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Wall NR, Fuller RN, Morcos A, De Leon M. Pancreatic Cancer Health Disparity: Pharmacologic Anthropology. Cancers (Basel) 2023; 15:5070. [PMID: 37894437 PMCID: PMC10605341 DOI: 10.3390/cancers15205070] [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: 09/20/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
Pancreatic cancer (PCa) remains a formidable global health challenge, with high mortality rates and limited treatment options. While advancements in pharmacology have led to improved outcomes for various cancers, PCa continues to exhibit significant health disparities, disproportionately affecting certain populations. This paper explores the intersection of pharmacology and anthropology in understanding the health disparities associated with PCa. By considering the socio-cultural, economic, and behavioral factors that influence the development, diagnosis, treatment, and outcomes of PCa, pharmacologic anthropology provides a comprehensive framework to address these disparities and improve patient care.
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Affiliation(s)
- Nathan R. Wall
- Division of Biochemistry, Department of Basic Science, Center for Health Disparities and Molecular Medicine, Loma Linda University, Loma Linda, CA 92350, USA; (R.N.F.); (A.M.)
| | - Ryan N. Fuller
- Division of Biochemistry, Department of Basic Science, Center for Health Disparities and Molecular Medicine, Loma Linda University, Loma Linda, CA 92350, USA; (R.N.F.); (A.M.)
| | - Ann Morcos
- Division of Biochemistry, Department of Basic Science, Center for Health Disparities and Molecular Medicine, Loma Linda University, Loma Linda, CA 92350, USA; (R.N.F.); (A.M.)
| | - Marino De Leon
- Division of Physiology, Department of Basic Science, Center for Health Disparities and Molecular Medicine, Loma Linda University, Loma Linda, CA 92350, USA;
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2
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Formative Assessment to Improve Cancer Screenings in American Indian Men: Native Patient Navigator and mHealth Texting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116546. [PMID: 35682130 PMCID: PMC9180909 DOI: 10.3390/ijerph19116546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 02/01/2023]
Abstract
Cancer screening rates among American Indian men remain low, without programs specifically designed for men. This paper describes the Community-Based Participatory Research processes and assessment of cancer screening behavior and the appropriateness of the mHealth approach for Hopi men's promotion of cancer screenings. This Community-Based Participatory Research included a partnership with H.O.P.I. (Hopi Office of Prevention and Intervention) Cancer Support Services and the Hopi Community Advisory Committee. Cellular phone usage was assessed among male participants in a wellness program utilizing text messaging. Community surveys were conducted with Hopi men (50 years of age or older). The survey revealed colorectal cancer screening rate increased from 51% in 2012 to 71% in 2018, while prostate cancer screening rate had not changed (35% in 2012 and 37% in 2018). Past cancer screening was associated with having additional cancer screening. A cellular phone was commonly used by Hopi men, but not for healthcare or wellness. Cellular phone ownership increased odds of prostate cancer screening in the unadjusted model (OR 9.00, 95% CI: 1.11-73.07), but not in the adjusted model. Cellular phones may be applied for health promotion among Hopi men, but use of cellular phones to improve cancer screening participation needs further investigation.
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Comparison of Study Quality as Determined by Standard Research and Community Engagement Metrics: A Pilot Study on Breast Cancer Research in Urban, Rural, and Remote Indigenous Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095008. [PMID: 35564401 PMCID: PMC9102080 DOI: 10.3390/ijerph19095008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 02/01/2023]
Abstract
The purpose of this review is to compare research evaluation tools to determine whether the tools typically used for assessing the quality of research adequately address issues of Indigenous health and culture, particularly when the studies are intended to benefit Indigenous peoples in urban, regional, rural, and remote settings. Our previously published systematic review evaluated studies about breast cancer using a modified Indigenous community engagement tool (CET). In this study, we evaluated the same studies using two commonly used tools: the Critical Appraisal Skills Programme (CASP) for qualitative research; and the Effective Public Health Practice Project (EPHPP) for quantitative research. The results were then compared to ascertain whether there was alignment between performances in terms of engagement and the CASP/EPHPP metrics. Of the 15 papers, 3 papers scored weakly on both metrics, and are therefore the least likely to offer reliable findings, while 2 papers scored strongly on both metrics, and are therefore the most likely to offer reliable findings. Beyond this summation, it was clear that the results did not align and, therefore, could not be used interchangeably when applied to research findings intended to benefit Indigenous peoples. There does not appear to be a pattern in the relationship between the reliability of the studies and the study settings. In order to address disparities in health outcomes, we must assess research through a typical research quality and cultural engagement and settings lens, ensuring that there is rigour in all aspects of the studies.
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Chief C, Sanderson PR, Willeto AAA, Yazzie A, McKinley A, Monroy FP, Harris RB, Oren E. "Nobody Is Talking About It": Diné (Navajo) Communities Speak About Stomach Cancer and Helicobacter pylori Infections. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:3-9. [PMID: 32700241 PMCID: PMC9936846 DOI: 10.1007/s13187-020-01831-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Stomach cancer is the third leading cause of cancer death globally. Helicobacter pylori plays a role in the healthy human gut, but is also associated with multiple chronic diseases, including stomach cancer. Though H. pylori prevalence is declining in parts of the world, it remains high among certain populations. In Arizona, stomach cancer rates are 3-4 times higher among the Navajo Nation population as compared with the non-Hispanic white population. This pilot project assessed adult Diné (Navajo) individuals' understanding and awareness regarding H. pylori infection and stomach cancer. Focus groups were held in three Diné communities. Data were analyzed thematically using a multi-investigator consensus approach. Participants had limited knowledge of H. pylori infection and stomach cancer and perceived local medical providers as also having limited knowledge on these conditions. Participants described poor health care experiences, structural inequalities, and environmental concerns and associated these with H. pylori infection and stomach cancer. This study highlights the need for additional research and education on current knowledge and perceptions of stomach cancer and H. pylori infections in Navajo Nation.
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Affiliation(s)
- Carmenlita Chief
- Center for Health Equity Research, College of Health and Human Services, Northern Arizona University, Flagstaff, AZ, USA.
| | - Priscilla R Sanderson
- Department of Health Sciences, College of Health and Human Services, Northern Arizona University, Flagstaff, AZ, USA
| | - Angela A A Willeto
- Department of Sociology, College of Social and Behavioral Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Alfred Yazzie
- Black Hills Center for American Indian Health, Winslow, AZ, USA
| | - Alexis McKinley
- Department of Health Sciences, College of Health and Human Services, Northern Arizona University, Flagstaff, AZ, USA
| | - Fernando P Monroy
- Department of Biological Sciences, College of Engineering, Forestry, and Natural Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Robin B Harris
- Department of Epidemiology and Biostatistics, Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Eyal Oren
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA
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Christie V, Green D, Amin J, Pyke C, Littlejohn K, Skinner J, McCowen D, Gwynne K. What Is the Evidence Globally for Culturally Safe Strategies to Improve Breast Cancer Outcomes for Indigenous Women in High Income Countries? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116073. [PMID: 34199955 PMCID: PMC8200222 DOI: 10.3390/ijerph18116073] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/13/2021] [Accepted: 06/02/2021] [Indexed: 11/16/2022]
Abstract
The aim was to systematically assess the evidence on whether cultural safety affects breast cancer outcomes with regards to care for Indigenous women in high income countries. We conducted a systematic review in accordance with PRISMA guidelines of peer-reviewed articles in Medline, EMBASE, CINAHL, Scopus, Web of Science, Proquest Sociology and Informit Rural health database and Indigenous collection databases. Key inclusion criteria were: adult female patients with breast cancer; high income country setting; outcome measure, including screening, diagnosis, treatment and follow up care. A total of 15 were selected. We developed a Community Engagement assessment tool in consultation with aboriginal researchers, based on the National Health and Medical Research Councils' community engagement guidelines, against which studies were appraised. This novel element allowed us to evaluate the literature from a new and highly relevant perspective. Thematic analysis of all 15 studies was also undertaken. Despite limited literature there are evidence-based strategies that are likely to improve outcomes for Indigenous women with breast cancer in high income countries and indicate that culture makes a positive difference. It is also clear that strong Indigenous community leadership and governance at all stages of the research including design is an imperative for feasibility.
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Affiliation(s)
- Vita Christie
- Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney 2109, Australia; (J.A.); (K.G.)
- Poche Centre for Indigenous Health, The University of Sydney, Sydney 2006, Australia;
- Correspondence:
| | - Debbie Green
- Armajun Aboriginal Health Service, Armidale 2350, Australia; (D.G.); (D.M.)
| | - Janaki Amin
- Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney 2109, Australia; (J.A.); (K.G.)
| | - Christopher Pyke
- Foundation for Breast Cancer Care, South Brisbane 4101, Australia; (C.P.); (K.L.)
| | - Karen Littlejohn
- Foundation for Breast Cancer Care, South Brisbane 4101, Australia; (C.P.); (K.L.)
| | - John Skinner
- Poche Centre for Indigenous Health, The University of Sydney, Sydney 2006, Australia;
| | - Deb McCowen
- Armajun Aboriginal Health Service, Armidale 2350, Australia; (D.G.); (D.M.)
| | - Kylie Gwynne
- Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney 2109, Australia; (J.A.); (K.G.)
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Gifford W, Rowan M, Dick P, Modanloo S, Benoit M, Al Awar Z, Wazni L, Grandpierre V, Thomas R, Sikora L, Graham ID. Interventions to improve cancer survivorship among Indigenous Peoples and communities: a systematic review with a narrative synthesis. Support Care Cancer 2021; 29:7029-7048. [PMID: 34028618 PMCID: PMC8464576 DOI: 10.1007/s00520-021-06216-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 04/09/2021] [Indexed: 01/15/2023]
Abstract
PURPOSE The purpose of this systematic review is to synthesize the evidence on the types of interventions that have been utilized by Indigenous Peoples living with cancer, and report on their relevance to Indigenous communities and how they align with holistic wellness. METHODS A systematic review with narrative synthesis was conducted. RESULTS The search yielded 7995 unique records; 27 studies evaluating 20 interventions were included. The majority of studies were conducted in USA, with five in Australia and one in Peru. Study designs were cross-sectional (n=13); qualitative (n=5); mixed methods (n=4); experimental (n=3); and quasi-experimental (n=2). Relevance to participating Indigenous communities was rated moderate to low. Interventions were diverse in aims, ingredients, and outcomes. Aims involved (1) supporting the healthcare journey, (2) increasing knowledge, (3) providing psychosocial support, and (4) promoting dialogue about cancer. The main ingredients of the interventions were community meetings, patient navigation, arts, and printed/online/audio materials. Participants were predominately female. Eighty-nine percent of studies showed positive influences on the outcomes evaluated. No studies addressed all four dimensions of holistic wellness (physical, mental, social, and spiritual) that are central to Indigenous health in many communities. CONCLUSION Studies we found represented a small number of Indigenous Nations and Peoples and did not meet relevance standards in their reporting of engagement with Indigenous communities. To improve the cancer survivorship journey, we need interventions that are relevant, culturally safe and effective, and honoring the diverse conceptualizations of health and wellness among Indigenous Peoples around the world.
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Affiliation(s)
- Wendy Gifford
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
| | - Margo Rowan
- Rowan Research and Evaluation, Ottawa, Ontario, Canada
| | - Peggy Dick
- Algonquins of Pikwakanagan Health Services and Family Health Team, Pikwakanagan, Ontario, Canada
| | - Shokoufeh Modanloo
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Maggie Benoit
- Algonquins of Pikwakanagan Health Services and Family Health Team, Pikwakanagan, Ontario, Canada
| | - Zeina Al Awar
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Liquaa Wazni
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Viviane Grandpierre
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Roanne Thomas
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Lindsey Sikora
- Health Sciences Library, University of Ottawa, Ottawa, Ontario, Canada
| | - Ian D Graham
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute (OHRI), University of Ottawa, Ottawa, Ontario, Canada
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Boyd AD, Song X, Furgal CM. A Systematic Literature Review of Cancer Communication with Indigenous Populations in Canada and the United States. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:310-324. [PMID: 31641979 DOI: 10.1007/s13187-019-01630-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Cancer is one of the leading causes of death among Indigenous populations. Communication campaigns are an important component of cancer prevention and treatment. However, communication about cancer with Indigenous populations has yet to be fully explored and understood. In this systematic literature review, we examine peer-reviewed research to gain insight into the factors that contribute to effective communication about cancer with Indigenous populations. The review yielded a total of 7313 potential articles and a total of 25 of these manuscripts met the inclusion criteria. Results indicate five primary factors that may increase the effectiveness of communication about cancer with Indigenous populations. Factors include the need to (1) respect traditional knowledge, (2) use appropriate language, (3) involve community members in the communication process, (4) include people from different generations in message design, and (5) engender trust in health communicators. Results also provide insight into communication methods that contribute to effective cancer communication. We identify gaps in the literature and provide recommendations for future cancer communication strategies and research with Indigenous populations.
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Affiliation(s)
- Amanda D Boyd
- The Edward R. Murrow College of Communication, Washington State University, 101 Goertzen Hall, Pullman, WA, 99163, USA.
| | - Xiaofei Song
- The Edward R. Murrow College of Communication, Washington State University, 101 Goertzen Hall, Pullman, WA, 99163, USA
| | - Chris M Furgal
- Indigenous Environmental Studies and Sciences Program, Trent University, 1600 West Bank Drive, Peterborough, ON, K9L 0G2, Canada
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Bea JW, de Heer H'D, Kinslow B, Valdez L, Yazzie E, Curley P, Dalgai S, Schwartz AL. Perceptions of Cancer Causes, Prevention, and Treatment Among Navajo Cancer Survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:493-500. [PMID: 30756323 PMCID: PMC6690813 DOI: 10.1007/s13187-019-01487-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Native Americans experience cancer-related health disparities. Yet, little is known about the current cancer experience in one of the largest Native American tribe, Navajo. A qualitative study of among Navajo cancer survivors, in which focus groups and individual interviews included questions related to perceptions of cancer causes, prevention, and treatment, allowed us to evaluate several aspects of the cancer experience from the Navajo perspective. An experienced, bilingual facilitator led the discussions using a standardized guide. Discussions were audio-recorded, documented by field notes, translated, as needed, and transcribed. NVivo software was used to summarize major themes according to the PEN-3 and health belief models. Navajo cancer survivors (N = 32) were both males (n = 13) and females (n = 19) that had been previously diagnosed with a variety of cancers: colorectal, breast, ovarian, cervical, esophageal, gall bladder, stomach, prostate, kidney, and hematologic. Many survivors had accurate knowledge of risk factors for cancer. Barriers to screening and clinical care included language, expense, geography, fear, lack of information, skepticism related to Western medicine, and treatment side effects. While some survivors experienced familial support, others were isolated from the family and community due to the perspective of cancer as a contagion. However, resilience, hope, trust in select community organizations, a desire to restore balance, and to support younger generations were positive attributes expressed regarding the treatment and recovery process. These evaluations need to be replicated across a larger cross-section of the Native cancer survivor community.
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Affiliation(s)
- Jennifer W Bea
- University of Arizona Cancer Center, 1515 N. Campbell Ave., Tucson, AZ, 85748, USA.
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA.
- The Collaboratory for Metabolic Disease Prevention and Treatment, University of Arizona, Tucson, AZ, USA.
| | | | | | - Luis Valdez
- Department of Health Promotion and Policy, University of Massachusetts, Amherst, Amherst, MA, USA
| | - Etta Yazzie
- University of Arizona Cancer Center, 1515 N. Campbell Ave., Tucson, AZ, 85748, USA
- Arizona Oncology Associates, Flagstaff, AZ, USA
| | - Pearl Curley
- Tuba City Regional Health Care Corporation, Tuba City, AZ, USA
| | - Shelby Dalgai
- University of Arizona School of Medicine, Tucson, AZ, USA
| | - Anna L Schwartz
- College of Health and Human Services, Northern Arizona University, Flagstaff, AZ, USA
- Arizona Oncology Associates, Flagstaff, AZ, USA
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10
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Tan ML, Lee KH, Yong WS, Rodgers C. The effects of a video-based education in women with newly diagnosed breast cancer in Singapore. Support Care Cancer 2018; 26:3891-3897. [DOI: 10.1007/s00520-018-4258-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 05/06/2018] [Indexed: 10/16/2022]
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Winston K, Grendarova P, Rabi D. Video-based patient decision aids: A scoping review. PATIENT EDUCATION AND COUNSELING 2018; 101:558-578. [PMID: 29102063 DOI: 10.1016/j.pec.2017.10.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 10/06/2017] [Accepted: 10/16/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This study reviews the published literature on the use of video-based decision aids (DA) for patients. The authors describe the areas of medicine in which video-based patient DA have been evaluated, the medical decisions targeted, their reported impact, in which countries studies are being conducted, and publication trends. METHOD The literature review was conducted systematically using Medline, Embase, CINAHL, PsychInfo, and Pubmed databases from inception to 2016. References of identified studies were reviewed, and hand-searches of relevant journals were conducted. RESULTS 488 studies were included and organized based on predefined study characteristics. The most common decisions addressed were cancer screening, risk reduction, advance care planning, and adherence to provider recommendations. Most studies had sample sizes of fewer than 300, and most were performed in the United States. Outcomes were generally reported as positive. This field of study was relatively unknown before 1990s but the number of studies published annually continues to increase. CONCLUSION Videos are largely positive interventions but there are significant remaining knowledge gaps including generalizability across populations. PRACTICE IMPLICATIONS Clinicians should consider incorporating video-based DA in their patient interactions. Future research should focus on less studied areas and the mechanisms underlying effective patient decision aids.
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Affiliation(s)
- Karin Winston
- Alberta Children's Hospital, 2800 Shaganappi Trail NW, Calgary, Alberta, T3B 6A8, Canada.
| | - Petra Grendarova
- University of Calgary, Division of Radiation Oncology, Calgary, Canada
| | - Doreen Rabi
- University of Calgary, Department of Medicine, Calgary, Canada
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Sanderson PR, Gene E, Scranton R, Willeto AAA, Joshweseoma L, Hardy LJ. A Southwestern Tribal Perspective on Traditional and Commercial Tobacco. CANCER HEALTH DISPARITIES 2018; 2:https://companyofscientists.com/index.php/chd/article/view/52/44. [PMID: 31663067 PMCID: PMC6818260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
American Indian or Alaska Natives have the highest rates of current cigarette (36.5%) and smokeless tobacco use (5.3%), and tobacco product (40.1%) and the second highest rate of current cigar use (6.1%) compared to all other racial-ethnic groups in the U.S. rates of American Indian or Alaska Native tobacco use vary by gender. Few studies examine perceptions of tobacco use among tribal members residing on and off the reservation. This study fills a gap in the literature by reporting the perceptions of 34 enrolled members of a southwestern tribe who reside on and off a tribal land using a Community-Based Participatory Research (CBPR) design through a collaboration between a university and a tribal health program. Researchers conducted seven focus groups; four on the southwest reservation and three within an urban community. The discussions were audio-recorded, transcribed, and analyzed using a multi-investigator consensus model. The use of tobacco (commercial or traditional) in southwest tribes is essential to cultural practices. Results depicted different views on cultural meaning and health impacts of commercial and traditional tobacco. Findings suggest the importance of local research to understand dimensions of tobacco use before moving forward with tobacco cessation programming.
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Affiliation(s)
- Priscilla R Sanderson
- Health Sciences Department of the College of Health and Human Services at Northern Arizona University
| | - Erelda Gene
- Northeastern State University Oklahoma, College of Optometry
| | | | - Angela A A Willeto
- Sociology and Social Work Department in the College of Social and Behavioral Sciences at Northern Arizona University
| | | | - Lisa J Hardy
- Anthropology Department in the College of Social and Behavioral Sciences at Northern Arizona University
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Jongen C, McCalman J, Bainbridge R, Clifford A. Cultural Competence Strengths, Weaknesses and Future Directions. SPRINGERBRIEFS IN PUBLIC HEALTH 2018. [DOI: 10.1007/978-981-10-5293-4_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Jongen CS, McCalman J, Bainbridge RG. The Implementation and Evaluation of Health Promotion Services and Programs to Improve Cultural Competency: A Systematic Scoping Review. Front Public Health 2017; 5:24. [PMID: 28289677 PMCID: PMC5327788 DOI: 10.3389/fpubh.2017.00024] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 02/08/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Cultural competency is a multifaceted intervention approach, which needs to be implemented at various levels of health-care systems to improve quality of care for culturally and ethnically diverse populations. One level of health care where cultural competency is required is in the provision of health promotion services and programs targeted to diverse patient groups who experience health-care and health inequalities. To inform the implementation and evaluation of health promotion programs and services to improve cultural competency, research must assess both intervention strategies and intervention outcomes. METHODS This scoping review was completed as part of a larger systematic literature search conducted on evaluations of cultural competence interventions in health care in Canada, the United States, Australia, and New Zealand. Seventeen peer-reviewed databases, 13 websites and clearinghouses, and 11 literature reviews were searched. Overall, 64 studies on cultural competency interventions were found, with 22 being health promotion programs and services. A process of thematic analysis was utilized to identify key intervention strategies and outcomes reported in the literature. RESULTS The review identified three overarching strategies utilized in health promotion services and programs to improve cultural competency: community-focused strategies, culturally focused strategies, and language-focused strategies. Studies took different approaches to delivering culturally competent health interventions, with the majority incorporating multiple strategies from each overarching category. There were various intermediate health-care and health outcomes reported across the included studies. Most commonly reported were positive reports of patient satisfaction, patient/participant service access, and program/study retention rates. The health outcome results indicate positive potential of health promotion services and programs to improve cultural competency to impact cardiovascular disease and mental health outcomes. However, due to measurement and study quality issues, it is difficult to determine the extent of the impacts. DISCUSSION Examined together, these intervention strategies and outcomes provide a framework that can be used by service providers and researchers in the implementation and evaluation of health promotion services and programs to improve cultural competency. While there is evidence indicating the effectiveness of such health promotion interventions in improving intermediate and health outcomes, further attention is needed to issues of measurement and study quality.
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Affiliation(s)
- Crystal Sky Jongen
- School of Human Health and Social Sciences, Central Queensland University, Cairns, QLD, Australia
| | - Janya McCalman
- School of Human Health and Social Sciences, Central Queensland University, Cairns, QLD, Australia
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Brown SR, Joshweseoma L, Saboda K, Sanderson P, Ami D, Harris R. Cancer Screening on the Hopi Reservation: A Model for Success in a Native American Community. J Community Health 2016; 40:1165-72. [PMID: 26091896 DOI: 10.1007/s10900-015-0043-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
American Indian women have lower cancer survival rates compared to non-Hispanic White women. Increased cancer screening fostered by culturally sensitive education and community programs may help decrease this disparity. This study assesses the effectiveness of Hopi Cancer Support Services (HCSS) in maintaining high rates of breast and cervical cancer screening among Hopi women and evaluates the impact of participation in HCSS programs on colorectal cancer (CRC) screening. A population-based survey was conducted on the Hopi reservation in 2012 (n = 252 women). Frequency of breast, cervical, and colorectal cancer screenings, participation in HCSS programs and barriers to screening were evaluated. Unconditional multiple logistic regression estimated the independent effect of the HCSS program on CRC screening. Approximately 88 % of Hopi women 40+ reported ever having had a mammogram; 71 % did so within the past 2 years. Approximately 66 % of women 50+ were ever screened for colorectal cancer (FOBT and/or colonoscopy). Women who had their last mammogram through HCSS were 2.81 (95 % CI 1.12, 7.07) times more likely to have been screened for CRC. Breast and cervical cancer screening continues at a high rate among Hopi women and is substantially greater than that reported prior to the inception of HCSS. Furthermore, participation in programs offered by HCSS is strongly associated with increased colorectal cancer screening. This tribal health program (HCSS) has strongly influenced cancer screening among Hopi women and is a model of a tribally run cancer prevention program.
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Affiliation(s)
- Sylvia R Brown
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin, Tucson, AZ, 85724-5163, USA. .,Arizona Cancer Center, University of Arizona, Tucson, AZ, USA.
| | - Lori Joshweseoma
- Hopi Department of Health and Human Services, The Hopi Tribe, Kykotsmovi, AZ, USA
| | | | - Priscilla Sanderson
- Department of Health Sciences, College of Health and Human Services and Department of Applied Indigenous Studies, College of Social and Behavioral Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Delores Ami
- Hopi Cancer Support Services, The Hopi Tribe, Kykotsmovi, AZ, USA
| | - Robin Harris
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin, Tucson, AZ, 85724-5163, USA.,Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
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Clifford A, McCalman J, Bainbridge R, Tsey K. Interventions to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA: a systematic review. Int J Qual Health Care 2015; 27:89-98. [PMID: 25758442 DOI: 10.1093/intqhc/mzv010] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2015] [Indexed: 11/14/2022] Open
Abstract
PURPOSE This article describes the characteristics and reviews the methodological quality of interventions designed to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA. DATA SOURCES A total of 17 electronic databases and 13 websites for the period of 2002-13. STUDY SELECTION Studies were included if they evaluated an intervention strategy designed to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, the USA or Canada. DATA EXTRACTION Information on the characteristics and methodological quality of included studies was extracted using standardized assessment tools. RESULTS OF DATA SYNTHESIS Sixteen published evaluations of interventions to improve cultural competency in health care for Indigenous peoples were identified: 11 for Indigenous peoples of the USA and 5 for Indigenous Australians. The main types of intervention strategies were education and training of the health workforce, culturally specific health programs and recruitment of an Indigenous health workforce. Main positive outcomes reported were improvements in health professionals' confidence, and patients' satisfaction with and access to health care. The methodological quality of evaluations and the reporting of key methodological criteria were variable. Particular problems included weak study designs, low or no reporting of consent rates, confounding and non-validated measurement instruments. CONCLUSION There is a lack of evidence from rigorous evaluations on the effectiveness of interventions for improving cultural competency in health care for Indigenous peoples. Future evaluations should employ more rigorous study designs and extend their measurement of outcomes beyond those relating to health professionals, to those relating to the health of Indigenous peoples.
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Affiliation(s)
- Anton Clifford
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Janya McCalman
- The Cairns Institute, James Cook University, Cairns, QLD, Australia
| | | | - Komla Tsey
- The Cairns Institute, James Cook University, Cairns, QLD, Australia
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Harun A, Harrison JD, Young JM. Interventions to improve patient participation in the treatment process for culturally and linguistically diverse people with cancer: a systematic review. Asia Pac J Clin Oncol 2012; 9:99-109. [PMID: 22897920 DOI: 10.1111/j.1743-7563.2012.01531.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Disparities in cancer outcomes for people from culturally and linguistically diverse (CALD) groups are well known. Improving CALD patients' active participation in treatment processes holds potential to improve outcomes, but little is known of effective strategies to facilitate this. This systematic review investigated interventions to improve three aspects of participation in cancer care among CALD groups, namely involvement in decision-making, communication with health providers and treatment adherence. A comprehensive search of electronic bibliographic databases was conducted to identify intervention studies that reported outcomes relevant to patient participation for CALD groups. Two reviewers independently critically appraised the studies and abstracted data. Of 10,278 potential articles, seven met the inclusion criteria, including three randomized controlled, three non-randomized and one mixed-method experimental studies. Interventions included the use of patient navigators, videos and decision aids. The impact on patient participation was varied. The effect of a decision aid and patient navigator interventions on communication with health providers was positive. While the use of a decisions aid successfully facilitated shared decision-making and patients' perception of treatment adherence, the use of patient navigators was ineffective. A computer support system was found to improve general patient participation; however little clarification of what this involved was provided. This systematic review identified few rigorous evaluations of interventions to improve treatment participation for CALD people with cancer, highlighting the lack of a robust evidence base to improve this crucial aspect of care. The development and evaluation of interventions for diverse populations remains a priority.
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Affiliation(s)
- Aisha Harun
- Surgical Outcomes Research Centre, Sydney Local Health Sydney Local Health District and Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
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