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Altman K, Yelton B, Porter DE, Kelsey RH, Friedman DB. The Role of Understanding, Trust, and Access in Public Engagement with Environmental Activities and Decision Making: A Qualitative Study with Water Quality Practitioners. Environ Manage 2023; 71:1162-1175. [PMID: 36867208 DOI: 10.1007/s00267-023-01803-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 02/19/2023] [Indexed: 05/15/2023]
Abstract
Advancing environmental health literacy in support of environmental management requires inclusive science communication, especially with environmental justice communities. In order to understand experiences of environmental practitioners in the realm of science communication, the Center for Oceans and Human Health and Climate Change Interactions at the University of South Carolina conducted two studies on science communication and research translation with the center's researchers and partners. This qualitative case study follows up with a select group of environmental practitioners on emergent themes from the initial work. It explores the specific topics of understanding, trust, and access and how those can become barriers or facilitators of public engagement with environmental activities and decision making. The authors conducted seven in-depth qualitative interviews with center partners whose work focuses on environmental water quality and impacts on human and environmental health. Key results indicate that the public may have limited understanding of scientific processes, establishing trust takes time, and access should be incorporated into the design of programs and activities to ensure broader reach. Findings from this research are relevant to other partner-engaged work and environmental management initiatives and provide insights on experiences, practices, and actions for equitable and effective stakeholder engagement and collaborative partnerships.
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Affiliation(s)
- Katya Altman
- Department of Environmental Health Sciences, Arnold School of Public Health and NIEHS Center for Oceans and Human Health and Climate Change Interactions, University of South Carolina, Columbia, SC, USA
| | - Brooks Yelton
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Dwayne E Porter
- Department of Environmental Health Sciences, Arnold School of Public Health and NIEHS Center for Oceans and Human Health and Climate Change Interactions, University of South Carolina, Columbia, SC, USA
| | - R Heath Kelsey
- University of Maryland Center for Environmental Science, Cambridge, MD, USA
- NIEHS Center for Oceans and Human Health and Climate Change Interactions, University of South Carolina, Columbia, SC, USA
| | - Daniela B Friedman
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health and NIEHS Center for Oceans and Human Health and Climate Change Interactions, University of South Carolina, Columbia, SC, USA.
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Ratnapradipa KL, Ranta J, Napit K, Luma LB, Robinson T, Dinkel D, Schabloske L, Watanabe‐Galloway S. Qualitative analysis of cancer care experiences among rural cancer survivors and caregivers. J Rural Health 2022; 38:876-885. [PMID: 35381622 PMCID: PMC9492624 DOI: 10.1111/jrh.12665] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE Rural (vs urban) patients experience poorer cancer outcomes and are less likely to be engaged in cancer prevention, such as screening. As part of a community needs assessment, we explored rural cancer survivors' and caregivers' experiences, perceptions, and attitudes toward cancer care services. METHODS We conducted 3 focus groups (N = 20) in Spring 2021 in rural Nebraska. FINDINGS Three patterns of cancer diagnosis were regular care/screening without noticeable symptoms, treatment for symptoms not initially identified as cancer related, and symptom self-identification. Most participants, regardless of how diagnosis was made, had positive experiences with timely referral for testing (imaging and biopsy) and specialist care. Physician interpersonal skills set the tone for patient-provider communication, which colored the perception of overall care. Participants with physicians and care teams that were perceived as "considerate," "compassionate," and "caring" had positive experiences. Participants identified specific obstacles to care, including financial barriers, transportation, and lack of support groups, as well as more general cultural barriers. Survivors and caregivers identified organization-based supports that helped them address such barriers. CONCLUSIONS Rural populations have unique perspectives about cancer care. Our results are being used by the state cancer coalition, state cancer control program, and the National Cancer Institute-designated cancer center to prioritize outreach and interventions aimed to reduce rural cancer disparities, such as revitalizing lay cancer navigator programs, conducting webinars for primary care and cancer specialty providers to discuss these findings and identify potential interventions, and collaborating with national and regional cancer support organizations to expand reach in rural communities.
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Affiliation(s)
- Kendra L. Ratnapradipa
- Department of EpidemiologyCollege of Public HealthUniversity of Nebraska Medical CenterOmahaNebraskaUSA
| | - Jordan Ranta
- Sarpy/Cass Health DepartmentPapillionNebraskaUSA
| | - Krishtee Napit
- Department of EpidemiologyCollege of Public HealthUniversity of Nebraska Medical CenterOmahaNebraskaUSA
| | - Lady Beverly Luma
- Office of Community Outreach and EngagementFred & Pamela Buffett Cancer CenterOmahaNebraskaUSA
| | | | - Danae Dinkel
- School of Health & KinesiologyUniversity of Nebraska at OmahaOmahaNebraskaUSA
| | | | - Shinobu Watanabe‐Galloway
- Department of EpidemiologyCollege of Public HealthUniversity of Nebraska Medical CenterOmahaNebraskaUSA,Office of Community Outreach and EngagementFred & Pamela Buffett Cancer CenterOmahaNebraskaUSA
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Yelton B, Lead JR, Adams SA, Brandt HM, Kulkarni S, Lewis KR, Fedrick D, Ureda JR, Friedman DB. How Do African-American Community Members' Perceptions About Environmental Risks of Breast Cancer Compare with the Current State of the Science? J Cancer Educ 2021; 36:1193-1200. [PMID: 32314309 PMCID: PMC7572772 DOI: 10.1007/s13187-020-01748-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
African-American (AA) women experience higher mortality from breast cancer than any other racial group. Understanding community-held perceptions of environmental contaminants as risk factors for breast cancer can inform the development of tailored prevention and education efforts for improve health outcomes. Six focus groups were conducted with AA participants in two counties in South Carolina, and themes were identified using open and axial coding. Perceived environmental risks for breast cancer most frequently discussed by participants were compared to findings from published systematic reviews. Frequently discussed environmental risk factors by participants were deodorants containing aluminum, plastics, pesticides, and air and water pollution. While perceptions of aluminum and air pollution as risk factors did not align with the state of the science, perceived risk factors of chemicals in plastics and pesticides were found to be in alignment. There is some congruence between perceived environmental risks for breast cancer within the AA community and the current state of the science; however, there is a need to communicate information that reflects current science regarding commonly held misconceptions. Development of evidence-based, clear, and culturally appropriate messaging that reflects the current state of the science is warranted.
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Affiliation(s)
- Brooks Yelton
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Arnold School of Public Health, 915 Greene Street, Columbia, SC, 29208, USA
- College of Social Work, University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA
| | - Jamie R Lead
- Department of Environmental Health Sciences, University of South Carolina, Arnold School of Public Health, 921 Assembly St, Columbia, SC, 29208, USA
- Center for Environmental Nanoscience and Risk, University of South Carolina, Arnold School of Public Health, 921 Assembly St, Columbia, SC, 29208, USA
| | - Swann Arp Adams
- Department of Epidemiology & Biostatistics, University of South Carolina, Arnold School of Public Health, 915 Greene Street, Columbia, SC, 29208, USA
- College of Nursing, University of South Carolina, 1601 Greene Street, Columbia, SC, 29208, USA
- Statewide Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
| | - Heather M Brandt
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Arnold School of Public Health, 915 Greene Street, Columbia, SC, 29208, USA
- Statewide Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
| | - Shibani Kulkarni
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Arnold School of Public Health, 915 Greene Street, Columbia, SC, 29208, USA
| | - Kaleea R Lewis
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Arnold School of Public Health, 915 Greene Street, Columbia, SC, 29208, USA
| | - Delores Fedrick
- Chester County Literacy Council, 109 Ella Street, Chester, SC, 29706, USA
| | - John R Ureda
- , Insights Consulting, Inc., 2728 Wilmot Ave, Columbia, SC, 29205, USA
| | - Daniela B Friedman
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Arnold School of Public Health, 915 Greene Street, Columbia, SC, 29208, USA.
- Statewide Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA.
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Friedman DB, Arent MA, Yelton B, Sakhuja M, Haynes VE, Noblet S, Brandt HM, Isenhower WD, Wandersman A, Zona D, New C, Fedrick D, Scaccia J, Bruner L. Development of a Clinical-Academic-Community Collaboration to Improve Health Literacy. J Prim Care Community Health 2021; 11:2150132720957440. [PMID: 32909496 PMCID: PMC7495516 DOI: 10.1177/2150132720957440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Limited health literacy is associated with poor patient health outcomes and
increased hospitalization rates. Patient-provider communication plays an
important role in patient health literacy and the understanding of medical
terminology. This study demonstrates how a collaboration between clinical,
academic, and community partners was instrumental in the design and
implementation of a clinic readiness assessment and a clinic-based pilot
intervention to encourage patient-provider communication and improve patient
health literacy. A state hospital association, academic research team, and
community adult literacy center director collaborated to develop a 60-item
clinic readiness assessment and an evidence-informed pilot intervention. The
clinic readiness assessment captured clinics’ motivation and capacity for pilot
implementation and providers’ current communication strategies. The intervention
centered around AskMe3™ educational materials and involved 2 patient visits
(initial and follow-up visits). Data collection instruments for the intervention
were administered verbally and included questions about patient demographics and
communication needs, and a single-item health literacy measure. Descriptive
statistics (frequencies/percentages) were used to analyze results from the
clinic readiness assessment and pilot intervention. Establishment of the
partnership, and collaborative, iterative development of the clinic readiness
assessment and pilot intervention are described. This pilot project resulted in
important lessons learned which led to critical modifications that will inform
future expansion of the intervention. Collaboration between healthcare leaders,
researchers, and community partners is recommended for developing clinic-based
health literacy initiatives.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Diana Zona
- South Carolina Hospital Association, Columbia, SC, USA
| | - Cyndi New
- South Carolina Hospital Association, Columbia, SC, USA
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Yelton B, Brandt HM, Adams SA, Ureda JR, Lead JR, Fedrick D, Lewis K, Kulkarni S, Friedman DB. "Talk About Cancer and Build Healthy Communities": How Visuals Are Starting the Conversation About Breast Cancer Within African-American Communities. Int Q Community Health Educ 2021; 41:267-274. [PMID: 32660340 PMCID: PMC7854839 DOI: 10.1177/0272684x20942076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
African-American (AA) women are at higher risk of breast cancer mortality than women of other races. Factors influencing breast cancer risk, including exogenous environmental exposures, and debate around timing of exposure and dose-response relationship, can cause misunderstanding. Collaboration with priority populations encourages culturally relevant health messaging that imparts source reliability, influences message adoption, and improves understanding. Through six focus groups with AA individuals in rural and urban counties in the southeastern United States, this study used a community-engaged participatory approach to design an innovative visual tool for disseminating breast cancer information. Results demonstrated that participants were generally aware of environmental breast cancer risks and were willing to share new knowledge with families and community members. Recommended communication channels included pastors, healthcare providers, social media, and the Internet. Participants agreed that a collaboratively designed visual tool serves as a tangible, focused "conversation starter" to promote community prevention and education efforts.
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Affiliation(s)
- Brooks Yelton
- College of Social Work, University of South Carolina
- South Carolina Cancer Prevention and Control Research Network, University of South Carolina
| | - Heather M. Brandt
- Department of Health Promotion, Education, and Behavior, University of South Carolina
- Statewide Cancer Prevention and Control Program, University of South Carolina
- The Graduate School, University of South Carolina
| | - Swann Arp Adams
- Statewide Cancer Prevention and Control Program, University of South Carolina
- Department of Epidemiology and Biostatistics, College of Nursing, University of South Carolina
| | | | - Jamie R. Lead
- Department of Environmental Health Sciences, Center for Environmental Nanoscience and Risk, University of South Carolina
| | | | - Kaleea Lewis
- Department of Health Sciences, University of Missouri
| | - Shibani Kulkarni
- Department of Health Promotion, Education, and Behavior, University of South Carolina
| | - Daniela B. Friedman
- Department of Health Promotion, Education, and Behavior, University of South Carolina
- Statewide Cancer Prevention and Control Program, University of South Carolina
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Fry SL, Kelly D, Hopkinson J. Using Card Games to study cultural differences in men's social talk about prostate cancer. J Adv Nurs 2020; 76:1840-1849. [PMID: 32242968 DOI: 10.1111/jan.14373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/26/2020] [Accepted: 03/23/2020] [Indexed: 11/29/2022]
Abstract
AIM To report the Card Games approach used to study men's talk about their risk for prostate cancer and as a method of data collection to analyse patterns of talk among distinct cultural groups. DESIGN A constructivist grounded theory approach using focus groups to analyse men's social talk about prostate cancer. METHODS Data were collected using three focus groups with African-Caribbean, Somali, and White British men. The focus groups were conducted in a location of the men's choice with a focus group facilitator and observer. Four Card Games were given to the men to encourage social talk. RESULTS The African-Caribbean men had the most democratic talk with the use of agreement and disagreement and the Somali men were the most inclusive of others and used the most humour. The White British men were competitive in their talk and the least inclusive of each other's views. CONCLUSION The Card Games revealed differences in the pattern of talk, which provided insight into how men may use social talk to develop their understanding of prostate cancer risk. This is useful for healthcare professionals as it provides a grounding for structuring discussions with men about prostate cancer, while understanding of how risk-related knowledge may be reconstructed in social talk and interactions. IMPACT The methodology discussed in this paper addressed the use of focus group to analyse talk of men from culturally diverse groups. The use of Card Games allowed the talk between the men to take centre stage and this allowed differences in the social talk of the men to become apparent. The use of this methodology could have an impact on approaches to researching cultural understandings of cancer risk, which may provide evidence on effective delivery of sociocultural relevant health education relating to cancer screening.
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Affiliation(s)
- Sarah L Fry
- School of Healthcare Sciences, Cardiff University, Wales, UK
| | - Daniel Kelly
- School of Healthcare Sciences, Cardiff University, Wales, UK
| | - Jane Hopkinson
- School of Healthcare Sciences, Cardiff University, Wales, UK
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Buregeya JM, Loignon C, Brousselle A. Contribution to healthy places: Risks of equity free health impact assessment. Eval Program Plann 2019; 73:138-145. [PMID: 30622062 DOI: 10.1016/j.evalprogplan.2018.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 11/09/2018] [Accepted: 12/22/2018] [Indexed: 06/09/2023]
Abstract
While health equity is central to health impact assessment [HIA], in reality, less is known about potential impacts of equity-free HIA on social inequalities. We assessed equity-free HIA case in a small city east of Montreal, which took place in a context of urban revitalization. We applied a combination of a quantitative review of community characteristics with a qualitative descriptive approach based on in-depth semi-structured interviews and a focus group with multiple stakeholders to shed light on the pitfalls of equity-free HIA. Our results pointed to gentrification process with a gradual relocation of low-income residents in the end. To mitigate mediating circumstances of gentrification and displacement, the municipality should support social housing or at least should ensure rent stabilization ordinance.
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Affiliation(s)
- Jean Marie Buregeya
- Clinical Sciences Program at the Research Centre Charles-LeMoyne - Saguenay-Lac-Saint-Jean, Faculty of Medicine and Health Sciences, Sherbrooke University, Longueuil Campus, Canada.
| | - Christine Loignon
- Department of Family Medicine at the Faculty of Medicine and Health Sciences, Sherbrooke University, Research Centre Charles-LeMoyne - Saguenay-Lac-Saint-Jean, Longueuil, Canada
| | - Astrid Brousselle
- School of Public Administration, University of Victoria -Victoria, Canada, Department of Community Health, Faculty of Medicine and Health Sciences, Sherbrooke University, Research Centre Charles-LeMoyne - Saguenay-Lac-Saint-Jean, Longueuil, Canada
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