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Bouchard EG, Saad-Harfouche FG, Clark N, Colon J, LaValley SA, Reid M, Attwood K, Bansal-Travers M, Glaser K. Adapting Community Educational Programs During the COVID-19 Pandemic: Comparing the Feasibility and Efficacy of a Lung Cancer Screening Educational Intervention by Mode of Delivery. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:854-862. [PMID: 35840859 PMCID: PMC9286703 DOI: 10.1007/s13187-022-02197-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 06/02/2023]
Abstract
Few eligible patients receive lung cancer screening. We developed the Lung AIR (awareness, information, and resources) intervention to increase community education regarding lung cancer screening. The intervention was designed as an in-person group intervention; however, the COVID-19 pandemic necessitated adapting the mode of delivery. In this study we examined intervention feasibility and efficacy overall and by mode of delivery (in-person group vs. one-on-one phone) to understand the impact of adapting community outreach and engagement strategies. Feasibility was examined through participant demographics. Efficacy was measured through pre/post knowledge, attitudes, and beliefs about lung cancer screening, and intention to complete screening. We reached N = 292 participants. Forty percent had a household income below $35,000, 58% had a high school degree or less, 40% were Hispanic, 57% were Black, and 84% reported current or past smoking. One-on-one phone sessions reached participants who were older, had lower incomes, more current smoking, smoked for more years, more cigarettes per day, lower pre-intervention lung cancer screening knowledge, and higher pre-intervention fear and worry. Overall pre/post test scores show significant increases in knowledge, salience, and coherence, and reduced fear and worry. Participants in the one-on-one phone sessions had significantly higher increases in salience and coherence and intention to complete screening compared to participants in the in-person group sessions. The Lung AIR intervention is a feasible and effective community-based educational intervention for lung cancer screening. Findings point to differences in reach and efficacy of the community-based intervention by mode of delivery.
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Affiliation(s)
- Elizabeth G Bouchard
- Department of Cancer Prevention and Control, Office of Community Outreach and Engagement, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA.
| | - Frances G Saad-Harfouche
- Department of Cancer Prevention and Control, Office of Community Outreach and Engagement, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Nikia Clark
- Department of Cancer Prevention and Control, Office of Community Outreach and Engagement, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Jomary Colon
- Department of Cancer Prevention and Control, Office of Community Outreach and Engagement, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Susan A LaValley
- Department of Cancer Prevention and Control, Office of Community Outreach and Engagement, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Mary Reid
- Department of Medical Oncology, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Kristopher Attwood
- Department of Biostatistics, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Kathryn Glaser
- Department of Cancer Prevention and Control, Office of Community Outreach and Engagement, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
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Feliciano-Rivera YZ, Net J, Sanchez P, Wahab RA, Mehta T, Yepes MM. Culturally Competent Care in the Breast Imaging Clinic: Hispanic/Latino Patients. JOURNAL OF BREAST IMAGING 2023; 5:188-194. [PMID: 38416924 DOI: 10.1093/jbi/wbac074] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Indexed: 03/01/2024]
Abstract
Hispanic/Latino people represent 19% of the U.S. population, and this proportion is expected to increase to 26% by 2050. Hispanic/Latino people comprise a diverse ethnic group that includes individuals from all races, religions, languages, cultural identities, and nationalities. Barriers to health care that have created significant disparities in this community include language, low socioeconomic status, and inability to afford health insurance. Health coverage for Hispanic/Latino people has been a longstanding problem in the U.S., stopping many of these patients from seeking preventive care such as screening mammography. Breast cancer is the most common cancer among Hispanic/Latino women in the U.S. and the leading cause of cancer death in this group. Five-year breast cancer survival in Hispanic/Latino women is slightly lower than that in non-Hispanic White women. Some of the factors that account for the ethnic disparities in breast cancer include lower levels of adherence to screening mammography of Hispanic/Latino women as a consequence of inadequate insurance coverage, language barriers, lack of transportation, being unable to leave work, and lack of childcare. By promoting a culturally sensitive clinical environment, breast radiologists can increase patient engagement, utilization of preventive services, treatment adherence rates, and overall health status.
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Affiliation(s)
| | - Jose Net
- University of Miami Miller School of Medicine, Department of Radiology, Miami, FL, USA
| | - Priscila Sanchez
- University of Miami Miller School of Medicine, Department of Radiology, Miami, FL, USA
| | - Rifat A Wahab
- University of Cincinnati Academic Health Center, Department of Radiology, Cincinnati, OH, USA
| | - Tejas Mehta
- UMass Memorial Medical Center-University Campus, Department of Radiology, Worcester, MA, USA
| | - Monica M Yepes
- University of Miami Miller School of Medicine, Department of Radiology, Miami, FL, USA
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Araujo JM, Gómez AC, Jongh WZD, Ausejo J, Córdova I, Schwarz LJ, Bretel D, Fajardo W, Saravia-Huarca LG, Barboza-Meca J, Morante Z, Guillén JR, Gómez H, Cárdenas NK, Hernández L, Melo W, Villarreal-Garza C, Caglevic C, Palacio C, García H, Mejía G, Flores C, Vallejos C, Pinto JA. A nationwide pilot study on breast cancer screening in Peru. Ecancermedicalscience 2023; 17:1494. [PMID: 36816782 PMCID: PMC9937072 DOI: 10.3332/ecancer.2023.1494] [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: 08/22/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction A high prevalence of advanced breast cancer (BC) is a common scenario in Latin America. In Peru, the frequency of BC at Stages III/IV is ≈50% despite implementation of a programme for breast cancer screening (BCS) along the country. We carried out a study to assess the feasibility and develop an instrument to evaluate the knowledge, barriers and perception about BCS in a nationwide pilot study in Peru among candidates for BCS. Methods We conducted a systematic review of 2,558 reports indexed in PubMed, Scopus, Web of Science, Medline-Ovid and EMBASE, regarding to our study theme. In total, 111 were selected and a 51-items survey was developed (eight items about sociodemographic characteristics). Patients were recruited in public hospitals or private clinics, in rural and urban areas of nine departments of Peru. Results We surveyed 488 women from: Lima (150), Cajamarca (93), Ica (59), Arequipa (56), Loreto (48), Ancash (38), Junín (15), Puerto Maldonado (15) and Huancavelica (14); 27.9% of them were from rural areas. The mean of age was 53.3 years (standard deviation ± 9.1). Regarding education level, 29.8% had primary, 33.2% secondary and 37.0% higher education. In total, 28.7% of women did not know the term 'mammogram' and 47.1% reported never receiving a BCS (36.9% from urban and 73.5% from rural population). In women that underwent BCS, only 67% knew it is for healthy women. In total, 54.1% of patients had low levels of knowledge about risk factors for BC (i.e. 87.5% of women respond that injuries in the breast produce cancer). Cultural, economic and geographic barriers were significantly associated with having a mammogram where 56.9% of participants considered a cost ≤ 7 USD as appropriate. Mammogram was perceived as too painful for 54.9% of women. In addition, women with a self-perception of low-risk for BC and a fatalistic perception of cancer were less likely to have a BCS. Conclusion We found that it is feasible to conduct a large-scale study in Peru. The results of this pilot study highlight an urgent need of extensive education and awareness about BCS in Peru.
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Affiliation(s)
- Jhajaira M Araujo
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru,Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Chorrillos, Lima 15067, Peru
| | - Andrea C Gómez
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru
| | - Winston Zingg-De Jongh
- Department of Molecular and Cellular Medicine, Texas A&M University, TX 77843, E.E.U.U., USA
| | - Jhon Ausejo
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Iván Córdova
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Luis J Schwarz
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Denisse Bretel
- Grupo de Estudios Clínicos Oncológicos Peruano (GECOPERU), Santiago de Surco, Lima 15038, Peru
| | - Williams Fajardo
- Servicio de Medicina Interna, Hospital Nacional Dos de Mayo, Lima 15003, Peru
| | | | | | - Zaida Morante
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru
| | - Juan R Guillén
- Hospital Félix Torrealva Gutiérrez- ESSALUD, Ica 11001, Peru
| | - Henry Gómez
- Grupo de Estudios Clínicos Oncológicos Peruano (GECOPERU), Santiago de Surco, Lima 15038, Peru
| | - Nadezhda K Cárdenas
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Lady Hernández
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Walter Melo
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Cynthia Villarreal-Garza
- Centro de Cáncer de Mama, Hospital Zambrano Hellion, Tecnológico de Monterrey, 66278 San Pedro Garza García, Monterrey, México
| | - Christian Caglevic
- Cancer Research Department, Fundacion Arturo Lopez Perez, Santiago de Chile 7500921, Chile
| | - Carolina Palacio
- Departamento de Oncología Clínica, Instituto de Cancerología Las Américas - AUNA, Medellín 050022, Colombia
| | - Héctor García
- Facultad de Medicina, Universidad de Antioquia, Medellín 050010, Colombia
| | - Gerson Mejía
- Departamento de Oncología Médica, Hospital Clínico VIEDMA, Cochabamba 0304, Bolivia
| | - Claudio Flores
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru
| | - Carlos Vallejos
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru
| | - Joseph A Pinto
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru,Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
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Rivera YM, Moran MB, Thrul J, Joshu C, Smith KC. When Engagement Leads to Action: Understanding the Impact of Cancer (Mis)information among Latino/a Facebook Users. HEALTH COMMUNICATION 2022; 37:1229-1241. [PMID: 34256676 PMCID: PMC8755854 DOI: 10.1080/10410236.2021.1950442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Latinos/as - the largest minority group in the U.S. - are avid Facebook users, making this an opportune tool to educate on the uptake of cancer prevention and screening behaviors. However, there is a dearth in scholarship exploring how Latinos/as engage with and act upon health content encountered on social media, which may be influenced by cultural values. This qualitatively-driven, mixed-methods study explores how Latinos/as engage with and act upon cancer prevention and screening information (CPSI) on Facebook. During one-on-one, in-depth interviews, participants (n = 20) logged onto their Facebook account alongside the researcher and discussed cancer-related posts they engaged with during the past 12 months. Interview questions included the reasons for engagement, and whether engagement triggered further action. Interviews were analyzed thematically. In parallel, a content analysis of the CPSI posts identified during the interviews was conducted. The majority of CPSI posts participants engaged with contained food-related content and visual imagery. Engagement was most common when individuals had personal relationships to the poster, when posts included videos/images, and when posts contained content promoting the curative properties of popular Latin American foods. Engagement often led to information-seeking and sharing, discussing content with others, and/or changing health behaviors. Findings highlight the importance of adequately contextualizing how cultural values influence the ways in which Latinos/as engage with and act upon CPSI on Facebook, which may lead individuals to bypass evidence-based procedures. Multi-pronged efforts are necessary to adequately leverage social media to empower Latinos/as to partake in behaviors that effectively reduce cancer health disparities.
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Affiliation(s)
- Yonaira M Rivera
- Department of Communication, School of Communication & Information, Rutgers University
| | - Meghan B Moran
- Department of Health, Behavior & Society, Johns Hopkins School of Public Health
| | - Johannes Thrul
- Department of Mental Health, Johns Hopkins School of Public Health
| | - Corinne Joshu
- Department of Epidemiology, Johns Hopkins School of Public Health
| | - Katherine C Smith
- Department of Health, Behavior & Society, Johns Hopkins School of Public Health
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Maxwell AE, Young S, Gomez N, Tran K, Chang LC, Nails E, Gere D, Bastani R. Aprendiendo de La Vida (Learning from Life): Development of a Radionovela to Promote Preventive Health Care Utilization among Indigenous Farmworkers from Mexico Living in California. THE JOURNAL OF MEDICAL HUMANITIES 2022; 43:365-376. [PMID: 34251581 PMCID: PMC10699854 DOI: 10.1007/s10912-021-09704-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/04/2021] [Indexed: 06/13/2023]
Abstract
Mixtecs and Zapotecs, originating from the Oaxaca area in Mexico, are among the largest indigenous groups of workers in California. Many adults in this community only access the health care system when sick and as a last resort. This article describes the development of a radionovela to inform the community about the importance of preventive health care. It was developed following the Sabido Method. The methodology to develop a radionovela may be of interest to other public health practitioners who want to develop educational materials in an engaging format, especially for communities that rely on oral, not written information.
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Affiliation(s)
- Annette E Maxwell
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
| | - Sandra Young
- Mixteco/Indigena Community Organizing Project, Oxnard, CA, USA
| | - Norma Gomez
- Mixteco/Indigena Community Organizing Project, Oxnard, CA, USA
| | - Khoa Tran
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
| | - L Cindy Chang
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
| | - Elisabeth Nails
- Art and Global Health Center, University of California, Los Angeles, CA, USA
| | - David Gere
- Art and Global Health Center, University of California, Los Angeles, CA, USA
| | - Roshan Bastani
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
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Evaluation of online Spanish and English health materials for preventive mastectomy. are we providing adequate information? Breast Cancer Res Treat 2021; 187:1-9. [PMID: 33721147 DOI: 10.1007/s10549-021-06171-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/24/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Breast cancer remains the leading cause of cancer-related death in US Hispanic women. When present, lower health literacy levels potentially within this patient population require tailored materials to address health disparities. We aim to evaluate and compare Spanish and English online health care informative resources on preventive mastectomy. METHODS A Google web search using "preventive mastectomy" and "mastectomía preventiva" was conducted. The first ten institutional/organizational websites in each language were selected. Assessment of mean reading grade level, cultural sensitivity, understandability, and actionability was carried out utilizing validated tools. RESULTS The mean reading grade level for English materials was 14.69 compared with 11.3 for Spanish, both exceeding the recommended grade level established by the AMA and NIH. The mean cultural sensitivity score for English information was 2.20 compared with 1.88 for Spanish information, both below the acceptability benchmark of 2.5. English webpages scored 65% and 35% for understandability and actionability, respectively, while Spanish webpages scored 47% and 18%. CONCLUSIONS Online English and Spanish preventive mastectomy materials were written at an elevated reading level and lacked cultural sensitivity. Spanish language information demonstrated inferior understandability, actionability, and cultural sensitivity. Addressing these issues provides an opportunity to help resolve health literature disparities regarding preventive mastectomy for US Hispanic women.
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Ramirez AG, Gallion KJ, Perez A, Adeigbe RT, Munoz E, Pasick RJ. Éxito!: Making an Impact in Training Latinos for Doctorates and Cancer Research. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:928-937. [PMID: 30014170 PMCID: PMC6335193 DOI: 10.1007/s13187-018-1397-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Latinos lag behind other racial/ethnic groups in pursuit of master's and doctoral degrees in public health and the health sciences. Éxito! is modeled after the Minority Training Program in Cancer Control Research (MTPCCR), which found that Latino participants went on to doctoral programs at a lower rate (12%) than African American (36%) and Asian participants (33%). Éxito! Latino Cancer Research Leadership Training is designed to increase the number of Latinos who pursue doctoral degrees and careers in cancer health disparity (CHD) research. The program has three components: recruitment with partnering universities and associations, an ethnically tailored intensive 5-day summer institute (SI), and 6-month paid internships offered on a competitive basis. Up to 20 master's level students/master's level health professionals are selected annually to participate in the SI; faculty are leaders in Latino CHD research. Funded by the National Cancer Institute (NCI) from 2011 to 2015, Éxito! recruited 101 summer institute participants and awarded 21 internships. Analyses of pre- and post-institute surveys showed significant increases in confidence to apply to a doctoral program and academic self-efficacy among summer institute participants, and significantly increased research skills among interns. Forty-three percent of Éxito! program alumni applied to a doctoral program (our main outcome) and 29.7% were currently enrolled. This is nearly double the rate for MTPCCR Latino participants (17%) for the corresponding time period. Éxito! is a model pipeline program for encouragement of Latinos on to doctoral programs (e.g., PhD and DrPH) with the potential to increase the pool of cancer health disparity researchers.
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Affiliation(s)
- Amelie G Ramirez
- UT Health San Antonio, School of Medicine, Department of Epidemiology and Biostatistics, Institute for Health Promotion Research, 7411 John Smith Dr., Suite 1000, San Antonio, TX, 78229, USA
| | - Kipling J Gallion
- UT Health San Antonio, School of Medicine, Department of Epidemiology and Biostatistics, Institute for Health Promotion Research, 7411 John Smith Dr., Suite 1000, San Antonio, TX, 78229, USA
| | - Arely Perez
- UT Health San Antonio, School of Medicine, Department of Epidemiology and Biostatistics, Institute for Health Promotion Research, 7411 John Smith Dr., Suite 1000, San Antonio, TX, 78229, USA.
| | - Rebecca T Adeigbe
- UT Health San Antonio, School of Medicine, Department of Epidemiology and Biostatistics, Institute for Health Promotion Research, 7411 John Smith Dr., Suite 1000, San Antonio, TX, 78229, USA
| | - Edgar Munoz
- UT Health San Antonio, School of Medicine, Department of Epidemiology and Biostatistics, Institute for Health Promotion Research, 7411 John Smith Dr., Suite 1000, San Antonio, TX, 78229, USA
| | - Rena J Pasick
- University of California, San Francisco, Division of General Internal Medicine, Helen Diller Family Comprehensive Cancer Center, Box 0128, 1450 3rd Street HD 553, San Francisco, CA, 94143, USA
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Lopez AM, Hudson L, Vanderford NL, Vanderpool R, Griggs J, Schonberg M. Epidemiology and Implementation of Cancer Prevention in Disparate Populations and Settings. Am Soc Clin Oncol Educ Book 2019; 39:50-60. [PMID: 31099623 DOI: 10.1200/edbk_238965] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Successful cancer prevention strategies must be tailored to support usability. In this article, we will focus on cancer prevention strategies in populations that differ by race and ethnicity, place and location, sexual orientation and gender identity, and age by providing examples of effective approaches. An individual may belong to none of these categories, to all of these categories, or to some. This intersectionality of belonging characterizes individuals and shapes their experiences. Even within a category, broad diversity exists. Effective cancer prevention strategies comprehensively engage the community at multiple levels of influence and may effectively include lay health workers and faith-based cancer education interventions. Health system efforts that integrate cancer health with other health promotion activities show promise. At the individual physician level, culturally literate approaches have demonstrated success. For example, when discussing cancer screening tests with older adults, clinicians should indicate whether any data suggest that the screening test improves quality or quantity of life and the lag time to benefit from the screening test. This will allow older adults to make an informed cancer screening decision based on a realistic understanding of the potential benefits and risks and their values and preferences. Addressing individual and health system bias remains a challenge. Quality improvement strategies can address gaps in quality of care with respect to timeliness of care, coordination of care, and patient experience. The time is ripe for research on effective and interdisciplinary prevention strategies that harness expertise from preventive medicine, behavioral medicine, implementation science, e-health, telemedicine, and other diverse fields of health promotion.
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Affiliation(s)
- Ana Maria Lopez
- 1 Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Lauren Hudson
- 2 University of Kentucky Markey Cancer Center, Lexington, KY
| | | | | | | | - Mara Schonberg
- 4 Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
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Power EJ, Chin ML, Haq MM. Breast Cancer Incidence and Risk Reduction in the Hispanic Population. Cureus 2018; 10:e2235. [PMID: 29713580 PMCID: PMC5919763 DOI: 10.7759/cureus.2235] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 02/26/2018] [Indexed: 12/26/2022] Open
Abstract
Breast cancer is the most common non-skin cancer amongst women worldwide and is the fifth leading cause of cancer-related mortality overall. It is also the foremost reason for cancer-related mortality in Hispanic females in the United States (US). Although the current incidence of breast cancer is significantly lower in Hispanics compared to that of non-Hispanic Whites (NHW) and Blacks, (91.9, 128.1, and 124.3 per 100,000, respectively, annually), this may increase if Hispanics develop similar lifestyle behaviors to other American women, in categories such as weight management, age at first birth, number of children, and breastfeeding habits. Stage-for-stage mortality for Hispanics is similar to NHWs, but the mortality rate is not declining as rapidly in this ethnic group. Hispanic women share many of the same risk factors for developing breast cancer as NHWs and Blacks. This suggests that many of the risk reduction strategies used in other racial populations may also benefit this group. Providing education about breast cancer and implementing risk reduction strategies in culturally-aware environments could help keep incidence low and reduce cancer-related mortality. Since Hispanics are the largest minority group in the US, this could have a significant impact on the incidence and mortality nationally.
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The impact of “Be Clear on Cancer” campaign on breast care services provided by a specialist oncoplastic unit – A retrospective case control study. Int J Surg 2017; 47:54-60. [DOI: 10.1016/j.ijsu.2017.09.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 09/15/2017] [Accepted: 09/18/2017] [Indexed: 11/23/2022]
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How will the 'cancer moonshot' impact health disparities? Cancer Causes Control 2017; 28:907-912. [PMID: 28770362 DOI: 10.1007/s10552-017-0927-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 07/19/2017] [Indexed: 12/12/2022]
Abstract
In 1971, President Nixon signed into law the National Cancer Act (NCA), colloquially known as the "War on Cancer", which pushed cancer onto the national agenda and is credited for many subsequent increases in the knowledge of the molecular, cellular, and genetic causes and effects of cancer. But even though cancer mortality has declined overall in intervening years after the NCA, cancer health disparities persist in the form of higher cancer incidence and mortality rates among certain cancer types and certain populations. Breast and cervical cancers disproportionately affect African American, Hispanic, and American Indian Women. Colorectal cancer is the second leading cause of death for Latinos (with men and women combined). Forty-five years after the NCA, how will the next enormous cancer initiatives-President Barack Obama's Cancer Moonshot and the All of Us Research Program (formerly the Precision Medicine Initiative Cohort Program)-impact cancer health disparities? The emergence of precision medicine and the sharing of information across sectors are at the heart of these large national initiatives and hold vast potential to address complex health disparities that remain in incidence reporting, incidence, treatment, prognoses, and mortality among certain cancer types and racial/ethnic minorities, including African Americans and Hispanics/Latinos, compared to Whites. But clinical research efforts and data collection have historically lacked diverse representation for various reasons, posing a large risk to these national initiatives in their ability to develop diverse cohorts that adequately represent racial/ethnic minorities. Efforts to reduce disparities and increase diversity in study cohorts have emerged, from patient navigation, to use of mobile technology to collect data, to national consortiums dedicated to including diverse groups, to university training on health disparities. These efforts point to the need for the Cancer Moonshot and precision medicine leaders to develop a multifaceted approach to address disparities in health and healthcare to promote a diverse healthcare workforce, patient-centered care, maintenance of a database of information regarding the state of health disparities, and the institution of measurable goals for improving care across all ethnic groups. If these elements are included, it is possible that the Cancer Moonshot and precision medicine will benefit the entire population of our country.
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Brandzel S, Chang E, Tuzzio L, Campbell C, Coronado N, Bowles EJA, Bradford SC, Buist DSM. Latina and Black/African American Women's Perspectives on Cancer Screening and Cancer Screening Reminders. J Racial Ethn Health Disparities 2016; 4:10.1007/s40615-016-0304-2. [PMID: 27864808 PMCID: PMC5436953 DOI: 10.1007/s40615-016-0304-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/06/2016] [Accepted: 10/13/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Racial and ethnic disparities continue to exist in cancer screening rates, especially among US Latina and Black/African American populations. We conducted six focus groups among 41 women from these communities in order to better understand their preferences about cancer screening reminders and the motivators and deterrents they face in obtaining recommended breast, cervical, and colon cancer screening. METHODS Using self-reported patient race/ethnicity from electronic medical records of a large, integrated health care system in Seattle, we recruited women ages 30-60 to participate in one of five 2-hour focus groups. Using verbatim transcripts from these discussions, we conducted a qualitative analysis to identify common themes. RESULTS The focus group participants were primarily strong endorsers and utilizers of recommended breast, cervical, and colon cancer screening services. Insurance and belief in preventive care were the most common motivators that they cited in obtaining cancer screening. However, they still reported multiple barriers to getting recommended cancer screening for themselves and community members, including lack of time, conflicting information about screening intervals, distrust in the health care system, and a lack of understanding of the benefits of preventive care. CONCLUSIONS Efforts to improve understanding about the benefits of cancer screening, clarify cancer screening guideline recommendations, increase cultural competency among health care professionals, and expand the times and locations where cancer screening is available are all options that may improve cancer screening rates among Latinas and Black/African American women.
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Affiliation(s)
- Susan Brandzel
- Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA
| | - Eva Chang
- RTI International, 307 Waverley Oaks Rd #101, Waltham, MA, 02452, USA
| | - Leah Tuzzio
- Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA
| | | | - Nora Coronado
- University of Washington, 1959 NE Pacific St., Seattle, WA, 98195, USA
| | - Erin J Aiello Bowles
- Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA
| | - Susan Carol Bradford
- Group Health Cooperative, Department of Clinical Improvement and Prevention, 201 16th Ave E, Seattle, WA, 98112, USA
| | - Diana S M Buist
- Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA.
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