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Waters AR, Bono MH, Ito Fukunaga M, Masud M, Mullins MA, Suk R, O'Leary MC, Adams SA, Ferrari RM, Wangen M, Odebunmi OO, Nash SH, Spees LP, Wheeler SB, Adsul P, Chebli P, Hirschey R, Studts JL, Seaman A, Lee M. LGBTQ+ cancer: priority or lip service? A qualitative content analysis of LGBTQ+ considerations in U.S. state, jurisdiction, and tribal comprehensive cancer control plans. Cancer Causes Control 2024:10.1007/s10552-024-01887-z. [PMID: 38796675 DOI: 10.1007/s10552-024-01887-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 05/06/2024] [Indexed: 05/28/2024]
Abstract
The National Comprehensive Cancer Control Program, a Centers for Disease Control and Prevention funded program, supports cancer coalitions across the United States (US) in efforts to prevent and control cancer including development of comprehensive cancer control (CCC) plans. CCC plans often focus health equity within their priorities, but it is unclear to what extent lesbian, gay, bisexual, transgender, queer/questioning, plus (LGBTQ+) populations are considered in CCC plans. We qualitatively examined to what extent LGBTQ+ populations were referenced in 64 U.S. state, jurisdiction, tribes, and tribal organization CCC plans. A total of 55% of CCC plans mentioned LGBTQ+ populations, however, only one in three CCC plans mentioned any kind of LGBTQ+ inequity or LGBTQ+ specific recommendations. Even fewer plans included mention of LGBTQ+ specific resources, organizations, or citations. At the same time almost three fourths of plans conflated sex and gender throughout their CCC plans. The findings of this study highlight the lack of prioritization of LGBTQ+ populations in CCC plans broadly while highlighting exemplar plans that can serve as a roadmap to more inclusive future CCC plans. Comprehensive cancer control plans can serve as a key policy and advocacy structure to promote a focus on LGBTQ+ cancer prevention and control.
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Affiliation(s)
- Austin R Waters
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
| | - Madeline H Bono
- Gender Multispecialty Service, Boston Children's Hospital, Boston, MA, USA
| | - Mayuko Ito Fukunaga
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Manal Masud
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Megan A Mullins
- O'Donnell School of Public Health, UT Southwestern Medical Center, Dallas, TX, USA
- Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Ryan Suk
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Meghan C O'Leary
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Swann A Adams
- Department of Biobehavioral Health and Nursing Science, College of Nursing, University of South Carolina, Columbia, SC, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Renée M Ferrari
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Mary Wangen
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
| | - Olufeyisayo O Odebunmi
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Sarah H Nash
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
| | - Lisa P Spees
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - Stephanie B Wheeler
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
| | - Prajakta Adsul
- Department of Internal Medicine, Division of Epidemiology, Biostatistics, and Preventive Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, USA
- Cancer Control and Research Program, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Perla Chebli
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, USA
| | - Rachel Hirschey
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- School of Nursing, University of North Carolina, Chapel Hill, NC, USA
| | - Jamie L Studts
- Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Cancer Prevention and Control Program, University of Colorado Cancer Center, Aurora, CO, USA
| | - Aaron Seaman
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Matthew Lee
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, USA
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Klenczar‐Castro B, Kittle KR, Anderson JG, Wharton W, Gilmore‐Bykovskyi A, Dowling NM, Perales‐Puchalt J, Flatt JD. Using concept mapping to identify recruitment and engagement strategies for inclusion of LGBTQIA+ populations in Alzheimer's disease and related dementia research. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2024; 10:e12477. [PMID: 38911875 PMCID: PMC11193133 DOI: 10.1002/trc2.12477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 04/11/2024] [Accepted: 04/14/2024] [Indexed: 06/25/2024]
Abstract
INTRODUCTION Past Alzheimer's disease and related dementias (ADRD) research has not considered ways to ensure the representation of diverse sexual and gender minorities. This study used concept mapping (CM) to identify strategies for engaging and recruiting LGBTQIA+ older adults living with memory loss and their caregivers into ADRD research. METHODS CM, involving brainstorming, thematic analysis, and rating of strategies, was conducted with 46 members from one national and three local community advisory boards. Data was analyzed using The Concept Systems Global MAX™ web platform. RESULTS One hundred twenty-two solutions were identified from June through December 2022, and represented five key themes: aging focused, LGBTQIA+ specific, memory loss and caregiving support focused, physical advertisements, and other media. Promising strategies included partnering with LGBTQIA+ health centers, attending social groups for older adults, and increasing community representation in marketing. DISCUSSION Tailored strategies, building trust, and community involvement are essential for engaging LGBTQIA+ individuals living with memory loss or ADRD and their caregivers in ADRD-focused research. Highlights Innovative ways to ensure the inclusion of LGBTQIA+ older adults in Alzheimer's disease and related dementias (ADRD) research can be bolstered through collaboration with key community stakeholders.Promising strategies for recruitment and engagement include partnering with LGBTQIA+ centers, attending social groups for older adults, and ensuring diverse representation in marketing.Tailored recruitment and engagement strategies are crucial for building trust with LGBTQIA+ populations to increase participation in ADRD research.
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Affiliation(s)
- Brittany Klenczar‐Castro
- Department of Social and Behavioral HealthSchool of Public HealthUniversity of NevadaLas VegasNevadaUSA
| | - Krystal R. Kittle
- Department of Health Promotion and PolicySchool of Public Health & Health SciencesUniversity of Massachusetts AmherstAmherstMassachusettsUSA
| | | | - Whitney Wharton
- Nell Hodgson Woodruff School of NursingEmory UniversityAtlantaGeorgiaUSA
| | - Andrea Gilmore‐Bykovskyi
- Berbee Walsh Department of Emergency MedicineSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - N. Maritza Dowling
- School of NursingThe George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Jaime Perales‐Puchalt
- Department of NeurologyUniversity of Kansas Alzheimer's Disease Research CenterKansas CityKansasUSA
| | - Jason D. Flatt
- Department of Social and Behavioral HealthSchool of Public HealthUniversity of NevadaLas VegasNevadaUSA
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Roh S, Lee YS, Kenyon DB, Elliott AJ, Petereit DG, Gaba A, Lee HY. Mobile Web App Intervention to Promote Breast Cancer Screening Among American Indian Women in the Northern Plains: Feasibility and Efficacy Study. JMIR Form Res 2023; 7:e47851. [PMID: 37471115 PMCID: PMC10401399 DOI: 10.2196/47851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/06/2023] [Accepted: 06/21/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Breast cancer is the most common cancer in the United States and the second leading cause of death for American Indian women. American Indian women have lower rates of breast cancer screening than other racial groups, and disparities in breast cancer mortality and survival rates persist among them. To address this critical need, a culturally appropriate, accessible, and personalized intervention is necessary to promote breast cancer screening among American Indian women. This study used mobile health principles to develop a mobile web app-based mammogram intervention (wMammogram) for American Indian women in a remote, rural community in the Northern Plains. OBJECTIVE This study aimed to assess the feasibility and efficacy of the wMammogram intervention, which was designed to motivate American Indian women to undergo breast cancer screening, as compared with the control group, who received an educational brochure. METHODS Using community-based participatory research (CBPR) principles and a multipronged recruitment strategy in a randomized controlled trial design, we developed the wMammogram intervention. This study involved 122 American Indian women aged between 40 and 70 years, who were randomly assigned to either the intervention group (n=62) or the control group (n=60). Those in the intervention group received personalized and culturally appropriate messages through a mobile web app, while those in the control group received an educational brochure. We measured outcomes such as mammogram receipt, intention to receive breast cancer screening after the intervention, and participants' satisfaction with and acceptance of the intervention. RESULTS A significantly higher proportion of women who received the wMammogram intervention (26/62, 42%; P=.009) completed mammograms by the 6-month follow-up than the control group (12/60, 20%). The wMammogram intervention group, compared with the control group, reported significantly higher ratings on perceived effectiveness of the intervention (t120=-5.22; P<.001), increase in knowledge (t120=-4.75; P<.001), and satisfaction with the intervention (t120=-3.61; P<.001). Moreover, compared with the brochure group, the intervention group expressed greater intention to receive a mammogram in the future when it is due (62/62, 100% vs 51/60, 85%) and were more willing to recommend the intervention they received to their friends (61/62, 98.4% vs 54/60, 90%) with statistically significant differences. CONCLUSIONS This study shows the feasibility and efficacy of the wMammogram intervention to promote breast cancer screening for American Indian women in a remote, rural community-based setting. Findings suggest that, with advancements in technology and the ubiquity of mobile devices, mobile web apps could serve as a valuable health intervention tool that builds upon low-cost technology and enhances accessibility and sustainability of preventive care to help reduce breast health disparities experienced in hard-to-reach American Indian populations. TRIAL REGISTRATION ClinicalTrials.gov NCT05530603; https://clinicaltrials.gov/ct2/show/NCT05530603.
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Affiliation(s)
- Soonhee Roh
- Department of Social Work, University of South Dakota, Sioux Falls, SD, United States
| | - Yeon-Shim Lee
- School of Social Work, San Francisco State University, San Francisco, CA, United States
| | - DenYelle B Kenyon
- Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, United States
| | - Amy J Elliott
- Avera Research Institute, Avera Health, Sioux Falls, SD, United States
| | - Daniel G Petereit
- Monument Health Cancer Care Institute, Rapid City, SD, United States
| | - Anu Gaba
- Sanford Roger Maris Cancer Center, University of North Dakota, Fargo, ND, United States
| | - Hee Yun Lee
- School of Social Work, University of Alabama, Tuscaloosa, AL, United States
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Moore JX, Andrzejak SE, Casanova T, Langston ME, Estvold S, Adsul P. Investigating the Joint Effect of Allostatic Load among Lesbian, Gay, and Bisexual Adults with Risk of Cancer Mortality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6120. [PMID: 37372707 DOI: 10.3390/ijerph20126120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/31/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023]
Abstract
Sexual minorities (SM) have higher chronic physiologic stress as indicated by allostatic load (AL), which may be explained in part by consistent experiences of discriminatory practices. This is one of the first studies to examine the joint effects of SM status and AL on the association with long-term risk for cancer death. Retrospective analyses were conducted on 12,470 participants using National Health and Nutrition Examination Survey (NHANES) from years 2001 through 2010 linked with the National Death Index through December 31, 2019. Cox proportional hazards models estimated adjusted hazard ratios (aHRs) of cancer deaths between groups of SM (those reporting as gay, lesbian, bisexual, or having same-sex sexual partners) status and AL. SM adults living with high AL (n = 326) had a 2-fold increased risk of cancer death (aHR: 2.55, 95% CI: 1.40-4.65) when compared to straight/heterosexual adults living with low AL (n = 6674). Among those living with high AL, SM (n = 326) had a 2-fold increased risk of cancer death (aHR: 2.26, 95% CI: 1.33-3.84) when compared to straight/heterosexual adults with high AL (n = 4957). SM with high AL have an increased risk of cancer mortality. These findings highlight important implications for promoting a focused agenda on cancer prevention with strategies that reduce chronic stress for SM adults.
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Affiliation(s)
- Justin Xavier Moore
- Cancer Prevention, Control & Population Health Program, Department of Medicine, Augusta University, Augusta, GA 30912, USA
- Institute of Preventive and Public Health, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Sydney Elizabeth Andrzejak
- Cancer Prevention, Control & Population Health Program, Department of Medicine, Augusta University, Augusta, GA 30912, USA
| | - Tracy Casanova
- Department of Psychiatry and Health Behavior, Georgia Cancer Center, Augusta University, Augusta, GA 30912, USA
| | - Marvin E Langston
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA 49305, USA
| | - Søren Estvold
- Department of Family Medicine, Augusta University, Augusta, GA 20912, USA
| | - Prajakta Adsul
- Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico, Albuquerque, NM 87131, USA
- Cancer Control and Population Sciences Research Program, Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM 87131, USA
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Hirst Y, Stoffel ST, Brewer HR, Timotijevic L, Raats MM, Flanagan JM. Understanding Public Attitudes and Willingness to Share Commercial Data for Health Research: Survey Study in the United Kingdom. JMIR Public Health Surveill 2023; 9:e40814. [PMID: 36951929 PMCID: PMC10131900 DOI: 10.2196/40814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Health research using commercial data is increasing. The evidence on public acceptability and sociodemographic characteristics of individuals willing to share commercial data for health research is scarce. OBJECTIVE This survey study investigates the willingness to share commercial data for health research in the United Kingdom with 3 different organizations (government, private, and academic institutions), 5 different data types (internet, shopping, wearable devices, smartphones, and social media), and 10 different invitation methods to recruit participants for research studies with a focus on sociodemographic characteristics and psychological predictors. METHODS We conducted a web-based survey using quota sampling based on age distribution in the United Kingdom in July 2020 (N=1534). Chi-squared tests tested differences by sociodemographic characteristics, and adjusted ordered logistic regressions tested associations with trust, perceived importance of privacy, worry about data misuse and perceived risks, and perceived benefits of data sharing. The results are shown as percentages, adjusted odds ratios, and 95% CIs. RESULTS Overall, 61.1% (937/1534) of participants were willing to share their data with the government and 61% (936/1534) of participants were willing to share their data with academic research institutions compared with 43.1% (661/1534) who were willing to share their data with private organizations. The willingness to share varied between specific types of data-51.8% (794/1534) for loyalty cards, 35.2% (540/1534) for internet search history, 32% (491/1534) for smartphone data, 31.8% (488/1534) for wearable device data, and 30.4% (467/1534) for social media data. Increasing age was consistently and negatively associated with all the outcomes. Trust was positively associated with willingness to share commercial data, whereas worry about data misuse and the perceived importance of privacy were negatively associated with willingness to share commercial data. The perceived risk of sharing data was positively associated with willingness to share when the participants considered all the specific data types but not with the organizations. The participants favored postal research invitations over digital research invitations. CONCLUSIONS This UK-based survey study shows that willingness to share commercial data for health research varies; however, researchers should focus on effectively communicating their data practices to minimize concerns about data misuse and improve public trust in data science. The results of this study can be further used as a guide to consider methods to improve recruitment strategies in health-related research and to improve response rates and participant retention.
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Affiliation(s)
- Yasemin Hirst
- Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Sandro T Stoffel
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- Institute of Pharmaceutical Medicine, University of Basel, Basel, Switzerland
| | - Hannah R Brewer
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Lada Timotijevic
- School of Psychology, University of Surrey, Guildford, United Kingdom
- Surrey Institute for People-Centred Artificial Intelligence, University of Surrey, Guildford, United Kingdom
- Institute for Sustainability, University of Surrey, Guildford, United Kingdom
| | - Monique M Raats
- School of Psychology, University of Surrey, Guildford, United Kingdom
- Surrey Institute for People-Centred Artificial Intelligence, University of Surrey, Guildford, United Kingdom
- Institute for Sustainability, University of Surrey, Guildford, United Kingdom
| | - James M Flanagan
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
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