TX , 77843
| | - Beth H. Chaney
- c Department of Health Education and Promotion , East Carolina University , 201 Christenbury Gym, Greenville , NC , 27858
| | - Don J. Chaney
- d Department of Health Education and Promotion , East Carolina University , 110g Christenbury, Greenville , NC , 27858
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Sun AC, Tsoh JY, Saw A, Chan JL, Cheng JW. Effectiveness of a culturally tailored diabetes self-management program for Chinese Americans. THE DIABETES EDUCATOR 2012; 38:685-94. [PMID: 22722610 PMCID: PMC4732271 DOI: 10.1177/0145721712450922] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of the study was to test the feasibility and efficacy of a diabetes self-management and education program for Chinese Americans in a support group format. The rationale for the study was to create culturally appropriate diabetes education and management programs in response to the growing diabetes prevalence among Chinese Americans. The investigators hypothesized that participants will have improved diabetes knowledge and practices, hemoglobin A1C, and social support. The study objectives were at least: 50% will have significant improvements in diabetes knowledge and practice activities, 30% of participants will have significant improvements in A1C, and 50% will report a gain in emotional support. METHODS The program consisted of 12 90-minute diabetes education and support group sessions offered in a medical office setting. The sample included 23 Chinese Americans with either type 1 or type 2 diabetes. Using a single-group, pre-post test design, A1C and diabetes knowledge were assessed at baseline and 6 months. Data were collected through clinical assessments and written questionnaires. RESULTS The results indicated high attendance and statistically significant increases in glycemic control and diabetes knowledge. Statistically insignificant differences were shown in diabetes management practices. Secondary outcomes assessed participants' perceived diabetes management and emotional and social support. CONCLUSIONS Diabetes Self-Management: A Cultural Approach (DSMCA) support group model demonstrates that a culturally tailored support group utilizing a community-based participatory research approach is an effective format to improve diabetes self-management skills among Chinese Americans. The program can be adapted for other ethnic populations. The efficacy of the intervention can be further tested in larger randomized trials.
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Affiliation(s)
- Angela C Sun
- Chinese Community Health Resource Center, San Francisco, California (Dr Sun, Ms Chan, Ms Cheng)
| | - Janice Y Tsoh
- University of California, San Francisco, San Francisco, California (Dr Tsoh)
| | - Anne Saw
- University of California, Davis, Davis, California (Dr Saw)
| | - Joanne L Chan
- Chinese Community Health Resource Center, San Francisco, California (Dr Sun, Ms Chan, Ms Cheng)
| | - Joyce W Cheng
- Chinese Community Health Resource Center, San Francisco, California (Dr Sun, Ms Chan, Ms Cheng)
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Banerjee AT, Watt L, Gulati S, Sung L, Dix D, Klassen R, Klassen AF. Cultural Beliefs and Coping Strategies Related to Childhood Cancer. J Pediatr Oncol Nurs 2011; 28:169-78. [DOI: 10.1177/1043454211408106] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The purpose of this study is to describe cultural beliefs and coping strategies related to dealing with childhood cancer identified through a qualitative study of the caregiving experiences of first-generation South Asian immigrant parents of children with cancer. A constructivist grounded theory approach was employed. Families with a child at least 6 months postdiagnosis were recruited from 5 Canadian pediatric oncology centers. In-depth semistructured interviews were conducted in English, Hindi, Punjabi, or Urdu with a sample of 25 South Asian parents. Analysis of interviews involved line-by-line coding and using the constant comparison method. The following 2 central themes related to culture and coping emerged: (a) cultural beliefs about childhood cancer being incurable, rare, unspeakable, and understood through religion and (b) parental coping strategies included gaining information about the child’s cancer, practicing religious rituals and prayers, trusting the health care professionals, and obtaining mutual support from other South Asian parents. These cultural beliefs and coping strategies have important implications for health care providers to understand the variations in the perceptions of childhood cancer and coping in order to implement culturally sensitive health care services.
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Affiliation(s)
| | - Lisa Watt
- McMaster University, Hamilton, Ontario, Canada
| | | | - Lillian Sung
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - David Dix
- BC Children’s Hospital, Vancouver, British Columbia, Canada
| | - Robert Klassen
- Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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Villar-Loubet O, Jones D, Waldrop-Valverde D, Bruscantini L, Weiss S. Sexual barrier acceptability among multiethnic HIV-positive and at-risk women. J Womens Health (Larchmt) 2011; 20:365-73. [PMID: 21526524 DOI: 10.1089/jwh.2009.1822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Sexual behavior interventions have been found to reduce sexual risk among HIV-seropositive and high-risk HIV-seronegative women. METHODS This study examined the influence of ethnicity and HIV serostatus on sexual barrier acceptability and use at short-term and long-term follow-up among African American and Hispanic (n=457) women participating in a gender and culturally tailored sexual risk reduction intervention. We hypothesized that sexual barrier acceptability and use would differ between ethnic groups but that this difference would dissipate after intervention participation. We further postulated that HIV-seropositive women would report greater acceptability and use of sexual barriers than seronegative women at baseline and that after participation in the intervention, acceptability and use would increase for both serostatus groups. RESULTS We enrolled 317 African American and 140 Hispanic women, 273 (60%) seropositive and 184 (40%)seronegative. Ethnic differences in the frequency of male and female condom use existed at baseline but were not found at 12-month follow-up. Male condom acceptability was higher among African American women than Hispanic women at baseline and 12-month follow-up. Seropositive women reported higher levels of consistent male condom use, but both ethnic and serostatus groups reported high levels (positive, 40%; negative, 52%) of inconsistent condom use. Most women had little experience with female condoms or lubricating gels and suppositories at baseline. No differences between ethnicities were identified in lubricant use. CONCLUSIONS Results support the use of a culturally tailored intervention among these populations to increase sexual barrier use and reduce sexual risk.
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Affiliation(s)
- Olga Villar-Loubet
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Avenue, Miami, Florida 33136, USA.
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Walsh JME, Karliner L, Burke N, Somkin CP, Pham LA, Pasick R. Physicians' approaches to recommending colorectal cancer screening: a qualitative study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2010; 25:385-90. [PMID: 20204571 PMCID: PMC2936570 DOI: 10.1007/s13187-010-0058-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2009] [Revised: 11/05/2009] [Accepted: 01/22/2010] [Indexed: 05/10/2023]
Abstract
Little is known about strategies that physicians use to encourage receipt of colorectal cancer screening (CRCS). This study conducted focus groups with physicians. Twenty-seven physicians participated in four focus groups. Physicians described four categories of approaches: (1) why screening is important, (2) providing test information, (3) motivational strategies, and (4) tailoring strategies. Participants reported tailoring based on their relationship with a patient, as well as to patient gender, education, and language. Tailoring to cultural background or ethnicity was not prominent. Most physicians reported a typical approach to CRCS and reported some tailoring based on gender, education, and language, but not on ethnicity.
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Affiliation(s)
- Judith M E Walsh
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, 1635 Divisadero Street, Suite 600, San Francisco, CA 94115-1793, USA.
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Walsh JME, Salazar R, Nguyen TT, Kaplan C, Nguyen LK, Hwang J, McPhee SJ, Pasick RJ. Healthy colon, healthy life: a novel colorectal cancer screening intervention. Am J Prev Med 2010; 39:1-14. [PMID: 20547275 PMCID: PMC4282133 DOI: 10.1016/j.amepre.2010.02.020] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Revised: 12/29/2009] [Accepted: 02/25/2010] [Indexed: 12/24/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) screening rates are increasing, but they are still low, particularly in ethnic minority groups. In many resource-poor settings, fecal occult blood test (FOBT) is the main screening option. INTERVENTION Culturally tailored telephone counseling by community health advisors employed by a community-based organization, culturally tailored brochures, and customized FOBT kits. DESIGN RCT. Participants were randomized to (1) basic intervention: culturally tailored brochure plus FOBT kit (n=765); (2) enhanced intervention: brochure, FOBT plus telephone counseling (n=768); or (3) usual care (n=256). SETTING/PARTICIPANTS Latino and Vietnamese primary care patients at a large public hospital. MAIN OUTCOME MEASURES Self-reported receipt of FOBT or any CRC screening at 1-year follow-up. RESULTS 1358 individuals (718 Latinos and 640 Vietnamese) completed the follow-up survey. Self-reported FOBT screening rates increased by 7.8% in the control group, by 15.1% in the brochure group, and by 25.1% in the brochure/telephone counseling group (p<0.01 for differences between each intervention and usual care and for the difference between brochure/telephone counseling and brochure alone). For any CRC screening, rates increased by 4.1% in the usual care group, by 11.9% in the FOBT/brochure group, and by 21.4% in the brochure/telephone counseling group (p<0.01 for differences between each intervention and usual care and for the difference between the basic and the enhanced intervention). CONCLUSIONS An intervention that included culturally tailored brochures and tailored telephone counseling increased CRC screening in Latinos and the Vietnamese. Brochure and telephone counseling together had the greatest impact. Future research should address replication and dissemination of this model for Latinos and Vietnamese in other communities, and adaptation of the model for other groups.
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Affiliation(s)
- Judith M E Walsh
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, San Francisco, California 94115, USA.
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Walsh JME, Salazar R, Kaplan C, Nguyen L, Hwang J, Pasick RJ. Healthy colon, healthy life (colon sano, vida sana): colorectal cancer screening among Latinos in Santa Clara, California. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2010; 25:36-42. [PMID: 20094827 PMCID: PMC2848346 DOI: 10.1007/s13187-009-0007-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Colorectal cancer (CRC) screening rates are low among Latinos. To identify factors associated with CRC screening, we conducted a telephone survey of Latino primary care patients aged 50-79 years. Among 1,013 participants, 38% were up-to-date (UTD) with fecal occult blood test (FOBT); 66% were UTD with any CRC screening (FOBT, sigmoidoscopy, or colonoscopy). Individuals less than 65, females, those less acculturated, and patients of female physicians were more likely to be UTD with FOBT. CRC screening among Latinos is low. Younger patients, women, and patients of female physicians receive more screening.
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Affiliation(s)
- Judith M E Walsh
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA 94115, USA.
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Pasick RJ, Barker JC, Otero-Sabogal R, Burke NJ, Joseph G, Guerra C. Intention, subjective norms, and cancer screening in the context of relational culture. HEALTH EDUCATION & BEHAVIOR 2010; 36:91S-110S. [PMID: 19805793 DOI: 10.1177/1090198109338919] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research targeting disparities in breast cancer detection has mainly utilized theories that do not account for social context and culture. Most mammography promotion studies have used a conceptual framework centered in the cognitive constructs of intention (commonly regarded as the most important determinant of screening behavior), self-efficacy, perceived benefit, perceived susceptibility, and/or subjective norms. The meaning and applicability of these constructs in diverse communities are unknown. The purpose of this study is to inductively explore the social context of Filipina and Latina women (the sociocultural forces that shape people's day-to-day experiences and that directly and indirectly affect health and behavior) to better understand mammography screening behavior. One powerful aspect of social context that emerged from the findings was relational culture, the processes of interdependence and interconnectedness among individuals and groups and the prioritization of these connections above virtually all else. The authors examine the appropriateness of subjective norms and intentions in the context of relational culture and identify inconsistencies that suggest varied meanings from those intended by behavioral theorists.
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Affiliation(s)
- Rena J Pasick
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA 94158-9001, USA.
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Nguyen TUN, Kagawa-Singer M. Overcoming barriers to cancer care through health navigation programs. Semin Oncol Nurs 2009; 24:270-8. [PMID: 19000601 DOI: 10.1016/j.soncn.2008.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To provide an overview of theoretical concepts in community-based, culturally tailored health navigation programs that have improved access to health care for ethnic minority populations, particularly for Asian Americans and Pacific Islanders. DATA SOURCES Published articles, reports, book chapters, government documents, research findings. CONCLUSION Community-based patient navigation interventions provide promising strategies for providing culturally tailored programs that are more likely to succeed in eliminating cancer disparities in screening and early detection of cancers for diverse cultural communities. IMPLICATIONS FOR NURSING PRACTICE Nurses need to be more involved in developing and delivering effective, culturally competent community-based cancer screening and treatment navigation programs through education, practice, research, and policy improvement.
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Hay J, Harris JN, Waters EA, Clayton MF, Ellington L, Abernethy AD, Prayor-Patterson H. Personal communication in primary and secondary cancer prevention: evolving discussions, emerging challenges. JOURNAL OF HEALTH COMMUNICATION 2009; 14 Suppl 1:18-29. [PMID: 19449265 DOI: 10.1080/10810730902806828] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Over the past several years, the science of cancer communication has been recognized as integral to the dissemination of cancer prevention and control strategies in both the general population as well as higher-risk groups. In this article we draw upon current literature and small group discussion in the 2008 Society for Behavioral Medicine Cancer Special Interest Group Pre-Conference Workshop on Cancer Communication to identify current findings, critical challenges, and future opportunities regarding personal communication of primary and secondary prevention of cancer. We organize our article with six critical questions: (1) What are the most important directions of research in this area? (2) Does personal cancer communication work through rational processes, or are affective and nonrational processes also involved? (3) Are our efforts adequate to reach underserved populations? (4) Are naturalistic communicative contexts given adequate consideration? (5) Has the field been adequately informed by social psychological and communication theories? (6) What are the best outcomes to document communication effectiveness? Our goals are to initiate thought and collaborative efforts among communication, public health, and behavioral science experts, as well as to establish research priorities at the interface of communication and cancer prevention and control sciences.
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Affiliation(s)
- Jennifer Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Ave., Seventh Floor, New York, NY 10022, USA.
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Michael YL, Farquhar SA, Wiggins N, Green MK. Findings from a community-based participatory prevention research intervention designed to increase social capital in Latino and African American communities. J Immigr Minor Health 2008; 10:281-9. [PMID: 17665307 DOI: 10.1007/s10903-007-9078-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A community-based participatory research intervention, Poder es Salud/Power for Health, employed Community Health Workers who used popular education to identify and address health disparities in Latino and African American communities in a metropolitan area in the United States. We assessed participants' social capital, self-rated health, and depressive symptoms at baseline and the end of the intervention. Social support and self-rated health improved while depressive symptoms decreased. Public health interventions involving diverse communities that are designed to build upon assets, such as existing levels of social capital, may improve health in those communities.
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Affiliation(s)
- Yvonne L Michael
- Department of Public Health and Preventive Medicine, Oregon Health and Science University, Portland, OR 97239-3098, USA.
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Connell P, Wolfe C, McKevitt C. Preventing stroke: a narrative review of community interventions for improving hypertension control in black adults. HEALTH & SOCIAL CARE IN THE COMMUNITY 2008; 16:165-187. [PMID: 18290982 DOI: 10.1111/j.1365-2524.2007.00737.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Incidence rates for stroke and hypertension are higher in black ethnic groups of African descent in the USA and UK than in white groups, suggesting a need for targeted intervention. We conduct a narrative review of published research evidence on community interventions to manage hypertension among black ethnic groups, and explore the concept of cultural sensitivity in these interventions. Data sources comprised computer-aided searches of published studies over the years 1981 to March 2006, on community strategies for improving hypertension control targeting black groups, and further references from these articles. Twenty-seven relevant studies were identified. Health education was associated with improvements in knowledge about hypertension, while education combined with individualised support for patients to self-manage hypertension, including goal setting and monitoring to enhance patient self-management of hypertension, and family support in managing hypertension were associated with reductions in blood pressure levels and improvements in blood pressure control. Collaboration with black communities, using local or minority ethnic staff, conducting preliminary research with target groups to investigate perceptions and canvass ideas for the intervention design were common methods assumed to achieve cultural sensitivity. Studies, however, provided insufficient robust evidence of the effectiveness of these strategies in terms of quantifiable outcomes, although this criterion is contested, with social justice arguments being offered instead. Implicit assumptions about homogeneity and shared interests within the 'community', and representation of 'community' views have implications for the effectiveness of interventions. These findings highlight areas for the future development of interventions to reduce hypertension rates in black groups, and factors that need to be robustly investigated and explicitly addressed in intervention design.
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Affiliation(s)
- Patricia Connell
- Division of Health and Social Care Research, King's College London, London, UK.
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Torres MI, Weeks MR. Sexual health protection, culture and community: contributions of anthropology to community health education approaches: an introduction. 1998-99. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2007; 25:165-8. [PMID: 17686701 DOI: 10.2190/0737-5027-2n6h-8h31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- M Idaí Torres
- University of Massachusetts, Amherst, Massachusetts, USA
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Abstract
The Special Populations Networks (SPN) Program was a 5-year, nationwide project funded by the National Cancer Institute to reduce cancer-related health disparities in minority and other underserved communities by building community health infrastructure, improving cancer awareness and use of cancer screening services, and increasing the cadre of minority junior scientists studying disparities issues. Through collaborations with a wide range of community and academic partners, the 18 grantee organizations: 1) developed culturally sensitive cancer communications approaches and materials; 2) conducted outreach and educational activities appropriate to their communities' needs and diverse cultures; and 3) trained and mentored young minority investigators who succeeded in winning support for pilot projects addressing local cancer health disparities issues, trained and deployed lay health workers, and worked with community and health provider organizations to improve understanding of cancer risk in these populations and encourage participation in appropriate clinical trials. SPN activities were grounded in community-based participatory research principles and practice. This overview highlights major project themes, provides examples of differing individual grantee approaches to similar issues, and describes key lessons learned, as reported by the SPN projects, that may guide future programmatic and research efforts to eliminate cancer health disparities in the United States. Cancer 2006. Published 2006 by the American Cancer Society.
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Affiliation(s)
- Mary Ann S Van Duyn
- Center to Reduce Cancer Health Disparities, National Cancer Institute, Rockville, Maryland 20852-8341, USA.
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Oetzel J, De Vargas F, Ginossar T, Sanchez C. Hispanic women's preferences for breast health information: subjective cultural influences on source, message, and channel. HEALTH COMMUNICATION 2007; 21:223-33. [PMID: 17567254 DOI: 10.1080/10410230701307550] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The purpose of this study was to investigate the influence of 3 subjective cultural variables--self-construals (independence and interdependence), ethnic identity (bicultural, assimilation, traditional, and marginal), and cultural health attributions (equity and behavioral-environmental attributions)--on source, message, and channel preferences for receiving breast health information by Hispanic women age 35 or older. Subjective cultural variables collectively accounted for 2% to 28% of the variance in communication preferences. In addition, several associations were discovered: (a) having an interdependent self-construal was associated positively with preferences for significant other as a source, family sources, fear messages, media channels, and face-to-face channels; (b) having a bicultural identity was associated positively with preferences for family sources and media channels, but negatively with a desire for no information; and (c) having a marginal identity and equity attributions were associated positively with preferences for fear messages and a desire for no information, but negatively with preferences for expert sources. These findings are discussed in the context of tailoring breast health information to Hispanic women using computer technology and entertainment-education.
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Affiliation(s)
- John Oetzel
- Department of Communication, University of New Mexico, Albuquerque, NM 87131, USA.
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Taylor VM, Choe JH, Yasui Y, Li L, Burke N, Jackson JC. Hepatitis B awareness, testing, and knowledge among Vietnamese American men and women. J Community Health 2006; 30:477-90. [PMID: 16370056 PMCID: PMC1810895 DOI: 10.1007/s10900-005-7282-3] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Southeast Asians have higher rates of liver cancer than any other racial/ethnic group in the United States. Chronic carriage of hepatitis B virus (HBV) is the most common underlying cause of liver cancer in the majority of Asian populations. Our objectives were to describe Vietnamese Americans' awareness of hepatitis B, levels of HBV testing, and knowledge about hepatitis B transmission; and to compare the HBV knowledge and practices of men and women. A community-based, in-person survey of Vietnamese men and women was conducted in Seattle during 2002. Seven hundred and fifteen individuals (345 men and 370 women) completed the questionnaire. Eighty-one percent of the respondents had heard of hepatitis B (76% of men, 86% of women) and 67% reported HBV testing (66% of men, 68% of women). A majority of the participants knew that HBV can be transmitted during sexual intercourse (71% of men, 68% of women), by sharing toothbrushes (67% of men, 77% of women), and by sharing razors (59% of men, 67% of women). Less than one-half knew that hepatitis B is not spread by eating food prepared by an infected person (46% of men, 27% of women), nor by coughing (39% of men, 25% of women). One-third of our respondents did not recall being tested for HBV. Important knowledge deficits about routes of hepatitis B transmission were identified. Continued efforts should be made to develop and implement hepatitis B educational campaigns for Vietnamese immigrant communities. These efforts might be tailored to male and female audiences.
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Affiliation(s)
- Victoria M Taylor
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109-1024, USA.
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Kreuter MW, Sugg-Skinner C, Holt CL, Clark EM, Haire-Joshu D, Fu Q, Booker AC, Steger-May K, Bucholtz D. Cultural tailoring for mammography and fruit and vegetable intake among low-income African-American women in urban public health centers. Prev Med 2005; 41:53-62. [PMID: 15916993 DOI: 10.1016/j.ypmed.2004.10.013] [Citation(s) in RCA: 158] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2004] [Revised: 10/18/2004] [Accepted: 10/19/2004] [Indexed: 11/22/2022]
Abstract
BACKGROUND It is widely accepted that disease prevention efforts should consider cultural factors when addressing the needs of diverse populations, yet there is surprisingly little evidence that doing so enhances effectiveness. The Institute of Medicine has called for randomized studies directly comparing approaches that do and do not consider culture. METHODS In a randomized trial, 1227 lower-income African-American women from 10 urban public health centers were assigned to either a usual care control group, or to receive a series of six women's health magazines with content tailored to each individual. By random assignment, these magazines were generated from either behavioral construct tailoring (BCT), culturally relevant tailoring (CRT) or both (BCT + CRT). The CRT magazines were based on four cultural constructs: religiosity, collectivism, racial pride, and time orientation. All tailored magazines sent to women ages 40-65 promoted use of mammography; magazines sent to women ages 18-39 promoted fruit and vegetable (FV) intake. Analyses examined changes from baseline to 18-month follow-up in use of mammography and servings of FV consumed daily. RESULTS Women receiving BCT + CRT magazines were more likely than those in the BCT, CRT, and control groups to report getting a mammogram (76% vs. 65% vs. 64% vs. 55%, respectively), and had greater increases in FV servings consumed daily (+0.96 vs. + 0.43 vs. + 0.25 vs. + 0.59). CONCLUSIONS Systematically integrating culture into tailored cancer prevention and control interventions may enhance their effectiveness in diverse populations.
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Affiliation(s)
- Matthew W Kreuter
- Health Communication Research Laboratory and Center of Excellence in Cancer Communication Research, Department of Community Health, School of Public Health, Saint Louis University (SLU), 3545 Lafayette Avenue, St. Louis, MO 63104, USA.
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Ahmad F, Shik A, Vanza R, Cheung A, George U, Stewart DE. Popular health promotion strategies among Chinese and East Indian immigrant women. Women Health 2005; 40:21-40. [PMID: 15778130 DOI: 10.1300/j013v40n01_02] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE To advance understanding about the popular health promotion strategies and factors associated with the successful transfer and uptake of health messages among Chinese and Indian immigrant women. METHODS Eight focus groups were conducted with 46 immigrant women, 24 from Mainland China and 22 from India, who had lived less than 5 years in Canada. Audiotaped data were transcribed, translated and analyzed by identification of themes and subcategories within and between groups. RESULTS In both ethnic groups, discussions on promoting health messages had five major themes, i.e., sources, barriers, facilitators, credibility and ways to improve access along with group specific sub-themes. Despite identification of several diverse sources of health information in the adopted country, Indian and Chinese immigrant women perceived most strategies as not very effective. The reasons of perceived ineffectiveness were barriers to accessing and comprehending the health messages; and limited prior exposure to institution based or formal health promotion initiatives. These women were more familiar with informal means of obtaining health information such as social networks, mass media and written materials in their mother tongue. CONCLUSION Existing health communication and health promotion models need to be re-orientated from a one-way information flow to a two-way dialogue model to bridge the gap between program efficacy and effectiveness to reach underserved immigrant women. An "outside the box" approach of non-institutional informal health promotion strategies needs to be tested for the studied groups.
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Affiliation(s)
- Farah Ahmad
- Women's Health Program at University Health Network, University of Toronto, Toronto, ON, Canada.
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Ahmad F, Cameron JI, Stewart DE. A tailored intervention to promote breast cancer screening among South Asian immigrant women. Soc Sci Med 2005; 60:575-86. [PMID: 15550305 DOI: 10.1016/j.socscimed.2004.05.018] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study developed and evaluated a socioculturally tailored intervention to improve knowledge, beliefs and clinical breast examination (CBE) among South Asian (SA) immigrant women. The intervention comprised a series of socioculturally tailored breast-health articles published in Urdu and Hindi community newspapers. A pre- and post-intervention design evaluated the impact of the mailed articles among 74 participants. The mean age of participants was 37 years (SD 9.7) and they had lived 6 years (SD 6.6) in Canada. After the intervention, there was a significant increase in self-reporting 'ever had' routine physical checkup (46.4-70.8%; p < 0.01) and CBE (33.3-59.7%; p < 0.001). Also, the total summed scores of accurate answers to 12 knowledge items increased (3.3-7.0; p < 0.001). For constructs of health belief model, participants rated their level of agreement for a number of items on a scale of 1-4 (disagree to agree). After the intervention the following decreased: misperception of low susceptibility to breast cancer among SA immigrant women (3.0-2.4; p < 0.001); misperception of short survival after diagnosis (2.7-1.8; p < 0.001); and perceived barriers to CBE (2.5-2.1; p < 0.001). Self-efficacy to have CBE increased (3.1-3.6; p < 0.001). The change scores of five predictor variables were entered in a direct logistic regression to predict the uptake of CBE among participants who never had it prior to the intervention. The model, as a set, was statistically reliable [chi2(5, n = 48) = 14.2 , p < 0.01] and explained 35% of variance in the outcome; perceived barriers remained an independently significant predictor. The results support the effectiveness of written socioculturally tailored language-specific health education materials in promoting breast cancer screening within the targeted population. Future research should test the intervention in other vulnerable populations.
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Affiliation(s)
- Farah Ahmad
- University Health Network & Faculty of Medicine, Women's Health Program, University of Toronto, 657 University Avenue, ML2-010A, Toronto, Ont., M5G 2N2, Canada.
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Magnussen L, Shoultz J, Oneha MF, Hla MM, Brees-Saunders Z, Akamine M, Talisayan B, Wong E. Intimate-partner violence: a retrospective review of records in primary care settings. ACTA ACUST UNITED AC 2005; 16:502-12. [PMID: 15617364 DOI: 10.1111/j.1745-7599.2004.tb00430.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The goals of this study were (a) to gather data regarding the documentation of disclosure of battering in primary care settings and (b) to collect demographic data, including ethnicity, of women who disclose intimate partner violence (IPV) in primary care settings in Hawaii. DATA SOURCES We conducted a retrospective chart review focusing on documentation of IPV in four community health centers on Oahu. The review included 337 charts. The data were analyzed using descriptive statistics. CONCLUSIONS Of the 337 records reviewed, IPV was reported in 31 (9.1%). Documentation of reported IPV differed among members of the various ethnic groups seen in the clinics. IMPLICATIONS FOR PRACTICE Practitioners should develop a common area for documenting reports of IPV. The level and depth of resources available within the setting and the community may affect providers' willingness to screen for IPV.
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Affiliation(s)
- Lois Magnussen
- University of Hawaii, Minoa's School of Nursing and Dental Hygiene, Honolulu, USA
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Abstract
The purpose of this study was to examine the relationships between acculturation level and perceptions of health access, Chinese health beliefs, Chinese health practices, and knowledge of breast cancer risk. This descriptive, correlational cross-sectional study used a survey approach. The sample included 135 Chinese women from the New York City metropolitan area. Data were analyzed using correlational techniques and polytomous regression. There were no significant relationships between acculturation and health access, Chinese health beliefs, Chinese health practices, and breast cancer risk knowledge. Only "years of education," "marital status," and "household income" significantly predicted breast cancer risk knowledge level. The data indicate that women with a better knowledge of breast cancer risk are twice as likely to have higher income and have more education. The most knowledgeable women are less likely to be married and less likely to have partners compared to least knowledgeable group. Providers need to promote health knowledge and provide information about as well as access to preventive health practices to the immigrant population, given that acculturation to the new dominant society is inevitable.
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Affiliation(s)
- Wei-Ti Chen
- Department of Community Health Systems, University of California San Francisco-School of Nursing, 2 Koret Way, San Francisco, CA 94143, USA.
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D'Alonzo KT, Stevenson JS, Davis SE. Outcomes of a program to enhance exercise self-efficacy and improve fitness in Black and Hispanic college-age women. Res Nurs Health 2004; 27:357-69. [PMID: 15362146 PMCID: PMC3210446 DOI: 10.1002/nur.20029] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A quasi-experimental design was used to test the outcomes of an exercise program directed towards Black and Hispanic college-age women. Forty-four women (36 Black, 7 Hispanic, and 1 Black/Hispanic) attended exercise classes three times per week for 16 weeks. At program completion, women were classified as either high attendees (n = 26) or low attendees (n = 18). Compared to low attendees, the high attendees had significantly higher exercise self-efficacy (p <.001), perceived benefits and barriers (p =.004), aerobic fitness, flexibility, muscle strength, and percentage of body fat (all p <.001). Daily activity levels improved significantly in the high attendance group following the program (p <.001) and at 8 weeks post-program completion (p =.01).
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Affiliation(s)
- Karen T D'Alonzo
- College of Nursing, Rutgers The State University of New Jersey, Newark, NJ 07102, USA
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Pasick RJ, Hiatt RA, Paskett ED. Lessons learned from community-based cancer screening intervention research. Cancer 2004; 101:1146-64. [PMID: 15316912 DOI: 10.1002/cncr.20508] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Behaviors associated with cancer screening have been the focus of intensive research over the past 2 decades, primarily in the form of intervention trials to improve screening based in both clinical and community settings. Meta-analyses and literature reviews have synthesized and organized the resulting literature. From the accumulated work, this review distilled lessons learned from cancer screening intervention research in community settings. The authors posed the question, "What do we know about the development of effective community-based interventions (the level of good over harm achieved in real-world conditions)?" Framed around the concept of focal points (the simultaneous combination of target population, behavioral objective, and setting for an intervention), 13 lessons were derived. One lesson was cross-cutting, and the other lessons addressed the three focal-point components and the major intervention categories (access-enhancing strategies, mass media, small media, one-on-one and small-group education, and combinations of these categories). To build more systematically on existing research, recommendations are made for new directions in basic behavioral and intervention research.
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Affiliation(s)
- Rena J Pasick
- Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California 94143-0981, USA.
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Abstract
This paper examines the role of culture as a factor in enhancing the effectiveness of health communication. We describe culture and how it may be applied in audience segmentation and introduce a model of health communication planning--McGuire's communication/persuasion model--as a framework for considering the ways in which culture may influence health communication effectiveness. For three components of the model (source, message, and channel factors), the paper reviews how each affects communication and persuasion, and how each may be affected by culture. We conclude with recommendations for future research on culture and health communication.
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Affiliation(s)
- Matthew W Kreuter
- Health Communication Research Laboratory, Department of Community Health, St. Louis, Missouri 63104, USA.
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Miller AM, Wilbur J, Chandler PJ, Sorokin O. Cardiovascular Disease Risk Factors and Menopausal Status in Midlife Women from the Former Soviet Union. Women Health 2003; 38:19-36. [PMID: 14664303 DOI: 10.1300/j013v38n03_03] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of this cross-sectional analysis is to examine modifiable CVD risk factors in relation to menopausal status, age, and length of residence in the U.S. of midlife women from the former Soviet Union. The analysis includes baseline data for 193 women, aged 40-70, who lived in the U.S. fewer than 8 years and were enrolled in an ongoing four-year study of post-immigration health and behavior change. Data collection was conducted in women's homes or other community locations. The presence of seven health risk indicators (obesity, dyslipidemia, high blood pressure, diabetes mellitus, sedentary lifestyle, smoking, and excessive alcohol use) was assessed. In addition, Framingham 10 year risk scores for heart disease, and the presence of metabolic syndrome, were calculated using recent National Cholesterol Education Program (ATP-III) guidelines. Consistent with the age distribution, 60% of the women were postmenopausal. Four risk indicators (obesity, dyslipidemia, high blood pressure, and sedentary lifestyle) were identified as significant areas of concern. Although the Framingham risk scores did not seem excessively high, almost 25% of the women had metabolic syndrome. Older and postmenopausal women had significantly higher scores on all risk estimates. When age and menopausal status were held constant, menopausal status remained an independent contributor for the number of CVD risk indicators. Issues specific to this group of women because of their pre- and post-migration lifestyles are discussed in relation to their CVD risk status.
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Egede LE, Zheng D. Racial/ethnic differences in adult vaccination among individuals with diabetes. Am J Public Health 2003; 93:324-9. [PMID: 12554594 PMCID: PMC1447738 DOI: 10.2105/ajph.93.2.324] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study examined whether differences in access to health care, health coverage, and socioeconomic status (SES) explained racial differences in influenza and pneumococcal vaccination rates in individuals with diabetes. METHODS We analyzed data on 1906 individuals from the 1998 National Health Interview Survey. We used multiple logistic regression to adjust for race/ethnicity, age, access to care, health insurance, and SES, and used SUDAAN for statistical analyses to yield national estimates. RESULTS Whites had higher vaccination rates than did African Americans or Hispanics. After adjustment for covariates, race/ethnicity predicted receipt of both vaccines independent of age, access to care, health care coverage, and SES. CONCLUSIONS Racial disparity in vaccination rates for adults with diabetes is independent of access to care, health care coverage, and SES.
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Affiliation(s)
- Leonard E Egede
- Department of Medicine, Medical University of South Carolina, Charleston 29401, USA.
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Hyman I, Guruge S, Makarchuk MJ, Cameron J, Micevski V. Promotion of Healthy Eating: Among New Immigrant Women in Ontario. CAN J DIET PRACT RES 2002; 63:125-9. [PMID: 12296978 DOI: 10.3148/63.3.2002.125] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Little attention has been given to the dietary patterns of new immigrant women in Canada. Research suggests that before migration, many immigrants, especially those from non-Western countries, consume a healthy diet, but this changes on migration. This paper presents information from a recently completed literature review conducted for the Women's Health Council of the Ontario Ministry of Health and Long-Term Care. The paper includes a review of the major determinants of food choice and health promotion strategies appropriate to new immigrant women. Our findings suggest that nutrition intervention for new immigrant women must consider the social context of these women's lives, address cultural, linguistic, economic and informational barriers and consider how these change over time. Recommendations are also made on how to best promote healthy eating in this group.
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Affiliation(s)
- Ilene Hyman
- The Centre for Research in Women's Health, University of Toronto, ON
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Shoultz J, Phillion N, Noone J, Tanner B. Listening to women: culturally tailoring the violence prevention guidelines from the put prevention into practice program. JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS 2002; 14:307-15. [PMID: 12138525 DOI: 10.1111/j.1745-7599.2002.tb00130.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To develop five reliable and valid (culturally tailored) guidelines focused on the prevention of violence as presented in the violence prevention guideline of the Put Prevention into Practice Clinician's Handbook on Preventative Services (PPIP). DATA SOURCES The data collection for this qualitative, descriptive design of naturalistic inquiry was focus group interviews with five different ethnic groups of women (Caucasian, Filipino, Hawaiian, Japanese and Hispanic) using a semi-structured interview guide. CONCLUSIONS The women interviewed provided a variety of suggestions for adaptations to the guideline. Cultural similarities and differences are presented. Development of a nonjudgmental and trusting relationship is key to disclosure. IMPLICATIONS FOR PRACTICE Violence against women is recognized as a major public health problem. Little is known about the effectiveness of standardized interventions such as those contained in the PPIP Handbook. Even less is known about the efficacy of such protocols within culturally diverse populations. Providers should consider adaptation of the guideline based on the individual relationship with the client. The next phase of this research is to implement the culturally tailored adaptations of these guidelines and test their effectiveness.
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Affiliation(s)
- Jan Shoultz
- University of Hawaii School of Nursing and Dental Hygiene, Honolulu, HI, USA.
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Kemppainen U, Tossavainen K, Vartiainen E, Pantelejev V, Puska P. Smoking patterns among ninth-grade adolescents in the Pitkäranta district (Russia) and in eastern Finland. Public Health Nurs 2002; 19:30-9. [PMID: 11841680 DOI: 10.1046/j.1525-1446.2002.19005.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study describes how ninth-grade adolescents' smoking behavior in the Pitkäranta district (Russia) differs from their eastern Finland counterparts. Cross-sectional data from the second North Karelia Youth Study and the Pitkäranta Youth Study were used. Subjects were all (n=385) ninth-grade students in 10 comprehensive schools in Pitkäranta and all (n=2098) students of the same age in 24 comprehensive schools in eastern Finland. Students were asked about their smoking status, intentions to smoke, smoking situations, acquisition of tobacco products, and opportunity to smoke in the school area. The results showed very large differences in the smoking prevalence between Pitkäranta and eastern Finland. For boys, the prevalence of daily smoking was 29% and 19% in Pitkäranta and eastern Finland, respectively. The differences in girls were adverse: 7% and 21% of girls in Pitkäranta and eastern Finland, respectively, were daily smokers. However, as many as one third of the nonsmoking girls in Pitkäranta stated that they may experiment or start smoking later. Boys in Pitkäranta had vaguer attitudes about remaining nonsmokers than boys in eastern Finland. This situation anticipates worsening of the smoking epidemic in Pitkäranta and requires an effective prevention policy and cooperation between different groups in society.
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Affiliation(s)
- Ulla Kemppainen
- Department of Nursing Science, University of Kuopio, Kuopio, Finland.
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