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Granda-Cameron C, Kates J, Wen KY. mHealth Interventions to Improve the Breast Cancer Continuum of Care from Prevention to Survivorship of Hispanic Women: A Scoping Review. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01658-7. [PMID: 37365425 DOI: 10.1007/s40615-023-01658-7] [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: 02/09/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Breast cancer is the leading cause of cancer mortality in Hispanic women in the USA. Current interventions to improve breast cancer care include the use of mHealth, but its application in Hispanic women is limited. This scoping review aimed to describe the extent of research literature on the use of mHealth throughout the breast cancer care continuum (prevention, early detection, and treatment) in Hispanic women. METHODS A scoping review guided by the Arksey and O'Malley methodological framework and the Joanna Briggs Institute scoping review reporting protocol. Literature search of peer-reviewed research articles from 2012 to 2022 in PubMed, Scopus, and CINAHL® was conducted in March and June 2022. RESULTS Of the 10 articles selected, seven included Hispanic breast cancer survivors and three included Hispanic women at risk for developing breast cancer. Seven articles involved mobile applications and three articles used text messaging and/or cell phone voicemail. Overall, the use of mHealth for breast cancer care in Hispanics was favorable but generalizability was limited given the type of design and small samples. All interventions were tailored to Hispanic culture. CONCLUSION Scarcity of research on mHealth in Hispanic breast cancer care highlights healthcare disparities in this population. Evidence from this review suggests the use of mHealth to be beneficial to improving breast cancer care in Hispanics, but more research is needed involving randomized clinical trials and larger samples.
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Affiliation(s)
- Clara Granda-Cameron
- Thomas Jefferson University College of Nursing, 901 Walnut Street, Suite 703, Philadelphia, PA, 19107, USA.
| | - Jeannette Kates
- Thomas Jefferson University College of Nursing, 901 Walnut Street, Suite 703, Philadelphia, PA, 19107, USA
| | - Kuang-Yi Wen
- Medical Oncology Department, Population Science Division, 834 Chestnut Street, Suite 300, Franklin Building, Philadelphia, PA, 19107, USA
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Molokwu JC, Dwivedi A, Alomari A, Shokar N. Effectiveness of a Breast Cancer Education Screening and NavigaTion (BEST) Intervention among Hispanic Women. Health Promot Pract 2023:15248399221135762. [PMID: 36635866 DOI: 10.1177/15248399221135762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND In the United States, breast cancer remains one of the most diagnosed cancers among females and remains the second leading cause of cancer death. In addition, breast cancer is most likely diagnosed at an advanced stage among Hispanic females in the United States due to lower mammogram utilization. AIMS The objective of this study was to determine the effectiveness of a multilevel, multicomponent community-based breast cancer screening intervention called the Breast Cancer Education Screening and NavigaTion (BEST) program. The primary outcome was the completion of a screening mammogram 4 months post-intervention. METHOD We used a pragmatic approach for evaluation, utilizing a quasi-experimental delayed intervention design. We recruited women from the community aged between 50 and 75, uninsured or underinsured, and overdue for screening. RESULTS Six hundred participants were recruited (300 intervention and 300 control). Among completers, the screening rate was 97% in the intervention group and 4.4% in the control group (RR = 22.2, 95% CI: 12.5-39.7, p < .001). In multivariable analysis, age ≥ 65 (RR = 1.29, p = .047), perceived benefits (RR = 1.04, p = .026), curability (RR = 1.24, p < .001), subjective norms (RR = 1.14, p = .014), and fatalism (RR = .96, p = .004) remained significantly associated with screening outcome. CONCLUSION A multicomponent, bilingual, and culturally tailored intervention effectively facilitated breast cancer screening completion in an underserved population of Hispanic women. Individuals with improved screening outcomes were more likely to have higher positive beliefs. Our study has important implications regarding using multicomponent interventions in increasing breast cancer screening completion in poorly screened populations. It also highlights differences in health belief motivation for breast cancer screening completion.
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Affiliation(s)
| | - Alok Dwivedi
- Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - Adam Alomari
- Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
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Acquati C, Chen TA, Martinez Leal I, Connors SK, Haq AA, Rogova A, Ramirez S, Reitzel LR, McNeill LH. The Impact of the COVID-19 Pandemic on Cancer Care and Health-Related Quality of Life of Non-Hispanic Black/African American, Hispanic/Latina and Non-Hispanic White Women Diagnosed with Breast Cancer in the U.S.: A Mixed-Methods Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413084. [PMID: 34948695 PMCID: PMC8702073 DOI: 10.3390/ijerph182413084] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic has had critical consequences for cancer care delivery, including altered treatment protocols and delayed services that may affect patients’ quality of life and long-term survival. Breast cancer patients from minoritized racial and ethnic groups already experience worse outcomes, which may have been exacerbated by treatment delays and social determinants of health (SDoH). This protocol details a mixed-methods study aimed at comparing cancer care disruption among a diverse sample of women (non-Hispanic White, non-Hispanic Black/African American, and Hispanic/Latina) and assessing how proximal, intermediate, and distal SDoH differentially contribute to care continuity and health-related quality of life. An embedded mixed-methods design will be implemented. Eligible participants will complete an online survey, followed by a semi-structured interview (with a subset of participants) to further understand factors that influence continuity of care, treatment decision-making, and self-reported engagement. The study will identify potentially modifiable factors to inform future models of care delivery and improve care transitions. These data will provide the necessary evidence to inform whether a subsequent, multilevel intervention is warranted to improve quality of care delivery in the COVID-19 aftermath. Additionally, results can be used to identify ways to leverage existing social resources to help manage and support patients’ outcomes.
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Affiliation(s)
- Chiara Acquati
- Graduate College of Social Work, University of Houston, 3511 Cullen Blvd, Houston, TX 77204, USA
- Department of Health Disparities Research, The UT MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA;
- Correspondence: ; Tel.: +1-713-743-4343
| | - Tzuan A. Chen
- HEALTH Research Institute, University of Houston, 4849 Calhoun Road, Houston, TX 77204, USA; (T.A.C.); (I.M.L.); (L.R.R.)
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
| | - Isabel Martinez Leal
- HEALTH Research Institute, University of Houston, 4849 Calhoun Road, Houston, TX 77204, USA; (T.A.C.); (I.M.L.); (L.R.R.)
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
| | - Shahnjayla K. Connors
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
- Department of Social Sciences, University of Houston-Downtown, Houston, TX 77002, USA
| | - Arooba A. Haq
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
| | - Anastasia Rogova
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
| | - Stephanie Ramirez
- College of Natural Sciences and Mathematics, University of Houston, 3507 Cullen Blvd, Houston, TX 77204, USA;
| | - Lorraine R. Reitzel
- HEALTH Research Institute, University of Houston, 4849 Calhoun Road, Houston, TX 77204, USA; (T.A.C.); (I.M.L.); (L.R.R.)
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
| | - Lorna H. McNeill
- Department of Health Disparities Research, The UT MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA;
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Mojica CM, Almatkyzy G, Morales-Campos D. A Cancer Education-Plus-Navigation Intervention Implemented Within a Federally Qualified Health Center and Community-Based Settings. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:152-159. [PMID: 31463809 DOI: 10.1007/s13187-019-01611-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Despite the availability of effective cancer screening tests, Latinos are screened at lower rates than non-Hispanic Whites. We implemented and evaluated the effectiveness of an evidence-based community health worker (CHW) cancer education-plus-navigation intervention designed to increase cancer screening, knowledge of screening guidelines, and the benefit of early detection. The project included a community and clinic component and served a primarily Latino population. In collaboration with a federally qualified health center (FQHC) and three community-based organizations, bilingual/bicultural CHWs recruited men and women (not up-to-date with the cancer screening guidelines) from a FQHC and the community. Participants received education plus navigation and no-cost cancer screening tests. Together with the FQHC, we outlined eligibility criteria, project protocols, project implementation, and evaluation activities. With the community organizations, we outlined recruitment protocols-when to recruit, how to recruit, and connections with other organizations. CHWs enrolled 3045 men and women into the education-plus-navigation intervention. Overall, 71% received at least one cancer screening. Stratifying by gender, 72% of women received at least one cancer screening test whereas 63% of enrolled men received a test for colorectal cancer. Knowledge of screening guidelines and the belief in early detection also increased from baseline to follow-up. Our evidence-based education-plus-navigation intervention successfully reached large numbers of underserved men and women and yielded positive changes in cancer screening and knowledge of screening guidelines and the belief in early detection. The inclusion of a clinic and community component ensured success of the project.
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Affiliation(s)
- Cynthia M Mojica
- College of Public Health and Human Sciences, Oregon State University, 2250 SW Jefferson Way, Waldo 445, Corvallis, OR, 97331, USA.
| | - Gulaiim Almatkyzy
- College of Public Health and Human Sciences, Oregon State University, 2250 SW Jefferson Way, Corvallis, OR, 97331, USA
| | - Daisy Morales-Campos
- Latino Research Initiative, The University of Texas at Austin, 210 W. 24th Street|Mailcode F9200, GWB 2.102, Austin, TX, 78712, USA
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Baik SH, Oswald LB, Buscemi J, Buitrago D, Iacobelli F, Perez-Tamayo A, Guitelman J, Penedo FJ, Yanez B. Patterns of Use of Smartphone-Based Interventions Among Latina Breast Cancer Survivors: Secondary Analysis of a Pilot Randomized Controlled Trial. JMIR Cancer 2020; 6:e17538. [PMID: 33289669 PMCID: PMC7755528 DOI: 10.2196/17538] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 06/10/2020] [Accepted: 11/11/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Latina breast cancer survivors experience poorer health-related quality of life (HRQoL), greater symptom burden, and more psychosocial needs compared to non-Latina breast cancer survivors. eHealth platforms such as smartphone apps are increasingly being used to deliver psychosocial interventions to cancer survivors. However, few psychosocial eHealth interventions have been developed specifically for Latina breast cancer survivors. Further, little is known about how Latinas, in general, engage with eHealth interventions and whether specific participant characteristics are associated with app use in this population. We evaluated the use of 2 culturally informed, evidence-based smartphone apps for Latina breast cancer survivors-one that was designed to improve HRQoL and reduce symptom burden (My Guide) and the other to promote healthy lifestyle behaviors (My Health). OBJECTIVE The objectives of our study were to explore the patterns of use of the My Guide intervention app and My Health attention-control app among Latina breast cancer survivors. METHODS Eighty Latina breast cancer survivors were randomized to use the My Guide or My Health app for 6 weeks. Assessments were collected at baseline (T1), immediately after the 6-week intervention (T2), and 2 weeks after T2 (T3). Specific study outcomes included subdomains of HRQoL, symptom burden, cancer-specific distress, cancer-relevant self-efficacy, and breast cancer knowledge. RESULTS On average, participants used their assigned app for more than 1 hour per week. Sociodemographic or psychological characteristics were not significantly associated with app use, except for employment status in the My Health group. Content related to common physical and emotional symptoms of breast cancer survivors as well as recommendations for nutrition and physical activity were most frequently accessed by My Guide and My Health participants, respectively. Lastly, clinically meaningful improvements were demonstrated in breast cancer well-being among low app users (ie, <60 minutes of use/week) of My Guide and social well-being among high app users (ie, ≥60 minutes of use/week) of My Health. CONCLUSIONS The favorable rates of participant use across both apps suggest that Latina breast cancer survivors are interested in the content delivered across both My Guide and My Health. Furthermore, since sociodemographic variables, excluding employment status, and baseline HRQoL (psychological variable) were not related to app use, My Guide and My Health may be accessible to diverse Latina breast cancer survivors. TRIAL REGISTRATION ClinicalTrials.gov NCT03645005; https://clinicaltrials.gov/ct2/show/NCT03645005.
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Affiliation(s)
- Sharon H Baik
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Supportive Care Medicine, City of Hope, Duarte, CA, United States
| | - Laura B Oswald
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Joanna Buscemi
- Department of Psychology, DePaul University, Chicago, IL, United States
| | - Diana Buitrago
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Francisco Iacobelli
- Department of Computer Science, Northeastern Illinois University, Chicago, IL, United States
| | | | - Judith Guitelman
- ALAS-WINGS, The Latina Association for Breast Cancer, Chicago, IL, United States
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, United States
| | - Betina Yanez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Agénor M, Pérez AE, Tabaac AR, Bond KT, Charlton BM, Bowen DJ, Austin SB. Sexual Orientation Identity Disparities in Mammography Among White, Black, and Latina U.S. Women. LGBT Health 2020; 7:312-320. [PMID: 32668184 PMCID: PMC7475089 DOI: 10.1089/lgbt.2020.0039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose: Our goal was to examine sexual orientation identity disparities in mammography in relationship to race/ethnicity among U.S. women. Methods: Using nationally representative 2013-2017 National Health Interview Survey data, we used multivariable logistic regression to estimate the odds of receiving a mammogram in the past year in relationship to sexual orientation identity among White, Black, and Latina U.S. women 40-75 years of age (N = 45,031) separately, adjusting for demographic factors. We also assessed whether socioeconomic and health care factors attenuated sexual orientation identity disparities in mammography across racial/ethnic groups. Results: Among White women, bisexual women had significantly lower adjusted odds of mammography compared to heterosexual women (odds ratio = 0.70, 95% confidence interval: 0.50-0.99). Among Black women, the adjusted odds of mammography were significantly higher among bisexual women relative to heterosexual women (2.53, 1.08-5.92). Black lesbian women appeared to have lower adjusted odds of mammography compared to their heterosexual counterparts; however, this difference was not statistically significant (0.80, 0.46-1.38). Similarly, among Latina women, lesbian women also seemed to have lower adjusted odds of mammography relative to heterosexual women, but this disparity was also not statistically significant (0.64, 0.37-1.13). Adding socioeconomic factors completely attenuated the disparity between White bisexual and heterosexual women (0.76, 0.52-1.10). Conclusions: Sexual orientation identity disparities in receiving a mammogram in the past year differed in relationship to race/ethnicity among White, Black, and Latina U.S. women. Additional research with larger samples of Black and Latina lesbian and bisexual women is needed to more accurately estimate and explain observed differences.
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Affiliation(s)
- Madina Agénor
- Department of Community Health, Tufts University, Medford, Massachusetts, USA
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
- Department of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Ashley E. Pérez
- Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Ariella R. Tabaac
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Keosha T. Bond
- Department of Public Health, New York Medical College, Valhalla, New York, USA
| | - Brittany M. Charlton
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Deborah J. Bowen
- Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle, Washington, USA
- Department of Health Services, University of Washington School of Public Health, Seattle, Washington, USA
| | - S. Bryn Austin
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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7
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Chebli P, Lemus J, Avila C, Peña K, Mariscal B, Merlos S, Guitelman J, Molina Y. Multilevel determinants of financial toxicity in breast cancer care: perspectives of healthcare professionals and Latina survivors. Support Care Cancer 2020; 28:3179-3188. [PMID: 31712953 PMCID: PMC7214214 DOI: 10.1007/s00520-019-05119-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 10/02/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE Financial toxicity is a multidimensional side effect of cancer treatment. Yet, most relevant research has focused on individual-level determinants of financial toxicity and characterized only patient perspectives. This study examined the multilevel determinants of financial toxicity from the perspectives of Latina breast cancer survivors and healthcare professionals. METHODS We analyzed qualitative data from focus groups with 19 Latina breast cancer survivors and interviews with 10 healthcare professionals recruited through community partners and venues in Chicago. RESULTS At the individual-level, the lack of knowledge and prioritization regarding financial aspects of care (e.g., costs of treatment, insurance coverage) was identified as important determinants of financial toxicity. However, healthcare professionals emphasized the need for early financial planning, while survivors prioritized survival over financial concerns immediately after diagnosis. At the interpersonal-level, social networks were identified as important platforms for disseminating information on financial resources. At the community-level, community norms and dynamics were identified as important barriers to seeking financial assistance. Access to culturally astute community-based organizations was considered one potential solution to eliminate these barriers. At the organizational/healthcare policy-level, financial assistance programs' restrictive eligibility criteria, lack of coverage post-treatment, limited availability, and instability were identified as major determinants of financial toxicity. CONCLUSION Our findings suggest that multilevel interventions at the individual-, interpersonal-, community-, and organizational/healthcare policy-levels are needed to adequately address financial toxicity among Latina and other survivors from disadvantaged communities.
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Affiliation(s)
- Perla Chebli
- School of Public Health, University of Illinois at Chicago, 649 SPHPI MC923, Chicago, IL, USA
| | - Jocelyne Lemus
- School of Public Health, University of Illinois at Chicago, 649 SPHPI MC923, Chicago, IL, USA
| | - Corazón Avila
- School of Public Health, University of Illinois at Chicago, 649 SPHPI MC923, Chicago, IL, USA
| | - Kryztal Peña
- School of Public Health, University of Illinois at Chicago, 649 SPHPI MC923, Chicago, IL, USA
| | | | | | | | - Yamilé Molina
- School of Public Health, University of Illinois at Chicago, 649 SPHPI MC923, Chicago, IL, USA.
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Richman AR, Torres E, Wu Q, Kampschroeder AP. Evaluating a Community-Based Breast Cancer Prevention Program for Rural Underserved Latina and Black Women. J Community Health 2020; 45:1205-1210. [PMID: 32529466 DOI: 10.1007/s10900-020-00856-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Persistent racial and ethnic disparities and rural-urban disparities in breast cancer mortality in North Carolina require attention. The Pitt County Breast Wellness Initiative-Education (PCBWI-E) provided culturally tailored breast cancer education and navigation to age-appropriate screening services (mammography and clinical breast exams) for uninsured and underinsured Black and Latina women age 25 and older in two rural counties in North Carolina (Pitt and Edgecombe Counties). Using a lay health model, the PCBWI-E trained 23 community members and public health undergraduate students as lay breast health educators. Breast health educators educated 735 women across the 2-year program. Baseline knowledge about breast health was low at year 1 and 2 (mean knowledge score = 59%, SD = 0.21 and 57%, SD = 0.22, respectively) and was higher at follow-up post-intervention for both years 1 and 2 (mean knowledge score = 78%, SD = 0.18 and 75%, SD = 0.19, respectively) (p < 0.001). In terms of navigation, almost three-quarters (72%) of those recommended to receive a mammogram, received one. Of the population served by the PCBWI-E who were aged 40 and above, 34% had never received a mammogram. Of those women who had never received a mammogram, 68% received one through the PCBWI-E program. The PCBWI-E was successful in increasing both breast health knowledge and access to age-appropriate breast cancer screening among uninsured and underserved Latina and Black women in rural eastern North Carolina. Future efforts should support the large-scale implementation of successful evidence-based culturally appropriate models like this one in the reduction of racial, ethnic, and rural breast cancer disparities.
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Affiliation(s)
- Alice R Richman
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 3107 Carol Belk Building, Greenville, NC, 27858, USA.
| | - Essie Torres
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 3107 Carol Belk Building, Greenville, NC, 27858, USA
| | - Qiang Wu
- Department of Biostatistics, College of Allied Health Sciences, East Carolina University, Health Sciences Building, Greenville, NC, USA
| | - Amy P Kampschroeder
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 3107 Carol Belk Building, Greenville, NC, 27858, USA
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Calidad de Vida: a systematic review of quality of life in Latino cancer survivors in the USA. Qual Life Res 2020; 29:2615-2630. [PMID: 32430782 DOI: 10.1007/s11136-020-02527-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cancer is the leading cause of death among Hispanics/Latinos. Thus, understanding health-related quality of life (HRQOL) needs among this diverse racial/ethnic group is critical. Using Ferrell's multidimensional framework for measuring QOL, we synthesized evidence on HRQOL needs among Hispanic/Latino cancer survivors. METHODS We searched MEDLINE/PubMed, EMBASE, CINAHL, and PsycINFO, for English language articles published between 1995 and January 2020, reporting HRQOL among Hispanic/Latino cancer survivors in the USA. RESULTS Of the 648 articles reviewed, 176 met inclusion criteria, with 100 of these studies focusing exclusively on breast cancer patients and no studies examining end-of-life HRQOL issues. Compared with other racial/ethnic groups, Hispanics/Latinos reported lower HRQOL and a higher symptom burden across multiple HRQOL domains. Over 80% of studies examining racial/ethnic differences in psychological well-being (n = 45) reported worse outcomes among Hispanics/Latinos compared with other racial/ethnic groups. Hispanic/Latino cancer survivors were also more likely to report suboptimal physical well-being in 60% of studies assessing racial/ethnic differences (n = 27), and Hispanics/Latinos also reported lower social well-being relative to non-Hispanics/Latinos in 78% of studies reporting these outcomes (n = 32). In contrast, reports of spiritual well-being and spirituality-based coping were higher among Hispanics/Latinos cancer survivors in 50% of studies examining racial/ethnic differences (n = 15). DISCUSSION Findings from this review point to the need for more systematic and tailored interventions to address HRQOL needs among this growing cancer survivor population. Future HRQOL research on Hispanics/Latinos should evaluate variations in HRQOL needs across cancer types and Hispanic/Latino subgroups and assess HRQOL needs during metastatic and end-of-life disease phases.
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Elimimian E, Elson L, Bilani N, Farrag SE, Dwivedi AK, Pasillas R, Nahleh ZA. Long-Term Effect of a Nonrandomized Psychosocial Mindfulness-Based Intervention in Hispanic/Latina Breast Cancer Survivors. Integr Cancer Ther 2020; 19:1534735419890682. [PMID: 31957499 PMCID: PMC6971966 DOI: 10.1177/1534735419890682] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: There is a paucity of research on the long-term impact of stress-reduction in Hispanic/Latina breast cancer (BC) survivors, a growing minority. In this article, we assess the long-term efficacy of an 8-week training program in mindfulness-based stress reduction (MBSR) on quality of life (QoL) in Hispanic BC survivors. Methods: Hispanic BC survivors, within the first 5 years of diagnosis, stages I to III BC, were recruited. Participants were enrolled in bilingual, 8-week intensive group training in MBSR and were asked to practice a- home, daily. They were also provided with audio recordings and a book on mindfulness practices. Patient-reported outcomes for QoL and distress were evaluated at baseline, and every 3 months, for 24 months. Results: Thirty-three self-identified Hispanic women with BC completed the MBSR program and were followed at 24 months. Statistically significant reduction was noted for the Generalized Anxiety Disorder measure (mean change −2.39, P=0.04); and Patient Health Questionnaire (mean change −2.27, P=0.04), at 24 months, compared with baseline. Improvement was noted in the Short-Form 36 Health-related QoL Mental Component Summary with an increase of 4.07 (95% confidence interval = 0.48-7.66, P=0.03). However, there was no significant change in the Physical Component Summary. Conclusions: Hispanic BC survivors who participated in an 8-week MBSR–based survivorship program reported persistent benefits with reduced anxiety, depression, and improved mental health QoL over 24 months of follow-up. Stress reduction programs are beneficial and can be implemented as part of a comprehensive survivorship care in BC patients.
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Affiliation(s)
| | - Leah Elson
- Maroone Cancer Center, Cleveland Clinic, Weston, FL, USA
| | - Nadeem Bilani
- Maroone Cancer Center, Cleveland Clinic, Weston, FL, USA
| | | | | | | | - Zeina A Nahleh
- Maroone Cancer Center, Cleveland Clinic, Weston, FL, USA
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Patel BK, Ridgeway JL, Ghosh K, Rhodes DJ, Borah B, Jenkins S, Suman VJ, Norman A, Jewett M, Singh D, Vachon CM, Radecki Breitkopf C. Behavioral and psychological impact of returning breast density results to Latinas: study protocol for a randomized clinical trial. Trials 2019; 20:744. [PMID: 31852492 PMCID: PMC6921571 DOI: 10.1186/s13063-019-3939-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 11/26/2019] [Indexed: 01/07/2023] Open
Abstract
Background Breast cancer is the most common cancer and the leading cause of cancer mortality among Latinas. As more is learned about the association between mammographic breast density (MBD) and breast cancer risk, a number of U.S. states adopted legislation and now a federal law mandates written notification of MBD along with mammogram results. These notifications vary in content and readability, though, which may limit their effectiveness and create confusion or concern, especially among women with low health literacy or barriers to screening. The purpose of this study is to determine whether educational enhancement of MBD notification results in increased knowledge, decreased anxiety, and adherence to continued mammography screening among Latina women in a limited-resources setting. Methods Latinas LEarning About Density (LLEAD) is a randomized clinical trial (RCT) comparing the impact of three notification approaches on behavioral and psychological outcomes in Latina women. Approximately 2000 Latinas undergoing screening mammography in a safety-net community clinic will be randomized 1:1:1 to mailed notification (usual care); mailed notification plus written educational materials (enhanced); or mailed notification, written educational materials, plus verbal explanation by a promotora (interpersonal). The educational materials and verbal explanations are available in Spanish or English. Mechanisms through which written or verbal information influences future screening motivation and behavior will be examined, as well as moderating factors such as depression and worry about breast cancer, which have been linked to diagnostic delays among Latinas. The study includes multiple psychological measures (anxiety, depression, knowledge about MBD, perceived risk of breast cancer, worry, self-efficacy) and behavioral outcomes (continued adherence to mammography). Measurement time points include enrollment, 2–4 weeks post-randomization, and 1 and 2 years post-randomization. Qualitative inquiry related to process and outcomes of the interpersonal arm and cost analysis related to its implementation will be undertaken to understand the intervention’s delivery and transferability. Discussion Legislation mandating written MBD notification may have unintended consequences on behavioral and psychological outcomes, particularly among Latinas with limited health literacy and resources. This study has implications for cancer risk communication and will offer evidence on the potential of generalizable educational strategies for delivering information on breast density to Latinas in limited-resource settings. Trial registration ClinicalTrials.gov, NCT02910986. Registered on 21 September 2016. Items from the WHO Trial Registration Data Set can be found in this protocol.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Matt Jewett
- Mountain Park Health Center, Phoenix, AZ, USA
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12
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Yanez B, Baik SH, Oswald LB, Buitrago D, Buscemi J, Iacobelli F, Perez-Tamayo A, Fajardo P, Serrano G, Guitelman J, Penedo FJ. An Electronic Health Intervention for Latina Women Undergoing Breast Cancer Treatment (My Guide for Breast Cancer Treatment): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e14339. [PMID: 31833834 PMCID: PMC6935046 DOI: 10.2196/14339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/09/2019] [Accepted: 08/13/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Among Latinas and Hispanics (henceforth referred to as Latinas), breast cancer is the most commonly diagnosed cancer and the leading cause of cancer-related deaths. However, few interventions have been developed to meet the needs of Latina women undergoing active treatment for breast cancer. OBJECTIVE This paper aims to describe the procedures and methods of My Guide for Breast Cancer Treatment and the plans for conducting a multisite randomized controlled trial to investigate the feasibility and preliminary efficacy of this smartphone-based app for Latina women in active treatment for breast cancer. METHODS Study participants will be randomized to the My Guide for Breast Cancer Treatment intervention or the enhanced usual care control condition for 12 weeks. Participants will have access to innovative features such as gamification via virtual awards to reinforce usage and an adaptive section that presents targeted material based on their self-reported concerns and needs. Using a stepped-care approach, intervention participants will also receive telecoaching to enhance their adherence to the app. Study outcomes and intervention targets will be measured at study enrollment (before randomization), 6 and 12 weeks after initial app use. General and disease-specific health-related quality of life (HRQoL) and symptom burden are the study's primary outcomes, whereas anxiety, depression, fear of cancer recurrence, physical activity, and dietary intake are secondary outcomes. RESULTS Recruitment began in August 2019 and is expected to be completed by August 2020. We expect to submit study results for publication by fall 2020. CONCLUSIONS My Guide for Breast Cancer Treatment has the potential to improve HRQoL and reduce symptom burden, and increase access to supportive care resources among Latina breast cancer patients. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/14339.
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Affiliation(s)
- Betina Yanez
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Sharon H Baik
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Laura B Oswald
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Diana Buitrago
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | | | | | | | - Precilla Fajardo
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Gabriela Serrano
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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13
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Disparities in Postmastectomy Breast Reconstruction: A Systematic Review of the Literature and Modified Framework for Advancing Research Toward Intervention. Ann Plast Surg 2019; 81:495-502. [PMID: 29851727 DOI: 10.1097/sap.0000000000001503] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND As the United States' population diversifies, eliminating disparities in health and healthcare has become increasingly important across all disciplines of medicine, including plastic and reconstructive surgery. This is evidenced by the growing body of literature in recent years focusing on disparities in postmastectomy breast reconstruction. No study to date has evaluated whether this research is progressing appropriately to promote tangible evidence-based interventions to reduce these disparities. METHODS A systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines was performed to identify studies focusing on disparities in postmastectomy breast reconstruction. A previously established public health framework for advancing health disparities research was used to inform analysis of the quality and progression of the included studies. This triphasic framework categorizes disparities research as follows: detecting (identifies and measures disparities in vulnerable populations), understanding (establishes determinants of disparities), or reducing (proposes and evaluates interventions for eliminating disparities). RESULTS Ninety-five studies were identified between 1979 and 2016, with 61 (64.2%) published after 2010. The majority of studies (51.6%) were retrospective cohort or case-control studies (American Society of Plastic Surgery level III evidence). Fifty-eight (63.7%), 31 (34.1%), and 2 (2.2%) studies provided detecting-, understanding- and reducing-phase disparities research, respectively. Non-plastic and reconstructive surgery journals accounted for 70.5% of all articles and for most higher phase research articles, publishing 83.9% and 100% of second and third phase studies, respectively. Disparity categories investigated included race/ethnicity, age, income, insurance status/type, geography, and education level, with race/ethnicity being the most common (73.7%). The most commonly measured outcome was percent of subpopulation receiving reconstruction (63, 66.3%), followed by reconstruction type (14, 16.7%). Patient-, provider-, system-, and research-level factors were all identified as potential targets for interventions to reduce disparities. CONCLUSIONS Despite a recent increase in literature focusing on postmastectomy breast reconstruction disparities, the majority focuses on identifying vulnerable populations with inadequate progression to second (understanding) and third (reducing) phases. Increasing research funding, availability of language-concordant and culturally concordant educational materials, and advocacy and sociopolitical awareness within the plastic surgery community is necessary to advance research on postmastectomy breast reconstruction and, ultimately, eliminate it.
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Sugita BM, Pereira SR, de Almeida RC, Gill M, Mahajan A, Duttargi A, Kirolikar S, Fadda P, de Lima RS, Urban CA, Makambi K, Madhavan S, Boca SM, Gusev Y, Cavalli IJ, Ribeiro EMSF, Cavalli LR. Integrated copy number and miRNA expression analysis in triple negative breast cancer of Latin American patients. Oncotarget 2019; 10:6184-6203. [PMID: 31692930 PMCID: PMC6817452 DOI: 10.18632/oncotarget.27250] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 09/16/2019] [Indexed: 12/18/2022] Open
Abstract
Triple negative breast cancer (TNBC), a clinically aggressive breast cancer subtype, affects 15–35% of women from Latin America. Using an approach of direct integration of copy number and global miRNA profiling data, performed simultaneously in the same tumor specimens, we identified a panel of 17 miRNAs specifically associated with TNBC of ancestrally characterized patients from Latin America, Brazil. This panel was differentially expressed between the TNBC and non-TNBC subtypes studied (p ≤ 0.05, FDR ≤ 0.25), with their expression levels concordant with the patterns of copy number alterations (CNAs), present mostly frequent at 8q21.3-q24.3, 3q24-29, 6p25.3-p12.2, 1q21.1-q44, 5q11.1-q22.1, 11p13-p11.2, 13q12.11-q14.3, 17q24.2-q25.3 and Xp22.33-p11.21. The combined 17 miRNAs presented a high power (AUC = 0.953 (0.78–0.99);95% CI) in discriminating between the TNBC and non-TNBC subtypes of the patients studied. In addition, the expression of 14 and 15 of the 17miRNAs was significantly associated with tumor subtype when adjusted for tumor stage and grade, respectively. In conclusion, the panel of miRNAs identified demonstrated the impact of CNAs in miRNA expression levels and identified miRNA target genes potentially affected by both CNAs and miRNA deregulation. These targets, involved in critical signaling pathways and biological functions associated specifically with the TNBC transcriptome of Latina patients, can provide biological insights into the observed differences in the TNBC clinical outcome among racial/ethnic groups, taking into consideration their genetic ancestry.
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Affiliation(s)
- Bruna M Sugita
- Department of Genetics, Federal University of Paraná, Curitiba, PR, Brazil.,Faculdades Pequeno Príncipe, Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, PR, Brazil
| | - Silma R Pereira
- Department of Biology, Federal University of Maranhão, São Luis, MA, Brazil
| | - Rodrigo C de Almeida
- Department of Biomedical Data Sciences, Section Molecular Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Mandeep Gill
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC, USA
| | - Akanksha Mahajan
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC, USA
| | - Anju Duttargi
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC, USA
| | - Saurabh Kirolikar
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC, USA
| | - Paolo Fadda
- Genomics Shared Resource, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Rubens S de Lima
- Breast Unit, Hospital Nossa Senhora das Graças, Curitiba, PR, Brazil
| | - Cicero A Urban
- Breast Unit, Hospital Nossa Senhora das Graças, Curitiba, PR, Brazil
| | - Kepher Makambi
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University Medical Center, Washington DC, USA
| | - Subha Madhavan
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC, USA.,Innovation Center for Biomedical Informatics (ICBI), Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC, USA
| | - Simina M Boca
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC, USA.,Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University Medical Center, Washington DC, USA.,Innovation Center for Biomedical Informatics (ICBI), Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC, USA
| | - Yuriy Gusev
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC, USA.,Innovation Center for Biomedical Informatics (ICBI), Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC, USA
| | - Iglenir J Cavalli
- Department of Genetics, Federal University of Paraná, Curitiba, PR, Brazil
| | | | - Luciane R Cavalli
- Faculdades Pequeno Príncipe, Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, PR, Brazil.,Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC, USA
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15
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Maxwell AE, Lucas-Wright A, Santifer RE, Vargas C, Gatson J, Chang LC. Promoting Cancer Screening in Partnership With Health Ministries in 9 African American Churches in South Los Angeles: An Implementation Pilot Study. Prev Chronic Dis 2019; 16:E128. [PMID: 31538568 PMCID: PMC6795066 DOI: 10.5888/pcd16.190135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Purpose and Objectives We conducted a pilot study to assess the degree to which an intervention led by community health advisors (CHAs) to promote cancer screening was delivered as intended and to estimate the potential effect of the intervention on receipt of screening. In contrast to previous studies and to maximize its potential public health impact, the intervention targeted 4 screening tests and only participants who were not up to date with screening guidelines for at least 1 cancer. Because CHAs had to both determine baseline adherence and provide counseling on 4 screening tests, the protocol was complex. Complex protocols can reduce implementation fidelity. Intervention Approach In partnership with health ministries at 9 African American churches in South Los Angeles, we conducted a 1-group pretest–posttest pilot study to assess the feasibility of implementing the intervention. CHAs recruited and obtained consent from church members aged 50 to 75 years; assessed adherence to national screening guidelines for breast, cervical, colorectal, and prostate cancer; and provided evidence-based strategies (one-on-one counseling, print materials, reminder calls) to encourage screening for tests that were overdue. Evaluation Methods We assessed implementation fidelity by reviewing baseline screening assessments and counseling scripts completed by CHAs. We estimated potential effect of the intervention on receipt of screening by using data from 3-month follow-up surveys, conducted by the research team, of participants who were nonadherent at baseline. Results From June 2016 to June 2018, 44 CHAs conducted baseline assessments of 775 participants, of whom 338 (44%) were nonadherent to national guidelines for 1 or more cancer screening tests. CHAs provided counseling to most nonadherent participants. At follow-up, about one-third of participants reported that they had discussed cancer screening with their provider and a smaller proportion reported receipt of a screening test; 13% of men and 25% of women reported receipt of colorectal cancer screening. Implications for Public Health This study demonstrates that with training and ongoing technical assistance, CHAs at African American health ministries can implement complex research protocols with good fidelity.
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Affiliation(s)
- Annette E Maxwell
- Center for Cancer Prevention and Control Research, University of California, Los Angeles Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California.,UCLA Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, A2-125 CHS, Box 956900, Los Angeles, CA 90095-6900.
| | - Aziza Lucas-Wright
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, California
| | - Rhonda E Santifer
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, California
| | - Claudia Vargas
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, California
| | - Juana Gatson
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, California
| | - L Cindy Chang
- Center for Cancer Prevention and Control Research, University of California, Los Angeles Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California.,Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, California
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16
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Molina Y, Watson KS, San Miguel LG, Aguirre K, Hernandez-Flores M, Giraldo TB, Lucio A, Coronado N, Matthews PA. Integrating multiple community perspectives in intervention development. HEALTH EDUCATION RESEARCH 2019; 34:357-371. [PMID: 31121040 PMCID: PMC6646948 DOI: 10.1093/her/cyz018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 04/29/2019] [Indexed: 06/09/2023]
Abstract
We offer a framework and exemplify how to integrate multiple community perspectives in research to develop breast cancer screening interventions among Latinas non-adherent to national guidelines. We leverage members of an academic institution's community consultative service [community engagement advisory board (CEAB) members]; study team members [community health workers (CHWs)] and study-eligible individuals (non-adherent Latinas). First, we asked what was needed from CEAB members (N=17), CHWs (N=14) and non-adherent Latinas (N=20) in one-time semi-structured group consultations and focus groups. Second, we drafted materials. Third, we conducted group consultations and focus groups with a new set of CEAB members (N=13), CHWs (N=17) and non-adherent Latinas (N=16) to reflect on our initial analysis and draft materials. Fourth, we finalized interventions. Certain recommendations were shared across stakeholders and simple to integrate (e.g. costs → access to free services). Some recommendations varied, but complementary integration was possible (e.g. location versus recruitment → multiple recruitment in multiple community areas). Others were distinct across stakeholders and resulted in strategies to recognize participants' agency and inform their choices about breast cancer screening (e.g. differences in preferred information about screening → personalized information and evidence about all screening options).
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Affiliation(s)
| | | | - Liliana G San Miguel
- Community Health Sciences Division, University of Illinois at Chicago, Chicago, IL, USA
| | - Karen Aguirre
- Community Health Sciences Division, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Tatiana B Giraldo
- Community Health Sciences Division, University of Illinois at Chicago, Chicago, IL, USA
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Maxwell AE, Santifer R, Chang LC, Gatson J, Crespi CM, Lucas-Wright A. Organizational readiness for wellness promotion - a survey of 100 African American church leaders in South Los Angeles. BMC Public Health 2019; 19:593. [PMID: 31101096 PMCID: PMC6525409 DOI: 10.1186/s12889-019-6895-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 04/25/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Churches are an important asset and a trusted resource in the African American community. We needed a better understanding of their readiness to engage in health promotion before launching a large-scale health promotion effort in partnership with South Los Angeles churches. METHODS In 2017, we conducted surveys with leaders of 100 churches. Surveys were conducted face-to-face (32%) or by telephone (68%) with senior pastors (one per church) and lasted on average 48 min. We compared small (less than 50 active members), medium (50-99 active members) and large churches (at least 100 active members), and assessed which church characteristics were associated with the implementation of wellness activities. RESULTS Medium and large churches conducted significantly more wellness activities than small churches and were more likely to have wellness champions and health policies. Regardless of church size, insufficient budget was the most commonly cited barrier to implement wellness activities (85%). A substantial proportion of churches was not sure how to implement wellness activities (61%) and lacked volunteers (58%). Forty-five percent of the variation in the number of wellness activities in the last 12 months was explained by church characteristics, such as size of congregation, number of paid staff, leadership engagement, having a wellness ministry and barriers. CONCLUSIONS Many churches in South Los Angeles are actively engaged in health promotion activities, despite a general lack of resources. We recommend a comprehensive assessment of church characteristics in intervention studies to enable the use of strategies (e.g., stratification by size) that reduce imbalances that could mask or magnify study outcomes. Our data provide empirical support for the inner settings construct of the Consolidated Framework for Implementation Research in the context of health promotion in African American churches.
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Affiliation(s)
- Annette E Maxwell
- University of California Los Angeles Fielding School of Public Health & Jonsson Comprehensive Cancer Center; UCLA Kaiser Permanente Center for Health Equity, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
| | - Rhonda Santifer
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - L Cindy Chang
- University of California Los Angeles Fielding School of Public Health & Jonsson Comprehensive Cancer Center; UCLA Kaiser Permanente Center for Health Equity, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.,Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Juana Gatson
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Catherine M Crespi
- University of California Los Angeles Fielding School of Public Health & Jonsson Comprehensive Cancer Center; UCLA Kaiser Permanente Center for Health Equity, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
| | - Aziza Lucas-Wright
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
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18
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Meneses K, Gisiger-Camata S, Benz R, Raju D, Bail JR, Benitez TJ, Pekmezi D, McNees P. Telehealth intervention for Latina breast cancer survivors: A pilot. ACTA ACUST UNITED AC 2019; 14:1745506518778721. [PMID: 29807495 PMCID: PMC5977430 DOI: 10.1177/1745506518778721] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Aim: This study was a pilot test of the Latina Breast Cancer Survivorship Intervention, a survivorship self-management intervention delivered via telephone. Materials and methods: This study used a wait-list control design with random assignment to either (1) support and early education or (2) support and delayed education. Latina breast cancer survivors were recruited through the Florida Cancer Data System Registry. Latinas with stage I–III breast cancer who completed primary cancer treatment 3 years prior to study enrollment were eligible. The Latina Breast Cancer Survivorship Intervention consisted of three education sessions delivered weekly via telephone and six telephone support calls, both delivered by a native Spanish speaker. Primary outcome variables included physical well-being, emotional well-being, fatigue, pain, and depressive symptoms. Data collection occurred at baseline, 3 months, and 6 months. Results: In total, 40 Latina breast cancer survivors who were middle-aged to older, married, with health insurance, and Spanish as preferred language enrolled in the Latina Breast Cancer Survivorship Intervention. Data were analyzed using mean change scores. Overall, physical and emotional well-being remained similar over time with well-being scores poorer compared with the general population. Pain levels improved over 6 months and showed a high effect size. Fatigue scores improved at 3 months and showed a moderate effect size. Depressive symptoms remained elevated but were not clinically significant. Conclusion: Telephone-based Latina Breast Cancer Survivorship Intervention reached Latina breast cancer survivors for survivorship education and support. Self-management of pain and fatigue showed improvement over time.
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Affiliation(s)
- Karen Meneses
- Office of Research and Scholarship, School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Silvia Gisiger-Camata
- Office of Research and Scholarship, School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
- Silvia Gisiger-Camata, Office of Research and Scholarship, School of Nursing, The University of Alabama at Birmingham, MT 415A, Birmingham, AL 35294, USA.
| | - Rachel Benz
- Office of Research and Scholarship, School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Dheeraj Raju
- Office of Research and Scholarship, School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jennifer R Bail
- Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tanya J Benitez
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Dorothy Pekmezi
- Department of Health Behavior, School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Patrick McNees
- School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL, USA
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Sleight AG, Lyons KD, Vigen C, Macdonald H, Clark F. The association of health-related quality of life with unmet supportive care needs and sociodemographic factors in low-income Latina breast cancer survivors: a single-centre pilot study. Disabil Rehabil 2018; 41:3151-3156. [PMID: 30052478 DOI: 10.1080/09638288.2018.1485179] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Purpose: Determine correlations between health-related quality of life (HRQOL), supportive care need, and sociodemographic factors in low-income Latina breast cancer survivors.Methods: A descriptive, survey-based, cross-sectional study was completed with 102 low-income Latina breast cancer survivors at a major public safety net hospital. Correlation coefficients were calculated between number of unmet supportive care needs (per Supportive Care Needs Survey), HRQOL (per SF-36), and sociodemographic variables.Results: Unmet supportive care needs were correlated with lower HRQOL in all domains (r > -0.40; p < 0.0001). Lower income was significantly associated with lower HRQOL (r > 0.21; p < 0.05) and more supportive care needs (r = -0.22; p < 0.05). Multimorbidity was significantly associated with decreased HRQOL (r > -0.23; p < 0.05) and greater supportive care need (r = 0.19; p < 0.05).Conclusions: Identifying and addressing unmet supportive care needs may improve HRQOL in low-income Latina breast cancer survivors. Rehabilitation interventions that address barriers to accessing supportive care related to low SES and multimorbidity may also improve health outcomes in this population. The dual effect of multimorbidity on both quality of life and level of supportive care need in this population warrants further investigation.Implications for rehabilitationScreening for unmet supportive care needs may be an important step in improving health-related quality of life during cancer rehabilitation.Challenges accompanying multimorbidity and lower socioeconomic status may prevent low-income cancer patients from accessing adequate supportive care.Rehabilitation interventions for socioeconomically disadvantaged cancer survivors should compensate for both socioeconomic status and the presence of comorbidities in order to reduce disparities in quality of life during survivorship.
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Affiliation(s)
- Alix G Sleight
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Kathleen Doyle Lyons
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.,Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Cheryl Vigen
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Heather Macdonald
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA.,Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Florence Clark
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
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Salinas JJ, Byrd T, Martin C, Dwivedi AK, Alomari A, Salaiz R, Shokar NK. Change in Breast Cancer Screening Knowledge is Associated With Change in Mammogram Intention in Mexican-Origin Women After an Educational Intervention. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2018; 12:1178223418782904. [PMID: 29977113 PMCID: PMC6024335 DOI: 10.1177/1178223418782904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/14/2018] [Indexed: 11/29/2022]
Abstract
Purpose: To determine the relationship between breast cancer screening knowledge and intent to receive a mammogram within 6 months in a sample of Mexican-origin women living in El Paso, Texas. Methods: A total of 489 uninsured Mexican-origin women were assigned to treatment or control and completed surveys at pre- and postintervention. Pre-post associations between breast cancer screening knowledge and intent were tested. Results: Participants were on average were 56.7 years of age and spoke primarily Spanish (92.6%). Most of the samples had not had a mammogram in 3 or more years (51.6%) and 14.6% had never had a mammogram. At baseline, the majority intended to be screened for breast cancer within the next 6 months (93.4%). At postintervention, half of the intervention group changed their 6-month intent to be screened for breast cancer from likely to unlikely. Change in intent was associated with a change in knowledge of risk of having a first child by the age of 30 and breast cancer being rare after the age of 70. Discussion: Intent to be screened for breast cancer in Mexican-origin women may be influenced by the type of knowledge. Conclusions: Change in screening knowledge may influence perceived risk that influences intention to be screened.
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Affiliation(s)
- Jennifer J Salinas
- Center of Emphasis in Cancer, Department of Biomedical Sciences, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA.,Department of Family and Community Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - Theresa Byrd
- Department of Public Health, Texas Tech Health University Sciences Center El Paso, El Paso, TX, USA
| | - Charmaine Martin
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - Alok K Dwivedi
- Department of Biomedical Sciences, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - Adam Alomari
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - Rebekah Salaiz
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - Navkiran K Shokar
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
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21
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Molina Y, San Miguel LG, Tamayo L, Robledo C, Díaz CS, Lucio A, Coronado N, Ferrans CE. The "Empowering Latinas to Obtain Breast Cancer Screenings" study: Rationale and design. Contemp Clin Trials 2018; 71:1-8. [PMID: 29803815 DOI: 10.1016/j.cct.2018.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/08/2018] [Accepted: 05/22/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Latinas suffer disproportionately from breast cancer (BC) in part due to lower guideline-concordant screening. Multiple intervention approaches have been developed to promote screening through direct patient education and empowerment approaches (i.e., training community members to share BC information). This study compares the relative effects of these approaches on: 1) women's BC screening; and, 2) women's dissemination of BC information within their social networks. DESIGN/METHODS Our quasi-experimental trial is being implemented in community venues in two predominantly Latino neighborhoods in South and West Chicago. Eligible participants: 1) are female; 2) are 52-74 years old; 3) have not obtained a mammogram in the past 2 years; and, 4) have not previously participated in health-related volunteerism. Based on their geographic location, participants are assigned to one of two group-based interventions. Both interventions consist of three two-hour sessions, which includes BC early detection education. The education intervention sessions also covers BC prevention (diet, physical activity), whereas the empowerment intervention covers sharing information with family/friends, and health volunteerism. Navigation is provided for all women who wish to obtain mammograms. Primary outcomes include: 1) receipt of BC screening; and, 2) participants' dissemination of BC information. Secondary outcomes include positive changes in 1) participants' self-reported psychosocial facilitators; and, 2) social network members' BC behaviors. DISCUSSION The design of our program allows for a preliminary comparison of the effectiveness of these two approaches. This work will inform larger comparativeness trials and offers a new approach to intervention evaluation via social network analysis.
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22
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Iacobelli F, Adler RF, Buitrago D, Buscemi J, Corden ME, Perez-Tamayo A, Penedo FJ, Rodriguez M, Yanez BR. Designing an mHealth application to bridge health disparities in Latina breast cancer survivors: a community-supported design approach. ACTA ACUST UNITED AC 2018; 2:58-76. [PMID: 30506017 DOI: 10.1080/24735132.2018.1452871] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Latina breast cancer patients in the USA report significantly worse cancer-related symptom burden and health-related quality of life than non-Hispanic whites. However, health literacy (e.g. knowledge about cancer, coping skills and communication) has been found to improve quality of life. In this paper, we present a case study of the methodology used to design Mi Guía (My Guide), a mobile application that aims to improve symptom burden and health-related quality of life among Hispanic women who have completed active treatment for breast cancer by increasing their health literacy. We developed a community-supported approach to building the application, which involved: (1) eliciting feedback from community leaders such as support group organizers and facilitators who are bilingual in Spanish and English, prioritize patients' preferences and best interests and have a unique knowledge of the women and their needs;(2) conducting a formal evaluation of design principles based on previous interaction design research and user responses;(3) incorporating feedback from potential future users. In this paper, we discuss our methodology, and the challenges and benefits of this approach. We believe that future studies that aim to develop mobile technologies for underserved populations may benefit from a community-supported approach to design.
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Affiliation(s)
- Francisco Iacobelli
- Department of Computer Science, Northeastern Illinois University, Chicago, IL, USA
| | - Rachel F Adler
- Department of Computer Science, Northeastern Illinois University, Chicago, IL, USA
| | - Diana Buitrago
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Joanna Buscemi
- Department of Psychology, DePaul University, Chicago, IL, USA.,institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Marya E Corden
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Frank J Penedo
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Melinda Rodriguez
- Department of Computer Science, Northeastern Illinois University, Chicago, IL, USA
| | - Betina R Yanez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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23
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Molina Y, McKell MS, Mendoza N, Barbour L, Berrios NM, Murray K, Ferrans CE. Health Volunteerism and Improved Cancer Health for Latina and African American Women and Their Social Networks: Potential Mechanisms. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:59-66. [PMID: 27328950 PMCID: PMC5179314 DOI: 10.1007/s13187-016-1061-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Health volunteerism has been associated with positive health outcomes for volunteers and the communities they serve. This work suggests that there may be an added value to providing underserved populations with information and skills to be agents of change. The current study is a first step toward testing this hypothesis. The purpose is to identify how volunteerism may result in improved cancer health among Latina and African American women volunteers. A purposive sample of 40 Latina and African American female adults who had participated in cancer volunteerism in the past 5 years was recruited by community advocates and flyers distributed throughout community venues in San Diego, CA. This qualitative study included semi-structured focus groups. Participants indicated that volunteerism not only improved their health but also the health of their family and friends. Such perceptions aligned with the high rates of self-report lifetime cancer screening rates among age-eligible patients (e.g., 83-93 % breast; 90-93 % cervical; 79-92 % colorectal). Identified mechanisms included exposure to evidence-based information, health-protective social norms and support, and pressure to be a healthy role model. Our findings suggest that train-the-trainer and volunteer-driven interventions may have unintended health-protective effects for participating staff, especially Latina and African American women.
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Affiliation(s)
- Yamile Molina
- University of Illinois at Chicago, Chicago, IL, USA.
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
| | | | | | - Lynda Barbour
- American Cancer Society Cancer Action Network, Washington, DC, USA
| | | | - Kate Murray
- University of California, San Diego, CA, USA
- Queensland University of Technology, Brisbane, Australia
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24
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Yanez BR, Buitrago D, Buscemi J, Iacobelli F, Adler RF, Corden ME, Perez-Tamayo A, Guitelman J, Penedo FJ. Study design and protocol for My Guide: An e-health intervention to improve patient-centered outcomes among Hispanic breast cancer survivors. Contemp Clin Trials 2018; 65:61-68. [PMID: 29198729 PMCID: PMC6040887 DOI: 10.1016/j.cct.2017.11.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 11/28/2017] [Accepted: 11/29/2017] [Indexed: 10/18/2022]
Abstract
Breast cancer is the most commonly diagnosed non-skin cancer in women and the leading cause of death among Hispanic women living in the United States. Relative to non-Hispanic white women, Hispanic women report poorer health related quality of life (HRQoL) after treatment. Although eHealth interventions delivered via Smartphones are a viable approach to addressing supportive care accessibility issues while also integrating multidisciplinary approaches for improving HRQoL, few eHealth interventions have been developed that specifically target Hispanic breast cancer survivors (BCS). This manuscript describes the methodology of a multi-site, randomized controlled behavioral trial investigating the feasibility and preliminary efficacy of a Smartphone application aimed at improving HRQoL and cancer-specific distress among Hispanic BCS. Participants will be randomized to receive the intervention application, My Guide (psychoeducation & self-management program), or the health education control condition application, My Health (health education), for six weeks. All participants will also receive weekly telecoaching to enhance adherence to both control and intervention conditions. We will measure the study's primary outcomes, general and disease-specific HRQoL and cancer-specific distress, at three time points: prior to, immediately after the intervention, and eight weeks after initial application use. My Guide may have the potential to improve HRQoL, and to address issues of limited access to supportive care among Hispanic women recovering from breast cancer treatment.
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Affiliation(s)
- Betina R Yanez
- Northwestern University, Department of Medical Social Sciences, 633 N St. Clair St. 19th Floor, Chicago, IL 60611, United States.
| | - Diana Buitrago
- Northwestern University, Department of Medical Social Sciences, 633 N St. Clair St. 19th Floor, Chicago, IL 60611, United States
| | - Joanna Buscemi
- DePaul University, Department of Psychology, 2219 N Kenmore Ave., Chicago, IL 60614, United States; University of Illinois at Chicago, Institute for Health Research and Policy, 1747 W Roosevelt Rd., Chicago, IL 60608, United States
| | - Francisco Iacobelli
- Northeastern Illinois University, Department of Computer Science, 5500 N St. Louis Ave., Chicago, IL 60625, United States
| | - Rachel F Adler
- Northeastern Illinois University, Department of Computer Science, 5500 N St. Louis Ave., Chicago, IL 60625, United States
| | - Marya E Corden
- Northwestern University, Department of Medical Social Sciences, 633 N St. Clair St. 19th Floor, Chicago, IL 60611, United States
| | - Alejandra Perez-Tamayo
- University of Illinois at Chicago, Department of Surgery, 1801 W Taylor St., Chicago, IL 60608, United States
| | - Judy Guitelman
- ALAS-WINGS, The Latina Association for Breast Cancer, 3023 N Clark St. Suite 613, Chicago, IL 60657, United States
| | - Frank J Penedo
- Northwestern University, Department of Medical Social Sciences, 633 N St. Clair St. 19th Floor, Chicago, IL 60611, United States
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25
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Molina Y, Pichardo CM, Patrick DL, Ramsey SD, Bishop S, Beresford SAA, Coronado GD. Estimating the costs and cost-effectiveness of promoting mammography screening among US-based Latinas. JOURNAL OF HEALTH DISPARITIES RESEARCH AND PRACTICE 2018; 12:10. [PMID: 34414017 PMCID: PMC8373201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE We characterize the costs and cost-effectiveness of a community health worker (CHW)-based intervention to promote screening mammography among US-based non-adherent Latinas. METHODS The parent study was a randomized controlled trial for 536 Latinas aged 42-74 years old who had sought care within a safety net health center in Western Washington. Participants were block-randomized within clinic to the control arm (usual care) or intervention arm (CHW-led motivational interviewing intervention). We used the perspective of the organization implementing promotional activities to characterize costs and cost-effectiveness. Cost data were categorized as program set-up and maintenance (initial training, booster/annual training) program implementation (administrative activities, intervention delivery); and, overhead/miscellaneous expenses. Cost-effectiveness was calculated as the incremental cost of screening for each additional woman screened between the intervention and control arms. RESULTS The respective costs per participant for standard care and the intervention arm were $69.96 and $300.99. There were no study arm differences in 1-year QALYs were small among women who completed a 12-month follow-up survey (intervention= 0.8827, standard care = 0.8841). Most costs pertained to program implementation and administrative activities specifically. The incremental cost per additional woman screened was $2,595.32. CONCLUSIONS Our findings are within the ranges of costs and cost-effectiveness for other CHW programs to promote screening mammography among underserved populations. Our strong study design and focus on non-adherent women provides important strengths to this body of work, especially give implementation and dissemination science efforts regarding CHW-based health promotion for health disparity populations.
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Affiliation(s)
| | | | - Donald L Patrick
- University of Washington and the Fred Hutchinson Cancer Research Center
| | - Scott D Ramsey
- University of Washington and the Fred Hutchinson Cancer Research
| | - Sonia Bishop
- University of Washington and the Fred Hutchinson Cancer Research
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26
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Scheel JR, Tillack AA, Mercer L, Coronado GD, Beresford SAA, Molina Y, Thompson B. Mobile Versus Fixed Facility: Latinas' Attitudes and Preferences for Obtaining a Mammogram. J Am Coll Radiol 2018; 15:19-28. [PMID: 29055611 PMCID: PMC5756515 DOI: 10.1016/j.jacr.2017.08.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 08/27/2017] [Accepted: 08/28/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE Mobile mammographic services have been proposed as a way to reduce Latinas' disproportionate late-stage presentation compared with white women by increasing their access to mammography. The aims of this study were to assess why Latinas may not use mobile mammographic services and to explore their preferences after using these services. METHODS Using a mixed-methods approach, a secondary analysis was conducted of baseline survey data (n = 538) from a randomized controlled trial to improve screening mammography rates among Latinas in Washington. Descriptive statistics and bivariate regression were used to characterize mammography location preferences and to test for associations with sociodemographic indices, health care access, and perceived breast cancer risk and beliefs. On the basis of these findings, a qualitative study (n = 18) was used to explore changes in perceptions after using mobile mammographic services. RESULTS More Latinas preferred obtaining a mammogram at a fixed facility (52.3% [n = 276]) compared with having no preference (46.3% [n = 249]) and preferring mobile mammographic services (1.7% [n = 9]). Concerns about privacy and comfort (15.6% [n = 84]) and about general quality (10.6% [n = 57]) were common reasons for preferring a fixed facility. Those with no history of mammography preferred a fixed facility (P < .05). In the qualitative study, Latinas expressed similar initial concerns but became positive toward the mobile mammographic services after obtaining a mammogram. CONCLUSIONS Although most Latinas preferred obtaining a mammogram at a fixed facility, positive experiences with mobile mammography services changed their attitudes toward them. These findings highlight the need to include community education when using mobile mammographic service to increase screening mammography rates in underserved communities.
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Affiliation(s)
- John R Scheel
- Department of Radiology, University of Washington, Seattle Cancer Care Alliance, Seattle, Washington.
| | - Allison A Tillack
- Department of Radiology, University of Washington, Seattle, Washington
| | | | | | | | - Yamile Molina
- Community Health Sciences Division, School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - Beti Thompson
- Fred Hutchinson Cancer Research Center, Seattle, Washington
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27
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Sanchez-Birkhead AC, Carbajal-Salisbury S, Larreta JA, Lovlien L, Hendricks H, Dingley C, Beck SL. A Community-Based Approach to Assessing the Physical, Emotional, and Health Status of Hispanic Breast Cancer Survivors. HISPANIC HEALTH CARE INTERNATIONAL 2017; 15:166-172. [PMID: 29164912 DOI: 10.1177/1540415317738016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Latina breast cancer survivors in the United States face disproportionate risk for poorer quality of life and physical health, as well as greater emotional distress. METHOD A cross-sectional survey was conducted to describe the physical, emotional, and general health status of 135 Latina breast cancer survivors served by a community-based program. RESULTS Of the 135 surveys sent, 48 survivors responded. Of those who responded, time since diagnosis ranged from 0 to 24 years ( M = 4.37; SD = 5.54); and 45.9% of the women rated physical health as poor or fair. Fatigue prevalence was high, with 60.5% reporting fatigue as moderate or severe. Nearly 80% reported having pain (score >0); 38.3% reported pain was moderate or severe. The women reported mild levels of anxiety and depression but high levels of stress ( M = 4.14; SD = 3.02). CONCLUSIONS Latina breast cancer survivors could benefit from interventions focused on commonly shared problems while tailoring specific interventions for subsets with more severe symptoms.
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Abstract
Despite increases in mammography rates among Latinas, screening rates remain lower than in non-Latina Whites and Latinas typically present with breast cancer at a later stage. Trained lay community workers (promotores) have been successfully used to increase screening mammography intention in Latinas. Little is known, however, about the potential mechanisms of these interventions, such as increased breast cancer knowledge (knowledge) and social interactions concerning mammography practices (social engagement). This prospective pre-post study examined this gap in the literature by (1) documenting changes in knowledge and social engagement after receipt of a promotores-based intervention; and (2) establishing if post-intervention knowledge and social engagement predicted mammography intention, after adjusting for socio-demographic and lifetime mammography history. There were significant increases in knowledge and social engagement about mammography. Finally, post-intervention social engagement was a significant predictor of mammography intention. Future promotores-based interventions should focus on enhancing social engagement to improve mammography intention and use.
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29
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Tetteh DA. The breast cancer fanfare: Sociocultural factors and women's health in Ghana. Health Care Women Int 2016; 38:316-333. [PMID: 27464066 DOI: 10.1080/07399332.2016.1215465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Traditional notions of the "full" woman and sociocultural beliefs about gender roles contribute to a unique experience of breast cancer in Africa. I used the critical feminist lens to analyze dis-courses about breast cancer in mainstream Ghanaian media. I found that breast cancer awareness is promoted amidst fanfare and that cultural notions of the female breasts, including their sexual appeal, are implied in breast cancer discourse. This obscures a nuanced understanding of the disease and women's health globally, limits the power of women to name their experiences, and contributes to the late presentation of the dis-ease in sub-Saharan Africa. I discuss the implications of the findings for international, interdisciplinary scholarship.
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Affiliation(s)
- Dinah A Tetteh
- a Department of Communication , Arkansas State University , Jonesboro , Arkansas , USA
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30
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Yanez B, McGinty HL, Buitrago D, Ramirez AG, Penedo FJ. Cancer Outcomes in Hispanics/Latinos in the United States: An Integrative Review and Conceptual Model of Determinants of Health. ACTA ACUST UNITED AC 2016; 4:114-129. [PMID: 27429867 DOI: 10.1037/lat0000055] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cancer is the leading cause of death among Hispanics. Compared to non-Hispanic Whites, Hispanics are more likely to be diagnosed with advanced stages of disease and experience poor quality of life following a cancer diagnosis. Cancer outcomes are influenced by a confluence of social, cultural, behavioral and biological factors. Yet, much of the behavioral and psychosocial research in oncology has focused on non-Hispanic Whites, thus limiting our understanding of the potential web of factors that can influence cancer-related outcomes among Hispanics. Furthermore, features of Hispanic ethnicity and culture may influence and interact with, social, psychosocial, health care, disease-specific, and medical factors known to influence cancer-related outcomes, yet very few studies have integrated Hispanic cultural processes when addressing cancer-related outcomes for this ethnic group. Guided by the extant literature in oncology, Hispanic culture and health, and previously established models of determinants of minority health, we present a conceptual model that highlights the interplay of social, cultural, psychosocial, disease-specific, health care, and medical factors as determinants of cancer outcomes (morbidity, mortality, quality of life) and review key evidence of how features of Hispanic culture may influence cancer outcomes and contribute to the disparate outcomes observed in Hispanic cancer samples relative to non-Hispanic Whites. Finally, we conclude with a discussion of future research opportunities and existing challenges to researching oncology outcomes among Hispanics.
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Affiliation(s)
- Betina Yanez
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Heather L McGinty
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Diana Buitrago
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Amelie G Ramirez
- Institute for Health Promotion, University of Texas Health Science Center
| | - Frank J Penedo
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
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31
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Molina Y, Plascak JJ, Patrick DL, Bishop S, Coronado GD, Beresford SAA. Neighborhood Predictors of Mammography Barriers Among US-Based Latinas. J Racial Ethn Health Disparities 2016; 4:233-242. [PMID: 27059049 DOI: 10.1007/s40615-016-0222-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 03/11/2016] [Accepted: 03/15/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Little is known about how neighborhood factors are associated with Latinas' barriers to cancer screening, including mammography. To address this gap, we examined barriers to mammography by neighborhood racial/ethnic composition and socioeconomic status among a federally qualified health center (FQHC)-based sample of non-adherent Latinas in Western Washington State. METHODS Baseline data were drawn from a larger intervention study (n = 536 Latinas). Women indicated why they had not obtained a mammogram in the past 2 years (no reason, knowledge, psychocultural, economic). American Community Survey (2007-2011) data were used to calculate four neighborhood measures that were categorized in tertiles (T): socioeconomic-based concentration, socioeconomic-based segregation, Latino-based concentration, and Latino-based segregation. RESULTS The proportion of women reporting knowledge-, psychocultural-, and economic-based reasons for not obtaining mammograms in the past 2 years was, respectively, 0.35, 0.19, and 0.31. Approximately 14 % indicated no particular reason. Relative to women residing in areas with greater Latino-based segregation, women in areas with less Latino-based segregation were less likely to report knowledge-based and economic-based reasons for not obtaining a mammogram (p ≤ 0.05). Relative to women residing in areas with greater concentration of Latinos, women in areas with the lowest concentrations were less likely to report knowledge-based reasons for not obtaining a mammogram (p ≤ 0.05). CONCLUSIONS Our findings provide important information about the role of neighborhood characteristics and mammography use among Latinas obtaining care from FQHCs. Future research might examine the mediating role of neighborhood characteristics in the efficacy of mammography screening interventions.
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Affiliation(s)
- Yamile Molina
- Community Health Sciences, University of Illinois-Chicago, Chicago, IL, USA. .,Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
| | - Jesse J Plascak
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | - Donald L Patrick
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | - Sonia Bishop
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Gloria D Coronado
- Kaiser Permanente Research Center for Health Research, Portland, OR, USA
| | - Shirley A A Beresford
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
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Talley CH, Yang L, Williams KP. Breast Cancer Screening Paved with Good Intentions: Application of the Information–Motivation–Behavioral Skills Model to Racial/Ethnic Minority Women. J Immigr Minor Health 2016; 19:1362-1371. [DOI: 10.1007/s10903-016-0355-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Tetteh DA, Faulkner SL. Sociocultural factors and breast cancer in sub-Saharan Africa: implications for diagnosis and management. ACTA ACUST UNITED AC 2016; 12:147-56. [PMID: 26757491 DOI: 10.2217/whe.15.76] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The incidence of breast cancer is on the rise in sub-Saharan Africa (SSA) and efforts at early diagnosis have not been very successful because the public has scant knowledge about the disease, a large percentage of breast cancer cases are diagnosed late and mainly rural SSA women's practice of breast self-examination is poor. In this paper, we argue that an examination of the social and cultural contexts of SSA that influence breast cancer diagnosis and management in the region is needed. We discuss the implications of sociocultural factors, such as gender roles and spirituality, on breast cancer diagnosis and management in SSA.
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Affiliation(s)
- Dinah A Tetteh
- Bowling Green State University, School of Media & Communication, 302 West Hall, Bowling Green, OH 43403, USA
| | - Sandra L Faulkner
- Bowling Green State University, School of Media & Communication, 302 West Hall, Bowling Green, OH 43403, USA.,Bowling Green State University, Women's Gender & Sexuality Studies, 236 Shatzel Hall, Bowling Green, OH 43403, USA
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Meneses K, Gisiger-Camata S, Schoenberger YM, Weech-Maldonado R, McNees P. Adapting an evidence-based survivorship intervention for Latina breast cancer survivors. ACTA ACUST UNITED AC 2015; 11:109-19. [PMID: 25776285 DOI: 10.2217/whe.14.65] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
AIM About 120,000 Latina breast cancer survivors (LBCS) live in the USA with the numbers expected to increase. LBCS experience survivorship disparities and report poor quality of life outcomes. Despite poor outcomes, few survivorship interventions for LBCS are available. Adapting evidence-based interventions for Latinas may be one strategy to reduce disparities. MATERIALS & METHODS An evidence-based intervention called the Breast Cancer Education Intervention was adapted for Latinas. First, certified translation and cognitive interview to assess cultural relevance were conducted. Next, a pilot sample of 40 Latinas who participated in the intervention were asked to provide follow-up evaluation of their satisfaction with and usefulness of the translated education manual and intervention. RESULTS Thirty LBCS completed the intervention, and 14 LBCS submitted an evaluation summary expressing satisfaction with usefulness, readability and relevance. CONCLUSION The process by which translation and cultural adaptation of an evidence-based intervention provides beginning foundation to support and reduce disparities among LBCS.
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Affiliation(s)
- Karen Meneses
- Office of Research & Scholarship, School of Nursing, University of Alabama at Birmingham, AL 35294, USA
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35
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Molina Y, Ornelas IJ, Doty SL, Bishop S, Beresford SAA, Coronado GD. Family/friend recommendations and mammography intentions: the roles of perceived mammography norms and support. HEALTH EDUCATION RESEARCH 2015; 30:797-809. [PMID: 26324395 PMCID: PMC4654755 DOI: 10.1093/her/cyv040] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 08/06/2015] [Indexed: 05/07/2023]
Abstract
Identifying factors that increase mammography use among Latinas is an important public health priority. Latinas are more likely to report mammography intentions and use, if a family member or friend recommends that they get a mammogram. Little is known about the mechanisms underlying the relationship between social interactions and mammography intentions. Theory suggests that family/friend recommendations increase perceived mammography norms (others believe a woman should obtain a mammogram) and support (others will help her obtain a mammogram), which in turn increase mammography intentions and use. We tested these hypotheses with data from the ¡Fortaleza Latina! study, a randomized controlled trial including 539 Latinas in Washington State. Women whose family/friend recommended they get a mammogram within the last year were more likely to report mammography intentions, norms and support. Perceived mammography norms mediated the relationship between family/friend recommendations and intentions, Mediated Effect = 0.38, 95%CI [0.20, 0.61], but not support, Mediated Effect = 0.002, 95%CI [-0.07, 0.07]. Our findings suggest perceived mammography norms are a potential mechanism underlying the effect of family/friend recommendations on mammography use among Latinas. Our findings make an important contribution to theory about the associations of social interactions, perceptions and health behaviors.
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Affiliation(s)
- Yamile Molina
- Community Health Sciences Division, University of Illinois-Chicago, Chicago, IL 60607, USA, Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA,
| | - India J Ornelas
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA, Department of Health Services, University of Washington, Seattle, WA 98122, USA
| | - Sarah L Doty
- Sea Mar community Health Centers, Seattle, WA 98108, USA
| | - Sonia Bishop
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Shirley A A Beresford
- Sea Mar community Health Centers, Seattle, WA 98108, USA, Department of Epidemiology, University of Washington, Seattle, WA 98122, USA and
| | - Gloria D Coronado
- Kaiser Permanente Research Center for Health Research, Portland, OR 97227, USA
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Mojica CM, Morales-Campos DY, Carmona CM, Ouyang Y, Liang Y. Breast, Cervical, and Colorectal Cancer Education and Navigation. Health Promot Pract 2015; 17:353-63. [DOI: 10.1177/1524839915603362] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Now that cancer has surpassed heart disease as the top cause of death for Hispanics in the United States, it is even more critical to focus on early detection of cancer in this population. We report the results of a theory-driven education-plus-navigation pilot intervention delivered by bilingual, bicultural community health workers (CHWs) with the goal of increasing cancer screening rates and knowledge among low-income Latinas. CHWs enrolled 691 eligible women, ages 18 to 75 years, considered rarely or never screened for breast, cervical, and colorectal cancer. Eligible women were scheduled for an education session and offered health care navigation support with appointment scheduling and reminder/follow-up calls. CHWs provided education to 535 (77%) eligible women, and arranged mammograms, Pap tests, or stool blood tests for 174 (25%) participants, with another 94 (14%) placed on a waiting list at a local health center. Statistically significant positive changes on knowledge of screening guidelines for breast, cervical, and colorectal cancer, and beliefs/attitudes regarding early detection were observed from pre- to posttest among eligible women who attended an educational session. Results highlight the effectiveness of CHW-directed interventions in recruiting individuals for programs, educating them, and influencing cancer knowledge and screening behavior.
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Affiliation(s)
| | | | - Christina M. Carmona
- The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Yongjian Ouyang
- The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Yuanyuan Liang
- The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Molina Y, Beresford SAA, Espinoza N, Thompson B. Psychological distress, social withdrawal, and coping following receipt of an abnormal mammogram among different ethnicities: a mediation model. Oncol Nurs Forum 2015; 41:523-32. [PMID: 25158657 DOI: 10.1188/14.onf.523-532] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE/OBJECTIVES To explore ethnic differences in psychological distress and social withdrawal after receiving an abnormal mammogram result and to assess if coping strategies mediate ethnic differences. DESIGN Descriptive correlational. SETTING Two urban mobile mammography units and a rural community hospital in the state of Washington. SAMPLE 41 Latina and 41 non-Latina Caucasian (NLC) women who had received an abnormal mammogram result. METHODS Women completed standard sociodemographic questions, Impact of Event Scale-Revised, the social dimension of the Psychological Consequences Questionnaire, and the Brief COPE. MAIN RESEARCH VARIABLES Ethnicity, psychological distress, social withdrawal, and coping. FINDINGS Latinas experienced greater psychological distress and social withdrawal compared to NLC counterparts. Denial as a coping strategy mediated ethnic differences in psychological distress. Religious coping mediated ethnic differences in social withdrawal. CONCLUSIONS Larger population-based studies are necessary to understand how ethnic differences in coping strategies can influence psychological outcomes. This is an important finding that warrants additional study among women who are and are not diagnosed with breast cancer following an abnormal mammogram. IMPLICATIONS FOR NURSING Nurses may be able to work with Latina patients to diminish denial coping and consequent distress. Nurses may be particularly effective, given cultural values concerning strong interpersonal relationships and respect for authority figures.
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Affiliation(s)
- Yamile Molina
- Division of Public Health Sciences, University of Washington, Seattle, WA
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Design, development, and feasibility of a spanish-language cancer survivor support group. Support Care Cancer 2015; 23:2145-55. [PMID: 25556609 DOI: 10.1007/s00520-014-2549-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 11/30/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Latino cancer survivors experience lower psychosocial well-being compared to non-Latino Whites. This study describes the development of a culturally appropriate support group and reports on feasibility of implementation and preliminary outcomes. METHODS Promotores (lay health workers) conducted all aspects of data collection and program implementation. Participants were 29 Spanish-speaking Latino cancer survivors (n = 12 men, 17 women) who took part in one of three study phases. Phase 1 included one-on-one interviews and focus groups (n = 14) to investigate psychosocial needs of survivors. During phase 2, a 10-week program was developed that integrated data from phase 1 and culturally relevant concepts. Session topics included stress, nutrition, physical activity, body image, sexuality, medical advocacy, and social support. In phase 3, the program was implemented within gender-specific groups (n = 15). Within-group pre-post comparisons of distress (distress thermometer, salivary cortisol) and quality of life (FACIT) were conducted. Follow-up focus groups assessed participant experience RESULTS Phase 1 activities identified survivor needs and interests (e.g., isolation, family and spirituality, supporting other Latinos with cancer). Evidence of program feasibility was demonstrated (e.g., 90-100% attendance, 100% data completion). While interpretation of significance is limited due to sample size, improvements in quality of life [functional (p = 0.05), social (p = 0.02), and meaning/purpose (p = 0.05)] were observed among women but not men. Qualitative follow-up revealed high satisfaction with group participation, but discomfort with the topic of sexuality in women. CONCLUSIONS This project demonstrates development and feasibility outcomes for providing culturally appropriate psychosocial support to Latino cancer survivors. Limitations, including lack of control group, and future directions are discussed.
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Perfect storm: illness, stress, and culture in a foreign land. Harv Rev Psychiatry 2015; 23:38-50. [PMID: 25563568 DOI: 10.1097/hrp.0000000000000071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Molina Y, Hohl SD, Ko LK, Rodriguez EA, Thompson B, Beresford SAA. Understanding the patient-provider communication needs and experiences of Latina and non-Latina White women following an abnormal mammogram. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2014; 29:781-789. [PMID: 24748097 PMCID: PMC4206667 DOI: 10.1007/s13187-014-0654-6] [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
Latinas are more likely to delay recommended follow-up care than non-Latina White (NLW) women after an abnormal mammogram result. Ethnic differences in communication needs and experiences with health-care staff and providers may contribute to these delays as well as satisfaction with care. Nonetheless, little research has explored the aspects of communication that may contribute to patient comprehension, adherence to follow-up care, and satisfaction across ethnicity. The purpose of this exploratory, qualitative study was to identify patients' communication needs and experiences with follow-up care among Latina and NLW women who received an abnormal mammogram. We conducted 41 semi-structured interviews with 19 Latina and 22 NLW women between the ages of 40 and 74 who had received an abnormal mammogram. Communication themes indicated that women's needs and experiences concerning abnormal mammograms and follow-up care varied across ethnicity. Latinas and NLW women appeared to differ in their comprehension of abnormal results and follow-up care as a result of language barriers and health literacy. Both groups of women identified clear, empathic communication as being important in patient-provider communication; however, Latinas underscored the need for warm communicative styles, and NLW women emphasized the importance of providing more information. Women with high levels of satisfaction with patient-provider interactions appeared to have positive perspectives of subsequent screening and cancer treatment. To improve patient satisfaction and adherence to follow-up care among Latinas, educational programs are necessary to counsel health-care professionals with regard to language, health literacy, and empathic communication needs in health-care service delivery.
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Affiliation(s)
- Yamile Molina
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N., M3-B232, Seattle, WA, 98109, USA,
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Molina Y, Thompson B, Ceballos RM. Physician and Family Recommendations to Obtain a Mammogram and Mammography Intentions: The Moderating Effects of Perceived Seriousness and Risk of Breast Cancer. JOURNAL OF WOMEN'S HEALTH CARE 2014; 3:199. [PMID: 25558437 PMCID: PMC4281937 DOI: 10.4172/2167-0420.1000199] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A growing body of literature has demonstrated psychosocial factors enable mammography intentions and usage among Latinas. Although these factors (e.g., family recommendations, breast cancer perceptions) likely influence one another, little research has examined interactive effects. The current study assessed the moderating effect of perceived breast cancer seriousness and risk on associations between recommendations to obtain mammography and mammography intentions. This sample included 97 Latinas in rural Eastern Washington State. After adjusting for age, two significant interactions emerged: perceived seriousness × physician recommendation and perceived risk × family recommendation. This exploratory study provides important directions for future communication research and planning to improve screening disparities.
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Affiliation(s)
- Yamile Molina
- Fred Hutchinson Cancer Research Center, Seattle, WA
- School of Public Health, Seattle, WA
- University of Illinois-Chicago, Chicago, IL
| | - Beti Thompson
- Fred Hutchinson Cancer Research Center, Seattle, WA
- School of Public Health, Seattle, WA
| | - Rachel M Ceballos
- Fred Hutchinson Cancer Research Center, Seattle, WA
- School of Public Health, Seattle, WA
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