Behavioral and Social Science最新文献

{"title":"Abstract B18: Attitudes, perceptions, and strategies toward increasing cancer screening, treatment, and participation in research among Latinos","authors":"Nadine J. Barrett, Kearston L Ingraham, Xiomara Boyce, Rebecca Reyes","doi":"10.1158/1538-7755.DISP17-B18","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-B18","url":null,"abstract":"Background: Nationally, cancer disparities negatively impact minority communities at alarming rates. Minorities have low rates of cancer screenings compared to white counterparts, resulting in Latinos having poor cancer outcomes in lung, colon, breast, and prostate cancers. Previous studies have examined race/ethnic cancer disparities, yet improved health outcomes are lagging in the Latino community. We assessed perceptions and recommendations to improving cancer screenings, treatment, research participation, and survivorship within the Latino community as part of the codevelopment of a health-equity agenda around cancer services and research at the Duke Cancer Institute. Methods: We conducted five 90-minute focus groups reaching a total of 51 members of the Latino community, including clergy, community members, survivors, caregivers, and local leaders, to identify the barriers and facilitators to engaging the Latino community in cancer services and research. Data were recorded and analyzed using Atlas Ti Software. Results: Barriers to cancer screenings and treatment included affordability of care, lack of health insurance or other financial resources, lack of knowing when to seek screenings, poor patient provider communication, treatment and options seem to be different based on insurance and/or immigration status, language barriers, machismo, stigma and fear of a cancer diagnosis, long wait times, and excessive and unclear paperwork when seeking cancer screening and treatment services. Participation in clinical trials and research was considered limited due to lack of outreach, education, and full engagement with the Latino community around research. Key strategies include engaging families and communities to increase community9s knowledge and access to prevention, screenings, and available treatment options, including clinical trials. Develop partnerships with Latino faith-based and serving organizations to extend services and education about cancer screenings and research. Have services more accessible and culturally responsive to promote screening and timely follow-up, and incorporate staff and lay community leaders to promote awareness and participation in research. Conclusion: Developing sustainable and equitable collaborations and partnerships between the cancer center and the Latino community to increase access to education, screening, treatment, and research is critical to addressing longstanding cancer disparities. There are key community-derived opportunities to incorporate culturally tailored community programs designed to ensure the Latino community and patients gain access to quality, culturally responsive health care and research. Ongoing outreach and education across the cancer continuum needs to reflect and respond to the values and perspectives of the Latino community. Leveraging the family and the community strengths to address the need and build capacity to fully engage in clinical services and research has the potential to y","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"113 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117054139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract B35: Factors associated with beliefs about genetics related to cancer risk among racial and ethnic adults 18 years and older in the United States","authors":"Lawrence P. McKinney, Gemechu B Gerbi, Mechelle D. Claridy, B. Rivers","doi":"10.1158/1538-7755.DISP17-B35","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-B35","url":null,"abstract":"Background: Recent data suggest a widening gap in the utilization of genetic testing for determining cancer risk among certain racial and ethnic groups in the United States (U.S.). As the availability increases, it remains unclear why minority populations are less likely to engage in genetic testing as compared to non-Hispanic Whites (NHW). It has been postulated that a host of factors may contribute to the disproportionate uptake of genetic testing; however, it remains unclear which factors are most salient for minority populations. The objective of this study was to examine the factors associated with beliefs about genetic testing among a racially and ethnically diverse group of adults in the U.S. Understanding these factors will further our understanding regarding the disparity in the uptake of genetic testing. Methods: Data for this study were obtained from the National Cancer Institute9s 2014 Health Information National Trends Survey (HINTS) Cycle 4, a cross-sectional survey of 2,753 American adults by telephone and postal mail. Bivariate chi-square analyses were conducted to examine the association between each explanatory variable (gender, race/ethnicity, age, level of education, level of income, genetic test knowledge) and the belief that health behaviors (i.e., diet, exercise, and smoking) determine whether a person will develop cancer and the belief that genetics determine whether a person will develop cancer. Multivariable logistic regression analyses were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) to determine whether race, genetic testing knowledge, health behavior beliefs, and sociodemographic factors affect beliefs in cancer genetics risk. Analyses were conducted using SAS version 9.4. Results: After adjusting for socioeconomic status, factors associated with higher odds of reporting that genetics determine whether a person will develop cancer was gender. Women were more than twice as likely to believe that genetics determine whether a person will develop cancer (AOR= 2.20; 95% CI=1.46,3.34). The factors associated with lower odds of reporting that genetics determine whether a person will develop cancer were: African American (AA) (AOR=0.52; 95% CI=0.30,0.89); Hispanic (AOR=0.57;95% CI=0.32,0.99); non-Hispanic Asian (AOR=0.33; 95% CI=0.14,0.79); Other, including Alaska Natives, American Indians, Native Hawaiians, or other Pacific Islanders, and non-Hispanic multiple race (AOR=0.38; 95% CI=0.15,0.95); those with a high school or less than high school education (AOR=0.34; 95% CI=0.19,0.60 and AOR=0.48; 95% CI=0.23-0.99, respectively); those who were age 75 and older (AOR=0.40; 95% CI=0.18,0.88); those earning less than $20,000 income (AOR=0.23; 95% CI=0.09,0.60); and those who believe that health behaviors determine whether a person will develop cancer (AOR=0.08; 95% CI=0.05,0.13). Contrary to our expectations, knowledge of genetic testing was found to be not statistically significant (AOR=0.8","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127057769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract C22: Cancer-related financial burden, employment, and health among rural cancer survivors","authors":"Emily Hallgren, L. Carnahan, Kristine Zimmermann, Y. Molina","doi":"10.1158/1538-7755.DISP17-C22","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-C22","url":null,"abstract":"Purpose: A growing body of literature has begun to document rural-urban disparities among cancer survivors. Rural survivors report worse mental health, health behaviors (e.g., smoking, physical activity), and self-rated health relative to urban counterparts. There is a need to determine modifiable determinants of these disparities, including work. Only one study of which we are aware has explored financial determinants of health: Weaver and colleagues found rural survivors were more likely to report not being able to work because of health-related reasons than urban counterparts. Little, however, is known about cancer-related financial burden during (e.g., filing for bankruptcy) and after treatment (e.g., not returning to work). Objective: This study seeks to: 1) characterize cancer-related financial burden and employment among rural survivors and 2) examine how these factors pertain to their self-rated health. Methods: We drew from an ongoing larger study that is characterizing the health needs of 600 rural cancer survivors and caregivers of cancer patients throughout Illinois State. Participants were recruited via non-probability based sampling methods, including physical flyers placed in rural community organizations (e.g., churches, hair salons, support groups), public health departments, clinics, hospitals, and cancer centers as well as at cancer-related events (e.g., Relay for Life); word of mouth; and electronic flyers distributed via websites, listservs, and social media. Interested participants contacted staff via the study website or phone number. To be eligible for the study, individuals self-reported: 1) being 18 years or older, 2) identifying as a survivor and/or caregiver, and 3) living in a rural part of Illinois State. After screening and providing informed consent, participants completed surveys by mail, phone, or website. Participants received $15 for their time and effort. Results: Since February, we have recruited 72 current survivors, 84% of whom completed the survey online and 27% of whom also self-reported having been caregivers of cancer patients during their lifetime. Our sample was largely female, married, and non-Latino White (NLW). Survivors in the sample are well-educated overall, with 52% holding a bachelor9s degree or above. The median annual household income (AHI) was $50,001 to $75,000, with 40% reporting an AHI of more than $75,000. Approximately 26% of respondents indicated cancer-related financial burden. With regard to work, 52% indicated cancer-related work stoppage, 18% indicated they did not return to work, and 40% indicated a reduced workload during treatment. Cancer-related financial burden was associated with family income, in that work stoppage was associated with lower annual household income (B = -0.32, 95% CI [-0.14, -1.35], p = .02). Finally, we examined how cancer-related financial burdens and employment factors were associated with rural residents9 self-rated health. Cancer-related employment fact","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"285 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126738933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract A13: Using boot camp translation to design a system-based intervention to improve rates of colon cancer screening using fecal immunochemical testing among Latino patients in community health centers","authors":"Jamie H. Thompson, Melinda M. Davis, Leann Michaels, Jennifer S Rivelli, Marta Castro, Anne L. Escaron, Brittany Younger, Melissa Castillo, Sacha Reich, G. Coronado","doi":"10.1158/1538-7755.DISP17-A13","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-A13","url":null,"abstract":"Introduction: Colon cancer is the second-leading cause of cancer death in the United States, and screening rates are disproportionately low among Latinos. In 2015, only 63% of eligible adults, and 50% of Latinos, were up to date with colon cancer screening recommendations. One factor thought to contribute to the low screening rate is that patient-facing health information for Latinos is difficult to understand and patients face challenges in taking appropriate health action. As part of the Participatory Research to Advance Colon Cancer Prevention (PROMPT) study that seeks to raise rates of colon cancer screening in a Latino-serving community health center in California, we used boot camp translation (BCT), a validated community-based participatory strategy, to elicit input from diverse stakeholders and refine the messages and format of colon cancer screening reminders for a clinic-based direct mail fecal immunochemical test (FIT) program. Methods: We adapted BCT to engage Latino patients and clinic staff in this research. Eligible patient participants were Latino, aged 50 to 75 years, able to speak English or Spanish, and willing to participate in a 6-hour in-person meeting and three 30-minute follow-up phone calls. Materials were developed in English and Spanish, and separate sessions were held for English- and Spanish-speaking participants. As part of the in-person sessions, a national bilingual colon cancer expert delivered a presentation on colon health, cancer screening, and messages to improve screening participation, specific to Latino populations. Following the presentation, BCT experts facilitated brainstorming sessions to obtain feedback on the presented information, followed by an interactive small-group session where participants reviewed sample written materials and reminder messages using various modalities (e.g., text, letter, automated and live calls). We asked participants to consider what information about colon cancer screening is important to share with other patients, what the best methods are to share these messages, and the frequency with which these messages should be delivered to patients to encourage FIT completion. Participants then engaged in a hands-on exercise to share input about the timing and frequency of reminder delivery. Results from the exercise were used to define the intervention for the PROMPT pilot. Results: A total of 25 adults participated in an in-person session (12 in the English-language session; 13 in the Spanish-language session). Participants were mostly clinic patients (84%) and the majority were female (80%). Among the patient participants, 57% were enrolled in Medicaid, and 67% reported an annual household income of less than $20,000. Key themes from the sessions included increasing awareness about colon cancer and screening options, stressing the urgency of screening, and using personalized messages such as “I” statements in letters or human voices on automated phone call reminders. Both sessio","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126066713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract B15: Colorectal cancer knowledge and adherence among Hispanic workers","authors":"J. Ou, A. Kirchhoff, E. Warner, Laura Martel, D. Kepka","doi":"10.1158/1538-7755.DISP17-B15","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-B15","url":null,"abstract":"Background: Hispanics report the lowest CRC screening rate of any ethnic group in the United States. Hispanics comprise 14% of Utah9s population and are growing rapidly. Most of the Hispanics in Utah are foreign-born immigrants who work low-wage jobs that do not offer health benefits, making them a high-risk population for low CRC screening rates. We partnered with companies in Salt Lake County with a large Hispanic employee population to implement an educational intervention to improve knowledge of and adherence to cancer screenings. We identify demographic predictors of CRC knowledge and adherence pre-intervention, and of improvements in adherence post-intervention. Methods: Current and previous employees of service/manual labor companies (e.g., professional cleaning, restaurants, construction) were recruited by local businesses and community organizations. Promotoras held educational sessions at the local businesses. Pre- and post-interviews measured CRC screening knowledge, adherence, demographics, and perceptions of CRC risk. Interviews were conducted in person or on the phone within 10 months of the intervention. Participants aged ≥50 were given FOBT/FIT tests. Chi-square tests examined differences in knowledge among participants and adherence preintervention. Multivariable logistic regression models identified predictors of knowledge, awareness, and adherence preintervention, and identified characteristics associated with improvements in adherence post-intervention. Results: We recruited 307 Hispanic employees. 95% of our population were Hispanic immigrants, 88% speak Spanish, 64% make $25,000 or less a year, and 70% do not have health insurance. 40% of adults aged ≥50 were adherent to CRC screening guidelines before the intervention; after the intervention, 66% of eligible adults were adherent, with the majority of the improvement in FOBT/FIT tests. We found significant differences in initial knowledge of CRC among participants aged 18 to 49 years (51%) vs age ≥50 years (85%, p Conclusions: Knowledge of CRC screenings among Hispanics is related to older age, education, and insurance. Providing FOBT/FIT yielded significant improvements in adherence. Ensuring that Hispanics have access to health insurance and affordable CRC screenings is a critical factor in improving CRC screenings in this vulnerable population. Citation Format: Judy Y. Ou, Anne C. Kirchhoff, Echo L. Warner, Laura Martel, Deanna Kepka. Colorectal cancer knowledge and adherence among Hispanic workers [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B15.","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133155187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract C28: Éxito! Cultivating new Latino scientists in cancer health disparities research","authors":"Arely Perez, K. Gallion, A. Ramirez","doi":"10.1158/1538-7755.DISP17-C28","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-C28","url":null,"abstract":"The Exito! Latino Cancer Research Leadership Training (Exito!) program was developed to encourage Latino master9s level students and graduates to pursue a doctoral degree and career in Latino cancer health disparities (CHD) research. Strengthening the academic pipeline for Latinos is critical for (1) ensuring that the next generation of health practitioners and researchers is representative of the U.S. population and (2) ensuring that culturally relevant solutions are developed to reduce health disparities and improve health equity among Latinos. The Exito! Program was established to address historically low numbers of Latino scientists in cancer health disparities research. Exito! comprises two main components: a 5-day summer institute (SI) for 25 attendees and paid internships offering practical cancer health disparities research experiences. SI attendees are recruited from across the U.S. through communications and partnerships with over 55 universities, 240 faculty members, and 40 national student organizations and associations. A competitive online application process is open each year from November to February with the SI occurring in early June. Twenty-five master9s-level students or master9s-level health professionals are selected to participate in the SI. The SI features presentations by leaders in Latino CHD research who discuss different aspects of graduate student life including such topics as academics, finances, and family life. Speakers are predominately Latinos and are encouraged to share their graduate school experiences. The internship component is designed to expose program participants/alumni to Latino cancer health disparities research, and enhance their research skills. To be considered for an internship, applicants must identify a mentor and submit a work plan during the program recruitment period outlining the scope of the research they would like to perform (e.g., secondary analysis of cancer-related data, field-experience on an established research project). All internships are conducted at the applicant9s home institution or university and are six months long. Exito! outcomes are measured through five surveys: pre/post-Summer Institute surveys, pre/post- internship surveys, and an annual alumni survey. The pre-SI survey collects demographic (e.g., age, gender, nativity), and academic information (e.g., stage in master9s program, familial expectations to attend and obtain graduate education), as well as information on the perception of academic barriers and facilitators (e.g., discrimination based on race, gender, age) and academic self-efficacy (e.g., confidence about writing a competitive personal statement, acceptance into a doctoral program of choice). The survey also captures information about participants9 confidence in applying to a doctoral program in the next year and the next five years, as well as their confidence in pursuing a career in cancer control research. The post-SI survey collects the same information","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123601171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract C29: Social networks at diagnosis and recurrence, breast cancer-specific mortality, and overall mortality in white and non-white women in the Pathways Study","authors":"Candyce H Kroenke, S. Gomez, M. Kwan, L. Kushi","doi":"10.1158/1538-7755.DISP17-C29","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-C29","url":null,"abstract":"Background: Women with larger social networks generally have better breast cancer survival. However, previous work has been conducted predominantly in white women. Therefore, we evaluated associations of social networks, social support, and breast cancer-specific and overall mortality in a large, Northern California cohort of women with breast cancer, evaluating whether associations differed in white and non-white women. Methods: This study included 4,505 women from the Pathways Study, a prospective cohort study examining predictors of outcomes in women diagnosed from 2006-2013 with stages I-IV breast cancer in Kaiser Permanente Northern California. Participants responded to questions on social ties (marital/intimate partner, close friends and relatives, community and religious participation) and to the Medical Outcomes Study social support survey approximately two months following diagnosis. We used proportional hazards regression to evaluate associations between social networks, social support and recurrence, breast cancer-specific mortality, and overall mortality. We further stratified by white vs. non-white race since the number of outcomes were too small in specific non-white racial/ethnic groups, which included African-American (AA), Asian/Pacific Islander (API), and Hispanic women. We then evaluated evidence of effect modification by this variable. Results: The cohort included 2,894 white and 1,611 non-white women. In multivariable-adjusted analyses of the full cohort, adjusted for sociodemographic characteristics, disease severity, treatment, and presence of comorbidity, women with small social networks had higher breast cancer-specific and overall mortality. However, associations differed substantially by race/ethnicity (p-value, test for interaction=0.02 for recurrence, p=0.07 for breast-cancer specific mortality, and p Conclusions: In white women, larger social networks were related to better survival, whereas among non-white women, those with moderate-sized networks had the lowest risks of recurrence and breast cancer-specific mortality. The influence of social networks on breast cancer outcomes may differ by race/ethnicity. Citation Format: Candyce Kroenke, Scarlett Lin Gomez, Marilyn Kwan, Lawrence Kushi. Social networks at diagnosis and recurrence, breast cancer-specific mortality, and overall mortality in white and non-white women in the Pathways Study [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C29.","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126781676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract C32: [Advocate Abstract:] Survivorship and African American women diagnosed with MBC","authors":"Y. Florence","doi":"10.1158/1538-7755.disp17-c32","DOIUrl":"https://doi.org/10.1158/1538-7755.disp17-c32","url":null,"abstract":"","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129248298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract C03: Reducing Muslim mammography disparities: Outcomes from a religiously tailored mosque-based intervention","authors":"A. Padela, S. Malik, S. Nageeb, M. Peek, M. Quinn","doi":"10.1158/1538-7755.DISP17-C03","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-C03","url":null,"abstract":"Objective: To describe the design of, and participant-level outcomes related to, a religiously tailored peer-led group education program that addressed mammography-related barrier beliefs of American Muslims. Methods: Using community-engaged research methods including a multidisciplinary community advisory board, we identified and then intervened upon barrier beliefs impeding mammography screening among American Muslim women. Phase 1 of the project involved focus groups and interviews with an ethnically diverse group of women aged 40 and older sampled from Muslim organizations to identify salient behavioral, normative, and control beliefs regarding mammography. Phase 2 entailed interviews with the same target population to elicit ideas about intervention design. CAB members and staff used these data to design the curriculum and messaging for a religiously tailored mosque-based intervention involving peer-led group education classes. Peer educators were recruited and trained from mosques and were religious and ethnically concordant with the target intervention population. The classes involved facilitated discussions and guest-led didactics covering religion and health and mammography. Survey data from group education participants were collected pre-intervention, post-intervention, 6 months post-intervention, and one year post-intervention. Survey instruments recorded changes in mammography intention, likelihood, confidence, and resonance with barrier and facilitator beliefs. The structural elements and messages of the classes tackled barrier beliefs in at least one of 3 ways: (i) Reprioritizing--introducing another religious belief that has greater resonance with participants such that the barrier belief is marginalized; (ii) Reframing the belief within a religious worldview such that it is consistent with the health behavior desired; and (iii) Reforming--using a religious scholar to provide “correct” interpretations of religious doctrine. Results: 52 Muslim women (mean age = 50 yrs) who had not had a mammogram in the past two years, of whom 18 were of Arab descent and 27 South Asian, participated in the two-session course. The pre- and post-self-reported likelihood of obtaining a mammogram increased significantly following the intervention (p=0.03), as did breast cancer screening knowledge (p=0.0002). Greater resonance with facilitator beliefs significantly predicted positive likelihood changes (OR 1.31, p=.003). Participants with higher negative religious coping (OR = 1.33, p=0.04) and greater resonance with facilitator beliefs (OR = 1.44, p = 0.00) had higher odds for having an intention to get a mammogram post the class, while those with higher religiosity (DUREL, OR = 0.72, p= 0.01), and more resonance with barrier beliefs (OR= 0.72, p= 0.01) had significantly lower intentions. At six months9 follow-up, 42% (n= 20/47) of participants had obtained a mammogram and 7.7% (n=4) were lost to follow-up. Conclusion: Our pilot mosque-based interventio","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115591058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract B21: Community health worker led smoking cessation intervention in Virginia Appalachia","authors":"Lindsay Hauser, Catherine Labgold, Roger T Anderson, F. Camacho","doi":"10.1158/1538-7755.DISP17-B21","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-B21","url":null,"abstract":"Introduction: Smoking in the United States has steadily declined over the past several years; however, rural Virginia Appalachian communities have a substantially higher than average smoking prevalence than the rest of the country. A major challenge in providing effective and sustainable cigarette-cessation services to Virginia Appalachia is the geographic and economic diversity of the region, combined with much of the population residing in poor, medically underserved rural areas. Previous research has suggested that community health workers (CHWs) may be valuable in regions with limited financial and medical resources by acting as a bridge between patients and providers when access is limited by distance, health care provider shortages, and cultural stigma. The purpose of this study was to assess the feasibility and success of using CHWs for smoking-cessation services in two Virginia Appalachian health care settings. Methods: Study enrollees were recruited from two sites: a local-family-owned pharmacy and a Federally Qualified Health Center (FQHC) in the Appalachian region of Virginia. Inclusion criteria were daily adult smokers (18+) who were patients at the clinic or the community pharmacy, and self-identified as ready to quit in the next 30 days. Enrollees were defined as individuals for whom a consent form and baseline assessment were completed. Enrollees were subset into a participant group defined as enrollees who completed at least the first session of the eight-session intervention plan. We used an intention-to-treat framework in calculating enrollee and participant quit rates. The program was designed to have eight sessions, with scheduling at the discretion of the CHW and participant. Sessions five and eight were to be completed by the respective health care provider for the clinic and pharmacy. Sessions one and two were completed by the CHW in person with the participant, and sessions three, four, six, and seven were completed by the CHW over the phone. During the sessions, CHWs helped participants develop skills in identifying and addressing barriers to a successful cigarette quit, providing support in adhering to their quit plan, and discussing challenges and barriers they were facing in their quit attempt. Results: Twenty-three individuals were enrolled in the study, with twenty distinguished as participants. The enrollee quit rate was 22%, with a participant quit rate of 25%. Overall, we found a statistically significant decrease in all participants9 average cigarettes smoked per day over the eight sessions. Almost all participants failed to complete sessions 5 and 8 with their health care provider. All participants highly rated the program with 100% satisfaction on flexibility of scheduling, level of comfort, positivity, and helpfulness of the CHW. Conclusion: The use of CHWs in Virginia Appalachian communities within our pilot study for cigarette cessation services appears promising. Challenges were noted in attendance to sessi","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"312 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115031657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}