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Rangel ML, Heredia NI, Reininger B, McNeill L, Fernandez ME. Educating Hispanics About Clinical Trials and Biobanking. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:1112-1119. [PMID: 30112612 PMCID: PMC6377344 DOI: 10.1007/s13187-018-1417-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Hispanics are under-represented in clinical research. To ensure that the Hispanic population benefits from advances in public health and medicine, including personalized medicine, there is a need to increase their participation in clinical trials and biobanking. There is a great need for improving awareness and addressing concerns individuals may have about participation. The purpose of this study was to adapt, implement, and evaluate educational materials about clinical trials and biobanking for Hispanic individuals. We adapted existing materials based on focus group data. We then trained four promotoras de salud to deliver education to Hispanic adults in community settings in Houston, TX. The promotoras educated 101 Hispanic adults, 51 on biobanking and 50 on clinical trials. Study staff administered brief pre- and post-test questionnaires that measured benefits, barriers, norms, self-efficacy, and intention to participate in either clinical trials or biobanking. Our sample was predominately female (83%) and Spanish-speaking (69%) and made less than $25,000 a year (87%). This intervention increased perceived benefits of participating in biobanking and clinical trials, self-efficacy for donating biospecimens, and intention to participate in biobanking if invited. Perceived barriers to participating declined. This study demonstrated that brief education can result in improved perceptions and attitudes related to participation in biobanking and clinical trials, and could increase participation. Researchers and practitioners could use these educational materials to educate Hispanic community members on clinical research potentially increasing participation rates in the future.
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Affiliation(s)
- M Lizette Rangel
- Department of Behavioral Science, MD Anderson Cancer Center, Houston, TX, USA.
| | - Natalia I Heredia
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX, USA
- Center for Health Promotion and Prevention Research, UTHealth School of Public Health, Houston, TX, USA
| | - Belinda Reininger
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Brownsville Regional Campus, Brownsville, TX, USA
| | - Lorna McNeill
- Department of Health Disparities, MD Anderson Cancer Center, Houston, TX, USA
| | - Maria E Fernandez
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX, USA
- Center for Health Promotion and Prevention Research, UTHealth School of Public Health, Houston, TX, USA
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Mosavel M, Barker KL, Gardiner HM, Siminoff LA. Responsiveness and adaptability in community engaged biobanking research: experiences from a Hispanic community. J Community Genet 2019; 10:395-406. [PMID: 30610570 PMCID: PMC6591347 DOI: 10.1007/s12687-018-0397-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 11/07/2018] [Indexed: 10/27/2022] Open
Abstract
The success of biobanking research relies on the willingness of the public to provide biological and sociological information, donate tissue samples, and complete psychosocial questionnaires. Medical advances made through biobanking research have limited reach if tissues are not obtained from a diverse sample of individuals. Within, we describe the process of transitioning a small group of Hispanic community members who met regularly into a more formal Hispanic Community Advisory Board (HCAB) for the Genotype-Tissue Expression (GTEx) project. The sole purpose of the HCAB was to provide input and feedback on GTEx and, specifically, how researchers can best address the concerns of the Hispanic community related to tissue donation. This initial purpose was adapted to be responsive to the HCAB's request to include educating others in the Hispanic community who were not a part of the advisory board about genomic biobanking. While HCAB members' knowledge of biobanking was limited, a strong need for culturally tailored information about the impact of biobanking medical discoveries and their potential benefit to the Hispanic community was expressed. The HCAB's feedback guided revisions to GTEx study documents to specifically address concerns about language use, clarity, and context including the need for consent forms to address cultural concerns and fears. HCAB members also collaborated on the development of a walk-through exhibition which provided a visual, narrative-based explanation of GTEx and the process of tissue donation for research and biobanking purposes. The HCAB demonstrated the value of including community participation in scientific research projects, for both scientists and lay communities, and underscored the importance of developing community engagement approaches that are adaptable and responsive to community needs. Our experience with the HCAB serves as exemplar for a unique paradigm of community inclusiveness and education in research.
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Affiliation(s)
- Maghboeba Mosavel
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, 830 East Main Street, One Capitol Square, 4th floor, Richmond, VA 23219 USA
| | - K. Laura Barker
- College of Public Health, Temple University, 1700 N. Broad Street, Suite 417, Philadelphia, PA 19121 USA
| | - Heather M. Gardiner
- Department of Public Health, College of Public Health, Temple University, 1301 Cecil B. Moore Ave., Ritter Annex, 9th Floor, Philadelphia, PA 19122 USA
| | - Laura A. Siminoff
- College of Public Health (286-00), Bell Building (TECH CENTER), 1101 Montgomery Ave., Philadelphia, PA 19122 USA
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Menon U, Ashing K, Chang MW, Christy SM, Friberg-Felsted K, Rivas VG, Gwede CK, Lu Q, Meade CD, Sly J, Wang M, Yanez B, Yeary K, Yi JC, Alcaraz KI. Application of the ConNECT Framework to Precision Health and Health Disparities. Nurs Res 2019; 68:99-109. [PMID: 30540700 PMCID: PMC6863736 DOI: 10.1097/nnr.0000000000000329] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND An emphasis on precision health (PH) has stimulated precision medicine studies to focus on the interplay of biological, behavioral, and environmental factors with disease risks, treatments, prognoses, and outcomes affecting health disparities. It is imperative, as well, that improving health equity among underserved populations remains central to the efforts and aims of PH. OBJECTIVES The aim if this study was to apply the transdisciplinary ConNECT Framework: A Model for Advancing Behavioral Medicine Science and Practice to Foster Health Equity to PH by integrating a population health agenda for reducing health disparities. METHODS There are five ConNECT principles: (a) integrating context; (b) fostering a norm of inclusion; (c) ensuring equitable diffusion of innovations; (d) harnessing communication technology; and (e) prioritizing specialized training as an organizing framework to PH, including examples of how to integrate behavioral and socioecological determinants to better understand the contexts of individuals, systems, and place to design targeted treatments and interventions. RESULTS We describe proactive, actionable strategies for the systematic application of ConNECT Framework principles to address health equity via the PH initiative. Context and implications for nursing research and practice are also described. DISCUSSION The ConNECT Framework emphasizes that diversity inclusion is imperative for true population health benefit from PH, broadly in public health, behavioral medicine, medicine, and nursing, to equip health researchers and practitioners to account for contextual socioecologic data that can be aligned with biologic data for more population responsive and individually tailored interventions to prevent, diagnose, and treat diseases.
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Affiliation(s)
- Usha Menon
- Usha Menon, PhD, RN, FAAN, is Professor and Vice Dean of Research, University of South Florida College of Nursing, Tampa, Florida. Kimlin Ashing, PhD, is Founding Director, Center of Community Alliance for Research Education, and Professor, Department of Population Sciences, Beckman Research Institute, City of Hope Medical Center, Duarte, California. Mei Wei Chang, PhD, RN, is Associate Professor, The Ohio State University, College of Nursing, Columbus. Shannon M. Christy, PhD, is Assistant Member, Department of Health Outcomes and Behavior, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida. Katarina Friberg-Felsted, PhD, is Assistant Professor, College of Nursing, University of Utah Salt Lake City. Virginia Gil Rivas, PhD, is Professor, Department of Psychological Science, University of North Carolina at Charlotte. Clement K. Gwede, PhD, MPH, RN, FAAN, is Senior Member, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida. Qian Lu, MD, PhD, is Associate Professor, Department of Health Disparities Research, MD Anderson Cancer Center, Houston, Texas. Cathy D. Meade, PhD, RN, FAAN, is Senior Member, Division of Population Science, H. Lee Moffitt Cancer Center, and Research Institute & Department of Oncological Sciences, University of South Florida, College of Medicine, Tampa, Florida. Jamila Sly, PhD, is Assistant Professor, Department of Oncology Sciences, Icahn School of Medicine at Mount Sinai, New York, New York. Monica Wang, ScD, MS, is Assistant Professor, Department of Community Health Sciences, Boston University School of Public Health, and Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Betina Yanez, PhD, is Assistant Professor, Department of Medical Social Sciences and Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Karen Yeary, PhD, is Associate Professor, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock. Jean C. Yi, PhD, is Staff Scientist, Project Director, Biobehavioral Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington. Kassandra I. Alcaraz, PhD, MPH, is Strategic Director of Health Disparities Research, Behavioral Research Center, American Cancer Society, Atlanta, Georgia
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Haring RC, Henry WA, Hudson M, Rodriguez EM, Taualii M. Views on clinical trial recruitment, biospecimen collection, and cancer research: population science from landscapes of the Haudenosaunee (People of the Longhouse). JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:44-51. [PMID: 27392418 PMCID: PMC5716929 DOI: 10.1007/s13187-016-1067-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Biomedical research in culturally distinct communities is often a challenge. Potential barriers to participation occur because science is presented in a format that lacks cultural acknowledgement. Investigations may also fail to showcase beneficial relevance to the communities or include them in true partnership. The history of biomedical research within Native American societies has been complicated by these issues. Historical trauma among many Native groups sometimes transcends into contemporary challenges in both recruitment to and participation particularly in biobanking research. The participants for this study included members of the Haudenosaunee, the People of the Longhouse. Native Americans, including the Haudenosaunee, endure some of the worst health disparities in the country. These include high rates of cancer, obesity, and diabetes which may be linked at least partially to genetic predisposition. Results from a Haudenosaunee urban population shared response on ways to improve recruitment strategies for biospecimen, cancer, and other health-related clinical trials. Mixed methods approaches were used, and community responses indicated the importance of creating trust through respectful partnership; promoting culturally appropriate recruitment materials; the need for a greater understanding of consenting and signature processes; the necessity for concise summary sheets; and a desire to have information that community member understand. Discussion items also include international Indigenous perspectives to biobanking and genetic-related health disparity research.
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Affiliation(s)
- Rodney C Haring
- Roswell Park Cancer Institute, Office of Cancer Health Disparities, Cancer Prevention and Population Sciences, Elm & Carlton Streets, Buffalo, NY, 14263, USA.
| | - Whitney Ann Henry
- Roswell Park Cancer Institute, Office of Cancer Health Disparities, Cancer Prevention and Population Sciences, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Maui Hudson
- Environmental Research Institute-Faculty of Science, Dept of Management Communications-Waikato Management School, University of Waikato: Maori & Indigenous Governance Centre-Faculty of Law, Private Bag 3105, Hamilton, 3240, New Zealand
| | - Elisa M Rodriguez
- Roswell Park Cancer Institute, Office of Cancer Health Disparities, Cancer Prevention and Population Sciences, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Maile Taualii
- Office of Public Health Studies, Native Hawaiian and Indigenous Health, 1960 East-West Road, Honolulu, HI, 96822, USA
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Alcaraz KI, Sly J, Ashing K, Fleisher L, Gil-Rivas V, Ford S, Yi JC, Lu Q, Meade CD, Menon U, Gwede CK. The ConNECT Framework: a model for advancing behavioral medicine science and practice to foster health equity. J Behav Med 2017; 40:23-38. [PMID: 27509892 PMCID: PMC5296246 DOI: 10.1007/s10865-016-9780-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 08/02/2016] [Indexed: 12/23/2022]
Abstract
Health disparities persist despite ongoing efforts. Given the United States' rapidly changing demography and socio-cultural diversity, a paradigm shift in behavioral medicine is needed to advance research and interventions focused on health equity. This paper introduces the ConNECT Framework as a model to link the sciences of behavioral medicine and health equity with the goal of achieving equitable health and outcomes in the twenty-first century. We first evaluate the state of health equity efforts in behavioral medicine science and identify key opportunities to advance the field. We then discuss and present actionable recommendations related to ConNECT's five broad and synergistic principles: (1) Integrating Context; (2) Fostering a Norm of Inclusion; (3) Ensuring Equitable Diffusion of Innovations; (4) Harnessing Communication Technology; and (5) Prioritizing Specialized Training. The framework holds significant promise for furthering health equity and ushering in a new and refreshing era of behavioral medicine science and practice.
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Affiliation(s)
- Kassandra I Alcaraz
- Behavioral Research Center, American Cancer Society, 250 Williams Street NW, Atlanta, GA, 30303, USA.
| | - Jamilia Sly
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kimlin Ashing
- Beckman Research Institute, City of Hope Medical Center, Duarte, CA, USA
| | - Linda Fleisher
- Center for Injury Research and Prevention, Fox Chase Cancer Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Virginia Gil-Rivas
- Department of Psychology, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Sabrina Ford
- College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Jean C Yi
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Qian Lu
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Cathy D Meade
- Moffitt Cancer Center, Population Science, Health Outcomes and Behavior, Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Usha Menon
- The University of Arizona College of Nursing, Tucson, AZ, USA
| | - Clement K Gwede
- Moffitt Cancer Center, Population Science, Health Outcomes and Behavior, Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
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Engaging diverse populations in biospecimen donation: results from the Hoy y Mañana study. J Community Genet 2016. [PMID: 27488840 DOI: 10.1007/s12687-016-0275-3.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022] Open
Abstract
The disproportionately lower number of certain subpopulations participating in clinical and prevention research has a significant impact on the representativeness of scientific outcomes. The Hoy y Mañana program (Today and Tomorrow) was developed as a culturally and linguistically appropriate education program to engage diverse medically underserved populations without a cancer diagnosis in biospecimen donation for cancer genomic research. Participants were recruited to in-depth community-based educational programs (∼45-60-min duration) or during open events in the community based on a convenience sampling. Programs were offered in English and Spanish. An on-site mobile lab along with phlebotomy services was provided at all programs and events to collect participant biospecimen (blood) samples to be stored at the cancer center's Data Bank and BioRepository (DBBR). The distributions for education, race/ethnicity, and gender were similar across the event types. Most of the participants were women. The analysis sample had a total of 311 participants, including 231 from the education programs and 80 participants from open events. Those with a higher education (college or more) were more likely to donate than those with a lower level of education (high school or less) (45 vs 28 %, p = 0.007). Actual donation status was not associated with age or race. Willingness to donate a biospecimen and biospecimen donation rates followed the same pattern with respect to participants with higher levels of education being more willing to donate and giving a blood donation. Prior to outreach efforts, less than 6 % of specimens donated to DBBR from healthy/non-cancer patients were from minority participants.
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Rodriguez EM, Saad-Harfouche FG, Miller A, Mahoney MC, Ambrosone CB, Morrison CD, Underwood W, Erwin DO. Engaging diverse populations in biospecimen donation: results from the Hoy y Mañana study. J Community Genet 2016; 7:271-277. [PMID: 27488840 DOI: 10.1007/s12687-016-0275-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 07/27/2016] [Indexed: 10/21/2022] Open
Abstract
The disproportionately lower number of certain subpopulations participating in clinical and prevention research has a significant impact on the representativeness of scientific outcomes. The Hoy y Mañana program (Today and Tomorrow) was developed as a culturally and linguistically appropriate education program to engage diverse medically underserved populations without a cancer diagnosis in biospecimen donation for cancer genomic research. Participants were recruited to in-depth community-based educational programs (∼45-60-min duration) or during open events in the community based on a convenience sampling. Programs were offered in English and Spanish. An on-site mobile lab along with phlebotomy services was provided at all programs and events to collect participant biospecimen (blood) samples to be stored at the cancer center's Data Bank and BioRepository (DBBR). The distributions for education, race/ethnicity, and gender were similar across the event types. Most of the participants were women. The analysis sample had a total of 311 participants, including 231 from the education programs and 80 participants from open events. Those with a higher education (college or more) were more likely to donate than those with a lower level of education (high school or less) (45 vs 28 %, p = 0.007). Actual donation status was not associated with age or race. Willingness to donate a biospecimen and biospecimen donation rates followed the same pattern with respect to participants with higher levels of education being more willing to donate and giving a blood donation. Prior to outreach efforts, less than 6 % of specimens donated to DBBR from healthy/non-cancer patients were from minority participants.
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Affiliation(s)
- Elisa M Rodriguez
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA.
| | - Frances G Saad-Harfouche
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Austin Miller
- Department of Biostatistics and Bioinformatics, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Martin C Mahoney
- Department of Medicine, Department of Health Behavior, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Christine B Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Carl D Morrison
- Center for Personalized Medicine, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Willie Underwood
- Department of Urology, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Deborah O Erwin
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA
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Baquet CR. A Legacy of Science and Community Engagement via the Community Networks Program. Prog Community Health Partnersh 2015. [PMID: 26213398 DOI: 10.1353/cpr.2015.0025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This special issue documents the progress of a unique group of research investigations that further legitimize the engagement of affected communities in quality cancer health disparities research and, the importance of mentoring and training of new and diverse health disparity researchers. The implications for the reduction and elimination of cancer health disparities within the United States are apparent. The diversity of populations included in these novel studies also has implications for addressing inequities in a global context.
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Hébert JR, Braun KL, Meade CD, Bloom J, Kobetz E. Community-Based Participatory Research Adds Value to the National Cancer Institute's Research Portfolio. Prog Community Health Partnersh 2015; 9 Suppl:1-4. [PMID: 26213397 PMCID: PMC4703947 DOI: 10.1353/cpr.2015.0022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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