Juan R. Canedo

Using a Participatory Research Process to Address Disproportionate Hispanic Cancer Burden

Community-based participatory research (CBPR) offers great potential for increasing the impact of research on reducing cancer health disparities. This article reports how the Community Outreach Core (COC) of the Meharry–Vanderbilt–Tennessee State University (TSU) Cancer Partnership has collaborated with community partners to develop and implement CBPR. The COC, Progreso Community Center, and Nashville Latino Health Coalition jointly developed and conducted the 2007 Hispanic Health in Nashville Survey as a participatory needs assessment to guide planning for subsequent CBPR projects and community health initiatives. Trained community and student interviewers surveyed 500 Hispanic adults in the Nashville area, using a convenience sampling method. In light of the survey results, NLHC decided to focus in the area of cancer on the primary prevention of cervical cancer. The survey led to a subsequent formative CBPR research project to develop an intervention, then to funding of a CBPR pilot intervention study to test the intervention.

Healthy Families Study: Design of a Childhood Obesity Prevention Trial for Hispanic Families

BACKGROUND The childhood obesity epidemic disproportionately affects Hispanics. This paper reports on the design of the ongoing Healthy Families Study, a randomized controlled trial testing the efficacy of a community-based, behavioral family intervention to prevent excessive weight gain in Hispanic children using a community-based participatory research approach. METHODS The study will enroll 272 Hispanic families with children ages 5-7 residing in greater Nashville, Tennessee, United States. Families are randomized to the active weight gain prevention intervention or an alternative intervention focused on oral health. Lay community health promoters implement the interventions primarily in Spanish in a community center. The active intervention was adapted from the We Can! parent program to be culturally-targeted for Hispanic families and for younger children. This 12-month intervention promotes healthy eating behaviors, increased physical activity, and decreased sedentary behavior, with an emphasis on parental modeling and experiential learning for children. Families attend eight bi-monthly group sessions during four months then receive information and/or support by phone or mail each month for eight months. The primary outcome is change in childrens body mass index. Secondary outcomes are changes in childrens waist circumference, dietary behaviors, preferences for fruits and vegetables, physical activity, and screen time. RESULTS Enrollment and data collection are in progress. CONCLUSION This study will contribute valuable evidence on efficacy of a childhood obesity prevention intervention targeting Hispanic families with implications for reducing disparities.

Assessing Community Readiness for Change in the Nashville Hispanic Community Through Participatory Research

Background: “New-growth communities” with rapidly growing Hispanic populations often have little experience with addressing the needs of this population. “Community readiness for change” is the degree to which a community is prepared to take action on an issue. Objectives: This study assessed the stage of community readiness for change in the area of Hispanic health in Nashville, using the community readiness model (CRM) and a community-based participatory research (CBPR) approach, through a partnership between an academic research center and a nonprofit, grassroots, Hispanic organization. Methods: Qualitative and quantitative data were collected by trained community interviewers and the academic researcher using a semistructured questionnaire based on the CRM. The sample of key informants included (1) a purposive sample of 18 organizations, and (2) a convenience sample of 50 Hispanic community members. Results: The organizations were at a higher stage (stage 5, preparation) than the Hispanic community members were (stage 4, preplanning), particularly in the dimensions of Leadership, Resources, and Knowledge of Efforts. The community members were also aware of fewer local efforts focused on Hispanic health than the organizations (average of 4.5 vs. 7.6). Conclusions: Recommendations were made for stageappropriate, community-level interventions. The assessment results are being used by Nashville Latino Health Coalition (NLHC) to plan collaborative initiatives to address Hispanic health needs in Nashville. This study demonstrates the utility of the CRM as a model for assessing a community’s stage of readiness to take action, and the feasibility of applying it using a CBPR approach in a “new-growth” Hispanic community.

Childhood obesity prevention cluster randomized trial for Hispanic families: outcomes of the healthy families study

Obesity prevalence is disproportionately high among Hispanic children.

Abstract 982: Increasing HPV vaccine utilization among Hispanic girls to reduce cervical cancer disparities

Incidence and mortality rates from cervical cancer are higher in Hispanic women compared to non-Hispanic white women. The purpose of this pilot study is to implement and assess a multilevel, culturally- and linguistically-appropriate social marketing intervention targeting the Hispanic population to increase utilization of the HPV vaccine among Hispanic girls ages 9-18 in Nashville/Davidson County, Tennessee. The specific aims are to (1) pre-test and disseminate culturally- and linguistically-appropriate media messages to promote use of the HPV vaccine in the target population; (2) provide information, referral and follow-up reminders to families to encourage initiation and completion of HPV vaccine series; and (3) assess the impact of the intervention by comparing changes in HPV vaccine utilization rates for Hispanic girls in partner clinics and in the state Immunization Registry. This pilot translational research study draws on Rogers’ Diffusion of Innovation theory. We employ the methodology of Community-Based Prevention Marketing, which combines social marketing theories and techniques with community-based participatory research (CBPR) approaches. The intervention uses a combination of Spanish-language media_radio, newspaper and printed brochures_to disseminate the messages throughout the community. A trained lay health promoter (promotora de salud) at Progreso Community Center receives phone calls to answer general questions about the vaccine and eligibility requirements for the VFC program, refers patients to appropriate locations to obtain the vaccine, and provides follow-up reminders. In this presentation we will present how formative research findings were used to develop the intervention and preliminary baseline intervention data. Targeted interventions to Hispanic communities such as this one to encourage use of a new cervical cancer vaccine could help eradicate ethnic disparities in cervical cancer. The study contributes valuable knowledge to the dearth of research on possible barriers for Hispanics to use this vaccine or about culturally- and linguistically-appropriate social marketing strategies for HPV vaccine use among Hispanics. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 982.

Abstract B6: Social marketing intervention to increase HPV vaccine utilization among Hispanic girls: Preliminary data

Incidence and mortality rates from cervical cancer are higher in Hispanic women compared to non-Hispanic white women. The recently approved HPV (human papillomavirus) vaccine has been proven effective in preventing 70% cervical cancer cases (those caused by two types of high-risk HPV). This translational research study draws on Rogers’ Diffusion of Innovation theory to address the need to hasten the pace of diffusion of this new vaccine, especially among populations with high rates of cervical cancer. An academic-community partnership employed the methodology of community-based prevention marketing (CBPM) to develop a culturally appropriate, multilevel intervention aimed at increasing the utilization of the HPV (human papillomavirus) vaccine against cervical cancer among Hispanic girls. CBPM combines social marketing theories and techniques with community-based participatory research (CBPR) approaches for the development and implementation of public health interventions aimed at producing behavior change. In this presentation we will present the social marketing plan used in the intervention and preliminary data. The intervention uses a combination of Spanish-language media-radio, newspaper and printed brochures-to disseminate the messages throughout the community. A trained lay health promoter (promotora de salud) at Progreso Community Center receives phone calls to answer general questions about the vaccine and eligibility requirements for the VFC program, refers patients to appropriate locations to obtain the vaccine, and provides follow-up reminders. We present baseline intervention data on rates of HPV vaccine utilization by race/ethnicity and preliminary data on responses to the media campaign. The study contributes valuable knowledge about culturally and linguistically appropriate social marketing strategies for HPV vaccine use among Hispanics. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B6.