Perceptions and Patterns of Cigarette and E-Cigarette Use among Hispanics: A Heterogeneity Analysis of the 2017-2019 Health Information National Trends Survey.

There are documented disparities in smoking behaviors among Hispanic adults in the U.S., but little is known about patterns of e-cigarette use. Using data from the HINTS 5 cycle 1-3, we examined cigarette and e-cigarette history and current use, as well as perceptions of the dangers of e-cigarette use relative to cigarette use. Primary predictors were Hispanic ethnic group, gender, age, education, income, and English language proficiency. Binary outcomes were modeled using the logit link, and multinomial outcome variables were modeled using generalized logit model. Fifty-three percent of participants were Mexican, 8% Puerto Rican, 4% were Cuban, and 35% identified as other Hispanics. Of the 1618 respondents, 23% were former cigarette smokers and 10% were current cigarette smokers. Twenty percent reported history of electronic cigarettes and 4% reported current use. In multivariable models, Hispanic women were significantly less likely to report ever being smokers compared to Hispanic men (aOR = 0.61, 95% CI = 0.42, 0.88). Puerto Ricans were 2.4 times as likely to report being current smokers (95% CI = 1.11, 5.11) compared to Mexicans. Among Hispanics, significant differences in e-cigarette and cigarette use behaviors emerged by gender, age, ethnicity, and cancer history, with implications for tailoring smoking prevention and cessation messages.

Breast cancer clinical characteristics and outcomes in Trinidad and Tobago.

Trinidad and Tobago (TT) is the country with the highest breast cancer mortality in the Caribbean. It is unknown whether biological, behavioral, environmental, or clinical factors play a significant role in such outcome. A total of 2,614 incident cases, histologically confirmed and recorded in the TT cancer registries between 1995 and 2005, with follow-up through 2009 were analyzed. Half of the cases were diagnosed between the ages of 40-59 years, 12.5% before the age of 40 years; 45% of women were diagnosed at localized stage and 43.7% were hormone receptor positive. Women diagnosed with distant staging were more likely to undergo chemotherapy compared to those with localized staging (OR 1.39; 95% CI 1.01-1.89). Hormone receptor negative cases were significantly less likely to undergo radiation or surgery therapy (OR 0.66; 95% CI 0.56-0.79 and OR 0.67; 95% CI 0.51-0.88 respectively) compared to those who were hormone receptor positive, but more than 1.5 times as likely to undergo chemotherapy. In multivariate analyses, advanced stage disease and negative hormone receptor status were independently significantly associated with poorer survival outcome. No racial/ethnic differences were observed with respect to treatment or survival. Although access to breast cancer screening and treatment is free in Trinidad and Tobago, breast cancer diagnosis occurs at advanced stages; use of multimodality therapy as a first course of treatment is low.

Addressing cancer disparities through community engagement: improving breast health among Haitian women.

PURPOSE/OBJECTIVES: To describe processes for fostering community engagement among Haitian women to facilitate breast health education and outreach that are consonant with Haitians' cultural values, literacy, and linguistic skills. DATA SOURCES: Existing breast cancer education and outreach efforts for Haitian immigrant communities were reviewed. Local community partners were the primary source of information and guided efforts to create a series of health-promoting activities. The resultant partnership continues to be linked to a larger communitywide effort to reduce cancer disparities led by the Tampa Bay Community Cancer Network. DATA SYNTHESIS: A systematic framework known as the CLEAN (Culture, Literacy, Education, Assessment, and Networking) Look Checklist guided efforts for improved communications. CONCLUSIONS: Community engagement forms the foundation for the development and adaptation of sustainable breast education and outreach. Understanding and considering aspects of Haitian culture are important to the provision of competent and meaningful care. IMPLICATIONS FOR NURSING: Nurses should expand their skills, knowledge, and competencies to better address the changing demographics of their communities. Nurses also can play a critical role in the development of outreach programs that are relevant to the culture and literacy of Haitian women by forming mutually beneficial partnerships that can decrease health disparities in communities.