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Andrews JE, Applequist J, Ward HL, Fuzzell LN, Vadaparampil ST. Cancer-related information behavior among black and hispanics in an NCI-designated comprehensive cancer center catchment. PATIENT EDUCATION AND COUNSELING 2023; 114:107812. [PMID: 37257260 DOI: 10.1016/j.pec.2023.107812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE This study aims to better understand health behaviors, particularly health information seeking, and how this impacts cancer care within underserved minority populations in a specific catchment area in Florida. METHODS We conducted an analysis of survey data from a 2019 community health survey conducted by the Moffit Cancer Center (MCC). We utilized the Comprehensive Model of Information Seeking (CMIS) as a framework and performed structural equation modeling (SEM) and related statistical analyses. RESULTS Our findings confirm that characteristics and demographics present a positive relationship to Online Health Information Seeking (OHIS). We also found that Utility had a negative significant relationship to OHIS. CONCLUSIONS We concluded that the CMIS is a useful framework for studying cancer-related information seeking, and that when properly executed in the confines of a study, can lend itself to in-depth statistical analyses as found in SEM. IMPLICATIONS The SEM revealed the CMIS to be promising with results in our analysis worthy of further investigation of cancer care and healthcare information access considering undeserved and minority populations. PRACTICE IMPLICATIONS Models such as the CMIS can be useful for understanding information seeking behaviors and to design information and communication interventions to improve access and health outcomes.
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Affiliation(s)
- James E Andrews
- School of Information, University of South Florida, Tampa, FL, USA.
| | | | - Heather L Ward
- School of Information, University of South Florida, Tampa, FL, USA
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Khan MM, Odoi A, Odoi EW. Geographic disparities in COVID-19 testing and outcomes in Florida. BMC Public Health 2023; 23:79. [PMID: 36631768 PMCID: PMC9832260 DOI: 10.1186/s12889-022-14450-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 10/25/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Understanding geographic disparities in Coronavirus Disease 2019 (COVID-19) testing and outcomes at the local level during the early stages of the pandemic can guide policies, inform allocation of control and prevention resources, and provide valuable baseline data to evaluate the effectiveness of interventions for mitigating health, economic and social impacts. Therefore, the objective of this study was to identify geographic disparities in COVID-19 testing, incidence, hospitalizations, and deaths during the first five months of the pandemic in Florida. METHODS: Florida county-level COVID-19 data for the time period March-July 2020 were used to compute various COVID-19 metrics including testing rates, positivity rates, incidence risks, percent of hospitalized cases, hospitalization risks, case-fatality rates, and mortality risks. High or low risk clusters were identified using either Kulldorff's circular spatial scan statistics or Tango's flexible spatial scan statistics and their locations were visually displayed using QGIS. RESULTS Visual examination of spatial patterns showed high estimates of all COVID-19 metrics for Southern Florida. Similar to the spatial patterns, high-risk clusters for testing and positivity rates and all COVID-19 outcomes (i.e. hospitalizations and deaths) were concentrated in Southern Florida. The distributions of these metrics in the other parts of Florida were more heterogeneous. For instance, testing rates for parts of Northwest Florida were well below the state median (11,697 tests/100,000 persons) but they were above the state median for North Central Florida. The incidence risks for Northwest Florida were equal to or above the state median incidence risk (878 cases/100,000 persons), but the converse was true for parts of North Central Florida. Consequently, a cluster of high testing rates was identified in North Central Florida, while a cluster of low testing rate and 1-3 clusters of high incidence risks, percent of hospitalized cases, hospitalization risks, and case fatality rates were identified in Northwest Florida. Central Florida had low-rate clusters of testing and positivity rates but it had a high-risk cluster of percent of hospitalized cases. CONCLUSIONS Substantial disparities in the spatial distribution of COVID-19 outcomes and testing and positivity rates exist in Florida, with Southern Florida counties generally having higher testing and positivity rates and more severe outcomes (i.e. hospitalizations and deaths) compared to Northern Florida. These findings provide valuable baseline data that is useful for assessing the effectiveness of preventive interventions, such as vaccinations, in various geographic locations in the state. Future studies will need to assess changes in spatial patterns over time at lower geographical scales and determinants of any identified patterns.
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Affiliation(s)
- Md Marufuzzaman Khan
- Department of Public Health, College of Education, Health, and Human Sciences, University of Tennessee, Knoxville, TN, USA
| | - Agricola Odoi
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - Evah W Odoi
- Department of Public Health, College of Education, Health, and Human Sciences, University of Tennessee, Knoxville, TN, USA.
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Dyal BW, Uscanga ZL, Bailey Z, Schmit S, Hoehn A, Garcia J, Gwede CK, Brownstein N, Powell-Roach K, Johnson-Mallard V, Krieger JL, Kobetz E, Vadaparampil S, Odedina FT, Wilkie DJ. Developing the Florida Academic Cancer Center Alliance Health Disparities Common Measure: The Florida Health and Ancestry Survey. Cancer Control 2022; 29:10732748221110897. [PMID: 35758601 PMCID: PMC9244925 DOI: 10.1177/10732748221110897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose Our specific aim was to develop and assess the consensus-based validity of common measures for understanding health behaviors and ancestry in Florida’s population subgroups and establish the feasibility of wide-scale implementation of the measures and biospecimen collection within three cancer centers’ catchment areas. Methods Using the National Cancer Institute’s Grid-Enabled Measures web-based platform and an iterative process, we developed the Florida Health and Ancestry Survey (FHAS). We then used three sampling approaches to implement the FHAS: community-engaged, panel respondent, and random digit dialing (RDD). We asked a subset of participants to provide a saliva sample for future validation of subjective ancestry report with DNA-derived ancestry markers. Results This process supported the FHAS content validity. As an indicator of feasibility, the goals for completed surveys by sampling approach were met for two of the three cancer centers, yielding a total of 1438 completed surveys. The RDD approach produced the most representative sample. The panel sampling approach produced inadequate representation of older individuals and males. The community-engaged approach along with social media recruitment produced extreme underrepresentation only for males. Two of the cancer centers mailed biospecimen kits, whereas one did not due to resource constraints. On average, the community engaged approach was more productive in obtaining returned biospecimen samples (80%) than the panel approach (48%). Conclusions We successfully developed and implemented the FHAS as a common measure to show its feasibility for understanding cancer health disparities in Florida. We identified sampling approach successes and challenges to obtaining biospecimens for ancestry research.
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Affiliation(s)
- Brenda W Dyal
- College of Nursing, Department of Biobehavioral Nursing Science, 3463University of Florida, Gainesville, FL, USA
| | - Zulema L Uscanga
- The Office of Community Outreach, Engagement and Equity, 25301Moffitt Cancer Center, Tampa, FL, USA
| | - Zinzi Bailey
- University of Miami Miller School of Medicine, Miami, FL, and Division of Medical Oncology, Department of Medicine, University of Miami Miller School of Medicine, 33315Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Stephanie Schmit
- Cleveland Clinic, Genomic Medicine Institute, Cleveland, OH, US and (2) Population and Cancer Prevention Program, Case Comprehensive Cancer Center, 196246Cleveland Clinic, Genomic Medicine Institute, Cleveland, OH, USA
| | - Alina Hoehn
- Department of Cancer Epidemiology, 25301Moffitt Cancer Center, Tampa, FL, USA
| | - Jennifer Garcia
- Department of Health Outcomes & Behaviors, Moffitt Cancer Center, Tampa, FL, USA
| | - Clement K Gwede
- Department of Health Outcomes & Behaviors, Moffitt Cancer Center, Tampa, FL, USA
| | - Naomi Brownstein
- Department of Biostatistics and Bioinformatics, 25301Moffitt Cancer Center, Tampa, FL, USA
| | - Keesha Powell-Roach
- College of Nursing, Department of Biobehavioral Nursing Science, Gainesville, FL, USA and University of Tennessee Health Science Center, Department of Health Promotion and Disease Prevention, 3463University of Florida, Memphis, TN, USA
| | - Versie Johnson-Mallard
- College of Nursing, Department of Family, Community and Health System Science, 3463University of Florida, Gainesville, Florida, USA
| | - Janice L Krieger
- STEM Translational Communication Center, 3463University of Florida, Gainesville, FL, USA
| | - Erin Kobetz
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, and Division of Medical Oncology, Department of Medicine, 12235University of Miami Miller School of Medicine, Miami, FL, USA
| | - Susan Vadaparampil
- Moffitt Cancer Center, The Office of Community Outreach, Engagement and Equity, Tampa, FL, USA.,Moffitt Cancer Center, Department of Health Outcomes & Behaviors, Moffitt Cancer Center, Tampa, FL, USA
| | - Folakemi T Odedina
- Moffitt Cancer Center, Department of Health Outcomes & Behaviors, Moffitt Cancer Center, Tampa, FL, USA
| | - Diana J Wilkie
- College of Nursing, Department of Biobehavioral Nursing Science, 3463University of Florida, Gainesville, FL, USA
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Lord J, Roberson S, Odoi A. Geographic disparities, determinants, and temporal changes in the prevalence of pre-diabetes in Florida. PeerJ 2021; 9:e10443. [PMID: 33520433 PMCID: PMC7811289 DOI: 10.7717/peerj.10443] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 11/07/2020] [Indexed: 12/17/2022] Open
Abstract
Background Left unchecked, pre-diabetes progresses to diabetes and its complications that are important health burdens in the United States. There is evidence of geographic disparities in the condition with some areas having a significantly high risks of the condition and its risk factors. Identifying these disparities, their determinants, and changes in burden are useful for guiding control programs and stopping the progression of pre-diabetes to diabetes. Therefore, the objectives of this study were to investigate geographic disparities of pre-diabetes prevalence in Florida, identify predictors of the observed spatial patterns, as well as changes in disease burden between 2013 and 2016. Methods The 2013 and 2016 Behavioral Risk Factor Surveillance System data were obtained from the Florida Department of Health. Counties with significant changes in the prevalence of the condition between 2013 and 2016 were identified using tests for equality of proportions adjusted for multiple comparisons using the Simes method. Flexible scan statistics were used to identify significant high prevalence geographic clusters. Multivariable regression models were used to identify determinants of county-level pre-diabetes prevalence. Results The state-wide age-adjusted prevalence of pre-diabetes increased significantly (p ≤ 0.05) from 8.0% in 2013 to 10.5% in 2016 with 72% (48/67) of the counties reporting statistically significant increases. Significant local geographic hotspots were identified. High prevalence of pre-diabetes tended to occur in counties with high proportions of non-Hispanic black population, low median household income, and low proportion of the population without health insurance coverage. Conclusions Geographic disparities of pre-diabetes continues to exist in Florida with most counties reporting significant increases in prevalence between 2013 and 2016. These findings are critical for guiding health planning, resource allocation and intervention programs.
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Affiliation(s)
- Jennifer Lord
- Biomedical and Diagnostic Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN, United States of America
| | | | - Agricola Odoi
- Biomedical and Diagnostic Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN, United States of America
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