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Patel SH, Ebrahimi S, Northfelt DW, Mathews TE, Omar FM, Martinez ED, DeWees TA, Okamoto JM. Understanding American Indian Perceptions Toward Radiation Therapy. Cancer Control 2020; 27:1073274820945991. [PMID: 32735143 PMCID: PMC7658722 DOI: 10.1177/1073274820945991] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/29/2020] [Accepted: 07/08/2020] [Indexed: 11/16/2022] Open
Abstract
Many American Indian (AI) and Alaska native (AN) patients do not complete guideline-concordant cancer care for the 4 most common cancers. Our aim was to better understand AI/AN attitudes toward radiation therapy (RT). Patients eligible for this survey study were AI/AN patients with cancer at the Phoenix Indian Medical Center who either received previous RT or were recommended to receive RT. An 18-item questionnaire was administered to each of the 50 participants from October 1, 2018, through February 15, 2019. Willingness to travel for RT was compared to respondent characteristics, concerns regarding RT, and obstacles to obtain RT. Duration of RT was important to 78% of patients: 24% would consider traveling 25 miles or more for a standard course, and 48% would travel that distance for a shorter course (P < .001). The top-ranked barriers to RT were transportation, cost of treatment, and insurance compatibility. The top-ranked concerns about RT were adverse effects, cost of treatment, and fear of RT. Concerns about adverse effects were associated with the radiation team's inability to explain the treatment (P = .05). Transportation concerns were significantly associated with accessibility (P = .02), communication with the RT team (P = .02), and fear of RT (P = .04). AI/AN patients are concerned about the adverse effects of RT and the logistics of treatment, particularly costs, transportation, and insurance compatibility. Use of culturally specific education and hypofractionation regimens may increase acceptance of RT for AI/AN patients with cancer, and this hypothesis will be tested in a future educational intervention-based study.
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Affiliation(s)
- Samir H. Patel
- Department of Radiation Oncology, Mayo Clinic Hospital, Phoenix, AZ, USA
| | - Sasha Ebrahimi
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA
| | - Donald W. Northfelt
- Division of Hematology and Medical Oncology, Mayo Clinic Hospital, Phoenix, AZ, USA
| | - Timothy E. Mathews
- Oncology Center of Excellence, Phoenix Indian Medical Center, Phoenix, AZ, USA
| | - Farhia M. Omar
- Office of Health Disparities Research, Mayo Clinic, Scottsdale, AZ, USA
| | - Erika D. Martinez
- Office of Health Disparities Research, Mayo Clinic, Scottsdale, AZ, USA
| | - Todd A. DeWees
- Health Services Research, Mayo Clinic Scottsdale, AZ, USA
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Wieland ML, Njeru JW, Okamoto JM, Novotny PJ, Breen-Lyles MK, Goodson M, Porraz Capetillo GD, Molina LE, Sia IG. Association of social network factors with weight status and weight loss intentions among hispanic adults. J Behav Med 2020; 43:155-165. [PMID: 31894451 PMCID: PMC7071972 DOI: 10.1007/s10865-019-00131-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 12/17/2019] [Indexed: 01/02/2023]
Abstract
Hispanic adults have the highest obesity prevalence in the United States, but little is known about weight-related social network influences. A community-based sample of 610 Hispanic participants completed height/weight and a survey. The proportion of overweight or obese (OW/OB) network members was higher for OW/OB respondents compared to normal weight respondents. Participants with high weight loss intentions reported more positive social norms for weight control, social support, and social cohesion. If most or all of OW/OB participant's social contacts were trying to lose weight, the odds that they were likely to try to lose weight was four times higher than other participants. The relationship between weight loss intentions and number of social contacts trying to lose weight was strongly mediated by social norms for weight control and social support. These results suggest that social contacts and functional network characteristics may impact weight status and weight control intentions among Hispanic adults.
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Affiliation(s)
- Mark L Wieland
- Department of Medicine, Mayo Clinic, Rochester, MN, USA.
- Division of Community Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Jane W Njeru
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
- Division of Community Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Janet M Okamoto
- Department of Health Sciences Research, Mayo Clinic, Scottsdale, AZ, USA
| | - Paul J Novotny
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | | | - Miriam Goodson
- Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
| | - Graciela D Porraz Capetillo
- Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
- Department of Language Services, Mayo Clinic, Rochester, MN, USA
| | - Luz E Molina
- Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
- Department of Language Services, Mayo Clinic, Rochester, MN, USA
| | - Irene G Sia
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
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Njeru JW, Wieland ML, Okamoto JM, Novotny PJ, Breen-Lyles MK, Osman A, Ahmed YA, Nur MA, Nur O, Sia IG. Social networks and obesity among Somali immigrants and refugees. BMC Public Health 2020; 20:238. [PMID: 32066416 PMCID: PMC7026979 DOI: 10.1186/s12889-020-8315-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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] [Received: 07/25/2019] [Accepted: 02/03/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Somali immigrants and refugees to the United States are at high risk for obesity and related cardiovascular risk. Social network factors influence health behaviors and are important contributors to the obesity epidemic. The objective of this study was to describe social networks and obesity-related characteristics among adult Somali immigrants in a Minnesota city in order to inform a community-based, participatory, research-derived, social network intervention to decrease obesity rates. METHODS Survey data (demographics, general health measures, and sociobehavioral and network measures) and height and weight measures (for calculating body mass index) were collected from adult Somali immigrants by bilingual study team members at community locations. Descriptive statistics were used to report the survey and biometric data. Logistic regression models were used to describe the basic associations of participants and network factors. Network data were analyzed to identify nodes and ties, to visualize the network, and to identify potential interventionists for a future social network intervention. RESULTS Of the 646 participants, 50% were overweight or affected by obesity. The network had 1703 nodes with 3583 ties between nodes, and modularity was high (0.75). Compared with respondents of normal weight, participants who were overweight or affected by obesity had more network members who were also overweight or obese (odds ratio [OR], 2.90; 95% CI, 1.11-7.56; P = .03); this was most notable for men (OR, 4.58; 95% CI, 1.22-17.22; P = .02) and suggestive for those 50 years or older (OR, 24.23; 95% CI, 1.55-377.83; P = .03). Weight loss intention among participants who were overweight or affected by obesity was associated with number of family members and friends trying to lose weight, enabling functional network factors (social norms for weight loss, social support for healthy eating, and social cohesion), and less favorable obesogenic social norms. CONCLUSIONS In this community sample of Somali immigrants, distinct social networks are clustered by weight status, and social contacts and functional network characteristics are related to individuals' weight loss intentions. These factors should be considered in weight loss interventions and programs. A social network intervention targeting weight loss, within a community-based participatory research framework, is feasible in this vulnerable population.
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Affiliation(s)
- Jane W Njeru
- Department of Medicine, Mayo Clinic, Rochester, MN, USA.
| | | | | | - Paul J Novotny
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | | | - Ahmed Osman
- Somali Community Resettlement Services, Rochester, MN, USA
| | - Yahye A Ahmed
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mohamud A Nur
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Omar Nur
- Somalia Rebuild Organization, Rochester, MN, USA
| | - Irene G Sia
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
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Zhan Y, Zhang Z, Okamoto JM, Zeng DD, Leischow SJ. Underage JUUL Use Patterns: Content Analysis of Reddit Messages. J Med Internet Res 2019; 21:e13038. [PMID: 31502542 PMCID: PMC6786857 DOI: 10.2196/13038] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 06/22/2019] [Accepted: 07/21/2019] [Indexed: 11/13/2022] Open
Abstract
Background The popularity of JUUL (an e-cigarette brand) among youth has recently been reported in news media and academic papers, which has raised great public health concerns. Little research has been conducted on the age distribution, geographic distribution, approaches to buying JUUL, and flavor preferences pertaining to underage JUUL users. Objective The aim of this study was to analyze social media data related to demographics, methods of access, product characteristics, and use patterns of underage JUUL use. Methods We collected publicly available JUUL-related data from Reddit. We extracted and summarized the age, location, and flavor preference of subreddit UnderageJuul users. We also compared common and unique users between subreddit UnderageJuul and subreddit JUUL. The methods of purchasing JUULs were analyzed by manually examining the content of the Reddit threads. Results A total of 716 threads and 2935 comments were collected from the subreddit UnderageJuul before it was shut down. Most threads did not mention a specific age, but ages ranged from 13 years to greater than 21 years in those that did. Mango, mint, and cucumber were the most popular among the 7 flavors listed on JUUL’s official website, and 336 subreddit UnderageJuul threads mentioned 7 discreet approaches to circumvent relevant legal regulations to get JUUL products, the most common of which was purchasing JUUL from other Reddit users (n=181). Almost half of the UnderageJuul users (389/844, 46.1%) also participated in discussions on the main JUUL subreddit and sought information across multiple Reddit forums. Most (64/74, 86%) posters were from large metropolitan areas. Conclusions The subreddit UnderageJuul functioned as a forum to explore methods of obtaining JUUL and to discuss and recommend specific flavors before it was shut down. About half of those using UnderageJuul also used the more general JUUL subreddit, so a forum still exists where youths can attempt to share information on how to obtain JUUL and other products. Exploration of such social media data in real time for rapid public health surveillance could provide early warning for significant health risks before they become major public health threats.
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Affiliation(s)
- Yongcheng Zhan
- Department of Management Information Systems, University of Arizona, Tucson, Tucson, AZ, United States
| | - Zhu Zhang
- State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,Shenzhen Artificial Intelligence and Data Science Institute (Longhua), Shenzhen, China
| | - Janet M Okamoto
- Department of Research, Mayo Clinic, Phoenix, AZ, United States
| | - Daniel D Zeng
- State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,Shenzhen Artificial Intelligence and Data Science Institute (Longhua), Shenzhen, China
| | - Scott J Leischow
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
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Patten CA, Albertie ML, Chamie CA, Brockman TA, Gorfine M, Nicholas R, Bock MJ, Okamoto JM, Penheiter SG, Balls-Berry JE. Addressing community health needs through community engagement research advisory boards. J Clin Transl Sci 2019; 3:125-128. [PMID: 31660236 PMCID: PMC6802408 DOI: 10.1017/cts.2019.366] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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] [Received: 01/03/2019] [Revised: 02/28/2019] [Accepted: 03/01/2019] [Indexed: 12/04/2022] Open
Abstract
Over 80% of CTSA programs have a community advisory board (CAB). Little is known about how research discussed with CABs aligns with community priorities (bidirectionality). This program evaluation assessed researcher presentations from 2014 to 2018 to the CABs linked to our CTSA at all three sites (Minnesota, Arizona, and Florida) for relevance to local community needs identified in 2013 and/or 2016. From content analysis, of 65 presentations total, 41 (63%) addressed ≥1 local health needs (47% Minnesota, 60% Florida, and 80% Arizona). Cross-cutting topics were cancer/cancer prevention (physical activity/obesity/nutrition) and mental health. Results could help to prioritize health outcomes of community-engaged research efforts.
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Affiliation(s)
- Christi A. Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
- Center for Clinical and Translational Science, Community Engagement Program, Mayo Clinic, Rochester, MN, USA
| | - Monica L. Albertie
- Office of Health Disparities Research, Mayo Clinic, Jacksonville, FL, USA
| | - Chara A. Chamie
- Office of Health Disparities Research, Mayo Clinic, Scottsdale, AZ, USA
| | - Tabetha A. Brockman
- Center for Clinical and Translational Science, Community Engagement Program, Mayo Clinic, Rochester, MN, USA
| | - Mary Gorfine
- Olmsted County Youth Commission, Rochester, MN, USA
| | | | - Martha J. Bock
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Janet M. Okamoto
- Department of Health Sciences Research, Mayo Clinic, Scottsdale, AZ, USA
| | | | - Joyce E. Balls-Berry
- Center for Clinical and Translational Science, Community Engagement Program, Mayo Clinic, Rochester, MN, USA
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Leppin AL, Okamoto JM, Organick PW, Thota AD, Barrera-Flores FJ, Wieland ML, McCoy RG, Bonacci RP, Montori VM. Applying Social Network Analysis to Evaluate Implementation of a Multisector Population Health Collaborative That Uses a Bridging Hub Organization. Front Public Health 2018; 6:315. [PMID: 30450355 PMCID: PMC6224340 DOI: 10.3389/fpubh.2018.00315] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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] [Received: 08/29/2018] [Accepted: 10/15/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Multisector collaboratives are increasingly popular strategies for improving population health. To be comprehensive, collaboratives must coordinate the activities of many organizations across a geographic region. Many policy-relevant models encourage creation and use of centralized hub organizations to do this work, yet there is little guidance on how to evaluate implementation of such hubs and track their network reach. We sought to demonstrate how social network analysis (SNA) could be used for this purpose. Methods: Through formative research, we defined and conceptualized key characteristics of a bridging hub network and identified a set of candidate measures—(1) network membership, (2) network interaction, (3) role and reach of the bridging hub, and (4) network collaboration—to evaluate its implementation within a pre-determined geographic region of Southeast Minnesota, USA. We then developed and administered a survey to assess outcomes as part of a SNA. We commented on the feasibility and usefulness of the methods. Results: The initial surveyed network consisted of 50 healthcare organizational sites and 50 community organizations representing sectors of public health, education, research, health promotion, social services, and long-term care and supports. Fifty-three of these organizations responded to the survey. The network's level of collaboration was “Cooperation” (level 2 of 5) and reported levels of collaboration varied by organization. Thirty-eight additional, unsurveyed organizations were identified as collaborators by respondents, pushing the theoretical network denominator up to 138 organizations. These additional organizations included grocery stores, ambulance services, and smaller, independent healthcare and community-based services focused on meeting the needs of underserved populations. The bridging hub organization had the highest betweenness centrality and was in good position to bridge healthcare and the community, although its organizational reach was estimated at only 51%. The SNA methods were feasible and useful for identifying opportunities and guiding implementation. Conclusions: Bridging hub organizations are not likely to link—or even be aware of—all relevant organizations in a geographic region at initial implementation. SNA may be a useful method for evaluating the value and reach of a bridging hub organization and guiding ongoing implementation efforts. Trial registration: http://ClinicalTrials.gov; #NCT03046498
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Affiliation(s)
- Aaron L Leppin
- Knowledge and Evaluation Research Unit, Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, United States
| | - Janet M Okamoto
- Department of Health Sciences Research, Mayo Clinic, Scottsdale, AZ, United States
| | - Paige W Organick
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, United States
| | - Anjali D Thota
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, United States
| | | | - Mark L Wieland
- Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Rozalina G McCoy
- Division of Primary Care Internal Medicine, Division of Health Care Policy and Research, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, United States
| | - Robert P Bonacci
- Department of Family and Community Medicine, Mayo Clinic, Rochester, MN, United States
| | - Victor M Montori
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, United States
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Ginexi EM, Huang G, Steketee M, Tsakraklides S, MacAllum K, Bromberg J, Huffman A, Luke DA, Leischow SJ, Okamoto JM, Rogers T. Social network analysis of a scientist–practitioner research initiative established to facilitate science dissemination and implementation within states and communities. Research Evaluation 2017. [DOI: 10.1093/reseval/rvx026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Elizabeth M Ginexi
- National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892 USA
| | - Grace Huang
- Westat, 1600 Research Blvd., Rockville, MD, 20850 USA
| | | | | | | | - Julie Bromberg
- BLH Technologies, Inc, 1803 Research Blvd #300, Rockville, MD, 20850 USA
| | - Amanda Huffman
- BLH Technologies, Inc, 1803 Research Blvd #300, Rockville, MD, 20850 USA
| | - Douglas A Luke
- Washington University, St. Louis Campus Box 1196, One Brookings Drive, MO 63130, USA
| | - Scott J Leischow
- Mayo Clinic in Arizona, 13400 E. Shea Blvd, MCCRB C-301, Scottsdale, AZ, 85259 USA
| | - Janet M Okamoto
- Mayo Clinic in Arizona, 13400 E. Shea Blvd, MCCRB C-301, Scottsdale, AZ, 85259 USA
| | - Todd Rogers
- RTI International, Public Health Research Division, 351 California Street, Suite 500, San Francisco, CA 94104, USA
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