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1.
J Cancer Educ ; 2024 May 02.
Article in English | MEDLINE | ID: mdl-38693423

ABSTRACT

Research advances on effective methods to prevent, diagnose, and treat cancer continue to emerge through clinical and genomic research. Most clinical trial and genomic research participants identify as White which limits the generalizability of research findings to non-White populations. With the development and access to technology, digital delivery of salient and tailored health education may provide innovative pathways to increase representation of African Americans (AA) and Hispanics in research. This project focused on the creation of a bioethical sensitive education video aimed at increasing participation in clinical trials and genomic research by bringing together experts from the community, healthcare, biomedical research, and public health. The goal was to utilize existing educational resources to create a tailored message to address AA/Hispanics' beliefs, values, and bioethical concerns related to participation in clinical and genomic research. Models of behavior change and communication theories were leveraged to frame key components of the message, which then informed the framework for the animated video. Development of the video consisted of six iterative phases: 1) writing sessions; 2) storyboarding; 3) animating; 4) screening/revisions; 5) acceptability testing; 6) finalization. The final animated video is approximately 5 min in length and covers several topics including the goal of clinical research, disparities in research participation, bioethical concerns, and genomic research regulations. Increasing AA and Hispanic participation in clinical and genomic research is imperative to achieving health equity. Tailored messages via short videos may assist in addressing the barriers and facilitators towards research participation and increase intentions to enroll in trials.

2.
J Community Psychol ; 52(2): 311-325, 2024 03.
Article in English | MEDLINE | ID: mdl-38263721

ABSTRACT

The current study is part of a community engaged planning phase and aimed to identify perceptions related to the prevalence of violent crime, crime contributors, the relationship between the community and law enforcement, and potential interventions and solutions. In March 2021, semistructured interviews were conducted with individuals from five groups who resided or worked in Bessemer, Alabama: (1) Law Enforcement, (2) Residents, (3) Civic Leaders, (4) Community Leaders, and (5) Victims of Crime. Interviews lasted approximately 60 min and were audio recorded, transcribed, and analyzed according to the guidelines of thematic analysis using NVivo 12. Emerging themes were examined in accordance with the CDC Social-Ecological Model: A Framework for Prevention. Participants (N = 18) were 50.0% female and 77.8% African American with an age range of 25-59 (mean = 43.4 years). Themes that emerged related to crime were: (1) impact, (2) contributors, and (3) solutions. Results indicate that impacts of violent crime at the individual level focused on fear, which led to widespread mental health issues. Relationship level impacts included a lack of trust of law enforcement and neighbors, and community level impacts were decreased neighborhood social cohesion as well as decreased safety. At the societal level, the poor reputation of the city was consistently highlighted. For contributors of crime, being a youth under age 30, drugs, and money were discussed as factors at the individual level. At the relationship level, participants mentioned poor parenting and gangs as crime contributing factors to violent crime. Furthermore, contributing issues related to underresourced schools as well as a poor relationship with law enforcement were brought up at the community level. Similarly, poverty was the overarching contributing issue at the societal level. Solutions that emerged included: education and training in life skills, focusing on young people, family/parenting, conflict resolution programs, programs within schools, improved relationships with law enforcement, and inclusive economic opportunities. Intervention plans are discussed that can merge these stakeholder findings with other data sources.


Subject(s)
Crime , Violence , Adolescent , Humans , Female , Adult , Middle Aged , Male , Qualitative Research , Social Environment , Residence Characteristics
3.
Front Psychol ; 14: 1196525, 2023.
Article in English | MEDLINE | ID: mdl-37575433

ABSTRACT

The Emotional Well-Being and Economic Burden (EMOT-ECON) Research Network is one of six research networks funded by the National Institutes of Health (NIH) to advance research about emotional well-being (EWB), and the only one that focuses on addressing how economic burden due to disease or illness affects EWB. The network convened researchers, patients, patient advocates, health care providers and other stakeholders from across the US to discuss the significance of addressing the impact of the economic burden of disease on EWB, the complexity of this prevalent problem for patients and families, and the research gaps that still need to be studied to ultimately develop strategies to reduce the impact of economic burden of disease on EWB and health. Participants identified some important future areas of research as those investigating: (i) prevalent and relevant emotions for patients experiencing economic burden of disease and financial hardship, and how their broader outlook on life is impacted; (ii) constructs and contexts that influence whether the economic burden is stressful; (iii) strategies to deal and cope and their positive or negative effects on EWB and health; and (iv) multi-level and multi-stakeholder interventions to address economic factors (e.g., costs, ability to pay), administrative burdens, education and training, and especially patients' emotional as well as financial status.

4.
Contemp Clin Trials ; 111: 106604, 2021 12.
Article in English | MEDLINE | ID: mdl-34757221

ABSTRACT

Background During the COVID-19 pandemic, in-person research assessments needed to be adapted to ensure safety of participants and staff. Participants' willingness to participate in research activities, how to prepare assessors to ensure data integrity, and the feasibility of modified protocols, were unknown. Within the AMPLIFI randomized clinical trial (RCT) for cancer survivors, we elicited participants' preferences and willingness to participate in Clinic, Home, or Virtual assessments, prepared assessors for, and implemented virtual assessments. Methods 1) We conducted phone surveys of potential AMPLIFI participants; 2) Based on survey results, we modified assessments from in-person to virtual visits (VV) by videoconference. Assessors were trained and certified, i.e., assessors recorded 3 assessments that were reviewed and scored by 2 investigators. The modified protocol was proposed to 62 participants: we report numbers of those who agreed to attend VV. Results 1) Survey results: Among 74 survey respondents, 44.6% preferred, 75.7% were willing to attend Clinic Visits; 32.4% preferred, 83.8% were willing to do VV; 23% preferred, 77% were willing to do Home Visits. Survivors 70+ were less likely than 50-69 years old to be willing to do VV: no other differences were noted by gender, race, rural status or education. 2) Assessment uptake: 66.1% agreed to attend VV, and of them 75.6% completed them. Conclusion Diverse research participants adapted to protocols that prioritize their safety, although older participants may be reluctant to do virtual assessments. Virtual assessments are feasible and research teams can rigorously prepare to collect quality data through them.


Subject(s)
COVID-19 , Aged , Humans , Middle Aged , Randomized Controlled Trials as Topic , SARS-CoV-2 , Surveys and Questionnaires , Telephone , Videoconferencing
5.
Ethn Health ; 26(1): 49-67, 2021 01.
Article in English | MEDLINE | ID: mdl-33472411

ABSTRACT

OBJECTIVE: The purpose of this study was to examine perceptions of COVID-19 related to prevention, coping, and testing of African American residents in under-resourced communities in Alabama. DESIGN: Guided by the PRECEDE-PROCEED model, virtual focus groups were conducted in five urban and rural Alabama communities using secure Zoom meetings. Community residents and stakeholders (N = 36 total) participated; meetings were audio- and video-recorded, transcribed, and analyzed according to Thematic Analysis. Themes were organized by the PRECEDE portion of the model in Predisposing, Reinforcing, and Enabling barriers and facilitators in three focus areas: prevention, coping, and testing. RESULTS: Prevention barriers included apathy, difficulty with social distancing, lack of information, mixed messages from authority figures, and lack of personal protective equipment (PPE). Prevention facilitators included concerns about contracting COVID-19, clear and consistent messages from trusted sources, contact tracing, and the provision of PPE. Coping barriers included food insecurity, mental health issues, isolation, economic hardships, lack of health care access, and issues with virtual schooling and church services, which were exacerbated by the inability to connect to the internet. Facilitators to coping included religious faith, increased physical activity, and a sense of hope. Testing barriers included misunderstanding, fear, mistrust, testing restrictions, and location of testing sites. Facilitators to testing included incentives, clear information from trusted sources, convenient testing locations, and free tests. CONCLUSION: Gaining community members' perspectives can identify barriers and facilitators to prevention, coping, and testing and potentially improve outcomes. While addressing the social determinants of health (e.g. income, education, medical trust) would be an effective path by which to diminish health disparities related to COVID-19, there is an urgent need to mitigate the spread and severity of COVID-19 in vulnerable populations. Interventions should focus on downstream determinants, such as those emerging from our study.


Subject(s)
Black or African American/statistics & numerical data , COVID-19 Testing , COVID-19/prevention & control , Health Services Accessibility , Poverty , Stakeholder Participation , Adaptation, Psychological , Alabama , COVID-19/psychology , Female , Focus Groups , Humans , Information Dissemination , Male , Middle Aged , Qualitative Research , Residence Characteristics
6.
J Am Coll Health ; 68(8): 864-871, 2020.
Article in English | MEDLINE | ID: mdl-31210596

ABSTRACT

OBJECTIVE: Lack of understanding regarding the function of sleep and lack of education regarding healthy sleep practices may hinder college students from getting sufficient quality sleep. The current study examines the effect of a text message based educational intervention aimed at improving sleep quality and sleep hygiene behaviors in freshman undergraduate college students. PARTICIPANTS: 135 undergraduate students were recruited fall of 2016. METHODS: Three discussion groups were held to test and refine the text message content. Students were randomized into a three-group pretest-posttest experimental design. Participants completed measures of sleep quality, sleep hygiene, and sleep knowledge. RESULTS: Data analysis indicated the intervention did not demonstrate significant differences between groups over time on sleep quality, sleep hygiene behaviors, and sleep knowledge. CONCLUSION: More research is needed to understand how best to harness text messaging technology and sleep health education to promote healthy sleep behaviors in college students.


Subject(s)
Behavior Therapy/methods , Health Promotion/methods , Sleep Deprivation/psychology , Sleep Deprivation/therapy , Sleep Hygiene , Students/psychology , Text Messaging , Adolescent , Adult , Female , Humans , Male , Students/statistics & numerical data , United States , Universities/statistics & numerical data , Young Adult
7.
Ann Intern Med ; 170(9_Suppl): S54-S61, 2019 05 07.
Article in English | MEDLINE | ID: mdl-31060056

ABSTRACT

Background: Despite recommendations to discuss the cost of care (CoC) with patients with cancer, little formal guidance is available on how to conduct these sensitive conversations in ways that are acceptable to both patients and providers. Objective: To explore the perspectives of patients and medical and nonmedical cancer center staff on CoC conversations. Design: In individual interviews, participants were asked to discuss the content of, timing of, and ideal person to hold CoC conversations. Interviews were transcribed verbatim. Content was analyzed to identify emerging essential elements. Setting: Division of Preventive Medicine, University of Alabama at Birmingham. Participants: 42 women aged 60 to 79 years with a history of breast cancer and 20 cancer center staff (6 physicians, 4 nurses, 5 patient navigators, 3 social workers, and 2 billing specialists). Results: Both patients and providers identified reassurance and action as essential elements of CoC conversations. Participants expressed the importance of reassurance that recommended medical care would not be affected by affordability challenges. Action was intended as discussions on ways to help patients cover treatment-related costs, such as discussion of payment plans or linkage to financial resources. Optimal timing for CoC conversations was felt to be after an initial consult visit but before treatment started. The person to hold these conversations should be compassionate, helpful, and knowledgeable of the patient's specific situation (for example, treatment plan, insurance coverage) and of the resources available to attain the patient's goals of care. Limitation: Interviews were limited to older breast cancer survivors and staff at 1 institution. Conclusion: Conversations about CoC extend beyond discussing costs and must be sensitive to the vulnerability experienced by patients. These findings can guide training of personnel involved in CoC conversations. Primary Funding Source: Robert Wood Johnson Foundation.


Subject(s)
Breast Neoplasms/economics , Cancer Care Facilities/economics , Cancer Care Facilities/organization & administration , Communication , Health Expenditures , Physician-Patient Relations , Aged , Allied Health Personnel , Cancer Survivors , Cost of Illness , Female , Humans , Interviews as Topic , Medical Staff, Hospital , Middle Aged , Qualitative Research , United States
8.
West J Nurs Res ; 41(3): 388-408, 2019 03.
Article in English | MEDLINE | ID: mdl-29726313

ABSTRACT

The purpose of our two-phase study was to develop acceptable text messages to increase physical activity. Four focus groups (two for each phase) were conducted with older African American women who had access to texting-capable mobile phones and were in the contemplation stage for physical activity. The mean age of Phase 1 participants (n = 12) was 71 and ranged from 65 to 86 years. Content analysis was used to identify fundamental themes that were later used to develop text messages. Six categories emerged from the data and 31 text messages were developed based on focus group input and national recommendations. The mean age of Phase 2 participants (n = 9) was 67 and ranged from 65 to 75 years. Descriptive statistics revealed 100% of participants understood all messages. When messages were evaluated individually, a minimum of 78% felt each message motivated activity and 67% said lengths were perfect. Findings identified messages that were relevant and potentially motivational to stimulate physical activity among this population.


Subject(s)
Black or African American , Exercise/psychology , Motivation , Text Messaging/trends , Aged , Cell Phone , Female , Focus Groups , Health Behavior , Humans
9.
Vaccine ; 36(28): 4126-4133, 2018 06 27.
Article in English | MEDLINE | ID: mdl-29793895

ABSTRACT

INTRODUCTION: Half of all new human papillomavirus (HPV) infections occur in adolescents and young adults, and this population has poor HPV vaccination rates. Rural areas of the U.S. have high rates of HPV-related diseases and low vaccination rates as well. The purpose of this study was to determine the perceived barriers and facilitators to HPV vaccination among adolescents and their caregivers in rural south Alabama. METHODS: Vaccinated and non-vaccinated adolescents ages 11-18 years old and primary caregivers were recruited from three rural counties in south Alabama. Participants completed individual interviews to discuss perceived barriers to vaccination and factors influencing their decision to vaccinate. Discussion groups were held to determine potential solutions to barriers elucidated from the interviews. Interview and discussion group transcripts were analyzed, and themes were identified. RESULTS: Approximately 62.5% of adolescents had not initiated the HPV vaccine series. Of those adolescents who started the vaccine series (n = 9, 37.5%), about half completed it (n = 5). Few participants in this study reported speaking with their health care provider (HCP) about the vaccine in the past year. Lack of information about the vaccine, its side effects, and no HCP recommendation were common barriers cited by non-vaccinators. Facilitators to vaccination included cancer prevention, discussion with HCP, and peer testimonials. Potential solutions to barriers were also discussed. CONCLUSIONS: Proposed strategies to increase HPV vaccination were similar between vaccinated and non-vaccinated groups. Education about HPV and the HPV vaccine is needed throughout these rural south Alabama communities to ensure informed decisions are made about vaccination and to increase vaccination rates.


Subject(s)
Caregivers/psychology , Papillomavirus Infections/prevention & control , Papillomavirus Vaccines/administration & dosage , Patient Acceptance of Health Care , Rural Population , Vaccination/psychology , Adolescent , Alabama , Child , Humans , Interviews as Topic
11.
Ethn Dis ; 27(Suppl 1): 329-336, 2017.
Article in English | MEDLINE | ID: mdl-29158658

ABSTRACT

Objective: The purpose of this article is to describe the process of conducting an assessment of neighborhood perceptions and cohesion by a community coalition-academic team created in the context of community-based participatory research (CBPR), to guide the design of locally relevant health initiatives. Methods: Guided by CBPR principles, a collaborative partnership was established between an academic center and a local, urban, underserved neighborhood in Birmingham, Alabama to identify and address community concerns and priorities. A cross-sectional survey was conducted in September 2016 among community residents (N=90) to examine perceptions of neighborhood characteristics, including social cohesion and neighborhood problems. Results: The major concerns voiced by the coalition were violence and lack of neighborhood cohesion and safety. The community survey verified the concerns of the coalition, with the majority of participants mentioning increasing safety and stopping the violence as the things to change about the community and the greatest hope for the community. Furthermore, results indicated residents had a moderate level of perceived social cohesion (mean = 2.87 [.67]). Conclusions: The Mid-South TCC Academic and Community Engagement (ACE) Core successfully partnered with community members and stakeholders to establish a coalition whose concerns and vision for the community matched the concerns of residents of the community. Collecting data from different groups strengthened the interpretation of the findings and allowed for a rich understanding of neighborhood concerns.


Subject(s)
Community Health Planning/methods , Community-Based Participatory Research/methods , Community-Institutional Relations , Surveys and Questionnaires , Urban Population , Adolescent , Adult , Aged , Alabama , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Male , Middle Aged , Young Adult
12.
Ethn Dis ; 27(Suppl 1): 347-354, 2017.
Article in English | MEDLINE | ID: mdl-29158660

ABSTRACT

Objective: This article describes Mayors Mentoring Mayors (3M), an initiative of the Arkansas Coalition for Obesity Prevention (ArCOP), which expanded to five states to become the signature community initiative of the Mid-South Transdisciplinary Collaborative Center (Mid-South TCC) for Health Disparities Research. Methods: The 3M program is an extension of the Growing Healthy Communities (GHC) program, which sought to build capacity within communities to reduce obesity by implementing policy, system and environmental (PSE) changes that support healthy living. GHC where the mayor was involved had the most significant changes toward better health. These mayors were recruited to share their successes, lessons learned, and best practices with their colleagues through a series of Lunch & Learns. Following the GHC and 3M models, a multi-state approach to expand 3M to five additional states was developed. ArCOP partnered with the Mid-South TCC to recruit mayors in the five states. Results: Five Lunch & Learn events were held across Arkansas between March and May 2015, with a total of 98 participants (40 mayors, 37 community leaders, 21 guests). Each regional Lunch & Learn had 1-2 host mayor(s) in attendance, with a total of 9 host mayors. For the 3M regional expansion project, eight GHC Recognition Applications from five states were submitted. Five communities, designated as Emerging, were funded to implement GHC projects. Conclusion: ArCOP successfully engaged mayors, elected officials, and stakeholders who can influence policy across Arkansas as well as in an additional five states in the Mid-South TCC region to implement obesity PSE prevention strategies.


Subject(s)
Community-Based Participatory Research/methods , Obesity/prevention & control , Power, Psychological , Public Health/trends , Health Promotion/methods , Humans , Morbidity/trends , Obesity/epidemiology , United States/epidemiology
13.
J Natl Med Assoc ; 109(4): 287-293, 2017.
Article in English | MEDLINE | ID: mdl-29173936

ABSTRACT

BACKGROUND: African Americans (AA) are a third as likely as Caucasians to become registered organ donors at the Department of Motorized Vehicles (DMV). The Department of Health and Human Services has set the goal that at least 50% of adults in each state are registered donors. AIMS: The purpose of this study was to explore the personal, behavioral and environmental factors associated with AA donor registration decision-making at the DMV. METHODS: Guided by the Social Cognitive Theory, 13 focus groups (n = 100 participants) were conducted with AAs within 3 months of visiting a DMV and making a decision regarding whether to become or to not become a registered donor. The data were analyzed using inductive thematic and qualitative content analyses. RESULTS: Study participants expressed a desire to learn more information while waiting in line at the DMV. Knowing a family member or friend in need of an organ transplant, and the desire to make one's own decision were two salient factors associated with the decision to become a registered organ donor. Several aspects of the DMV environment (e.g., noisy, overcrowded, lacking privacy) were cited as deterrents to becoming a registered donor. DISCUSSION: This study highlights the personal, behavioral and environmental factors associated with AA organ donor registration decision-making at the DMV. CONCLUSION: The DMV is a setting where many adults make a decision about organ donation. Policies that create an environment in the DMV to support informed decision-making (e.g., privacy, informed clerks, available educational materials, etc.) are indicated.


Subject(s)
Black or African American/psychology , Decision Making , Health Knowledge, Attitudes, Practice/ethnology , Motivation , Tissue Donors/psychology , Adult , Aged , Alabama , Female , Focus Groups , Humans , Male , Middle Aged , Motor Vehicles , Psychological Theory , Qualitative Research
14.
Ethn Dis ; 27(Suppl 1): 277-286, 2017.
Article in English | MEDLINE | ID: mdl-29600806

ABSTRACT

Objective: The purpose of this article is to describe the background and experience of the Academic-Community Engagement (ACE) Core of the Mid-South Transdisciplinary Collaborative Center for Health Disparities Research (Mid-South TCC) in impacting the social determinants of health through the establishment and implementation of a regional academic-community partnership. Conceptual Framework: The Mid-South TCC is informed by three strands of research: the social determinants of health, the socioecological model, and community-based participatory research (CBPR). Combined, these elements represent a science of engagement that has allowed us to use CBPR principles at a regional level to address the social determinants of health disparities. Results: The ACE Core established state coalitions in each of our founding states-Alabama, Louisiana, and Mississippi-and an Expansion Coalition in Arkansas, Tennessee, and Kentucky. The ACE Core funded and supported a diversity of 15 community engaged projects at each level of the socioecological model in our six partner states through our community coalitions. Conclusion: Through our cross-discipline, cross-regional infrastructure developed strategically over time, and led by the ACE Core, the Mid-South TCC has established an extensive infrastructure for accomplishing our overarching goal of investigating the social, economic, cultural, and environmental factors driving and sustaining health disparities in obesity and chronic illnesses, and developing and implementing interventions to ameliorate such disparities.


Subject(s)
Community-Based Participatory Research/organization & administration , Health Status Disparities , Interdisciplinary Research/methods , Social Determinants of Health , Humans , United States
15.
Support Care Cancer ; 24(4): 1841-8, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26452487

ABSTRACT

PURPOSE: Patient-centered evaluation is a critical but often overlooked component of intervention research. The Rural Breast Cancer Survivors (RBCS) Intervention is a survivorship education and support intervention designed for rural breast cancer survivors. Here, we describe evaluation of the RBCS Intervention from the participants' experience. METHODS: Three hundred sixty-four breast cancer survivors participating in the RBCS Intervention were asked to complete the RBCS Evaluation Survey that consisted of 6 quantitative statements and 12 qualitative questions via mail. RESULTS: Two hundred twenty-one participants (61 %) returned the RBCS Evaluation Survey. All 221 completed the qualitative component, and 91 (25 %) completed the quantitative. Overall, participants indicated that the education materials were easy to understand and addressed their quality of life concerns. Majority (94 %) indicated that the survivorship information was helpful in making health decisions and communicating concerns to family (87 % strongly agree/agree) and oncology team (88 % strongly agree/agree). Only 66 % indicated that the survivorship educational materials were provided at an appropriate time after completion of primary breast cancer treatment. Qualitative data suggested that participants had positive perceptions and experiences and found the RBCS Intervention helpful. One-on-one interaction with the intervention nurses was the single most highly valued aspect. CONCLUSION: Overall, the RBCS Intervention was helpful. Education materials addressed quality of life concerns. Breast cancer survivors developed skills in communicating with their family and oncology team. Intervention nurses were identified as the most valuable aspect of the program. Suggestions include earlier timing of survivorship education and support, and adaptation using social media access to serve other rural survivors. RELEVANCE: Patient-centered evaluations, using both quantitative and qualitative data, provide enriched understanding of evidence-based survivorship interventions and should be considered a standard for future work.


Subject(s)
Breast Neoplasms/therapy , Patient Outcome Assessment , Adult , Female , Humans , Middle Aged , Quality of Life , Rural Population , Surveys and Questionnaires , Survivors
16.
Womens Health (Lond) ; 11(2): 109-19, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25776285

ABSTRACT

AIM: About 120,000 Latina breast cancer survivors (LBCS) live in the USA with the numbers expected to increase. LBCS experience survivorship disparities and report poor quality of life outcomes. Despite poor outcomes, few survivorship interventions for LBCS are available. Adapting evidence-based interventions for Latinas may be one strategy to reduce disparities. MATERIALS & METHODS: An evidence-based intervention called the Breast Cancer Education Intervention was adapted for Latinas. First, certified translation and cognitive interview to assess cultural relevance were conducted. Next, a pilot sample of 40 Latinas who participated in the intervention were asked to provide follow-up evaluation of their satisfaction with and usefulness of the translated education manual and intervention. RESULTS: Thirty LBCS completed the intervention, and 14 LBCS submitted an evaluation summary expressing satisfaction with usefulness, readability and relevance. CONCLUSION: The process by which translation and cultural adaptation of an evidence-based intervention provides beginning foundation to support and reduce disparities among LBCS.


Subject(s)
Breast Neoplasms/ethnology , Hispanic or Latino , Patient Education as Topic/organization & administration , Quality of Life , Survivors , Breast Neoplasms/psychology , Cultural Competency , Female , Humans , Patient Satisfaction , Women's Health
17.
J Cancer Educ ; 30(4): 642-7, 2015 Dec.
Article in English | MEDLINE | ID: mdl-25572461

ABSTRACT

Health issues are a concern in Alabama's Black Belt region, which runs across the southwestern part of the state and includes some of the poorest counties in the USA. As part of a Center for Disease Control (CDC)-sponsored study, we collected data covering several cancer (e.g., prostate, breast, skin) and other health-related indicators (e.g., stress, insurance, stroke, heart disease) from 647 predominantly African-American adults over the age of 50 in 20 communities in 7 Black Belt counties in 2005 and 2006. Here, we provide an account of the state of the health of older African-Americans and compare their outcomes to those of their White counterparts in the region. African-Americans report having generally lower levels of health and were less apt to have a cancer history (ps<0.05) than the Whites in the region. Gender differences with respect to BMIs and smoking are also evident, with women having higher BMIs but lower levels of smoking. Physicians and researchers covering or interested in generally impoverished rural areas may find our results useful for comparative purposes.


Subject(s)
Black or African American/statistics & numerical data , Health Status , Neoplasms/epidemiology , White People/statistics & numerical data , Adult , Alabama/epidemiology , Female , Follow-Up Studies , Humans , Male , Middle Aged
18.
J Cancer Educ ; 30(4): 636-41, 2015 Dec.
Article in English | MEDLINE | ID: mdl-25355523

ABSTRACT

Mobile phone-based interventions can play a significant role in decreasing health disparities by enhancing population and individual health. The purpose of this study was to explore health ministry leaders (HMLs) and congregation members' communication technology usage and to assess the acceptability of mobile technology for delivery of cancer information. Six focus groups were conducted in two urban African-American churches with trained HMLs (n=7) and congregation members (n=37) to determine mobile phone technology usage and identify barriers and facilitators to a mobile phone intervention. All participants were African-American, majority were female (80% of HMLs; 73% of congregation members), and the mean age was 54 (HMLs) and 41 (congregation members). All of the HMLs and 95% of congregation members indicated owning a mobile phone. All HMLs reported sending/receiving text messages, whereas of the congregation members, 85% sent and 91% received text messages. The facilitators of a text messaging system mentioned by participants included alternative form of communication, quick method for disseminating information, and accessibility. The overall main barriers reported by both groups to using mobile technology include receiving multiple messages, difficulty texting, and cost. Ways to overcome barriers were explored with participants, and education was the most proposed solution. The findings from this study indicate that HMLs and congregation members are interested in receiving text messages to promote healthy lifestyles and cancer awareness. These findings represent the first step in the development of a mobile phone-based program designed to enhance the work of health ministry leaders.


Subject(s)
Cell Phone/statistics & numerical data , Delivery of Health Care , Health Education/methods , Information Dissemination/methods , Leadership , Text Messaging/statistics & numerical data , Adult , Communication , Female , Follow-Up Studies , Government Agencies , Humans , Male , Middle Aged , Workforce , Young Adult
19.
Am J Prev Med ; 45(5): 543-50, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24139766

ABSTRACT

BACKGROUND: Tailored, web-assisted interventions can reach many smokers. Content from other smokers (peers) through crowdsourcing could enhance relevance. PURPOSE: To evaluate whether peers can generate tailored messages encouraging other smokers to use a web-assisted tobacco intervention (Decide2Quit.org). METHODS: Phase 1: In 2009, smokers wrote messages in response to scenarios for peer advice. These smoker-to-smoker (S2S) messages were coded to identify themes. Phase 2: resulting S2S messages, and comparison expert messages, were then e-mailed to newly registered smokers. In 2012, subsequent Decide2Quit.org visits following S2S or expert-written e-mails were compared. RESULTS: Phase 1: a total of 39 smokers produced 2886 messages (message themes: attitudes and expectations, improvements in quality of life, seeking help, and behavioral strategies). For not-ready-to-quit scenarios, S2S messages focused more on expectations around a quit attempt and how quitting would change an individual's quality of life. In contrast, for ready-to-quit scenarios, S2S messages focused on behavioral strategies for quitting. Phase 2: In multivariable analysis, S2S messages were more likely to generate a return visit (OR=2.03, 95% CI=1.74, 2.35), compared to expert messages. A significant effect modification of this association was found, by time-from-registration and message codes (both interaction terms p<0.01). In stratified analyses, S2S codes that were related more to "social" and "real-life" aspects of smoking were driving the main association of S2S and increased return visits. CONCLUSIONS: S2S peer messages that increased longitudinal engagement in a web-assisted tobacco intervention were successfully collected and delivered. S2S messages expanded beyond the biomedical model to enhance relevance of messages. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT00797628 (web-delivered provider intervention for tobacco control [QUIT-PRIMO]) and NCT01108432 (DPBRN Hygienists Internet Quality Improvement in Tobacco Cessation [HiQuit]).


Subject(s)
Crowdsourcing/methods , Internet , Peer Group , Smoking Cessation/methods , Adult , Aged , Attitude to Health , Female , Humans , Male , Middle Aged , Motivation , Multivariate Analysis , Quality of Life , Smoking/psychology , Smoking Cessation/psychology , Smoking Prevention , Time Factors , Young Adult
20.
JMIR Mhealth Uhealth ; 1(2): e22, 2013 Sep 09.
Article in English | MEDLINE | ID: mdl-25099140

ABSTRACT

BACKGROUND: Communication technologies can play a significant role in decreasing communication inequalities and cancer disparities by promoting cancer control and enhancing population and individual health. Studies have shown that technology, such as the mobile phone short message service (SMS) or text messaging, can be an effective health communication strategy that influences individuals' health-related decisions, behaviors, and outcomes. OBJECTIVE: The purpose of this study was to explore usage of communication technologies, assess the acceptability of mobile technology for delivery and access of health information, and identify cancer and health information needs among Deep South Network for Cancer Control trained Community Health Advisors as Research Partners (CHARPs). METHODS: A mixed-method design was used, and a triangulation protocol was followed to combine quantitative and qualitative data. Focus groups (4 focus groups; n=37) and self-administered surveys (n=77) were conducted to determine CHARPs mobile phone and text message usage. The objective was to include identification of barriers and facilitators to a mobile phone intervention. RESULTS: All participants were African American (37/37, 100%), 11/37 (89%) were women, and the mean age was 53.4 (SD 13.9; focus groups) and 59.9 (SD 8.7; survey). Nearly all (33/37, 89%) of focus group participants reported owning a mobile phone. Of those, 8/33 (24%) owned a smartphone, 22/33 (67%) had a text messaging plan, and 18/33 (55%) and 11/33 (33%) received and sent text messages several times a week or day, respectively. Similar responses were seen among the survey participants, with 75/77 (97%) reporting owning a mobile phone, and of those, 22/75 (30%) owned a smartphone, 39/75 (53%) had a text messaging plan, and 37/75 (50%) received and 27/75 (37%) sent text messages several times a week or day. The benefits of a text messaging system mentioned by focus group participants included alternative form of communication, quick method for disseminating information, and privacy of communication. The main barriers reported by both groups to using mobile technology to receive health information were cost and not knowing how to text message. Ways to overcome barriers were explored with focus group participants, and education was the most proposed solution. Majority of CHARPs were in favor of receiving a weekly text message that would provide cancer/health information. CONCLUSIONS: The findings from this study indicate that CHARPs are receptive to receiving text messages focusing on cancer/health information and would be likely to engage in mobile health research. These findings represent the first step in the development of an interactive mobile health program designed to provide cancer/health information and a support network for the Deep South Network Community Health Advisors as Research Partners (DSN CHARPs).

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