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Soca Lozano S, Buro AW, Gonzalez-Videla K, Rodriguez C, Rancourt D, Gray HL, Bailey R, Redwine L, Stern M. Training Promotoras to Implement a Mindfulness-Based Healthy Lifestyle Program in Rural Communities. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:406-412. [PMID: 38520425 PMCID: PMC11162307 DOI: 10.1016/j.jneb.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/22/2024] [Accepted: 02/25/2024] [Indexed: 03/25/2024]
Abstract
Partnering with promotoras to implement a healthy lifestyle intervention has proven efficacious in reaching community members whom they serve. However, there are no clearly defined guidelines for implementing promotora training, especially when it involves developing mindfulness skills in promotoras unfamiliar with this concept. This is a report about the facilitators and barriers to training promotoras to implement a mindfulness-enhanced healthy eating and physical activity intervention, ADAPT+, using the Train-the-Trainer model. Following this model, we laid the foundations for sustained implementation of ADAPT+ even after the training process. Future studies may examine how these guidelines help map promotora training in other mindfulness-related interventions.
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Affiliation(s)
- Sandra Soca Lozano
- Department of Educational and Psychological Studies, College of Education, University of South Florida, Tampa, FL
| | - Acadia W Buro
- College of Population Health, University of New Mexico, NM
| | - Karen Gonzalez-Videla
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL
| | | | - Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, FL
| | - Heewon L Gray
- College of Public Health, University of South Florida, Tampa, FL
| | | | - Laura Redwine
- Department of Family Medicine and Community Health, Miller School of Medicine, University of Miami, Tampa, FL
| | - Marilyn Stern
- College of Population Health, University of New Mexico, NM; Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL.
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Mariño JM, Nunes LMP, Ali YCMM, Tonhi LDC, Salvetti MDG. Educational interventions for cervical cancer prevention: a scoping review. Rev Bras Enferm 2023; 76:e20230018. [PMID: 38018622 PMCID: PMC10680385 DOI: 10.1590/0034-7167-2023-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/12/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVES to identify, map and describe characteristics of educational interventions for cervical cancer prevention in adult women. METHODS a scoping review conducted on eleven databases and the gray literature, including studies that described educational interventions aimed at preventing cervical cancer in adult women. RESULTS thirty-three articles with 151,457 participants were analyzed. The most used educational strategies were participatory discussions and educational leaflets. Most of the interventions took place in a single session, ranging from 40 to 60 minutes. The most used theoretical model in interventions to improve women's compliance with Pap smear was the Health Belief Model. CONCLUSIONS group discussions, lectures and educational brochures can increase knowledge and reduce barriers to cervical cancer prevention. Theory-based and culturally sensitive interventions can have a positive impact on women's health.
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Affiliation(s)
- Josiane Montanho Mariño
- Universidade de São Paulo. São Paulo, São Paulo, Brazil
- Universidade Federal do Amazonas. Coari, Amazonas, Brazil
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Korn AR, Walsh-Bailey C, Correa-Mendez M, DelNero P, Pilar M, Sandler B, Brownson RC, Emmons KM, Oh AY. Social determinants of health and US cancer screening interventions: A systematic review. CA Cancer J Clin 2023; 73:461-479. [PMID: 37329257 PMCID: PMC10529377 DOI: 10.3322/caac.21801] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/05/2023] [Accepted: 05/08/2023] [Indexed: 06/19/2023] Open
Abstract
There remains a need to synthesize linkages between social determinants of health (SDOH) and cancer screening to reduce persistent inequities contributing to the US cancer burden. The authors conducted a systematic review of US-based breast, cervical, colorectal, and lung cancer screening intervention studies to summarize how SDOH have been considered in interventions and relationships between SDOH and screening. Five databases were searched for peer-reviewed research articles published in English between 2010 and 2021. The Covidence software platform was used to screen articles and extract data using a standardized template. Data items included study and intervention characteristics, SDOH intervention components and measures, and screening outcomes. The findings were summarized using descriptive statistics and narratives. The review included 144 studies among diverse population groups. SDOH interventions increased screening rates overall by a median of 8.4 percentage points (interquartile interval, 1.8-18.8 percentage points). The objective of most interventions was to increase community demand (90.3%) and access (84.0%) to screening. SDOH interventions related to health care access and quality were most prevalent (227 unique intervention components). Other SDOH, including educational, social/community, environmental, and economic factors, were less common (90, 52, 21, and zero intervention components, respectively). Studies that included analyses of health policy, access to care, and lower costs yielded the largest proportions of favorable associations with screening outcomes. SDOH were predominantly measured at the individual level. This review describes how SDOH have been considered in the design and evaluation of cancer screening interventions and effect sizes for SDOH interventions. Findings may guide future intervention and implementation research aiming to reduce US screening inequities.
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Affiliation(s)
- Ariella R. Korn
- Cancer Prevention Fellowship Program, Implementation Science Team, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
- Behavioral and Policy Sciences Department, RAND Corporation, Boston, MA
| | - Callie Walsh-Bailey
- Prevention Research Center, Brown School at Washington University in St. Louis, St. Louis, MO
| | - Margarita Correa-Mendez
- Cancer Prevention Fellowship Program, Implementation Science Team, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Peter DelNero
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Meagan Pilar
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO
| | - Brittney Sandler
- Bernard Becker Medical Library, Washington University School of Medicine, St. Louis, MO
| | - Ross C. Brownson
- Prevention Research Center, Brown School at Washington University in St. Louis, St. Louis, MO
- Department of Surgery, Division of Public Health Sciences, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Karen M. Emmons
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - April Y. Oh
- Implementation Science Team, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
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Lemmo D, Martino ML, Vallone F, Donizzetti AR, Freda MF, Palumbo F, Lorenzo E, D'Argenzio A, Caso D. Clinical and psychosocial constructs for breast, cervical, and colorectal cancer screening participation: A systematic review. Int J Clin Health Psychol 2023; 23:100354. [PMID: 36415605 PMCID: PMC9677078 DOI: 10.1016/j.ijchp.2022.100354] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 11/02/2022] [Indexed: 11/19/2022] Open
Abstract
Research has identified a wide range of psychosocial factors associated to choosing to engage in ongoing cancer screenings. Nevertheless, a systematic review of the theoretical frameworks and constructs underpinning studies on breast, cervical, and colorectal cancer screening participation has yet to be conducted. As part of the action-research project “Miriade,” the present study aims to identifying the main theoretical frameworks and constructs adopted in the literature over the past five years to explain cancer screening participation. According to the PRISMA guidelines, a search of the MEDLINE/PubMed and PsycINFO databases was made. Empirical studies conducted from 2017 to 2021 were included. The following keywords were used: breast OR cervical OR colorectal screening AND adhesion OR participation OR engagement AND theoretical framework OR conceptual framework OR theory. Overall, 24 articles met the inclusion criteria. Each theoretical framework highlighted clinical and psychosocial constructs of cancer screening participation, focusing on the individuals (psycho-emotional functioning and skills plan) and/or the health services perspectives. Findings from the present study acknowledge the plurality of the theoretical frameworks and constructs adopted to predict or promote breast, cervical, and colorectal cancer screening adhesion and the need for new research efforts to improve the effectiveness of cancer screening promotion interventions.
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Affiliation(s)
- Daniela Lemmo
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
- Corresponding author.
| | - Maria Luisa Martino
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Federica Vallone
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Anna Rosa Donizzetti
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | | | - Francesco Palumbo
- Department of Political Science, University of Naples Federico II, Naples, Italy
| | - Elvira Lorenzo
- Directorate General for Health Protection and Coordination of the Regional Health System, Campania Region, Italy
| | - Angelo D'Argenzio
- Directorate General for Health Protection and Coordination of the Regional Health System, Campania Region, Italy
| | - Daniela Caso
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
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5
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Lee CN, Matthew RA, Orpinas P. Design, implementation, and evaluation of community health worker training programs in Latinx communities: A scoping review. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:382-405. [PMID: 35716392 PMCID: PMC10084025 DOI: 10.1002/jcop.22910] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/04/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
This review examines the current reporting trends of program design, implementation, and evaluation of training programs for Latinx community health workers. Five scholarly databases were searched using a scoping review methodology to identify articles describing training programs for Latinx community health workers. The timeframe was 2009 to 2021. We identified 273 articles, with 59 meeting inclusion criteria. Researchers thematically coded the articles to identify reporting strategies related to program design, implementation, and evaluation. Findings suggest a lack of consensus in reporting elements critical to program resources, instructor qualifications, frequency and length of training implementation, theoretical background, and pedagogical tools associated with the training program. We offer detailed reporting recommendations of community health worker training programs to support the consistent dissemination of promising practices and facilitate the initiation of new programs for Latinx community health workers.
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Affiliation(s)
- Christina N. Lee
- Department of Anthropology, Franklin College of Arts and ScienceUniversity of GeorgiaAthensGeorgiaUSA
| | | | - Pamela Orpinas
- Department of Health Promotion and Behavior, College of Public HealthUniversity of GeorgiaAthensGeorgiaUSA
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Ewing AP, Alalwan MA, Brown JA, Adekunle TE, Korley ND, Nafiu TC, Coughlin EC, Parvanta CP, Meade CD, Gwede CK, Best AL. Physically fit with a higher cancer risk? Influences of cervical cancer screening among a sample of physically active women ages 21-49 living in the United States. Prev Med Rep 2022; 30:101978. [PMID: 36157713 PMCID: PMC9494240 DOI: 10.1016/j.pmedr.2022.101978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
To achieve the lowest risk level for various cancers, individuals would engage in several healthy lifestyle behaviors and age-eligible cancer screenings as recommended. Nonetheless, research has largely omitted exploration of concurrent primary and secondary prevention behaviors. This study was designed to explore influences of cervical cancer screening among physically active women who reported participation in recreational sports. U.S. based women between the ages of 21–49, who had never been diagnosed with cancer, were eligible to complete a web-based survey. Logistic regression analyses were conducted using SAS 9.4. On average, women were 31 years of age (N = 394) and self-identified as Black (51.3 %). Although low overall (30.7 %), higher odds of cervical cancer screening were associated with age (OR = 1.06, 95 % CI = 1.03–1.10), employment (OR = 2.43, 95 % CI = 1.14–5.18), knowledge of cancer-related risk behaviors (OR = 4.04, 95 % CI = 1.33–12.28), routine doctor’s visit (OR = 4.25, 95 % CI = 1.56–11.54), and team-based vs individual-based sport participation (OR = 1.95, 95 % CI = 1.13–3.34). Our study provides insight into the health profile of physically active women, ages 21–49, as it relates to risks for cervical cancer. Screening uptake among this diverse sample was much lower than the general population and national goals set by Healthy People 2030. Interventions should be tailored to increase knowledge of cancer-related risk behaviors, access to healthcare, and recommended cervical cancer screenings among even assumed-to-be healthy populations.
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Affiliation(s)
- A P Ewing
- The Ohio State University College of Public Health, Division of Epidemiology (APE, MAA, NDK, TCN), 1841 Neil Ave Building 293, Columbus OH 43210, USA
| | - M A Alalwan
- The Ohio State University College of Public Health, Division of Epidemiology (APE, MAA, NDK, TCN), 1841 Neil Ave Building 293, Columbus OH 43210, USA
| | - J A Brown
- University of North Carolina Chapel Hill, Department of Epidemiology, Gillings School of Global Public Health (JAB) CB # 7400 135 Dauer Drive, Chapel Hill NC 27599, USA
| | - T E Adekunle
- School of Public Health and Information Sciences (SPHIS), University of Louisville (TEA) 485 E Gray St, Louisville KY 40202, USA
| | - N D Korley
- The Ohio State University College of Public Health, Division of Epidemiology (APE, MAA, NDK, TCN), 1841 Neil Ave Building 293, Columbus OH 43210, USA
| | - T C Nafiu
- The Ohio State University College of Public Health, Division of Epidemiology (APE, MAA, NDK, TCN), 1841 Neil Ave Building 293, Columbus OH 43210, USA
| | - E C Coughlin
- College of Public Health, University of South Florida (ECC, CPP, ALB) 13201 Bruce B Downs Blvd, Tampa, FL 33612, USA
| | - C P Parvanta
- College of Public Health, University of South Florida (ECC, CPP, ALB) 13201 Bruce B Downs Blvd, Tampa, FL 33612, USA
| | - C D Meade
- Moffitt Cancer Center, Population Science, Health Outcomes and Behavior (CDM, CKG) 4117 E Fowler Ave, Tampa, FL 33612, USA
| | - C K Gwede
- Moffitt Cancer Center, Population Science, Health Outcomes and Behavior (CDM, CKG) 4117 E Fowler Ave, Tampa, FL 33612, USA
| | - A L Best
- College of Public Health, University of South Florida (ECC, CPP, ALB) 13201 Bruce B Downs Blvd, Tampa, FL 33612, USA
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7
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Effects of mobile Health (mHealth) application on cervical cancer prevention knowledge and screening among women social support groups with low-socioeconomic status in Mysuru city, Southern India. PLoS One 2022; 17:e0273070. [PMID: 36048892 PMCID: PMC9436151 DOI: 10.1371/journal.pone.0273070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 08/02/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Cervical cancer is an important area of action because of the mortality and morbidity of the disease, and the potential for effective prevention by screening. Involving the social support groups by health education improves cervical cancer screening and early detection of the disease in the community. In the ongoing efforts to strengthen cervical cancer prevention, control, and management, digital health and technology will have a significant role to play.
Objective
To assess the effectiveness of the mHealth-based intervention on cervical cancer preparedness among women social support groups.
Materials & methods
A pre-post interventional study was conducted among women social support groups from lower socio-economic status, identified from the field practice area. Purposive sampling technique was employed. A Cervical Cancer Awareness Measure (CAM) instrument was used to assess the cancer preparedness among the social support group women After taking inputs from the stakeholders’ mobile health application was developed. The mHealth educational intervention was given to 102 women. Both pre-and post-test questionnaires were administered through mHealth application to assess the change in knowledge after a gap of 1 month to 2 months. The data obtained was coded and entered into Microsoft Excel worksheet 2016 and was later imported and analyzed using SPSS version 22 (licensed to the Institute). The difference in median scores of knowledge and practice were interpreted as statistically significant at p value of < 0.05.
Results & conclusion
Before the intervention only 13 (12.7%) of them had heard about cervical cancer. There was a significant increase in the knowledge about warning signs & symptoms, risk factors of cervical cancer, and HPV vaccination. Around 5% increase in Pap smear test uptake.
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Power R, Ussher JM, Hawkey A, Missiakos O, Perz J, Ogunsiji O, Zonjic N, Kwok C, McBride K, Monteiro M. Co-designed, culturally tailored cervical screening education with migrant and refugee women in Australia: a feasibility study. BMC Womens Health 2022; 22:353. [PMID: 35987620 PMCID: PMC9391656 DOI: 10.1186/s12905-022-01936-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background Participation of culturally and linguistically diverse (CALD) women from migrant and refugee backgrounds in cervical screening is crucial to eliminate cervical cancer as a public health problem within the next 20 years. However, CALD women report low participation in cervical screening. Barriers to participation can be addressed with culturally tailored, community-based programs. There is a need for research to explore the process, feasibility, acceptability and barriers to cultural tailoring in the delivery and evaluation of cervical screening health education. Methods CALD community health workers took part in a 2 day training program then co-designed, culturally tailored and co-facilitated cervical screening health promotion forums within their communities. Forums were delivered to a total of seven groups, involving 12 sessions and 71 CALD women. The forums were evaluated for feasibility, acceptability, implementation and effectiveness using a survey, interviews and observations. Data were collected from CALD women, facilitators and researchers. Results The co-design and co-delivery of cervical screening health promotion forums was time and resource intensive however allowed for deeper cultural tailoring resulting in engagement with ‘hard to reach’ CALD women, improved health literacy and intention to screen. Flexibility in the intervention implementation was crucial to ensure forums were responsive to community interests and needs. Online delivery of the forums in response to the COVID-19 pandemic was acceptable to most groups. Conclusions Co-designed, culturally tailored cervical screening health promotion forums are feasible and acceptable to CALD women, in both face-to-face and online formats. Adjustments to the intervention protocol were recommended to improve future implementation.
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Battaglia TA, Zhang X, Dwyer AJ, Rush CH, Paskett ED. Change agents in the oncology workforce: Let's be clear about community health workers and patient navigators. Cancer 2022; 128 Suppl 13:2664-2668. [PMID: 35699614 DOI: 10.1002/cncr.34194] [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: 09/14/2021] [Revised: 01/18/2022] [Accepted: 03/01/2022] [Indexed: 11/12/2022]
Abstract
Despite efforts of professional organizations and government agencies to solidify the professional identities of community health workers and patient navigators in the oncology workforce, the scientific literature perpetuates wide variation in the nomenclature used to define these natural change agents, who have proven efficacy in improving access to quality cancer care for historically marginalized populations. To disseminate, sustain, and scale-up these life-saving roles in cancer care, the oncology field must come together now to adopt clear and consistent job titles and occupational identities.
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Affiliation(s)
- Tracy A Battaglia
- Women's Health Unit, Section of General Internal Medicine, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts
| | - Xiaochen Zhang
- Comprehensive Cancer Center, Division of Population Sciences, The Ohio State University, Columbus, Ohio
| | - Andrea J Dwyer
- Department of Community and Behavioral Health, School of Public Health, University of Colorado, Aurora, Colorado
| | - Carl H Rush
- Community Resources, LLC, San Antonio, Texas
| | - Electra D Paskett
- Comprehensive Cancer Center, Division of Population Sciences, The Ohio State University, Columbus, Ohio
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Sanchez Antelo V, Szwarc L, Paolino M, Saimovici D, Massaccesi S, Viswanath K, Arrossi S. A Counseling Mobile App to Reduce the Psychosocial Impact of Human Papillomavirus Testing: Formative Research Using a User-Centered Design Approach in a Low-Middle-Income Setting in Argentina. JMIR Form Res 2022; 6:e32610. [PMID: 35023843 PMCID: PMC8796044 DOI: 10.2196/32610] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/01/2021] [Accepted: 11/17/2021] [Indexed: 01/16/2023] Open
Abstract
Background Human papillomavirus (HPV) testing detects sexually transmitted infections with oncogenic types of HPV. For many HPV-positive women, this result has negative connotations. It produces anxiety, fear of cancer or death, and disease denial. Face-to-face counseling could present many difficulties in its implementation, but a counseling mobile app could be practical and may help HPV-positive women reduce the psychosocial impact of the result, improve their knowledge of HPV and cervical cancer, and increase adherence to follow-up. Objective This study aims to understand HPV-tested women’s perceptions about an app as a tool to receive information and support to reduce the emotional impact of HPV-positive results. We investigated their preferences regarding app design, content, and framing. Methods We conducted formative research based on a user-centered design approach. We carried out 29 individual online interviews with HPV-positive women aged 30 years and over and 4 focus groups (FGs) with women through a virtual platform (n=19). We shared a draft of the app's potential screens with a provisional label of the possible content, options menus, draft illustrations, and wording. This allowed us to give women understandable triggers to debate the concepts involved on each screen. The draft content and labels were developed drawing from the health belief model (HBM) and integrative behavioral model (IBM) variables and findings of mobile health literature. We used an FG guide to generate data for the information architecture (ie, how to organize contents into features). We carried out thematic analysis using constructs from the HBM and IBM to identify content preferences and turn them into app features. We used the RQDA package of R software for data processing. Results We found that participants required more information regarding the procedures they had received, what HPV-positive means, what the causes of HPV are, and its consequences on their sexuality. The women mentioned fear of the disease and stated they had concerns and misconceptions, such as believing that an HPV-positive result is a synonym for cancer. They accepted the app as a tool to obtain information and to reduce fears related to HPV-positive results. They would use a mobile app under doctor or health authority recommendation. The women did not agree with the draft organization of screens and contents. They believed the app should first offer information about HPV and then provide customized content according to the users’ needs. The app should provide information via videos with experts and testimonies of other HPV-positive women, and they suggested a medical appointment reminder feature. The app should also offer information through illustrations, or infographics, but not pictures or solely text. Conclusions Providing information that meets women’s needs and counseling could be a method to reduce fears. A mobile app seems to be an acceptable and suitable tool to help HPV-positive women.
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Affiliation(s)
- Victoria Sanchez Antelo
- Centro de Estudios de Estado y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
| | - Lucila Szwarc
- Centro de Estudios de Estado y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
| | - Melisa Paolino
- Centro de Estudios de Estado y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
| | - Diana Saimovici
- Centro de Estudios de Estado y Sociedad, Ciudad Autónoma de Buenos Aires, Argentina
| | - Silvia Massaccesi
- Secretaria de Salud de Ituzaingó, Instituto Provincial del Cáncer, Ministerio de Salud de la Provincia de Buenos Aires, Ituzaingo, Argentina
| | - Kasisomayajula Viswanath
- McGraw-Patterson Center for Population Sciences, Dana-Farber Cancer Institute, Boston, MA, United States.,Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Silvina Arrossi
- Centro de Estudios de Estado y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
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Mboineki JF, Wang P, Dhakal K, Getu MA, Chen C. The Effect of Peer-Led Navigation Approach as a Form of Task Shifting in Promoting Cervical Cancer Screening Knowledge, Intention, and Practices Among Urban Women in Tanzania: A Randomized Controlled Trial. Cancer Control 2022; 29:10732748221089480. [PMID: 35666651 PMCID: PMC9174555 DOI: 10.1177/10732748221089480] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Even though the government's priorities in preventing cervical cancer are implemented in urban areas, the screening rate remains unsatisfactory at 6%, compared to 70% recommended by the world health organization. The ongoing public health education has not resulted in sufficient screening rates. The study aims to assess peer-led navigation (PLNav) in promoting cervical cancer screening knowledge, intention, and practices among urban women in Tanzania. Since PLNav is the form of task shifting, it involves delegating cervical-cancer-related tasks from healthcare professionals to community health workers (CHWs). METHODS It is a community-based randomized controlled trial conducted in Dar es Salaam in Tanzania March-Sept 2020. The PLNav involved the CHWs delivering health education, counselling and navigation assistance to community women (COMW). The CHWs help women who have never undergone cervical cancer screening (CCS) and those who have undergone CCS but with a precancerous cervical lesion to overcome screening barriers. The data related to PLNav were analyzed by descriptive statistics, an independent-samples t-test, repeated measures ANOVA and linear regression. RESULTS The repeated measures ANOVA across time showed that PLNav intervention on mean knowledge score changes was statistically significant in the intervention group compared with the control group's usual care, [F (1, 43) = 56.9, P < .001]. At the six-month follow-up, 32 (72.7%) out of 44 participants from the intervention group had screened for cervical cancer, and only one participant (2.3%) from the control group screened. The PLNav intervention on CCS uptake changes was statistically significant in the intervention group compared with usual care in the control group [F (1, 43) = 100.4, P < .001]. The effect of time on CCS uptake in the intervention and control groups was statistically significant [F (1.64, 70.62) = 73.4, P < .001]. CONCLUSION Peer-led navigation (PLNav) was effective in promoting cervical cancer screening knowledge, intention, and uptake.
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Affiliation(s)
- Joanes Faustine Mboineki
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.,12636School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China.,School of Nursing and Public Health, The University of Dodoma, Tanzania
| | - Panpan Wang
- 12636School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Kamala Dhakal
- 12636School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Mikiyas Amare Getu
- 12636School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Changying Chen
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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12
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Female health education package enhances knowledge, attitudes, and self-efficacy of housewives in cervical cancer screening. ENFERMERIA CLINICA 2021. [PMID: 33849166 DOI: 10.1016/j.enfcli.2020.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This research was conducted to identify the effectiveness of FEMALE health education on the knowledge, attitudes, and self-efficacy of women in the Banjarbaru Selatan District, Banjarbaru. The quasi experimental pre-post test with control group design. Study was carried out on 428 housewives, 213 as control groups and 215 as intervention groups respectively. The sampling technique used convenience sampling. The results showed that there was a significant differences before and after intervention in knowledge, attitudes, and self-efficacy in women (p=0.000, p=0.003, and p=0.002 respectively) in the intervention group which is also significant different from respondent in the control group. This study recommends that nurses could use this FEMALE health education to educate women in the community in order to improve the coverage of cervical cancer screening.
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Kugel C, Seda CH. Migrant and Seasonal Farmworkers: Cancer Risks, Barriers to Care, and Ways to Overcome Them. Clin J Oncol Nurs 2021; 25:219-222. [PMID: 33739336 DOI: 10.1188/21.cjon.219-222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Migrant and seasonal farmworkers (MSFWs) encounter numerous and overlapping barriers to healthcare access, including economic, cultural, linguistic, and logistic factors, all of which may contribute to disparities in cancer outcomes. For many MSFWs and their families, healthcare access and continuity are further eroded by their mobility. In addition, MSFWs experience occupational exposures that increase their risk of cancer.
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14
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Kronenfeld JP, Graves KD, Penedo FJ, Yanez B. Overcoming Disparities in Cancer: A Need for Meaningful Reform for Hispanic and Latino Cancer Survivors. Oncologist 2021; 26:443-452. [PMID: 33594785 DOI: 10.1002/onco.13729] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/29/2020] [Indexed: 12/12/2022] Open
Abstract
Hispanic and Latino (HL) cancer survivors are at a critical disadvantage compared with non-Hispanic White (NHW) patients regarding sociodemographic adversities and access to equitable treatment options. By 2030, there will be about four million HL cancer survivors in the U.S., representing nearly 20% of survivors in this country. Hispanics and Latinos are subjected to significant challenges in accessing and receiving equitable care relative to NHWs. Hispanics and Latinos also experience lower rates of health insurance and financial resources, limiting health care options. These disparities often originate from disparate social determinants of health, including lower funding for education and school programs, greater neighborhood stressors and violence, lower access to healthy and affordable food, and greater barriers to community health and exercise opportunities. Even among HL cancer survivors with proper access to health care, they experience disparate treatment options, including low inclusion in clinical trials and/or access to experimental therapies. A solution to these barriers necessitates complex and systemic changes that involve, for example, investing in public health programs, increasing the diversity and cultural awareness of the medical workforce, and promoting research opportunities such as clinical trials that are inclusive of HLs. Only through meaningful reform will equitable cancer care be available for all in the U.S. regardless of racial and/or ethnic background. This article reviews some of the critical social determinants of health and biases relevant to HL cancer survivors and provides recommendations for achieving cancer health equity. IMPLICATIONS FOR PRACTICE: Hispanics and Latinos experience a significant and often disproportionate cancer-related burden compared with non-Hispanic and Latino White individuals and other racial and ethnic groups. Meaningful reform to achieve health equity in oncology should focus on approaches to gaining trust among diverse patients, cultural and community sensitivity and engagement in oncology care and research, diversifying the workforce, and improving inclusion in clinical trial participation. Taken together, these recommendations can lead to exemplary and equitable care for all patients.
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Affiliation(s)
- Joshua P Kronenfeld
- University of Miami Miller School of Medicine & Sylvester Comprehensive Cancer Center, Miami, Florida, USA
| | - Kristi D Graves
- Georgetown University Lombardi Comprehensive Cancer Center, Washington, District of Columbia, USA
| | - Frank J Penedo
- University of Miami Miller School of Medicine & Sylvester Comprehensive Cancer Center, Miami, Florida, USA
| | - Betina Yanez
- Northwestern University Feinberg School of Medicine and Lurie Comprehensive Cancer Center, Chicago, Illinois, USA
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15
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Fuzzell LN, Perkins RB, Christy SM, Lake PW, Vadaparampil ST. Cervical cancer screening in the United States: Challenges and potential solutions for underscreened groups. Prev Med 2021; 144:106400. [PMID: 33388330 DOI: 10.1016/j.ypmed.2020.106400] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 12/09/2020] [Accepted: 12/29/2020] [Indexed: 12/16/2022]
Abstract
Cervical cancer screening rates in the United States are generally high, yet certain groups demonstrate disparities in screening and surveillance. Individuals at greatest risk for cervical cancer are often from marginalized or underserved groups who do not participate in regular screening for a variety of reasons. Using the Population-based Research to Optimize the Screening Process (PROSPR) Trans-Organ Conceptual Model, including concepts of individual-, provider-, facility-, system-, or policy-level factors, we provide a commentary to highlight reasons for low screening participation among subgroups in the U.S. These include racial and ethnic minorities, rural residents, sexual and gender minorities, those with limited English proficiency, those with particular religious beliefs, and various health conditions. We describe barriers and offer potential solutions for each group. In addition, we discuss cross-cutting barriers to screening including difficulty interacting with the healthcare system (limited knowledge and health literacy, lack of provider recommendation/contact), financial (cost, lack of insurance), and logistical barriers (e.g., lack of usual source of care, competing demands, scheduling issues). Solutions to address these barriers are needed to improve screening rates across all underscreened groups. Changes at state and national policy levels are needed to address health insurance coverage. Mobile screening, ensuring that interpreters are available for all visits, and targeted in reach at non-gynecological visits can further overcome barriers. Employing community outreach workers can increase community demand for screening, and patient navigators can improve adherence to both screening and follow-up diagnostic evaluation. HPV self-sampling can address multiple barriers to cervical cancer screening.
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Affiliation(s)
- Lindsay N Fuzzell
- Moffitt Cancer Center, Department of Health Outcomes & Behavior, 12902 Magnolia Dr. Tampa, FL 33612, United States of America.
| | - Rebecca B Perkins
- Boston University School of Medicine, 85 E. Concord St., Boston, MA 02118, United States of America
| | - Shannon M Christy
- Moffitt Cancer Center, Department of Health Outcomes & Behavior, 12902 Magnolia Dr. Tampa, FL 33612, United States of America; Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, 12902 Magnolia Dr. Tampa, FL 33612, United States of America; University of South Florida, College of Medicine, 12901 Bruce B Downs Blvd., Tampa, FL 33612, United States of America
| | - Paige W Lake
- Moffitt Cancer Center, Department of Health Outcomes & Behavior, 12902 Magnolia Dr. Tampa, FL 33612, United States of America
| | - Susan T Vadaparampil
- Moffitt Cancer Center, Department of Health Outcomes & Behavior, 12902 Magnolia Dr. Tampa, FL 33612, United States of America; Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, 12902 Magnolia Dr. Tampa, FL 33612, United States of America; University of South Florida, College of Medicine, 12901 Bruce B Downs Blvd., Tampa, FL 33612, United States of America.
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16
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Kronenfeld JP, Graves KD, Penedo FJ, Yanez B. Overcoming Disparities in Cancer: A Need for Meaningful Reform for Hispanic and Latino Cancer Survivors. Oncologist 2021. [PMID: 33594785 DOI: 10.1002/onco.13729.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Hispanic and Latino (HL) cancer survivors are at a critical disadvantage compared with non-Hispanic White (NHW) patients regarding sociodemographic adversities and access to equitable treatment options. By 2030, there will be about four million HL cancer survivors in the U.S., representing nearly 20% of survivors in this country. Hispanics and Latinos are subjected to significant challenges in accessing and receiving equitable care relative to NHWs. Hispanics and Latinos also experience lower rates of health insurance and financial resources, limiting health care options. These disparities often originate from disparate social determinants of health, including lower funding for education and school programs, greater neighborhood stressors and violence, lower access to healthy and affordable food, and greater barriers to community health and exercise opportunities. Even among HL cancer survivors with proper access to health care, they experience disparate treatment options, including low inclusion in clinical trials and/or access to experimental therapies. A solution to these barriers necessitates complex and systemic changes that involve, for example, investing in public health programs, increasing the diversity and cultural awareness of the medical workforce, and promoting research opportunities such as clinical trials that are inclusive of HLs. Only through meaningful reform will equitable cancer care be available for all in the U.S. regardless of racial and/or ethnic background. This article reviews some of the critical social determinants of health and biases relevant to HL cancer survivors and provides recommendations for achieving cancer health equity. IMPLICATIONS FOR PRACTICE: Hispanics and Latinos experience a significant and often disproportionate cancer-related burden compared with non-Hispanic and Latino White individuals and other racial and ethnic groups. Meaningful reform to achieve health equity in oncology should focus on approaches to gaining trust among diverse patients, cultural and community sensitivity and engagement in oncology care and research, diversifying the workforce, and improving inclusion in clinical trial participation. Taken together, these recommendations can lead to exemplary and equitable care for all patients.
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Affiliation(s)
- Joshua P Kronenfeld
- University of Miami Miller School of Medicine & Sylvester Comprehensive Cancer Center, Miami, Florida, USA
| | - Kristi D Graves
- Georgetown University Lombardi Comprehensive Cancer Center, Washington, District of Columbia, USA
| | - Frank J Penedo
- University of Miami Miller School of Medicine & Sylvester Comprehensive Cancer Center, Miami, Florida, USA
| | - Betina Yanez
- Northwestern University Feinberg School of Medicine and Lurie Comprehensive Cancer Center, Chicago, Illinois, USA
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17
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Mboineki JF, Wang P, Chen C. Fundamental Elements in Training Patient Navigators and Their Involvement in Promoting Public Cervical Cancer Screening Knowledge and Practices: A Systematic Review. Cancer Control 2021; 28:10732748211026670. [PMID: 34169777 PMCID: PMC8236772 DOI: 10.1177/10732748211026670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/23/2021] [Accepted: 05/30/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cervical cancer screening remains unsatisfactory in some regions due to hindrances. This study aims to explore fundamental elements in training patient navigators and their involvement in promoting screening knowledge and practices. METHODS This systematic review study included only English published articles between 2014 and 2019 from PubMed/Medline, EBSCO, Science Direct, and Wiley online library. RESULTS Healthcare professionals trained patient navigators in 3 days regarding screening basics, along with group discussions and role-plays. They delivered effective health education and navigation assistance. CONCLUSION The group education session facilitated by patient navigators, coupled with navigation care, resulted in a high screening rate.
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Affiliation(s)
- Joanes Faustine Mboineki
- First Affiliated Teaching Hospital of Zhengzhou University, Zhengzhou, Henan, China
- School of Nursing, Zhengzhou University, Zhengzhou, China
- College of Health Sciences, The University of Dodoma, Dodoma, Tanzania
| | - Panpan Wang
- School of Nursing, Zhengzhou University, Zhengzhou, China
| | - Changying Chen
- First Affiliated Teaching Hospital of Zhengzhou University, Zhengzhou, Henan, China
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18
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Victoria SA, Racquel E K, Lucila S, Melisa P, Viswanath K, Silvina A. Knowledge and perceptions regarding triage among human papillomavirus-tested women: A qualitative study of perspectives of low-income women in Argentina. ACTA ACUST UNITED AC 2020; 16:1745506520976011. [PMID: 33264086 PMCID: PMC7716054 DOI: 10.1177/1745506520976011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: Among cancer prevention studies, little is known about knowledge, attitudes, and beliefs toward triage adherence in the context of the human papillomavirus self-collection test. This formative research aims to identify knowledge, attitudes, and beliefs related to human papillomavirus and cervical cancer prevention specifically about adherence to Pap triage among women residing in a low-income province in Argentina. Methods: We conducted six focus groups, stratified by residence and age. All participants were aged 30 or older and had performed human papillomavirus self-collection. Data collection and thematic analysis were carried out using constructs from the Health Belief Model. Results: Misinformation regarding human papillomavirus and cervical cancer was common and was a source of distress. Women could not distinguish Pap screening from triage; human papillomavirus risk perception was limited but cervical cancer was perceived as a threatening disease. Women were willing to follow-up after receiving an abnormal screening result. Negative views about clinician-collected screening/triage were common, defined as painful and shameful, and comes with an economic cost (transport/time). Lack of help from family/friends was an obstacle to adhering to triage. Health issues in the family’s records and a physician’s recommendation were a cue to adhere to triage. Conclusion: Lack of knowledge or misinformation of the causes of cervical cancer, human papillomavirus, and the multi-step screening and triage process are barriers to follow-up adherence. Interventions to improve communication between women and health providers about screening results and follow-up are needed. Also, health services should be organized to respond to women’s needs and reduce access barriers to follow-up.
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Affiliation(s)
| | - Kohler Racquel E
- Cancer Health Equity, Cancer Institute of New Jersey, Rutgers-The State University of New Jersey, New Brunswick, NJ, USA
| | - Szwarc Lucila
- Centro de Estudios de Estado y Sociedad/Consejo Nacional de Investigaciones Científicas y Técnicas Buenos Aires, Buenos Aires, Argentina
| | - Paolino Melisa
- Centro de Estudios de Estado y Sociedad/Consejo Nacional de Investigaciones Científicas y Técnicas Buenos Aires, Buenos Aires, Argentina
| | - Kasisomayajula Viswanath
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Arrossi Silvina
- Centro de Estudios de Estado y Sociedad/Consejo Nacional de Investigaciones Científicas y Técnicas Buenos Aires, Buenos Aires, Argentina
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19
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COVID-19 Pandemic among Latinx Farmworker and Nonfarmworker Families in North Carolina: Knowledge, Risk Perceptions, and Preventive Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165786. [PMID: 32785108 PMCID: PMC7459606 DOI: 10.3390/ijerph17165786] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/01/2020] [Accepted: 08/07/2020] [Indexed: 12/20/2022]
Abstract
(1) Background: The COVID-19 pandemic poses substantial threats to Latinx farmworkers and other immigrants in food production and processing. Classified as essential, such workers cannot shelter at home. Therefore, knowledge and preventive behaviors are important to reduce COVID-19 spread in the community. (2) Methods: Respondents for 67 families with at least one farmworker (FWF) and 38 comparable families with no farmworkers (nonFWF) in North Carolina completed a telephone survey in May 2020. The survey queried knowledge of COVID-19, perceptions of its severity, self-efficacy, and preventive behaviors. Detailed data were collected to document household members’ social interaction and use of face coverings. (3) Results: Knowledge of COVID-19 and prevention methods was high in both groups, as was its perceived severity. NonFWF had higher self-efficacy for preventing infection. Both groups claimed to practice preventive behaviors, though FWF emphasized social avoidance and nonFWF emphasized personal hygiene. Detailed social interactions showed high rates of inter-personal contact at home, at work, and in the community with more mask use in nonFWF than FWF. (4) Conclusions: Despite high levels of knowledge and perceived severity for COVID-19, these immigrant families were engaged in frequent interpersonal contact that could expose community members and themselves to COVID-19.
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20
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Kelley EG, Yarrington CD, Calderwood L, Torrey Sosa L, Connors PD. The importance of personalismo: Navigating obstacles in recruitment strategies for Spanish speakers in marginalized communities. J Genet Couns 2020; 29:391-398. [PMID: 32144873 DOI: 10.1002/jgc4.1240] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 02/08/2020] [Accepted: 02/11/2020] [Indexed: 11/06/2022]
Abstract
Recruitment obstacles with Spanish-speaking individuals and members of marginalized communities have been documented in the literature in narrative form, but quantitative data on effective strategies are limited. Within our research protocol assessing the impact of a storytelling intervention on knowledge and uptake of cell-free DNA (cfDNA) aneuploidy screening, three different recruitment strategies were trialed and enrollment rates were compared. Throughout the study, field notes were collected from observations in recruitment efforts. We demonstrate the effectiveness of language-concordant, personal interactions, and culturally tailored materials for recruitment of Spanish-speaking participants into genomic research studies. We also offer commentary on the experience of the researchers that provides insights to inform recruitment methods for marginalized communities.
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Affiliation(s)
- Emily G Kelley
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.,Department of Obstetrics and Gynecology, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
| | - Christina D Yarrington
- Department of Obstetrics and Gynecology, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
| | - Laurel Calderwood
- Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA.,Department of Pediatrics, Division of Medical Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Lillian Torrey Sosa
- Department of Obstetrics and Gynecology, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
| | - Philip D Connors
- Department of Obstetrics and Gynecology, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
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21
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Sanchez Antelo V, Kohler RE, Curotto M, Viswanath KV, Paolino M, Arrossi S. Developing SMS Content to Promote Papanicolaou Triage Among Women Who Performed HPV Self-collection Test: Qualitative Study. JMIR Form Res 2020; 4:e14652. [PMID: 32032940 PMCID: PMC7084289 DOI: 10.2196/14652] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 01/23/2020] [Accepted: 02/06/2020] [Indexed: 12/19/2022] Open
Abstract
Background SMS interventions are effective in promoting a variety of health behaviors; however, there is limited information regarding the use of SMS for cervical cancer screening and follow-up care. The Application of Communication and Information Technologies to Self-Collection study aims to evaluate a multicomponent mobile health intervention to increase triage adherence among women with human papillomavirus (HPV)–positive self-collected tests in Jujuy, Argentina. Here, we describe the formative results used to design the content of the SMS to be tested in the trial. Objective This study aimed to understand the cultural and contextual elements, women’s beliefs, and perceptions regarding the use of SMS by the health care system and women’s preferences about the message content. Methods We conducted five focus groups (FGs), stratified by rural or urban residence and age. All participants were aged 30 years or older and had performed HPV self-collection. Participatory techniques, including brainstorming, card-based classification, and discussions were used to debate the advantages and disadvantages of messages. We openly coded the discussions for agreements and preferences regarding the SMS content. Messages for both HPV-negative and HPV-positive women were validated through interviews with health authorities and 14 HPV-tested women. The final versions of the messages were pilot-tested. Results A total of 48 women participated in the FGs. Participants rejected receiving both negative and positive HPV results by SMS because, for them, the delivery of results should be done in a face-to-face interaction with health professionals. They stressed the importance of the SMS content informing them that results were available for pick up and reflecting the kind of relationship that they have with the community health workers and the nearest health center. Women considered that a personalized SMS was important, as was the use of a formal yet warm tone. Owing to confidentiality issues, not using the word “HPV” was also a key component of the desired SMS content; therefore, the final message included the term “self-collection” without the mention of HPV infection. Results from the validation stage and pilot test showed high acceptability of the final version of the message. Conclusions The results suggest that SMS is accepted when notifying women about the availability of the HPV test result, but it should not replace the delivery of results in face-to-face, doctor-patient encounters. In addition, messages must be tailored and must have a persuasive tone to motivate women to adhere to the triage.
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Affiliation(s)
| | - Racquel E Kohler
- Cancer Health Equity, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Mariana Curotto
- Programa Nacional de Prevención de Cáncer Cervicouterino, Instituto Nacional del Cáncer, Buenos Aires, Argentina
| | - Kasisomayajula Vish Viswanath
- Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, United States.,McGraw-Patterson Center for Population Sciences, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Melisa Paolino
- Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Silvina Arrossi
- Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
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22
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Preston SM, Darrow WW. Improving Human Papillomavirus-Related Knowledge and Attitudes Among Ethnically Diverse Young Adults. Health Equity 2019; 3:254-263. [PMID: 31289786 PMCID: PMC6608686 DOI: 10.1089/heq.2018.0091] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Purpose: To make baseline comparisons and evaluate the efficacy of an intervention designed to improve human papillomavirus (HPV) and HPV vaccine awareness, knowledge, and attitudes among ethnically diverse participants. Methods:Design: Pre- and post-intervention surveys. Setting: An urban, Hispanic-Serving South Florida university. Subjects: Three hundred eighty-seven diverse college students attending a gender studies course. Intervention: Students received a brief educational message designed to improve HPV-related knowledge and attitudes. Baseline and follow-up survey data were collected. Measures: Outcome measures included baseline and follow-up awareness of HPV, perceived knowledge of HPV and HPV vaccination, measured knowledge score, vaccine attitudes, and doses of HPV vaccine received. Analysis: Chi-square, analysis of covariance (ANCOVA), and Wilcoxon rank-sum tests were used to compare baseline differences and evaluate the efficacy of the intervention. Results: Hispanic participants had more positive attitudes toward HPV vaccination (62% vs. 44%, p=0.009) and were more willing to become vaccinated (66% vs. 46%, p=0.02) than non-Hispanic participants at baseline. Hispanic women (48%) were more likely to have initiated HPV vaccination than Hispanic men (27%, p=0.006). At baseline, only 30% of participants scored ≥4/7 points in knowledge. Participants' HPV knowledge improved by 41% after the intervention, with no difference by ethnicity in the post-intervention score. Conclusion: The intervention was useful in improving HPV-related knowledge and attitudes among diverse college students. Future studies should examine barriers to vaccination among ethnic minorities.
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Affiliation(s)
- Sharice M Preston
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
| | - William W Darrow
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida
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23
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Educating Latinas about cervical cancer and HPV: a pilot randomized study. Cancer Causes Control 2019; 30:375-384. [PMID: 30830494 DOI: 10.1007/s10552-019-01150-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 02/22/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The purpose of this study was to assess effects of three different educational intervention arms on knowledge of and intention to receive Pap testing and HPV co-testing. METHODS Three active educational intervention arms were developed: a fotonovela, a radionovela, and a digital story. A pilot randomized controlled trial of 160 Latinas was conducted to assess the effectiveness of the intervention arms in increasing knowledge of cervical cancer and HPV and intention to be screened for cervical cancer compared to an attention control group (flu vaccination). RESULTS Women in all three treatment arms significantly increased knowledge about cervical cancer compared to control arm (p = 0.02). Knowledge about cervical cancer screening also increased in the active arms compared to control (p = 0.0003). Knowledge of HPV risk also increased relative to the control (p = 0.0001). There were no significant differences between the intervention arms in increased knowledge of cervical cancer or cervical cancer screening (p = 0.57 and 0.16, respectively). DISCUSSION This study supported the use of small media interventions in narrative education form as effective in increasing knowledge and intention to be screened for cervical cancer. The three culturally relevant interventions, built on qualitative data, were all successful in increasing knowledge.
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