An exploration of Latino smokers and the use of pharmaceutical aids.

BACKGROUND: Latino smokers are less likely than white non-Latino smokers to use nicotine replacement therapy (NRT) or bupropion when trying to quit smoking. The current study explored sociocultural and psychosocial factors related to nonuse of smoking-cessation medications among Latino smokers. METHODS: Structured discussions were held with six separate focus groups of current smokers (n =49) who self-identified as Latino, had attempted to quit in the past 12 months, and were aged 35 to 64 years. Participants were recruited from Latino-serving health clinics, community events, and community organizations. Session recordings were transcribed, and content analysis was used to organize themes into categories. RESULTS: Six thematic categories emerged across most or all discussion groups: (1) smoking is a weakness rather than an illness, (2) pharmaceuticals are generally avoided, (3) NRT is mistrusted, (4) bupropion is widely rejected, (5) views are mixed regarding ethnic dimensions of smoking and quitting, and (6) misconceptions are common regarding smoking and cessation. CONCLUSIONS: Cognitive reframing strategies should be developed and tested for Latino smokers who decline pharmacologic smoking-cessation assistance for reasons other than well-informed autonomous choice.

Latinos report less use of pharmaceutical aids when trying to quit smoking.

BACKGROUND: Latino smokers are more likely than white non-Latino smokers to attempt cessation, but less likely to receive cessation advice from physicians or to use nicotine replacement therapy (NRT). Proposed underlying causes have included lighter smoking, lower financial status, and less healthcare access. This study assessed these factors as possible explanations for disparate rates of smoking-cessation support. METHODS: Data were analyzed from a random, population-level telephone survey of Colorado adults that interviewed 10,945 white non-Latino respondents and 1004 Latino respondents. For the current analysis, main outcome measures were receipt of physician advice to quit smoking, use of NRT, and use of bupropion or other anti-depressant for smoking cessation. RESULTS: Latino smokers reported higher prevalence of quit attempts (71.5% v 61.6%, p <0.01) but less physician advice to quit smoking (46.4% v 56.2%, p <0.05) and less use of NRT or an anti-depressant for cessation (10.6% v 24.8%, p <0.0001). Adjusted for potentially confounding factors, the odds ratio (OR) for less Latino use of cessation medications was substantial and significant (full model OR=0.31; 95% confidence interval, 0.17 to 0.57). The adjusted OR for physician cessation advice was not significant. CONCLUSIONS: Population-level differences in health status, smoking level, financial status, or healthcare access do not explain why Latino smokers less often use proven pharmaceutical aids to increase cessation. Further research is needed to understand these disparities, and greater effort is needed to deliver cessation support to Latino smokers seeking to quit.

Distinct beliefs, attitudes, and experiences of Latino smokers: relevance for cessation interventions.

PURPOSE: Determine the extent to which Latino smokers are using effective interventions for smoking cessation, with particular focus on nicotine replacement therapy (NRT). Related aims were to explore cultural, attitudinal, knowledge, and socioeconomic variables associated with treatment use. DESIGN: Cross-sectional telephone survey of two groups of Colorado adult smokers: Latinos (n = 1010) and non-Latino whites (n = 519). SETTING: Colorado. METHODS: Computer-assisted telephone survey in either Spanish or English. Survey addressed sociodemographic variables; smoking and cessation history; knowledge, attitudes, and beliefs about smoking and quitting; and experiences in and attitudes toward the health care setting. PARTICIPANTS: Latino and non-Latino white adult Colorado residents who reported being regular smokers. RESULTS: Colorado Latinos report using NRT substantially less often than do non-Latino whites residing in the state. This and other differences in the study were more pronounced in Latinos characterized as low acculturation on the basis of a language preference variable. Latinos smoke somewhat less than non-Latino whites and report lower levels of dependence. They appear to be motivated to quit but endorse attitudes and beliefs antithetical to NRT use. Health care access was lower among Latinos, and this was related to lower reports of lifetime NRT use. Receipt of recommended practitioner intervention (the "five As") did not differ by ethnicity. CONCLUSIONS: Results suggested that use of effective cessation interventions among Latinos may be enhanced by education about nicotine addiction and NRT. Policy change to increase health care access also showed promise.

The Latina Breast Cancer Screening Sacle: beliefs about breast cancer and breast cancer screening.

The Latina Breast Cancer Screening (LBCS) was developed to measure Latinas' culturally-shared health beliefs about breast cancer and breast cancer screening. A 60-item LBCS scale was tested with 288 participants and reduced to 35 items using principal components analyses. The 35-item LBCS scale and other measures were administered to a second sample of 147 participants to establish the scale's validity and reliability. A six-factor solution suggested six LBCS sub-scales. The LBCS in its entirety displayed strong internal consistency (alpha =.93) with adequate estimates of convergent, discriminant, and predictive validity. The LBCS scale appears to be a valid and reliable measure.

"Get smart Colorado": impact of a mass media campaign to improve community antibiotic use.

CONTEXT: Large-scale strategies are needed to reduce overuse of antibiotics in US communities. OBJECTIVES: To evaluate the impact of a mass media campaign-"Get Smart Colorado"-on public exposure to campaign, antibiotic use, and office visit rates. DESIGN: Nonrandomized controlled trial. SETTING: Two metropolitan communities in Colorado, United States. SUBJECTS: The general public, managed care enrollees, and physicians residing in the mass media (2.2 million persons) and comparison (0.53 million persons) communities. INTERVENTION: : The campaign consisting of paid outdoor advertising, earned media and physician advocacy ran between November 2002 and February 2003. PRINCIPAL MEASURES: Antibiotics dispensed per 1000 persons or managed care enrollees, and the proportion of office visits receiving antibiotics measured during 10 to 12 months before and after the campaign. RESULTS: After the mass media campaign, there was a 3.8% net decrease in retail pharmacy antibiotic dispenses per 1000 persons (P = 0.30) and an 8.8% net decrease in managed care-associated antibiotic dispenses per 1000 members (P = 0.03) in the mass media community. Most of the decline occurred among pediatric members, and corresponded with a decline in pediatric office visit rates. There was no change in the office visit prescription rates among pediatric or adult managed care members, nor in visit rates for complications of acute respiratory tract infections. CONCLUSIONS: A low-cost mass media campaign was associated with a reduction in antibiotic use in the community, and seems to be mediated through decreases in office visits rates among children. The campaign seems to be cost-saving.

The greater Denver Latino Cancer Prevention/Control Network. Prevention and research through a community-based approach.

The Latino/a Research & Policy Center (LRPC), at the University of Colorado (UC) at Denver and Health Sciences Center built the Greater Denver Latino Cancer Prevention Network, a successful cancer prevention network, in 6 Denver metro area counties. The Network consisted of 23 Latino community-based organizations, health clinics, social service agencies, faith-based groups, and employee-based organizations; 2 migrant health clinics; and 14 scientific partners including the UC Comprehensive Cancer Center, the Colorado Department of Public Health and Environment, and the American Cancer Society. The Network focused on 5 significant cancers: breast, cervical, lung, colorectal, and prostate cancer. The Steering Committee initiated a review process for junior researchers that resulted in 5 NCI-funded pilot projects. Pilot projects were conducted with various Latino populations. The Network developed community education and health promotion projects including the bilingual outreach play The Cancer Monologues. The Network's partnership also started and held 2 annual health fairs, Dia de la Mujer Latina/Day of the Latina Woman, and annual health prevention summits. The Special Population Network (SPN) adapted and revised a clinical trials education outreach module that reached Network community partners. SPN partners recruited Latino/a students to cancer research through a6-week NCI training program held yearly at the UCHSC campus. The Network methodology of bringing together the Latino community with the scientific community increased the level of awareness of cancer in the Latino community and increased cancer research and the level of engagement of the scientific partners with the Latino community. Cancer 2006. (c) 2006 American Cancer Society.

Appropriate antibiotic use: variation in knowledge and awareness by Hispanic ethnicity and language.

BACKGROUND: Recent campaigns are informing the public that antibiotics are inappropriate for viral respiratory infections. As little is known about their effect on populations challenged by less access to care, lower education, low income, low English proficiency, or non-mainstream cultural backgrounds, this study assessed knowledge, attitudes, and awareness in an ethnically diverse community. METHODS: A telephone survey in English or Spanish of a cross-sectional, random sample of 692 non-Hispanic whites (NHWs) and 300 Hispanics in Colorado. RESULTS: For all respondent groups, knowledge of appropriate antibiotic use for colds and bronchitis was low. Hispanics surveyed in Spanish, compared with non-Hispanic whites, had significantly lower knowledge about antibiotics for colds, higher knowledge for bronchitis, lower awareness about antibiotic resistance, and greater dissatisfaction if an antibiotic were not prescribed. In all comparisons, English-language Hispanics tended to reflect non-Hispanic white response patterns. Independent predictors of awareness were ethnicity, education, and age. Independent predictors of dissatisfaction were ethnicity, knowledge about antibiotic use for colds, and bronchitis. Ethnicity was an independent predictor of knowledge about the inappropriateness of antibiotics for colds and bronchitis. CONCLUSIONS: To bridge knowledge gaps, educational campaigns for all segments of the population are needed. Content should be responsive to heterogeneity within populations.