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Bantham A, Taverno Ross SE, Sebastião E, Hall G. Overcoming barriers to physical activity in underserved populations. Prog Cardiovasc Dis 2020; 64:64-71. [PMID: 33159937 DOI: 10.1016/j.pcad.2020.11.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 11/01/2020] [Indexed: 12/14/2022]
Abstract
There is compelling evidence suggesting underserved populations, including racial/ethnic minorities and individuals with low socioeconomic status, are less likely to partake in sufficient amounts of physical activity (PA) at recommended levels. Communities of color and low-income individuals face institutional, societal, and environmental barriers that may prevent them from achieving adequate levels of PA. However, these communities also possess a wealth of knowledge, assets, and support that can be harnessed to help individuals meet PA guidelines. This paper outlines the barriers to PA and explores how to overcome them, drawing from case studies of successful, evidence-based interventions that use culturally- and linguistically- appropriate approaches to increase PA in underserved populations.
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Affiliation(s)
- Amy Bantham
- Move to Live More, LLC, Somerville, MA, United States of America
| | - Sharon E Taverno Ross
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Emerson Sebastião
- Department of Kinesiology and Physical Education, Northern Illinois University, DeKalb, IL, United States of America
| | - Grenita Hall
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America.
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Galbraith-Gyan KV, Lechuga J, Jenerette CM, Palmer MH, Moore (Ret.) LTCAD, Hamilton JB. HPV vaccine acceptance among African-American mothers and their daughters: an inquiry grounded in culture. ETHNICITY & HEALTH 2019; 24:323-340. [PMID: 28553758 PMCID: PMC6175663 DOI: 10.1080/13557858.2017.1332758] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
BACKGROUND Much of the research on African-Americans' HPV vaccine acceptance has largely focused on racial/ethnic differences related to cognitive, socio-economical, and structural factors that contribute to differences in HPV vaccine acceptance and completion. A growing body of literature suggest that cultural factors, such as mistrust of healthcare providers (HCPs) and the healthcare system, religion, and social norms related to appropriate sexual behaviors, also plays a prominent role in their HPV vaccine acceptance. However, these studies were limited in their use of theoretical approaches necessary to conceptualize and operationalize culture. OBJECTIVE To explore the influence of culture on African-American mothers' and daughters' HPV vaccine acceptance using the PEN-3, a culturally-centered conceptual framework. METHODS Grounded theory techniques were used to explore cultural factors that influenced the acceptance of the HPV vaccine among African-American mothers (n = 28) and their daughters (n = 34). RESULTS Positive attitudes towards vaccination stemmed from beliefs that the HPV vaccine has cancer prevention benefits and that vaccinations in general protected against infectious diseases. Negative attitudes stemmed from beliefs that the HPV vaccine was too new, not effective, daughters were too young, and that vaccines were not a one-size-fits-all intervention. Majority of mothers and daughters indicated that their religious doctrine did not impede their HPV vaccination decisions. For a few mothers, religious beliefs could not be separated from their HPV vaccination decisions and ultimately deterred HPV vaccine acceptance. HCP recommendations were valued however mothers were often dissatisfied with the detail of information communicated. Support networks provided both positive and negative types of social support to mothers and daughters. The media highlighted the cancer prevention benefits of the HPV vaccine and unintentionally communicated negative information of the HPV vaccine, which deterred HPV vaccine acceptance. CONCLUSION Study findings can inform the development of culturally appropriate interventions that advances the evidence on cervical cancer prevention.
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Affiliation(s)
- Kayoll V. Galbraith-Gyan
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA,
| | - Julia Lechuga
- College of Education, Lehigh University, Bethlehem, PA, USA,
| | - Coretta M. Jenerette
- Department of Adult and Geriatric Health; School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, CB #7460, Chapel Hill, NC, USA,
| | - Mary H. Palmer
- Health Care Environment Division, University of North Carolina at Chapel Hill, Carrington Hall, CB #7460, Chapel Hill, NC, USA,
| | | | - Jill B. Hamilton
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA,
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Solari A, Giordano A, Kasper J, Drulovic J, van Nunen A, Vahter L, Viala F, Pietrolongo E, Pugliatti M, Antozzi C, Radice D, Köpke S, Heesen C. Role Preferences of People with Multiple Sclerosis: Image-Revised, Computerized Self-Administered Version of the Control Preference Scale. PLoS One 2013; 8:e66127. [PMID: 23823627 PMCID: PMC3688863 DOI: 10.1371/journal.pone.0066127] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 05/01/2013] [Indexed: 12/21/2022] Open
Abstract
Background The Control Preference Scale (CPS) is the most frequently used measure of patients’ preferred roles in treatment decisions. We revised the original CPS and developed a new computerized patient self-administered version (eCPS). We used the eCPS to assess role preferences, and their determinants, in Italian and German people with multiple sclerosis (MS). Methods New cartoons were produced, based on MS health professional and patient input/feedback and previous findings, and pilot tested on 26 Italian and German MS patients. eCPS acceptability and reliability (weighted kappa statistic, wK) in comparison to the original tool, was determined in 92 MS patients who received both CPS versions in random order. Results The new cartoons were well accepted and easily interpreted by patients, who reported they based their choices mainly on the text and considered the images of secondary importance. eCPS reliability was moderate (wK 0.53, 95% confidence interval [CI] 0.40–0.65) and similar to the test-retest reliability of face-to-face administration assessed in a previous publication (wK 0.65, 95% CI 0.45–0.81). Higher education (odds ratio [OR] 3.74, 95% CI 1.00–14.05) and German nationality (OR 10.30, 95% CI 3.10–34.15) were associated with preference for an active role in the logistic model. Conclusions The newly devised eCPS was well received and considered easy to use by MS patients. Reliability was in line with that of the original version. Role preference appears affected by cultural characteristics and (borderline statistical significance) education.
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Affiliation(s)
- Alessandra Solari
- Unit of Neuroepidemiology, Foundation Istituto Di Ricovero e Cura a Carattere Scientifico Neurological Institute C. Besta, Milan, Italy
- * E-mail:
| | - Andrea Giordano
- Unit of Neuroepidemiology, Foundation Istituto Di Ricovero e Cura a Carattere Scientifico Neurological Institute C. Besta, Milan, Italy
| | - Jurgen Kasper
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jelena Drulovic
- Institute of Neurology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Liina Vahter
- Department of Neurology, West-Tallinn Central Hospital, Tallinn, Estonia
| | - Frederique Viala
- Department of Neurology, Purpan University Hospital, Toulouse, France
| | - Erika Pietrolongo
- Department of Neuroscience and Imaging, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Maura Pugliatti
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Carlo Antozzi
- Department of Neuromuscular Diseases, Foundation Istituto Di Ricovero e Cura a Carattere Scientifico Neurological Institute C. Besta, Milan, Italy
| | - Davide Radice
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - Sascha Köpke
- Nursing Research Group, Institute of Social Medicine, University of Lübeck, Lübeck, Germany
| | - Christoph Heesen
- Institute for Neuroimmunology and Clinical MS Research (inims), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Kagawa Singer M. Applying the concept of culture to reduce health disparities through health behavior research. Prev Med 2012; 55:356-61. [PMID: 22391576 DOI: 10.1016/j.ypmed.2012.02.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 02/20/2012] [Accepted: 02/20/2012] [Indexed: 10/28/2022]
Abstract
Culture is often cited as an underlying cause of the undue burden of disease borne by communities of color along the entire life cycle. However, culture is rarely defined or appropriately measured. Scientifically, culture is a complex, integrated, and dynamic conceptual framework that is incongruent with the way it is operationalized in health behavior theories: as a unidimensional, static, and immutable character element of a homogeneous population group. This paper lays out this contradiction and proposes a more scientifically grounded approach to the use of culture. The premise is that if the concept of culture were better operationalized, results from studies of diverse population groups would produce findings that are more scientifically valid and relevant to the community. Practitioners could then use these findings to develop more effective strategies to reduce health disparities and improve the health of all population groups. Six steps are proposed to increase our ability to achieve greater clarity on what culture is and to identify how it impacts health behavior and ultimately health outcomes, enabling researchers to build a stronger science of cultural diversity.
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Affiliation(s)
- Marjorie Kagawa Singer
- UCLA School of Public Health and Department of Asian American Studies, Los Angeles, CA, USA.
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Harrop JP, Nelson DE, Kuratani DG, Mullen PD, Paskett ED. Translating cancer prevention and control research into the community setting: workforce implications. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:S157-S164. [PMID: 22362356 DOI: 10.1007/s13187-012-0329-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A gap exists between cancer prevention research and its translation into community practice. Two strategies to reduce this gap are community-based participatory research (CBPR) and dissemination research. CBPR offers an avenue to engage academic and community partners, thereby providing mechanisms for joint learning and application of knowledge. Dissemination research examines the movement of evidence-based public health and clinical innovations to practice settings. While applying these approaches may reduce the gap between research and practice, the cancer prevention workforce may be inadequate in size, insufficiently trained, lack resources and incentives, or face structural barriers to effectively participate in CBPR and disseminate evidence-based research findings into practice. Information on translating cancer prevention information to communities and workforce implications was obtained from a panel of experts and through a review of the literature on CBPR and dissemination research. The expert panel and literature review identified major barriers to successfully conducting CBPR and dissemination research in community settings. Barriers included inadequate policies; insufficient networking and communication infrastructures; unsupportive research cultures, climates, and mindsets; inadequate researcher and practitioner education; and limited CBPR and dissemination research with adequate study designs. No specific estimates of the cancer prevention workforce were found; however, indirect evidence for a shortfall were identified. We recommend expanding CBPR training for academic and community partners; increasing funding for dissemination research and practice; supporting proven partnerships; and providing strategic coordination for government agencies, research institutions, nongovernmental organizations, and the private sector to foster better dissemination of information and integration of community-based cancer prevention and control programs and practices. Specific challenges and needs that must be addressed to improve the translation of cancer prevention research into community settings were identified.
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Affiliation(s)
- J Phil Harrop
- College of Public Health, Division of Health Services Management and Policy, Comprehensive Cancer Center, The Ohio State University, 1590 North High Street, Suite 525, Columbus, OH 43201, USA
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Kagawa-Singer M, Padilla GV, Ashing-Giwa K. Health-Related Quality of Life and Culture. Semin Oncol Nurs 2010; 26:59-67. [DOI: 10.1016/j.soncn.2009.11.008] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Yancey AK. The meta-volition model: organizational leadership is the key ingredient in getting society moving, literally! Prev Med 2009; 49:342-51. [PMID: 19744510 DOI: 10.1016/j.ypmed.2009.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Revised: 08/31/2009] [Accepted: 09/01/2009] [Indexed: 10/20/2022]
Abstract
This paper argues that substantive and sustainable population-wide improvements in physical activity can be achieved only through the large scale adoption and implementation of policies and practices that make being active the default choice and remaining inactive difficult. Meta-volition refers to the volition and collective agency of early adopter leaders who implement such changes in their own organizations to drive productivity and health improvements. Leaders, themselves, are motivated by strong incentives to accomplish their organizational missions. The meta-volition model (MVM) specifies a cascade of changes that may be sparked by structural integration of brief activity bouts into organizational routine across sectors and types of organizations. MVM builds upon inter-disciplinary social ecological change models and frameworks such as diffusion of innovations, social learning and social marketing. MVM is dynamic rather than static, integrating biological influences with psychological factors, and socio-cultural influences with organizational processes. The model proposes six levels of dissemination triggered by organizational marketing to early adopter leaders carried out by "sparkplugs," boisterous leaders in population physical activity promotion: initiating (leader-leader), catalyzing (organizational-individual), viral marketing (individual-organizational), accelerating (organizational-organizational), anchoring (organizational-community) and institutionalizing (community-individual). MVM embodies public-private partnership principles, a collective investment in the high cost of achieving and maintaining active lifestyles.
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Affiliation(s)
- Antronette K Yancey
- Department of Health Services, Center to Eliminate Health Disparities, Center for Health Policy Research, UCLA School of Public Health, 31-235 CHS, 650 Charles Young Drive South, Los Angeles, CA 90095, USA.
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