Implementation and Evaluation of a Large Community-Based Colorectal Cancer Screening Program.

CONTEXT: Colorectal cancer (CRC) screening can significantly reduce incidence and mortality; however, screening rates are suboptimal. The lowest rates are among those with no usual source of care and the uninsured. OBJECTIVE: We describe the implementation and evaluation of a community-based CRC screening program from 2012 to 2015 designed to increase screening within a predominantly Hispanic US-Mexico border population. METHODS: The multicomponent, evidence-based program provided in-person, bilingual, culturally tailored health education facilitated by community health workers, no-cost primarily stool-based testing and diagnostic colonoscopy, and navigation. We recruited uninsured individuals due for CRC screening from clinics and community sites. An extensive qualitative and quantitative program process and outcome evaluation was conducted. RESULTS: In total, 20 118 individuals were approached, 8361 were eligible for screening; 74.8% completed screening and 74.6% completed diagnostic testing; 14 cancers were diagnosed. The mean age of participants was 56.8 years, and the majority were Hispanic, female, and of low socioeconomic status. The process evaluation gathered information that enabled effective program implementation and demonstrated effective staff training, compliance with processes, and high patient satisfaction. CONCLUSIONS: This program used a population-based approach focusing on uninsured individuals and proved successful at achieving high fecal immunochemical test kit return rates and colonoscopy completion rates. Key factors related to its success included tailoring the intervention to our priority population, strong partnerships with community-based sites and clinics, expertise in clinical CRC screening, and an active community advisory board. This program can serve as a model for similar populations along the border to increase CRC screening rates among the underserved.

Oxidative Stress in Postbariatric Patients: A Systematic Literature Review Exploring the Long-term Effects of Bariatric Surgery.

Background: The present study investigates the impact of oxidative stress after bariatric surgery in patients with obesity. This field of study has gained great interest in recent years due to the role that oxidative stress plays in metabolic diseases. Obesity, by itself, can generate an increase in reactive oxygen and nitrogen species, intensifying cellular damage and promoting the progression of adverse metabolic conditions. In this context, bariatric surgery emerges as a candidate capable of modifying oxidative stress biomarkers, facilitating the patient's metabolic recovery. Methods: A systematic review was carried out, identifying 30 studies found in databases such as PubMed, Scopus, Web of Science, and Google Scholar. It looked at the link between oxidative stress and recovery after bariatric surgery in patients. The selection of studies was based on the measurement of oxidative stress biomarkers before and after surgical intervention. Results: The results reveal a significant decrease in oxidative stress biomarkers after bariatric surgery. However, a notable variability in antioxidant activity is observed between different patients, as well as a significant influence of comorbidities. Conclusions: Bariatric surgery is postulated as an effective intervention in reducing oxidative stress in patients with obesity, enhancing antioxidant activity and improving patient recovery. This finding highlights the importance of considering oxidative stress management as an integral part of postoperative care, suggesting the need to implement complementary treatment strategies to optimize health outcomes.

Molecular, biochemical, and sensorial characterization of cocoa (Theobroma cacao L.) beans: A methodological pathway for the identification of new regional materials with outstanding profiles.

Cocoa is an economically important product in Colombia. On-farm germplasm evaluations enable the selection of superior genotypes for propagation and distribution across the country. This study examined 12 cocoa samples from Antioquia along with five reference materials, employing 96 single nucleotide polymorphism (SNP) markers. Furthermore, these genetic findings were correlated with physical, chemical, and sensory attributes. Primary coordinate analysis revealed that the majority of samples were hybrids derived from five original germplasm pools, including Criollo, Amelonado, and three Upper Amazon Forastero cocoas. The integral profile of the 12 selected materials was classified into Modern Criollo (Rodriguez-Medina et al., 2019) [3], Forasteros (Rodriguez-Medina et al., 2019) [3], and Trinitarios (Borja Fajardo et al., 2022) [6]. Three key factors were identified to best account for the sample classification: type of variety, functional properties, and quality.

Implementing a mailed stool sample screening program in clinics providing care for an underserved Hispanic population.

Colorectal cancer (CRC) is a leading cause of cancer-related deaths in Hispanics in the US. Despite this, Hispanics are being screened for CRC at a much lower rate than their non-Hispanic white counterparts. Implementing mailed fecal immunochemical tests (FITs) is a cost-effective intervention for increasing CRC screening rates in vulnerable populations, such as Hispanic populations in border metroplexes. We aimed to describe the effect of introductory calls coupled with mailed in-home FIT kits on CRC screening completion in two federally qualified health centers (FQHCs) in a US-Mexico border county. This was a prospective, pragmatic, two-arm intervention study with participants allocated to receive a FIT kit with a reminder call (usual care) or usual care preceded by an introductory call. The primary outcome was the percentage of patients who returned the FIT kits. Participants who returned to the FIT were primarily unemployed (54.4%), had less than a high school education (60.2%), lived in the US for at least 20 years (74.4%), and had poor self-reported health (54.4%). In addition, we observed a statistically significant increase in the absolute rate (4.5%, P = 0.003) of FITs returned when a mailed FIT kit was preceded by an introductory call compared with no initial call. This study demonstrated that adding an introductory phone call significantly improved the screening completion rate in a mailed-out CRC screening intervention in the US-Mexico border population.

Low Sleep Hygiene Is Associated with Less Adherence to the Mediterranean Diet in Chilean Schoolchildren from Rural Public Schools-A Cross-Sectional Study.

The Mediterranean diet stands as a widely acknowledged and health-promoting dietary pattern, renowned for its notable linkage to the mitigation of noncommunicable chronic maladies. Nonetheless, the existing body of evidence concerning the potential interrelation between sleep hygiene and this dietary regimen remains circumscribed. The main objective was to determine the association between sleep hygiene and adherence to the Mediterranean diet in Chilean schoolchildren from rural public schools in southern Chile. A non-experimental study was carried out, with an analytical, cross-sectional design. A total of 265 students (56.6% women, mean age 13.5 ± 1.8) from a rural community in southern Chile were recruited. Sleep habits were evaluated using Section 6 of the Life Habits and Adolescence Questionnaire, Sleep and Rest, and adherence to the Mediterranean diet was assessed with the KIDMED Mediterranean Diet Adherence Questionnaire. The main results indicated that 52.8% of schoolchildren need to improve adherence to the Mediterranean diet and 16.6% have a low-quality Mediterranean diet. A high percentage of schoolchildren have behaviors related to poor sleep hygiene (going to bed late (46%), waking up tired and wanting to continue sleeping (63.8%), and having problems falling asleep (42.6%)). Schoolchildren who got up after 8:30 a.m., those who fell asleep after midnight, upon conducting a comparative analysis of the students based on their sleep patterns, those who woke up tired and those who had trouble falling asleep had a lower level of adherence to the Mediterranean diet compared to schoolchildren who got up earlier than 8:30 a.m., fell asleep before midnight, did not wake up tired, and those who did not find it difficult to fall asleep, respectively. In conclusion, having poor sleep patterns including difficulties in both awakening and falling asleep are associated with less adherence to the Mediterranean diet in schoolchildren from rural public schools in southern Chile. Monitoring these variables and promoting healthy lifestyle habits within the educational community are essential measures.

Assessing Muscle Fatigue in Multiple Sclerosis using the Sample Entropy of Electromyographic Signals: A Proof of Concept.

Background: Multiple sclerosis (MS) is a progressive and neurodegenerative disease of the central nervous system. Its symptoms vary greatly, which makes its diagnosis complex, expensive, and time-consuming. One of its most prevalent symptoms is muscle fatigue. It occurs in about 92% of patients with MS (PwMS) and is defined as a decrease in maximal strength or energy production in response to contractile activity. This article aims to compare the behavior of a healthy control (HC) with that of a patient with MS before and after muscle fatigue. Methods: For this purpose, a static baropodometric test and a dynamic electromyographic analysis are performed to calculate the area of the stabilometric ellipse, the remitting MS (RMS) value, and the sample entropy (SampEn) of the signals, as a proof of concept to explore the feasibility of this test in the muscle fatigue quantitative analysis; in addition, the statistical analysis was realized to verify the results. Results: According to the results, the ellipse area increased in the presence of muscle fatigue, indicating a decrease in postural stability. Likewise, the RMS value increased in the MS patient and decreased in the HC subject and the opposite behavior in the SampEn was observed in the presence of muscle fatigue. Conclusion: Thus, this study demonstrates that SampEn is a viable parameter to estimate muscle fatigue in PwMS and other neuromuscular diseases.

Factors Affecting Completion of Human Papillomavirus Vaccination Series by Gender in a Predominantly Hispanic Border Town Community.

OBJECTIVES: The human papillomavirus (HPV) vaccine is recommended for females and males aged 9 to 45. Nationally, the HPV vaccination rates are lower for males than females; however, this has not been studied in a US-Mexico border community. Our study aims to report the HPV vaccination completion by gender and determine which sociodemographic factors influence vaccination. METHODS: This cross-sectional study was conducted among uninsured and underinsured individuals aged between 9 and 26 years served through a community-based HPV vaccine program in El Paso, TX. Data collected included demographic information, psychosocial variables, and vaccine administration data. Descriptive statistics were used to summarize demographic data. Unadjusted t test/Fisher exact test and multivariable relative risk regression were run on significant variables to determine the association with vaccine completion by gender. RESULTS: Most participants were female (63.4%), and an overall vaccine series completion was 30.67%. We found no significant difference in HPV vaccine completion rates by gender. Males who resided in the United States for more than a decade were 31% more likely to complete the vaccine series, and females who had 9 to 13 years of education had lower odds of vaccine completion. Knowledge significantly increased after the intervention for both genders (p = .002). There was no significant change in psychosocial variables from the preintervention to the immediate postintervention survey. CONCLUSIONS: Our multicomponent, culturally tailored intervention may equally impact male and female participants and encourages all genders to complete their HPV vaccine series. Additional studies with a larger male sample are needed.

Comparison of Narrative Video and Flipchart Presentation to Promote Cervical Cancer Screening Among Latinas Along the Border.

INTRODUCTION: Cervical cancer incidence and mortality is higher among Latinas compared with non-Hispanic White women and barriers to screening include lack of knowledge, lack of access to health care, and cultural factors. Both video and printed material have been found effective as health education tools in underserved populations. The purpose of this study was to show no difference between a flipchart presentation facilitated by a community health worker and a narrative video with limited in-person interaction in increasing cervical cancer screening rates among Latinas along the U.S.-Mexico border. METHODS: Study design: Randomized controlled study. Participants: women in a community-based cervical cancer screening program. OUTCOMES: Primary outcome was screening completion and secondary outcomes were changes in psychosocial variables. RESULTS: Total sample size was 500. Most participants were born in Mexico, had a low annual income, preferred Spanish, and did not have a regular doctor. Overall, 371 (74.2%) participants completed screening. There was no significant difference in screening completion between educational delivery modes. The only variable significantly associated with screening completion was age, with 51- to 65-year-olds being 44% more likely than 21- to 40-year-olds to have a Pap test. The only psychosocial variable that was significantly different by delivery mode was perceived susceptibility. The majority of all participants found both the video and flipchart presentation to be acceptable. CONCLUSION: A health promotion program delivered via self-administered video or PowerPoint slides showed no difference in increasing cervical cancer screening rates.

An active break program (ACTIVA-MENTE) at elementary schools in Chile: study protocol for a pilot cluster randomized controlled trial.

Background: Physical inactivity is prevalent in childhood. Schools can be an ideal context to promote the regular practice of physical activity since children spend there a large part of the day. In this sense, an emerging and current trend is active breaks at school. This article presents a study protocol that seeks to assess the feasibility and effectiveness of an intervention with active breaks (ACTIVA-MENTE program) in a school context on physical activity, on-task classroom behavior, and the physical activity enjoyment in schoolchildren. Methods: The protocol includes children aged 10 to 11 years. Two groups will be randomized (intervention and control groups). The intervention group will use the active break program, ACTIVA-MENTE, which consists of the application of a 4-min, 30-s video with moderate to vigorous-intensity physical activity. These breaks will be taken 6 times a day in the classes for 6 weeks. The total physical activity will be measured with accelerometers (Actigraph wGT3X-BT), the on-task behavior through the Direct Behavior Rating Scale and the level of enjoyment through the Physical Activity Enjoyment Scale. Discussion: Previous research reported that active breaks have positive results in physical activity levels. This study will be one of the few to design active breaks through videos without depending on the presence of a physical education teacher and it can also provide new findings on the effectiveness of an active break's structure (e.g., types of exercises and intensity) on the indicated outcomes. Expected results: It is expected that the ACTIVA-MENTE program can be a suitable program for school settings, potentially increasing physical activity levels, and the commitment to the task, as well as be a pleasant moment for the students. Clinical trial registration: Clinicaltrials.gov, identifier NCT05403996.

Which one? A comparative study of traditional and sports uniforms on academic achievement, cognitive performance, playtime, bullying, and discrimination in adolescents: The Cogni-Action Project.

Objective: The aim of this study was to compare academic achievement, cognitive performance, playtime, bullying, and discrimination in adolescents according to traditional uniforms (TUs) and sports uniforms (SUs) worn at school, while simultaneously exploring the influence of the school vulnerability index. Methods: A total of 988 Chilean adolescents (52.6% boys) aged 10-14 years participated in this cross-sectional study. Academic achievement was evaluated by the average grade in maths, language, and science grades, while cognitive performance was assessed through eight cognitive tasks. TUs affecting physical activity, playtime, bullying, and discrimination were queried. Mixed model analyses were performed. Results: No differences were observed in academic achievement (TU: 5.4 ± 0.1 vs. SU: 5.5 ± 0.2, p = 0.785) or in cognitive performance (TU: 99.6 ± 0.8 vs. SU: 98.9 ± 1.8, p= 0.754) according to the school uniformtype. Moreover, 64.1 % of participants declared that wearing TU affects their physical activity (traditional uniforms: + 8 min and sports uniforms: + 20 min), and those who believed so spent more time playing than those who answered negatively (14.5 min, p = 0.012). Finally, adolescents wearing SU displayed a lower feeling of bullying and discrimination; this finding depended mainly on the school's vulnerability. Conclusion: It is concluded that wearing TU does not show an educational advantage at an academic and cognitive level that justifies its obligation. In addition, it could be suggested that schools consider adolescents' opinions in adopting a more comfortable uniform, such as the SU. This feasible and low-cost measure would help to increase adolescents' physical activity during the school day, and, contrary to belief, it would not be related to increased feelings of bullying and discrimination.

[Association between sleep disorders and academic performance: Finding of health survey and academic performance in the Bio-Bio province 2018]. / Asociación entre problemas de sueño y rendimiento escolar: Resultados de la encuesta de salud y rendimiento escolar de la provincia del Biobío 2018.

OBJECTIVE: To analyze the association between sleep disorders, behaviors associated with cognition, and academic performance in elementary school students. SUBJECTS AND METHOD: Analytical and cross-sectional research including 733 students from 5th and 8th grades from public schools par ticipating in the study "Health survey and academic performance in the Bio-Bio Province 2018". The sleep disorders were reported through a sleep self-report questionnaire, and the academic per formance was measured through the grade point average (GPA) in subjects language, mathematics, physical education, general point averages, and perception of cognitive functions in a school context. RESULTS: 81.9% of the schoolchildren indicated problems with bedtime routines. The students with sleep disorders of both sexes presented higher memory problems, are slower in resolving math pro blems, have higher difficulties to maintain attention in classes, have more problems solving complex tasks, and more nervousness during a test than the student classified as not having sleep disorders. Additionally, the students with sleep disorders presented lower grades in their GPA and the subjects mathematics, language, and physical education than those students without sleep disorders. Con clusion: A high prevalence of bedtime routine problems was detected as well as an association bet ween sleep disorders and lower academic performance together with a worse perception of cognitive functions in schoolchildren. Implementing health promotion strategies, focused on sleep hygiene in educational centers could improve academic performance.

Prevalence of Colorectal Cancer Screening Among Hispanic Subgroups in the United States: NHIS 2010 and 2015 Data.

Introduction: Much of the data related to colorectal cancer (CRC) disease burden among Hispanics is grouped together. The purpose of our study was to better understand the current screening uptake across Hispanic subgroups. Methods: Data from the CRC screening portion of the 2010 and 2015 Adult Cancer Control Module of the National Hispanic Interview Survey (NHIS). A univariate and multivariable analysis were conducted. Results: Total sample size: 7,389. Subgroup with most participants: Mexican-American. For all Hispanics, 24% were up to date with CRC screening. In adjusted analyses, variables significantly associated with being up to date among all Hispanics were: older age (prevalence ratio [PR] = 1.03; p = <.0001), female sex (PR = 1.28; p = 0.003), more than high school education (PR = 1.25; p = 0.006), annual household income between $45,000 and $74,999 ( PR = 1.51; p = 0.018), living in the United States for 15 years or more (PR = 1.45; p = 0.039), having health insurance (PR = 2.06; p = <.0001), and having a first-degree relative with CRC (PR = 1.35; p < .0001). Discussion: Various social determinants of health were found to be associated with increased prevalence of being up to date with CRC screening among different Hispanic subgroups. Conclusion: These findings serve as a starting point to develop interventions tailored to specific Hispanic subgroups with social determinants of health, namely low socioeconomic status, at the forefront of development.

Evaluation of a Narrative Video to Promote Prevention and Early Detection of Cervical Cancer Among Latinas.

OBJECTIVE: To evaluate the impact of an online-delivered, theory-based narrative video on cervical cancer screening knowledge, attitudes, and beliefs in a predominantly Latino community. METHODS: The study design was a nonrandomized pretest-posttest evaluation. The eligibility criteria included men and women 18 years or older not previously enrolled in our community cervical cancer screening program who had internet access. Participants were recruited via in-person county-wide flyer distribution and social media dissemination. The intervention involved a narrative video designed for Latinas delivered via the internet. The 17-minute video is novella style, with a culturally tailored storyline and setting that covers cervical cancer risk factors and statistics, importance of screening, and addresses testing barriers. The measures were knowledge about cervical cancer and screening, perceived susceptibility, perceived seriousness, perceived benefits, perceived barriers, subjective norms, and self-efficacy. Analysis was performed using change scores for knowledge and psychosocial variables and descriptive statistics for satisfaction and acceptability of the video. RESULTS: Data from 227 surveys were analyzed; respondent mean age: 37.6 years; 98.8% female, 88.8% Hispanic; 42.0% had an annual income of $20,000 or less; and 85.2% had at least a high school education. Knowledge and all psychosocial variables improved significantly. More than 90% of the participants rated all of the satisfaction items as good or excellent. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: A culturally appropriate narrative video about cervical cancer and screening disseminated online effectively improved knowledge and psychosocial variables among Latinas. Our findings indicate that health promotion interventions online could be effective for improving desired health behavior through a new means of educational dissemination by way of websites and social media outlets.

Brechas en telemedicina: caracterización de consultas ambulatorias a teledermatología en Chile entre 2018-2020 / Gaps in telemedicine: characterization of ambulatory teledermatology consultations in Chile, between 2018 and 2020

Introducción: La teledermatología (TD) se ha desarrollado de manera importante en los últimos años. Además de mejorar el acceso de la población a consultas médicas, permite el diagnóstico precoz de lesiones complejas. En Chile, la TD forma parte de la plataforma Hospital Digital del Ministerio de Salud desde el 2018, en modalidad asincrónica. El objetivo de este estudio es la caracterización epidemiológica de las consultas ambulatorias a TD en Chile entre los años 2018-2020. Materiales y Métodos: Estudio descriptivo retrospectivo. Se analizaron las consultas ambulatorias a TD y a dermatología en el período 2018-2020, a partir de los datos del Departamento de Estadísticas e Información de Salud, y los datos de población total a partir del Instituto Nacional de Estadísticas, por lo que no se requirió comité de ética. Resultados: Del total de teleconsultas realizadas entre 2018-2020, un 14,2% correspondió a TD. De ellas, el 86,1% corresponden a consultas nuevas, y el 13,9% a controles. Del total de pacientes, el 63,0% fueron mujeres, mientras que el 78,9% fueron mayores de 15 años. Se realizaron 20,35 consultas a TD por cada 10.000 habitantes a nivel nacional, y 17,21 consultas dermatológicas por cada consulta a TD. Discusión: La TD es una de las principales aplicaciones de la telemedicina en Chile. La variación entre las regiones con respecto al número de consultas a TD podría deberse a factores que requieren mayor estudio. Es probable que la TD mantenga un rol creciente debido al desarrollo tecnológico y los beneficios demostrados de esta herramienta.

Introduction: Teledermatology (TD) has greatly developed in recent years. Besides improving access to medical consultations, it also allows the early diagnosis of complex lesions. In Chile, TD forms part of the Digital Hospital platform of the Ministry of Health since 2018, in a store-and-forward form. The objective of this study is to characterize ambulatory consultations with TD in Chile between 2018 and 2020. Materials and Methods: A retrospective descriptive study was performed. Ambulatory consultations with TD and dermatology between 2018-2020 were analyzed from data obtained from the Department of Statistics and Health Information, and population data were obtained from the Statistics National Institute, which did not require ethical approval. Results: Of the total teleconsultations made in the 2018-2020 period, 14.2% belonged to TD. From that, 86.1% were new consultations, and 13.9% were controls. Women represented 63.0% of the patients, while 78.9% were older than 15 years old. For every 10,000 inhabitants, 20.35 total consultations were made with TD nationwide, and 17.21 dermatological consultations were made for each consultation with TD. Discussion: TD is one of the main applications of telemedicine in Chile. The variation in the number of consultations with TD between regions could be caused by factors that require further study. It is likely that TD will keep a growing role due to technological development and benefits shown by this tool.

Anxiety, Low Self-Esteem and a Low Happiness Index Are Associated with Poor School Performance in Chilean Adolescents: A Cross-Sectional Analysis.

OBJECTIVE: To analyze the relationship between anxiety, self-esteem, happiness index and primary school students' academic performance in Chilean adolescents from the Biobío province. METHODOLOGY: 733 (46.1% girls; 12 (1.3 years)) public primary school students that completed the 2018 Health and School Performance Survey carried out in the Biobío province were included in this cross-sectional analysis. The BECK Anxiety Inventory (BAI) was used to measure anxiety while happiness index and self-esteem were measured using the subjective happiness scale and the Rosenberg self-esteem scale, respectively. School performance was measured by grade point average (GPA) of language, math, physical education and cumulative GPA, and behavior associated with cognition in the school context was also considered. The relationship between mental health indicators and school performance was investigated using a one-way ANOVA and Pearson correlation. RESULTS: In comparison to students with low anxiety levels and high self-esteem and happiness levels, students with higher anxiety levels, lower self-esteem and happiness levels perceived themselves as having memory problems. They were also slower to solve math problems, had a shorter attention span in class and presented more difficulties in solving complex tasks, as well as being more nervous during testing. These students also got the lowest grade point average in math, language and physical education. CONCLUSIONS: High anxiety levels, low self-esteem and low happiness levels were associated with lower school performance and weaker behavior associated with cognition in Chilean adolescents. Implementing plans of emotional education and mental health could improve academic achievement.

[Increased screen hours are associated with low school performance]. / Aumento de horas de pantalla se asocia con un bajo rendimiento escolar.

OBJECTIVE: To analyze whether screen time is related to lower academic performance in second-cycle students and to determine differences by sex. SUBJECTS AND METHOD: Analytical, retrospective, and cross-sectional research. 733 students from the 5th to 8th year of public schools participating in the study "school health and performance survey in the Biobío province 2018" were recruited. The use of the screen was self-reported through daily hours in front of the TV, video games, and the internet. School performance was measured with the report card of reading, math, physical education, and the grade point average and through behaviors related to cognition in the school context. To determine the relationship between screen time and school performance, the Pearson's correlation coefficient was determined, and to measure the influence of sex and screen hours on the grades, a two-way ANOVA was performed. RESULTS: The students spend 6.1 ± 5.3 hours in front of a screen daily. Boys spend more time playing video games and girls surfing the internet. Both boys and girls who spend more hours in front of a screen, mainly playing video games and surfing the internet, presented lower grades in mathematics, reading, physical education, grade point average, and had less memory, were slower in solving mathematical problems and had more difficulties in maintaining attention in class or solving complex tasks. CONCLUSION: Screen use is negatively associated with academic performan ce, as well as behaviors related to cognition in students of both sexes.

Could Physical Fitness Be Considered as a Protective Social Factor Associated with Bridging the Cognitive Gap Related to School Vulnerability in Adolescents? The Cogni-Action Project.

The first aim was to compare differences between school vulnerability groups, fitness levels, and their combination in adolescent cognitive performance. The second aim was to determine the mediation role of fitness in the association between school vulnerability and cognitive performance. A total of 912 Chilean adolescents aged 10-14 years participated in this study. The school vulnerability index (SVI) assigned by the Chilean Government was categorized into high-, mid-, or low-SVI. Adolescents were classified as fit or unfit according to their global fitness z-score computed from their cardiorespiratory (CRF), muscular (MF), and speed/agility fitness (SAF) adjusted for age and sex. A global cognitive score was estimated through eight tasks based on a neurocognitive battery. Covariance and mediation analyses were performed, adjusted for sex, schools, body mass index, and peak high velocity. Independent analyses showed that the higher SVI, the lower the cognitive performance (F(6,905) = 18.5; p < 0.001). Conversely, fit adolescents presented a higher cognitive performance than their unfit peers (F(5,906) = 8.93; p < 0.001). The combined analysis found cognitive differences between fit and unfit adolescents in both the high- and mid-SVI levels (Cohen's d = 0.32). No differences were found between fit participants belonging to higher SVI groups and unfit participants belonging to lower SVI groups. Mediation percentages of 9.0%, 5.6%, 7.1%, and 2.8% were observed for the global fitness score, CRF, MF, and SAF, respectively. The mediation effect was significant between low- with mid-high-SVI levels but not between mid- and high-SVI levels. These findings suggest that an adequate physical fitness level should be deemed a protective social factor associated with bridging the cognitive gap linked to school vulnerability in adolescents. This favourable influence seems to be most significant in adolescents belonging to a more adverse social background.

Outcomes of a Multicomponent Culturally Tailored Cervical Cancer Screening Intervention Among Underserved Hispanic Women (De Casa en Casa).

Hispanic women have almost double the cervical cancer incidence and are twice as likely to die from cervical cancer compared with non-Hispanic White women. Cervical cancer is preventable with screening, and based on available data, multiple component screening interventions have been proposed as a strategy to maximize screening, but such studies are lacking. We sought to test the effectiveness of a multicomponent screening intervention for primary prevention and early detection of cervical cancer among underserved Hispanic women. We conducted a prospective community-based cervical cancer screening intervention utilizing a quasi-experimental design. The intervention was theory based, delivered by bilingual community health workers, combined education and reduction of noneconomic barriers, and addressed economic barriers. Components included outreach, education, provision of no-cost Papanicolaou and human papillomavirus screening, on-site diagnostic and treatment colposcopy, and patient navigation with tracking to facilitate screening, diagnosis, and treatment. The main outcome was self-reported screening. We recruited 300 intervention group and 299 control group participants. Mean age of the sample was 44.7 years. The majority were Hispanic (98%), born in Mexico (79%), and had a Spanish-language preference (86%). In intention-to-treat analyses, the intervention group had a relative risk of screening of 14.58 (95% confidence interval = 8.57-24.80, p < .001) compared with the control group. A multilevel, multiple component culturally tailored bilingual cervical cancer screening intervention combining education, navigation, and no-cost screening can significantly increase cervical cancer screening uptake in a high-risk, underscreened population and has the potential to affect cervical cancer health disparities.

HPV Vaccine Beliefs and Correlates of Uptake Among Hispanic Women and Their Children on the US-Mexico Border.

INTRODUCTION: Human Papilloma Virus (HPV) is the most common sexually transmitted infection nationally. Although preventable, uptake of the HPV vaccine is low. The purpose of this study was to describe HPV vaccine knowledge and beliefs and psychosocial correlates of vaccine uptake among adult females and their children in a US-Mexico border community. MATERIALS AND METHODS: We conducted a survey of uninsured women aged 21-65 years living in Texas who were due for cervical cancer screening. We utilized descriptive statistics to report demographic and psychosocial variables. We used logistic regression analysis to identify correlates of prior vaccine uptake. RESULTS: 599 women completed surveys: mean age was 44.69 years, 97.8%, were Hispanic and 86% were Spanish speaking; 5% had been vaccinated. Awareness of HPV infection & HPV vaccine was 81.6% & 68.6% respectively. Scores for mean perceived susceptibility was low and mean perceived benefits was high; the mean score for knowledge was 3.69 out of 6. Common parental barriers to child vaccination were cost, lack of accessibility and lack of information. Correlates of past HPV vaccine uptake among adult women were younger age, monthly income of $2,500-$5,000, full-time employment, US birth, and higher perceived severity of HPV. Older age was a correlate of vaccine uptake for daughters. DISCUSSION AND CONCLUSION: Findings revealed low HPV vaccine uptake among adult Hispanic women, but high vaccine acceptability for their sons and daughters. Culturally tailored educational interventions are needed to improve HPV knowledge and HPV vaccine uptake among adults and their children.

The Prevalence of Genital Human Papillomavirus Subtypes in a Cohort of Hispanic Women Presenting for Cervical Cancer Screening Along the US-Mexico Border.

Introduction : Hispanic women residing along the US-Mexico border have the highest cervical cancer incidence rates in the US. Genital human papillomavirus (HPV) is the major causative agent, but more information is needed about the prevalence and distribution of genital HPV subtypes in this high-risk population. Methods : A population-based cross-sectional study of uninsured Hispanic women along the US-Mexico border was conducted and participants had their cervical specimens undergo DNA extraction followed by HPV genotype testing using the Linear Assay from Roche® Diagnostics, to identify 37 genital HPV subtypes. Results : Among the 585 women aged 21-65 years, 584 self-identfied as Hispanic. Any HPV subtype prevalence was 53.2% (95% CI: 49.0%-57.3%) and of these 52% (i.e. 27.5% of the total) had single infections and 48% (i.e. 25.6% of the total) had multiple infections. High-risk HPV prevalence was 15.6% (95% CI: 24-31.3%). The mean number of subtypes among those testing positive was 2.1 (SD 1.6). The prevalence of any HPV and high-risk HPV showed a U shaped pattern with age; and prevalence of 16/18 and non-16/18 high-risk subtypes (e.g. 31, 33, 35, 39, 45, 51, 52, 58); also varied with age. Forty-one percent of high-risk HPV occurrences were of a subtype not covered by the current nonavalent HPV vaccine. Discussion : Our findings suggest a different high-risk HPV subtype pattern and age distribution among Hispanic women in the USA, which could have implications for future cervical cancer prevention strategies.