Assuring Health Access and Culturally Competent Health Services Through the Latino Health for All Coalition.

Although the importance of health care access is widely acknowledged, less is known about how partnerships can help assure access to quality health services for those experiencing health inequities. This report describes implementation of collaborative efforts through the Health Access Committee of the Latino Health for All Coalition (Wyandotte County/Kansas City, Kansas) to address its three goal areas (1) improving cultural competence through organizational change, (2) improving access to quality health services through access to diabetes prevention services, and (3) improving access and linkage to care via enrollment in health insurance. Using community-based participatory approaches, we documented and reflected on the pattern of activities facilitated by the coalition and its partners for each goal area over a 1-year period. This case report outlines strategies, activities, and lessons learned by coalition partners. This article offers practical guidance about how to structure and implement a coalition that provides technical support for increasing health care access and cultural competency.

Empowering Promotores de Salud as partners in cancer education and research in rural southwest Kansas.

PURPOSE/OBJECTIVES: To describe community-based participatory processes used to develop promotore training on cancer research, and to assess the feasibility of training promotores from rural communities to disseminate cancer research information. DESIGN: Prospective, cohort design. SETTING: Rural communities in the state of Kansas. SAMPLE: 34 Spanish-speaking promotores attended an information session; 27 enrolled and 22 completed training. METHODS: With input from a community advisory board, the authors developed a leadership and cancer curriculum and trained Spanish-speaking promotores to disseminate information on cancer research. Promotores completed pretraining and post-training surveys in Spanish to assess demographic characteristics and changes in knowledge of cancer, cancer treatment and cancer research studies, and intent to participate in cancer research. MAIN RESEARCH VARIABLES: Cancer knowledge, awareness of cancer clinical trials, interest in participating in cancer clinical research studies. FINDINGS: Compared to pretraining, after training, promotores were more likely to correctly define cancer, identify biopsies, describe cancer stages, and report ever having heard of cancer research studies. CONCLUSIONS: Completion rates of the training and willingness to participate in cancer research were high, supporting the feasibility of training promotores to deliver community-based education to promote cancer research participation. IMPLICATIONS FOR NURSING: Nursing professionals and researchers can collaborate with promotores to disseminate cancer education and research among underserved rural Latino communities in Kansas and elsewhere. Members of these communities appear willing and interested in improving their knowledge of cancer and cancer clinical trials.

Induction of Fetal Hemoglobin In Vivo Mediated by a Synthetic γ-Globin Zinc Finger Activator.

Sickle cell disease (SCD) and ß-thalassemia patients are phenotypically normal if they carry compensatory hereditary persistence of fetal hemoglobin (HPFH) mutations that result in increased levels of fetal hemoglobin (HbF, γ-globin chains) in adulthood. Thus, research has focused on manipulating the reactivation of γ-globin gene expression during adult definitive erythropoiesis as the most promising therapy to treat these hemoglobinopathies. Artificial transcription factors (ATFs) are synthetic proteins designed to bind at a specific DNA sequence and modulate gene expression. The artificial zinc finger gg1-VP64 was designed to target the -117 region of the (A)γ-globin gene proximal promoter and activate expression of this gene. Previous studies demonstrated that HbF levels were increased in murine chemical inducer of dimerization (CID)-dependent bone marrow cells carrying a human ß-globin locus yeast artificial chromosome (ß-YAC) transgene and in CD34(+) erythroid progenitor cells from normal donors and ß-thalassemia patients. Herein, we report that gg1-VP64 increased γ-globin gene expression in vivo, in peripheral blood samples from gg1-VP64 ß-YAC double-transgenic (bigenic) mice. Our results demonstrate that ATFs function in an animal model to increase gene expression. Thus, this class of reagent may be an effective gene therapy for treatment of some inherited diseases.