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1.
Transl Behav Med ; 10(3): 546-554, 2020 08 07.
Artículo en Inglés | MEDLINE | ID: mdl-32766867

RESUMEN

Churches are well positioned to promote better mental health outcomes in underserved populations, including rural adults. Mind-body (MB) practices improve psychological well-being yet are not widely adopted among faith-based groups due to conflicting religious or practice beliefs. Thus, "Harmony & Health" (HH) was developed as a culturally adapted MB intervention to improve psychosocial health in urban churchgoers and was adapted and implemented in a rural church. The purpose of this study was to explore the feasibility, acceptability, and efficacy of HH to reduce psychosocial distress in rural churchgoers. HH capitalized on an existing church partnership to recruit overweight or obese (body mass index [BMI] ≥25.0 kg/m2) and insufficiently active adults (≥18 years old). Eligible adults participated in an 8 week MB intervention and completed self-reported measures of perceived stress, depressive symptoms, anxiety, and positive and negative affect at baseline and postintervention. Participants (mean [M] age = 49.1 ± 14.0 years) were mostly women (84.8%), non-Hispanic white (47.8%) or African American (45.7%), high socioeconomic status (65.2% completed ≥bachelor degree and 37.2% reported an annual household income ≥$80,000), and obese (M BMI = 32.6 ± 5.8 kg/m2). Participants reported lower perceived stress (t = -2.399, p = .022), fewer depressive symptoms (t = -3.547, p = .001), and lower negative affect (t = -2.440, p = .020) at postintervention. Findings suggest that HH was feasible, acceptable, and effective at reducing psychosocial distress in rural churchgoers in the short-term. HH reflects an innovative approach to intertwining spirituality and MB practices to improve physical and psychological health in rural adults, and findings lend to our understanding of community-based approaches to improve mental health outcomes in underserved populations.


Asunto(s)
Negro o Afroamericano , Población Rural , Adolescente , Adulto , Índice de Masa Corporal , Femenino , Humanos , Persona de Mediana Edad , Obesidad/prevención & control , Sobrepeso
2.
J Adolesc Young Adult Oncol ; 9(1): 47-54, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31600095

RESUMEN

Purpose: Adolescents and young adults (AYAs) with cancer are a vulnerable population with decreased attendance at National Cancer Institute (NCI) comprehensive cancer centers and Children's Oncology Group (COG) facilities. Decreased attendance at NCI/COG facilities has been associated with poor cancer outcomes. The objective of this study was to evaluate cancer care patterns of AYAs compared with children, within Pennsylvania, and factors associated with attending an NCI/COG facility. Methods: Data from the Pennsylvania Cancer Registry between 2010 and 2015 for patients aged 0-39 years at cancer diagnosis were used. Primary analyses focused on age at diagnosis, insurance status, race, ethnicity, gender, cancer type, stage, diagnosis year, and distance to the NCI/COG facility. The primary outcome was receipt of care at an NCI/COG facility. Odds ratios (ORs) were calculated using multivariable logistic regression models. Sensitivity analyses were conducted to test and estimate robustness. Results: A sample of 15,002 patients, ages 0-39, was obtained, including 8857 patients (59%) who attended an NCI/COG facility. Patients were significantly less likely to attend an NCI/COG facility if they were aged 31-39 years (OR 0.054, 95% confidence interval [CI] 0.04-0.07), non-White (OR 0.890, 95% CI 0.80-0.99), Hispanic (OR 0.701, 95% CI 0.59-0.83), female (OR 0.915, 95% CI 0.84-1.00), had Medicaid insurance (OR 0.836, 95% CI 0.75-0.93), and lived further from an NCI/COG facility. Sensitivity analyses largely corroborated the performed estimates. Conclusions: AYAs with cancer in Pennsylvania have disproportionate attendance at specialized NCI/COG facilities across a variety of demographic domains. Enhancing the attendance of AYAs with cancer at these specialized centers is crucial to improve cancer outcomes.


Asunto(s)
Salud Infantil/tendencias , Accesibilidad a los Servicios de Salud/normas , Disparidades en Atención de Salud/normas , Admisión del Paciente/estadística & datos numéricos , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , National Cancer Institute (U.S.) , Pennsylvania , Estados Unidos , Adulto Joven
3.
Cancer Prev Res (Phila) ; 7(8): 796-804, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24938534

RESUMEN

Epidemiologic and laboratory studies indicate that dietary selenium protects against prostate cancer. Results from clinical trials suggest that selenium-enriched yeast (SY) but not selenomethionine (SeMet) may be effective at reducing prostate cancer risk. Our objectives were to directly compare for the first time the effects of SeMet and SY on prostate cancer relevant biomarkers in men. We performed a randomized double blind, placebo-controlled trial of SY (200 or 285 µg/day) and SeMet (200 µg/day) administered for 9 months in 69 healthy men. Primary endpoints included blood levels of selenium-containing compounds and oxidative stress biomarkers [urine 8-hydroxy-2'-deoxyguanosine (8-OHdG) and 8-iso-prostaglandin-F2α (8-iso-PGF2α) and blood glutathione (GSH)]. Secondary endpoints included plasma glucose and PSA levels. Compliance was high in all groups (>95%). Plasma selenium levels were increased 93%, 54%, and 86% after 9 months in SeMet and low- and high-dose SY groups, respectively, and returned to baseline levels after a 3-month washout (P < 0.05). Levels of 8-OHdG and 8-iso-PGF2α were decreased 34% and 28%, respectively, after 9 months in the high-dose SY group (P < 0.05). These decreases were greatest in individuals with low baseline plasma levels of selenium (<127 ng/mL). No changes in serum PSA or blood glucose and GSH were observed. Overall, we showed for the first time, reductions in biomarkers of oxidative stress following supplementation with SY but not SeMet in healthy men. These findings suggest that selenium-containing compounds other than SeMet may account for the decrease in oxidative stress.


Asunto(s)
Biomarcadores/metabolismo , Estrés Oxidativo/efectos de los fármacos , Selenio/administración & dosificación , Selenometionina/administración & dosificación , Adulto , Anciano , Biomarcadores/orina , Glucemia/análisis , Suplementos Dietéticos , Método Doble Ciego , Glutatión/metabolismo , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana Edad , Antígeno Prostático Específico/metabolismo , Selenio/sangre , Adulto Joven
4.
Health Educ Behav ; 39(6): 745-51, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22467637

RESUMEN

Community-based participatory research (CBPR) is being used increasingly to address health disparities and complex health issues. The authors propose that CBPR can benefit from a systems science framework to represent the complex and dynamic characteristics of a community and identify intervention points and potential "tipping points." Systems science refers to a field of study that posits a holistic framework that is focused on component parts of a system in the context of relationships with each other and with other systems. Systems thinking tools can assist in intervention planning by allowing all CBPR stakeholders to visualize how community factors are interrelated and by potentially identifying the most salient intervention points. To demonstrate the potential utility of systems science tools in CBPR, the authors show the use of causal loop diagrams by a community coalition engaged in CBPR activities regarding youth drinking reduction and prevention.


Asunto(s)
Investigación Participativa Basada en la Comunidad/métodos , Teoría de Sistemas , Adolescente , Conducta del Adolescente , Alcoholismo/epidemiología , Ambiente , Humanos , Características de la Residencia , Medio Social
5.
J Cancer Educ ; 25(1): 55-60, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20087800

RESUMEN

The growth of geographic information systems (GIS) for comprehensive cancer control (CCC) planning activities has been documented. We examined concerns about use and derived principles for practice. A national survey of US CCC program managers (n = 49) was conducted. Results include statements and frequency of barriers to use GIS mapping for CCC. Uses of GIS for CCC activities have benefits, but must be considered within organizational frameworks designed to safeguard confidentiality of health information and community relationships. Education to guide understanding of and input into the decisions linked to GIS mapping can limit possible harms while advancing CCC aims.


Asunto(s)
Sistemas de Información Geográfica , Neoplasias/epidemiología , Neoplasias/prevención & control , Vigilancia de Guardia , Humanos , Estados Unidos
6.
Health Promot Pract ; 10(4): 579-87, 2009 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-18381971

RESUMEN

Geographic information systems (GIS) mapping technologies have potential to advance public health promotion by mapping regional differences in attributes (e.g., disease burden, environmental exposures, access to health care services) to suggest priorities for public health interventions. Training in GIS for comprehensive cancer control (CCC) has been overlooked. State CCC programs' GIS training needs were assessed by interviewing 49 state CCC directors. A majority perceived a need for GIS training, slightly more than half of state CCC programs had access to geocoded data, and the majority of programs did not require continuing education credits of their staff. CCC directors perceived judging maps and realizing their limitations as important skills and identified epidemiologists, CCC staff, public health officials, policy makers, and cancer coalition members as training audiences. They preferred in-class training sessions that last a few hours to a day. Lessons learned are shared to develop training programs with translatable GIS skills for CCC.


Asunto(s)
Sistemas de Información Geográfica , Capacitación en Servicio/organización & administración , Neoplasias/epidemiología , Práctica de Salud Pública , Femenino , Promoción de la Salud/métodos , Humanos , Masculino , Neoplasias/prevención & control , Vigilancia de Guardia , Análisis de Área Pequeña
7.
Health Policy ; 87(2): 185-93, 2008 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-18243396

RESUMEN

OBJECTIVES: Through a long history of cancer policies, public health has a foundation for cancer research and data to use in applying technological advancements for U.S. cancer control efforts. Geographic information systems (GIS) are one technology enabling the visualization of cancer risk patterns associated with incidence, mortality, and accessibility to care. METHODS: U.S. Comprehensive Cancer Control (CCC) program directors were interviewed from 49 of 50 states to assess use and function of GIS tools for mapping data related to cancer control policies and practices. Interviews were coded to obtain frequencies of response associated with content domains mapped using GIS tools and the perceived relative advantages. RESULTS: Significant relationships were found between the mapping of behavioral risk factors, health care services, transportation access, and policy advantages identified by program managers. The mapping of cancer incidence, mortality, and staging, transportation access, and multiple layers of content were found to have significant associations with perceived research advantages. CONCLUSIONS: U.S. CCC program managers recognize several important advantages relating to health policy and research for use of GIS tools in cancer control efforts. The application of GIS in U.S. cancer control efforts is employed unevenly, suggesting the need for innovative policies to support accessibility.


Asunto(s)
Actitud del Personal de Salud , Sistemas de Información Geográfica/estadística & datos numéricos , Neoplasias/epidemiología , Administración en Salud Pública , Informática en Salud Pública/estadística & datos numéricos , Sistema de Registros/estadística & datos numéricos , Análisis por Conglomerados , Demografía , Exposición a Riesgos Ambientales , Control de Formularios y Registros , Política de Salud , Accesibilidad a los Servicios de Salud , Humanos , Incidencia , Entrevistas como Asunto , Estadificación de Neoplasias , Neoplasias/prevención & control , Administración en Salud Pública/educación , Administración en Salud Pública/estadística & datos numéricos , Medición de Riesgo , Asunción de Riesgos , Estados Unidos/epidemiología
8.
J Cancer Surviv ; 1(3): 205-11, 2007 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-18648971

RESUMEN

In 2002, 10.4% of the 10 million persons alive who have ever been diagnosed with cancer had colorectal cancer (CRC). Barriers, such as distance, terrain, access to care and cultural differences, to CRC survivorship may be especially relevant in rural communities. We tested the hypothesis that teams from rural cancer coalitions and hospitals would develop a Community Plan (CP) to enhance CRC survivorship. We used community-based participatory research and the PRECEDE-PROCEED model to train teams from rural cancer coalitions and hospitals in Pennsylvania and New York. We measured knowledge at three points in time and tested the change with McNemar's test, corrected for multiple comparisons (p < 0.0167). We also conducted a qualitative review of the CP contents. Fourteen (93.3%) of the 15 coalitions or hospitals initially recruited to the study completed a CP. Knowledge in public health, sponsorship of A National Action Plan for Cancer Survivorship, and CRC survivorship and treatment increased. Teams identified perceived barriers and community assets. All teams planned to increase awareness of community assets and almost all planned to enhance treatment-related care and psychosocial care for the CRC survivor; 50% planned to enhance primary care and CRC screening. The study demonstrated the interest and ability of rural organizations to plan to enhance CRC survivorship, including linkage of CRC survivorship to primary care. Rural cancer coalitions and hospitals may be a vehicle to develop local action for A National Action Plan. Access to more comprehensive care for CRC cancer survivors in rural communities appears to be facilitated by the community-based initiative described and investigated in this study. Efforts such as these could be replicated in other rural communities and may impact the care and quality of life of survivors with many types of cancers. While access to health services may be increased through community-based initiatives, we still need to measure the impact of such initiatives on the long term health and well being of cancer survivors in rural locations.


Asunto(s)
Neoplasias Colorrectales/epidemiología , Planificación en Salud Comunitaria , Redes Comunitarias/organización & administración , Población Rural/estadística & datos numéricos , Sobrevivientes , Anciano , Neoplasias Colorrectales/mortalidad , Neoplasias Colorrectales/prevención & control , Neoplasias Colorrectales/psicología , Neoplasias Colorrectales/terapia , Femenino , Accesibilidad a los Servicios de Salud , Hospitales Comunitarios/organización & administración , Humanos , Masculino , Tamizaje Masivo/organización & administración , Persona de Mediana Edad , New York/epidemiología , Pennsylvania/epidemiología , Atención Primaria de Salud , Calidad de Vida , Grupos de Autoayuda/organización & administración , Apoyo Social , Tasa de Supervivencia
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