Advancing Health Equity Knowledge, Attitudes, and Beliefs Within a National Health Nonprofit Organization.

OBJECTIVE: This study presents survey results assessing the impact of the American Cancer Society (ACS) health equity (HE) training on staff knowledge, attitudes, and beliefs about HE and social determinants of health (SDOH). DESIGN: This study is a quasi-experimental design examining survey responses over time and comparing responses from staff who participated in ACS HE training sessions and education opportunities and those who did not. SETTING: An electronic Web survey was distributed to all ACS and American Cancer Society Cancer Action Network (ACS CAN) staff in each of the 3 years that the training was held (2018-2020). PARTICIPANTS: ACS and ACS CAN staff who chose to take the survey were included in the study. INTERVENTION: Engagement with training hosted by the ACS HE team was examined. Training sessions were intended to introduce staff to HE and SDOH in the context of cancer outcomes and provide staff with the skills to become HE champions in the organization. MAIN OUTCOME MEASURES: This study examines whether participation in training sessions hosted by the HE team had an impact on knowledge of HE terms, attitudes, and beliefs about HE and engagement with HE. RESULTS: Trained respondents had a significantly higher HE knowledge summary score (98%) than those who were not trained (79%, SD = 0.26100, P < .001). Respondents who participated in training were more likely to believe that they could advance HE through their work at ACS and ACS CAN (88% compared with 66% of those who were not trained, SD = 0.47300, P < .001). Respondents who participated in training scored an average of 4.7 out of 6 on HE engagement compared with 3.8 among the untrained (SD = 1.425, P < .001). CONCLUSIONS: These findings demonstrate that participation in HE training is associated with higher levels of knowledge about HE and stronger personal attitudes and beliefs about the importance of addressing SDOH. This is a foundational step in staff taking action to integrate HE concepts into their day-to-day work toward reducing inequities in access to cancer treatment and health outcomes.

Program Design for Healthy Weight in Lesbian and Bisexual Women: A Ten-City Prevention Initiative.

PURPOSE: Adult lesbian and bisexual (LB) women are more likely to be obese than adult heterosexual women. To address weight- and fitness-related health disparities among older LB women using culturally appropriate interventions, the Office on Women's Health (OWH) provided funding for the program, Healthy Weight in Lesbian and Bisexual Women (HWLB): Striving for a Healthy Community. This paper provides a description of the interventions that were implemented. METHODS: Five research organizations partnered with lesbian, gay, bisexual, and transgender community organizations to implement healthy weight interventions addressing the needs of LB women 40 years and older. The interventions incorporated evidence-based recommendations related to physical activity and nutrition. Each group intervention developed site-specific primary objectives related to the overall goal of improving the health of LB women and included weight and waist circumference reduction as secondary objectives. A 57-item core health survey was administered across the five sites. At a minimum, each program obtained pre- and post-program assessments. RESULTS: Each program included the OWH-required common elements of exercise, social support, and education on nutrition and physical activity, but adopted a unique approach to deliver intervention content. CONCLUSION: This is the first time a multisite intervention has been conducted to promote healthy weight in older LB women. Core measurements across the HWLB programs will allow for pooled analyses, and differences in study design will permit analysis of site-specific elements. The documentation and analysis of the effectiveness of these five projects will provide guidance for model programs and future research on LB populations.

Improving water quality communications at beaches: input from stakeholders.

OBJECTIVES: Water quality communication practices vary widely and stakeholder input has not played a role in defining acceptable levels of risk. Although the 2012 Recreational Water Quality Criteria (RWQC) emphasize the importance of promptly notifying the public about hazardous conditions, little is known about the public's understanding of notifications, or about levels of risk deemed acceptable. We sought to address these gaps. METHODS: A mixed methods approach was used. Focus groups (FGs) provided qualitative data regarding the understanding of surface water quality, awareness, and use, of currently available water quality information, and acceptability of risk. Intercept interviews (INTs) at recreation sites provided quantitative data. RESULTS: INTs of 374 people and 15 FG sessions were conducted. Participants had limited awareness about water quality information posted at beaches, even during swim bans and advisories. Participants indicated that communication content should be current, from a trusted source, and describe health consequences. Communicating via mobile electronics should be useful for segments of the population. Risk acceptability is lower with greater outcome severity, or if children are impacted. CONCLUSIONS: Current water quality communications approaches must be enhanced to make notification programs more effective. Further work should build on this initial effort to evaluate risk acceptability among US beachgoers.