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Lumpkins CY, Nelson R, Twizele Z, Ramírez M, Kimminau KS, Philp A, Mustafa RA, Godwin AK. Communicating risk and the landscape of cancer prevention - an exploratory study that examines perceptions of cancer-related genetic counseling and testing among African Americans and Latinos in the Midwest. J Community Genet 2023; 14:121-133. [PMID: 36930422 PMCID: PMC10021032 DOI: 10.1007/s12687-022-00629-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 12/21/2022] [Indexed: 03/18/2023] Open
Abstract
African American (AA) and Latino populations are impacted disproportionately by cancer incidence and mortality compared to the general US population. Contributing to these rates are multiple inheritable cancers that impact both men and women. Some of these diseases may be detected through genetic counseling and germline DNA testing; however, AA and Latinos are unaware and have limited knowledge and thus significantly underutilize these services and technologies. Research to detect influencing factors to testing uptake has also been slow due to multiple factors. The research team followed a community-based participatory research (CBPR) approach and worked with a Community Advisory Board composed of cancer survivors and co-survivors to design the exploratory study. Six focus groups were held with a pilot sample of African Americans and Latinos who self-reported to be at-risk for cancer (N = 53). The study was held over a 2-month period where attitudes, perceptions, and beliefs about cancer risk and preference regarding cancer-related genetic counseling and testing risk communication were explored. Themes that emerged included (1) the lack of knowledge about cancer-related genetic counseling and testing; (2) cancer is feared often; (3) cancer-related genetic testing was perceived as something that could help but was also perceived as unnecessary testing that exposed individuals to medical harm; and (4) benefits to test were perceived as favorable for medical personnel but not for the patient. Implications of the study provide a unique lens to explore how lived experiences among AA and Latinos may inform strategic risk communication about cancer-related genetic counseling and testing and help advance cancer health equity. Participants viewed cancer genetic testing as important cancer risk prevention strategies. Identification of perceptions of cancer risk and cancer-related genetic counseling and testing in collaboration with members of the community is needed to bolster communication efforts among these populations.
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Affiliation(s)
- Crystal Y Lumpkins
- Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
| | - Rafaela Nelson
- Pediatrics Department, University of Kansas Medical Center, Kansas City, KS, USA
| | - Zawadi Twizele
- University of Kansas Medical Center, Kansas City, KS, USA
| | - Mariana Ramírez
- Department of Population Health, JUNTOS Center for Advancing Latino Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Kim S Kimminau
- Department of Family and Community Medicine, University of Missouri, Columbia, MO, USA
| | | | - Reem A Mustafa
- Department of Internal Medicine, University of Kansas Health System, Kansas City, KS, USA
| | - Andrew K Godwin
- Department of Microbiology, Molecular Genetics and Immunology, University of Kansas Medical Center, Kansas City, KS, USA
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Doornbos MM, Zandee GL, Timmermans B, Moes J, DeGroot J, DeMaagd-Rodriguez M, Smit-Scholman J, Zietse M, Heitsch E, Quist M. Women supporting women: Supportive/educative groups for ethnically diverse, urban, impoverished women dealing with depression and anxiety. Arch Psychiatr Nurs 2018; 32:524-529. [PMID: 30029743 DOI: 10.1016/j.apnu.2018.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 01/08/2018] [Accepted: 02/11/2018] [Indexed: 10/18/2022]
Abstract
Depression and anxiety are mental health issues that disproportionately affect urban, ethnically diverse, impoverished women. Using community based participatory research and in the context of long-term partnerships between a nursing department and underserved neighborhoods that are predominately Black, Hispanic, and White respectively, supportive/educative groups were offered. The study employed a quasi-experimental, nonequivalent comparison group pretest-posttest design. Seventy-two women aged 17-88 years participated. Repeated measures ANOVA indicated a significant increase in knowledge for self-care for depression and anxiety and a significant decrease in anxiety and depression symptomatology from before to after the group sessions.
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Hanks RS, Myles H, Wraight S, Williams MC, Patterson C, Hodnett BM, Broadnax A, Shelley-Tremblay S, Crook E. A Multigenerational Strategy to Transform Health Education into Community Action. Prog Community Health Partnersh 2018; 12:121-128. [PMID: 29755055 DOI: 10.1353/cpr.2018.0027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The National Institute for Minority Health and Health Disparities funded Centers of Excellence to address health disparities through research, education and professional training, and community engagement. This article summarizes a decade of multigenerational educational programing embedded in the Community Engagement Core (CEC) of the National Institute for Minority Health and Health Disparities-funded Center for Healthy Communities-Center of Excellence at the University of South Alabama. OBJECTIVES Our objective is to demonstrate how community-based participatory research (CBPR) initiated the multigenerational approach, uniting the community health education and the educational pipeline programs, and transformed a traditional professional symposium into a mechanism to increase community participation and action. METHODS Community engagement and education adhered to CBPR principles and methods. A 3-year planning process before full funding of the Center of Excellence allowed the CHC to develop community partnerships and implement pilot projects that would assure community access and participation in COE programs. Program innovation was rooted in community suggestions and community priorities. The annual Regional Health Disparities Symposium (RHDS) was literally transformed through community engagement. CONCLUSIONS Education programs for adults and youth achieved their goals independently, the STARS AND STRIPES (Student Training for Academic Reinforcement in the Sciences and Special Training to Raise Interest and Prepare for Entry into the Sciences) pipeline program has a success rate of 88% for participants' admission to colleges and universities. CHA-led events have documented an outreach to more than 6,500 community members and the COE has funded eight CHA-led projects directly addressing community action plans developed through CBPR methods during the history of the RHDS. But the real story has emerged from transformative multigenerational interaction via CBPR.
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Discovering Their Needs. J Christ Nurs 2016; 33:E50-5. [DOI: 10.1097/cnj.0000000000000328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Khodyakov D, Mikesell L, Schraiber R, Booth M, Bromley E. On using ethical principles of community-engaged research in translational science. Transl Res 2016; 171:52-62.e1. [PMID: 26773561 PMCID: PMC4833614 DOI: 10.1016/j.trsl.2015.12.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 11/20/2015] [Accepted: 12/16/2015] [Indexed: 11/20/2022]
Abstract
The transfer of new discoveries into both clinical practice and the wider community calls for reliance on interdisciplinary translational teams that include researchers with different areas of expertise, representatives of health care systems and community organizations, and patients. Engaging new stakeholders in research, however, calls for a reconsideration or expansion of the meaning of ethics in translational research. We explored expert opinion on the applicability of ethical principles commonly practiced in community-engaged research (CEnR) to translational research. To do so, we conducted 2 online, modified-Delphi panels with 63 expert stakeholders who iteratively rated and discussed 9 ethical principles commonly used in CEnR in terms of their importance and feasibility for use in translational research. The RAND/UCLA appropriateness method was used to analyze the data and determine agreement and disagreement among participating experts. Both panels agreed that ethical translational research should be "grounded in trust." Although the academic panel endorsed "culturally appropriate" and "forthcoming with community about study risks and benefits," the mixed academic-community panel endorsed "scientifically valid" and "ready to involve community in interpretation and dissemination" as important and feasible principles of ethical translational research. These findings suggest that in addition to protecting human subjects, contemporary translational science models need to account for the interests of, and owe ethical obligations to, members of the investigative team and the community at large.
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Affiliation(s)
- Dmitry Khodyakov
- Behavioral/Social Scientist, The RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, Phone: +1-310-393-0411x 6159
| | - Lisa Mikesell
- Assistant Professor, Communication Department, School of Communication and Information, Institute for Health, Health Care Policy and Aging Research, Rutgers University, 4 Huntington Street, New Brunswick, NJ 08901-1071
| | - Ron Schraiber
- Executive Director, The Well-Being Programs, Inc., 644 Knoll Drive, P.O. Box 1104, Crestline, CA 92324
| | - Marika Booth
- Statistical Project Associate, The RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, Phone: +1-310-393-0411x 6338
| | - Elizabeth Bromley
- Assistant Professor in Residence, Semel Institute Center for Health Services and Society, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Research Psychiatrist, Desert Pacific MIRECC, West Los Angeles VA Healthcare Center, 10920 Wilshire Blvd, Los Angeles, CA 90024
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Bryan V, Brye W, Hudson K, Dubose L, Hansberry S, Arrieta M. Investigating health disparities through community-based participatory research: lessons learned from a process evaluation. SOCIAL WORK IN PUBLIC HEALTH 2014; 29:318-334. [PMID: 24871770 PMCID: PMC4272491 DOI: 10.1080/19371918.2013.821356] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This article describes one university's efforts to partner with a local agency (the "Coalition") within a disadvantaged, predominantly African American neighborhood, to assist them with studying their community's health disparities and health care access. The final, mutually agreed-upon plan used a community-based participatory research approach, wherein university researchers prepared neighborhood volunteers and Coalition members to conduct face-to-face interviews with residents about their health and health care access. Subsequently, the Coalition surveyed 138 residents, and the agency now possesses extensive data about the nature and extent of health problems in their community. Lessons learned from these experiences are offered.
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Affiliation(s)
- Valerie Bryan
- a Department of Sociology, Anthropology, and Social Work , University of South Alabama , Mobile , Alabama , USA
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Mikesell L, Bromley E, Khodyakov D. Ethical community-engaged research: a literature review. Am J Public Health 2013; 103:e7-e14. [PMID: 24134352 PMCID: PMC3828990 DOI: 10.2105/ajph.2013.301605] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2013] [Indexed: 11/04/2022]
Abstract
Health research has relied on ethical principles, such as those of the Belmont Report, to protect the rights and well-being of research participants. Community-based participatory research (CBPR), however, must also consider the rights and well-being of communities. This requires additional ethical considerations that have been extensively discussed but not synthesized in the CBPR literature. We conducted a comprehensive thematic literature review and summarized empirically grounded discussions of ethics in CBPR, with a focus on the value of the Belmont principles in CBPR, additional essential components of ethical CBPR, the ethical challenges CBPR practitioners face, and strategies to ensure that CBPR meets ethical standards. Our study provides a foundation for developing a working definition and a conceptual model of ethical CBPR.
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Affiliation(s)
- Lisa Mikesell
- Lisa Mikesell is with the Communication Department, School of Communication and Information, Rutgers University, New Brunswick, NJ. Elizabeth Bromley is with the Semel Institute Center for Health Services and Society, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, and the Greater Los Angeles VA Healthcare System. Dmitry Khodyakov is with the RAND Corporation, Santa Monica, CA
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Ayoola AB, Zandee GL. Low-income women's recommendations for promoting early pregnancy recognition. J Midwifery Womens Health 2013; 58:416-22. [PMID: 23879232 DOI: 10.1111/jmwh.12078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study explored low-income women's perspectives on how to promote early recognition of pregnancy as one strategy to address community residents' concerns related to unintended pregnancy. Unintended pregnancy, which is more prevalent among low-income women and minorities, has been associated with various adverse pregnancy outcomes. METHODS This study used the ideological perspective of community-based participatory research. Six focus groups were conducted in 3 low-income, urban, medically underserved neighborhoods with ethnically diverse populations. Neighborhood women who were either pregnant or had experienced a pregnancy within 3 years were invited to participate in the study. A structured interview guide focused the discussion on how to promote early recognition of pregnancy within the existing context of unintended pregnancies in the neighborhoods. Focus-group sessions were audiotaped, then transcribed verbatim; the data were analyzed using an open-coding template approach assisted by QSR NVivo 8 software. RESULTS Forty-one women aged 18 to 44 years participated in the study. Thirty-nine percent were African American, 24.4% were Hispanic/Latino, 19.5% were American Indians, and 17.1% were white. Three primary themes were identified: 1) women should know the menstrual/ovulation and pregnancy-related changes that occur in their bodies; 2) women should be prepared to confirm their pregnancies early, as soon as they suspect they may be pregnant; and 3) both information and emotional support are needed for pregnancy-related issues. "Knowing your body" was the strongest advice to promote early recognition of pregnancy. DISCUSSION The participants in this study suggested that education about reproductive changes should be initiated during early adolescence and in the preconception period. Early testing and confirmation of pregnancy should also be promoted, especially for women who have unprotected intercourse. Local resources for information and emotional support during pregnancy should be accessible to women.
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Affiliation(s)
- Adejoke B Ayoola
- Department of Nursing, Calvin College, 1734 Knollcrest Circle SE, Grand Rapids, MI 49546, USA.
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Melvin CL, Corbie-Smith G, Kumanyika SK, Pratt CA, Nelson C, Walker ER, Ammerman A, Ayala GX, Best LG, Cherrington AL, Economos CD, Green LW, Harman J, Hooker SP, Murray DM, Perri MG, Ricketts TC. Developing a research agenda for cardiovascular disease prevention in high-risk rural communities. Am J Public Health 2013; 103:1011-21. [PMID: 23597371 PMCID: PMC3698719 DOI: 10.2105/ajph.2012.300984] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2012] [Indexed: 11/04/2022]
Abstract
The National Institutes of Health convened a workshop to engage researchers and practitioners in dialogue on research issues viewed as either unique or of particular relevance to rural areas, key content areas needed to inform policy and practice in rural settings, and ways rural contexts may influence study design, implementation, assessment of outcomes, and dissemination. Our purpose was to develop a research agenda to address the disproportionate burden of cardiovascular disease (CVD) and related risk factors among populations living in rural areas. Complementary presentations used theoretical and methodological principles to describe research and practice examples from rural settings. Participants created a comprehensive CVD research agenda that identified themes and challenges, and provided 21 recommendations to guide research, practice, and programs in rural areas.
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Zandee GL, Bossenbroek D, Slager D, Gordon B. Teams of Community Health Workers and Nursing Students Effect Health Promotion of Underserved Urban Neighborhoods. Public Health Nurs 2013; 30:439-47. [DOI: 10.1111/phn.12031] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Dianne Slager
- Nottawaseppi Huron Band of the Potawatomi Health Center; Wyoming; Michigan
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Kreuter MW, Kegler MC, Joseph KT, Redwood YA, Hooker M. The impact of implementing selected CBPR strategies to address disparities in urban Atlanta: a retrospective case study. HEALTH EDUCATION RESEARCH 2012; 27:729-741. [PMID: 22717942 PMCID: PMC3529631 DOI: 10.1093/her/cys053] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 03/08/2012] [Indexed: 06/01/2023]
Abstract
In 2005, the Institute of Public Health at Georgia State University (GSU) received a 3-year community-based participatory research (CBPR) grant from the National Center for Minority Health and Health Disparities entitled Accountable Communities: Healthy Together (ACHT). Because urban health disparities result from complex interactions among social, economic and environmental factors, ACHT used specific CBPR strategies to engage residents, and promote the participation of community organizations serving, a low-income community in urban Atlanta to: (i) identify priority health and social or environmental problems and (ii) undertake actions to mitigate those problems. Three years after funding ended, a retrospective case study, using semi-structured, taped interviews was carried out to determine what impacts, if any, specific CBPR strategies had on: (i) eliciting resident input into the identification of priority problems and (ii) prompting actions by community organizations to address those problems. Results suggest that the CBPR strategies used were associated with changes that were supported and sustained after grant funding ended. Insights were also gained on the longer term impacts of ACHT on community health workers. Implications for future CBPR efforts, for researchers and for funders, are discussed.
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Silka L. Community research in other contexts: learning from sustainability science. J Empir Res Hum Res Ethics 2010; 5:3-11. [PMID: 21133782 DOI: 10.1525/jer.2010.5.4.3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In health research, community based participatory research (CBPR) has seen remarkable growth as an approach that overcomes many of the ethical concerns raised by traditional approaches. A community of CBPR scholars is now sharing ideas and devising new approaches to collaborative research. Yet, this is occurring in isolation from similar efforts using different nomenclature and occurring outside of health research areas. There is much to be gained by bringing these parallel discussions together. In sustainability science, for example, scholars are struggling with the question of how stakeholders and scientists can coproduce knowledge that offers useful solutions to complex and urgent environmental problems. Like CBPR in health, sustainability science is denigrated for perceived lack of rigor because of its applied problem focus and lack of positivist approach. Approaches to knowledge creation in sustainability science involve "new" ideas such as wicked problems and agent-based modeling, which would be equally applicable to CBPR. Interestingly, sustainability research is motivated less by recognition of the corrosive effects of the inequality of power than from frustration at how limited the impact of research has been, a perspective that might be useful in CBPR, particularly in conjunction with the use of some borrowed tools of sustainability science such as wicked problem analysis and agent-based modeling. Importantly, the example of sustainability science has the potential to keep CBPR from entering into a new orthodoxy of how research should be done.
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Affiliation(s)
- Linda Silka
- Margaret Chase Smith Policy Center, University of Maine, Orono, ME 04469, USA.
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Mullins CD, Onukwugha E, Cooke JL, Hussain A, Baquet CR. The Potential Impact Of Comparative Effectiveness Research On The Health Of Minority Populations. Health Aff (Millwood) 2010; 29:2098-104. [DOI: 10.1377/hlthaff.2010.0612] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- C. Daniel Mullins
- C. Daniel Mullins ( ) is a professor in the Pharmaceutical Health Services Research Department, University of Maryland School of Pharmacy, in Baltimore
| | - Eberechukwu Onukwugha
- Eberechukwu Onukwugha is an assistant professor in the Pharmaceutical Health Services Research Department, University of Maryland School of Pharmacy
| | - Jesse L. Cooke
- Jesse L. Cooke is a consultant based in San Diego, California
| | - Arif Hussain
- Arif Hussain is a professor of medicine at the University of Maryland School of Medicine
| | - Claudia R. Baquet
- Claudia R. Baquet is a professor of medicine and the associate dean for policy and planning at the University of Maryland School of Medicine
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