Beverly J. Gor

Racial Disparity and Socioeconomic Status in Association With Survival in Older Men with Local/Regional Stage Prostate Cancer: Findings From a Large Community-Based Cohort

Few studies have examined the outcomes for Hispanic men with prostate carcinoma and incorporated socioeconomic factors in association with race/ethnicity in affecting survival, adjusting for factors on cancer stage, grade, comorbidity, and treatment.

Hepatitis B and Hepatitis C Prevalence and Treatment Referral Among Asian Americans Undergoing Community-Based Hepatitis Screening

OBJECTIVES We sought to identify cross-sectional hepatitis B virus (HBV) and HCV prevalence among Asian Americans at a community health fair and to assess referral rates. METHODS We determined HBV prevalence with hepatitis B surface antigen (HBsAg), antibodies to hepatitis B core antigen (anti-HBc), and antibodies to hepatitis B surface antigen (anti-HBs). We determined HCV prevalence with hepatitis C antibodies. Successful referral occurred when participants with HBV or HCV were contacted, medically evaluated, and given contact information of liver specialists for care. RESULTS Of 202 people screened, 118 were Asian Americans (65 Chinese and 39 Vietnamese). Twelve had chronic HBV with positive HBsAg. However, chronic HBV prevalence increased from 10.2% to 13.6% by concomitant HBsAg, anti-HBc, and anti-HBs testing. Prevalence of HCV was 6% overall but 15.4% among Vietnamese. Overall, 83% of patients with chronic HBV and 100% of patients with occult HBV or HCV were successfully referred. CONCLUSIONS Concomitant HBsAg, anti-HBc, and anti-HBs testing permits diagnosis of chronic, occult HBV infections missed by testing with HBsAg alone. Persons identified with HBV or HCV at community health fairs can be successfully referred.

Young Asian Americans' knowledge and perceptions of cervical cancer and the human papillomavirus.

Cervical cancer is a major health disparity among Asian Americans, with cervical cancer rates of Vietnamese women being significantly higher than for the general US female population and low screening rates reported for Asian American females. Focus groups and interviews were conducted with young Vietnamese, Filipino, and Korean adults (ages 18–29) to collect information on knowledge, perceptions and sources of information regarding cervical cancer, Pap tests and the human papillomavirus. 16 Korean, 18 Vietnamese, and 18 Filipino (50% female) adults participated in the study. Many participants had never heard of HPV, cervical cancer and Pap testing. Cervical cancer screening rates were low for Korean and Vietnamese females and were influenced by moral beliefs and lack of awareness. Culturally relevant education materials that consider specific Asian ethnicity and language are needed to increase awareness of cervical cancer, Pap testing, and HPV among Asian American young adults

Associations Between Body Size and Serum Estradiol and Sex Hormone-Binding Globulin Levels in Premenopausal African American Women

CONTEXT African American (AA) women have the highest rates of premenopausal breast cancer; however, it is unclear whether body size contributes to the hormonal patterns potentially associated with increased breast cancer risk in these women. OBJECTIVE To characterize the association between body size and serum levels of estradiol and sex hormone-binding globulin (SHBG) levels in a sample of premenopausal AA women. DESIGN A total of 164 premenopausal AA women who were not pregnant or breastfeeding were recruited for this study. Serum samples were collected during the early follicular phase, and trained staff collected body size measurements. Multiple linear regression models were performed to assess potential associations. MAIN OUTCOME MEASURES Serum estradiol and SHBG levels. RESULTS Many (81%) of the women enrolled were overweight or obese. Both waist-to-hip ratio (WHR) (β = 2.68, P = .008) and waist circumference (WC) (β = 2.02, P = .046) were positively associated with higher levels of estradiol. All measures of body was significantly and inversely associated with SHBG levels (all P < .05). CONCLUSIONS Premenopausal AA women with higher WHR or larger WC may have higher levels of estradiol and lower levels of SHBG. Thus, WHR or WC may be better indicators for assessing hormonal patterns implicated in breast cancer pathogenesis in these women.

Addressing cancer health disparities using a global biopsychosocial approach.

The Center for Research on Minority Health has translated the biopsychosocial framework to address global cancer health disparities through the integration of biological (eg, endogenous steroids, genetic susceptibility, and pesticide levels) and behavioral (eg, dietary interventions) determinants, along with community‐based research (eg, comprehensive involvement of community advisory boards) and educational approaches (eg, kindergarten through postgraduate training). Evidence of successful implementation of this framework includes health disparities training for >2000 individuals ranging from elementary to the postgraduate level, and conducting transdisciplinary projects that incorporate traditional and nontraditional health professionals to examine associations between biological and nonbiological determinants of health. Examples and recommendations for implementation of the biopsychosocial approach as it applies to cancer health disparities research are described. Cancer 2010.

Perceptions of Generic Drug Discount Programs Among Low-Income Women: A Qualitative Study

PURPOSE Increasing the awareness and use of generic drug discount programs (GDDP) may improve access to essential prescription drugs. However, little is known about public perceptions of GDDPs. The purpose of this study is to understand the perceptions and utilization patterns of low-income women regarding GDDP. METHODS Using a purposive sampling strategy, we conducted seven focus groups with a total of 50 participants using a semistructured guide to assess awareness and utilization of GDDP. Transcripts of the focus groups were systematically analyzed across groups with a general inductive approach for qualitative data analysis. RESULTS Five major categorical themes emerged from the focus group content analysis: 1) Perceived differences between generic and brand-name prescription drugs, 2) barriers to utilizing GDDP, 3) lack of adequate communication between pharmacy, physician and patient about GDDP, 4) perceived health impact of utilizing GDDPs, and 5) perceived health care savings. Most participants indicated that they perceive no difference between generic and brand-name prescription drugs. Lack of awareness was indicated as a barrier to utilization. There was general agreement among participants that GDDP can help to maintain health while saving money. CONCLUSION Study participants demonstrated generally favorable perceptions regarding GDDPs. Our findings underscore the need for policies that encourage expansion of the GDDP formulary and increasing awareness and utilization of GDDP.

Development of a Health Risk Factors Questionnaire for Chinese and Vietnamese Residents of the Houston, Texas Area

The purpose of the Asian American Health Needs Assessment (AsANA) project was to collect information on the health risks, behaviors, and beliefs among Chinese and Vietnamese residents in the Houston area, two of the largest Asian American subgroups in Texas. The first phase of the project was to develop the AsANA survey instrument, which was adapted from the Texas Community Health Survey, a condensed version of the Behavioral Risk Factors Surveillance System. This report describes the steps used in adapting, modifying and developing the survey instrument, and provides insights, which may assist other investigators conducting similar research.

Circle of sisters: Raising awareness of native American women to breast cancer

The Circle of Sisters is a breast cancer education initiative that incorporates free mammography for American Indian women. In two separate but similar initiative-sponsored one-day events, 37 American Indian women underwent screening mammography and experienced a full day of culturally tailored educational activities. Women observed a cooking demonstration, participated in moderate exercise activity, strung beads to learn about the dimensions of breast tumors, and listened to an American Indian breast cancer survivor recount her story of diagnosis and treatment. Significant shifts in opinion included an increase in the understanding that a woman’s chances of being diagnosed with breast cancer increase with age (p=.015) and with never bearing children (p <.001) and that breast cancer can be detected early (p=.043). The percentage of those expressing an intention to get a mammogram every year grew from 81.1% to 94.6%.

Houston AANCART best practices: from vision to synergy to reality.

The theme for the 2004 AANCART Academy, “Community Partnerships for Cancer Control: From Vision to Synergy to Reality”, characterizes Best Practices for the Houston AANCART site. Researchers and community members share a common vision for addressing the cancer and health disparities that exist in our Asian community. They banded together synergistically to bring to reality the programs and projects that are enabling more Asian Americans to understand their risks for cancer, receive screening and education, and access treatment and survivorship support. Along the way, Houston AANCART was also able to conduct meaningful and relevant community‐based participatory research and to train young Asian and other investigators in how to reach out to this community in a culturally sensitive and appropriate manner. Cancer 2005.

Physical Activity Behaviors and Influences Among Chinese–American Children Aged 9–13 Years: A Qualitative Study

Low physical activity is a major health issue among Chinese Americans. This study explored Chinese–American children’s physical activity behaviors and influencing factors. Twenty-five children of Chinese or Taiwanese descent were interviewed to understand their favorite sports or physical activities, physical activity environments, and influences on their physical activity. All were between the ages of 9 and 13. Interviews were transcribed and coded using thematic data analysis procedures. Major themes included: (1) team sports, particularly basketball, were commonly listed as favorite sports or activities; (2) physical activity occurred mostly at school or an after-school setting; and (3) family played a major role in physical activity. Some trends/differences were detected based on age, sex, and socioeconomic status. Interventions to promote physical activity among Chinese–American children should emphasize team sports and encourage physical activity in schools, but also explore ways to involves families outside of school.