Kipling J. Gallion

Media and Community Campaign Effects on Adult Tobacco Use in Texas

The present study reports on the effects on adult tobacco cessation of a comprehensive tobacco-use prevention and cessation program in the state of Texas. Differences in cessation rates across treatment conditions were measured by following a panel of 622 daily smokers, recruited from the original cross-sectional sample, from baseline to follow-up. The adult media campaign combined television, radio, newspaper and billboard advertisements featuring messages and outreach programs to help adults avoid or quit using tobacco products. The ads also promoted quitting assistance programs from the American Cancer Society Smokers’ Quitline, a telephone counseling service. The cessation component of the intervention focused on increasing availability of and access to cessation counseling services and pharmacological therapy to reduce nicotine dependence. Both clinical and community-based cessation programs were offered. Treatment areas which combined cessation activities with high level media campaigns had a rate of smoking reduction that almost tripled rates in areas which received no services, and almost doubled rates in areas with media campaigns alone. Analyses of the dose of exposure to media messages about smoking cessation show greater exposure to television and radio messages in the areas where high level media was combined with community cessation activities than in the other areas. Results also show that exposure to media messages was related to processes of change in smoking cessation and that those processes were related to the quitting that was observed in the group receiving the most intensive campaigns.

Advancing the role of participatory communication in the diffusion of cancer screening among hispanics

Based on previously demonstrated methods, a cancer prevention program combining media and interpersonal communication was conducted in a Texas border city (Brownsville) in 1995-1996. To evaluate the program a quasi-experimental panel design study followed 107 women in a program site and 105 women in a comparison site from 1994 to 1996. Women in the program site reported an increase in levels of Pap screening adherence.

A national agenda for Latino cancer prevention and control

Although cancer is a leading cause of morbidity and premature death among Latinos, there is limited knowledge of cancer‐related issues and priorities of greatest significance to the Latino population, the largest minority group in the nation. This information is vital in helping to guide Latino cancer research, training, and awareness efforts at national, regional, and local levels. To help identify cancer issues of greatest relevance to Latinos, Redes En Acción, The National Hispanic/Latino Cancer Network, a major network among the National Cancer Institutes Special Populations Networks, conducted a survey of 624 key opinion leaders from around the country. Respondents were asked to rank the three cancer sites most important to Latinos in their region and the five issues of greatest significance for this populations cancer prevention and control. Recommendations were prioritized for three specific areas: 1) research, 2) training and/or professional education, and 3) awareness and/or public education. Among cancers, breast carcinoma was ranked number one, followed in order by cervical and lung carcinomas. The issues of greatest significance to Latinos were 1) access to cancer screening and care, 2) tobacco use, 3) patient–doctor communication, 4) nutrition, and 5) risk communication. This survey solicited information from scientists, health care professionals, leaders of government agencies, professional and community‐based organizations, and other stakeholders in Latino health. The results laid the foundation for a national Redes En Acción Latino cancer agenda, thus providing a useful tool for individuals and organizations engaged in cancer prevention and control efforts among the Hispanic–Latino population. Cancer 2005. Published 2005 by the American Cancer Society.

Reducing time-to-treatment in underserved Latinas with breast cancer: The Six Cities Study

The interaction of clinical and patient‐level challenges following a breast cancer diagnosis can be a significant source of health care disparities. Failure to address specific cultural features that create or exacerbate barriers can lead to less‐than optimal navigation results, specifically in Hispanic/Latino women.

Time to definitive diagnosis of breast cancer in Latina and non-Hispanic white women: the six cities study

Time delay after an abnormal screening mammogram may have a critical impact on tumor size, stage at diagnosis, treatment, prognosis, and survival of subsequent breast cancer. This study was undertaken to evaluate disparities between Latina and non-Hispanic white (NHW) women in time to definitive diagnosis of breast cancer after an abnormal screening mammogram, as well as factors contributing to such disparities.As part of the activities of the National Cancer Institute (NCI)-funded Redes En Acción research network, clinical records of 186 Latinas and 74 NHWs who received abnormal screening mammogram results were reviewed to determine the time to obtain a definitive diagnosis. Data was obtained from participating clinics in six U.S. cities and included demographics, clinical history, and mammogram characteristics. Kaplan-Meier estimates and Cox proportional hazards models were used to test differences in median time to definitive diagnosis by ethnicity after adjusting for clinic site, demographics, and clinical characteristics.Time-to-event analysis showed that Latinas took 2.2 times longer to reach 50% definitively diagnosed with breast cancer relative to NHWs, and three times longer to reach 80% diagnosed (p=0.001). Latinas’ median time to definitive diagnosis was 60 days compared to 27 for NHWs, a 59% gap in diagnosis rates (adjusted Hazard Ratio [aHR] = 1.59, 95% CI = 1.09, 2.31; p=0.015). BI-RADS-4/5 women’s diagnosis rate was more than twice that of BI-RADS-3 (aHR = 2.11, 95% CI = 1.18, 3.78; p=0.011).Disparities in time between receipt of abnormal screening result and definitive diagnosis adversely affect Latinas compared to NHWs, and remain significant after adjusting for demographic and clinical variables. With cancer now the leading cause of mortality among Latinos, a greater need exists for ethnically and culturally appropriate interventions like patient navigation to facilitate Latinas’ successful entry into, and progression through, the cancer care system.

Exploring Potential Research Contributions to Policy The Salud America! Experience

BACKGROUNDnIncreasingly, funders expect that public health researchers will include policy contributions as outcomes. Lack of agreement as to what constitutes a policy contribution of research provides little conceptual or implementation guidance to researchers who lack policy training, as well as to evaluators called on to assess good policy contribution.nnnPURPOSEnThis study applies a previously developed policy framework to explore potential policy contributions from research conducted by 20 principal investigators of Salud America!, the Robert Wood Johnson Foundations (RWJF) Research Network to Prevent Obesity Among Latino Children.nnnMETHODSnThe literature-driven Policy Contribution Spectra served as the conceptual framework to jointly develop 20 cases of potential policy contribution. Data collection included document reviews and interviews. Data analysis included within- and cross-case analyses, member checking, data triangulation, and expert reviews.nnnRESULTSnPlotting all 20 projects on the Policy Contribution Spectra showed projects have the potential to contribute to policy across intervention types (e.g., needs assessment or applied research); levels (e.g., local or state); timing (e.g., before or after policy enactment); and outcomes (e.g., process action or health benefits). Potential policy contributions on the Spectra framework were shown as multidirectional; multilayered (e.g., simultaneous state and local action); and multidimensional (e.g., multiple strategies aimed at multiple stakeholders).nnnCONCLUSIONSnThe Policy Contribution Spectra adds a useful policy lens to existing public health practice by enabling researchers, funders, advocates, and evaluators to visualize, reframe, discuss, and communicate with policymakers and the public to resolve important public health issues.

Salud America! A National Research Network to Build the Field and Evidence to Prevent Latino Childhood Obesity

Foodandbeveragecompa-nies have come under scrutiny for marketing strategiesused to target youth to promote unhealthy food items.The use of popular licensed characters for product pro-motion, television advertisement, and marketing usingdigital and social media channels is a strategy used tocreate brand recognition and loyalty among youth.

Abstract A39: GMaP Region 4 clinical trials outreach for Latinos

Background: One of the National Cancer Institute9s (NCI) Center to Reduce Cancer Health Disparities (CRCHD) Transdisciplinary Geographical Management of Cancer Health Disparities Program (GMAP) focuses is to connect underrepresented communities with research, training and outreach efforts. GMaP Region 4 composed of 9 states (Arizona, Colorado, Kansas, Nebraska, New Mexico, Oklahoma, Texas Utah and Wyoming), developed Clinical Trials Outreach for Latinos (CTOL) and educational module to help close the gap of clinical trial and biospecimen information within our minority community. Although clinical trials are operational in some of our sites, the overall number of eligible clinical trial participants per site is much higher than the number of actual participants in clinical trials. Drawing on the Region 4 Implementation Plan, which identified the need for CT accrual especially among low income English- and Spanish-speaking Latinos, we developed an intervention to test a CT education and outreach project in at least five different sites in Region 4. CTOL Program Purpose: Increase Latinos9 informed decision-making about joining clinical trials and donating biospecimens. Highlight the importance of participating in trials and donating biospecimens. Discuss risks and benefits of participation in trials and donating biospecimens. Provide resources for available local and national trials and biobanks. Methodology: The CTOL involved the design and testing of a pilot CT education program through focus groups to implementation of the module. The project coordinator/health educator identified community organizations to the introduce CTOL and arranged for the educational sessions. The outreach strategy was to conduct a 20 to 30 minute session “piggy backed” into regularly scheduled group meetings. Prior to the presentation participants were asked to provide demographic information in a sign-in sheet. The presentations contained 4 pre-evaluation questions in which participants were asked to raise their hand if they agreed with the statement. After the session, participants asked questions and then answered several post-evaluation questions. Results: Seventy-two education sessions were conducted at five sites: 1) The University of Texas Health Science Center San Antonio, 2) New Mexico State University, 3) University of Arizona Cancer Center, 4) Good Samaritan Hospital (NE), and 5) Penrose Cancer Center (CO). The GMaP program in Region 4 included over 1200 participants in 12 different cities in 5 states (AZ, CO, NE, NM, and TX). Participants represented 155 different zip codes with the majority being Hispanic white females. At the beginning of the sessions, about 60% had heard about clinical trials however not many people really understood how they worked (33%) and fewer people neither understood nor knew about biospecimens or biobanks (17%). At the end of the sessions most participants gained knowledge about clinical trials and biospecimens with most post questions receiving over 80% “yes” responses. Sixty percent indicated they would be interested in future participation in clinical trials and biospecimen collection. Conclusions: Tailoring the form, content and delivery of education materials to an intended audience are essential for an effective program or intervention. We found that participants were not very informed about clinical trials or biospecimens but indicated that their knowledge and attitudes towards these issues increased or improved after exposure to our CTOL. Based on our findings we continued to refine the program and created “The Clinical Trials Outreach for Latinos: Program Replication Manual”, which we believe could assist other communities and stakeholders to disseminate this information and program in their own communities. Citation Format: Rose A. Trevino-Whitaker, Amelie G. Ramirez, Kipling Gallion, Mary O9Connell. GMaP Region 4 clinical trials outreach for Latinos. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A39.

Latino Youth and Obesity: Communication/Media Influence on Marketing

Increasing childhood obesity rates have led many public health researchers, child health advocates, and policy makers to carefully examine the strategies food and beverage companies use to target children (Larson & Story, 2008; Nestle, 2006).

Abstract A11: Text messaging cessation service for young adult Latinos in South Texas: Program protocol and preliminary results

Smoking among Latino young adults (18-29) in South Texas is high (23.2% to 25.7%), representing a serious public health problem. Yet few are reached by services to help them quit smoking. Young adult Latinos are heavy users of mobile devices for texting and access to mobile media. These have an extraordinary theoretical potential for assisting smoking cessation by providing peer modeling and eliciting social reinforcement for behavior change. Thus, we are developing bilingual text messaging and mobile media services specifically targeting Latino young adults in South Texas to quit smoking. Methods: Following a six-month preparatory phase of work to finalize promotional plans, develop and pretest evidence-based, culturally tailored English and Spanish SMS (text message) cessation services, we will launch an intensive social and mobile media promotional campaign to recruit 3,000 young adult cigarette smokers to this service. This project9s innovative features include attention to a population that has not been served with efforts to promote smoking cessation. We will employ social media (Facebook, Twitter, Instagram and YouTube) for outreach young adults who smoke. Text messages include links to web pages with additional content and YouTube videos with peer modeling of reasons and skills to quit smoking. We are transforming evidence-based SMS cessation assistance methods that have previously been available only in English or with generic Spanish translation, to fit the language use and cultural milieu of young Spanish and English speakers. Preliminary Results: Results of our initial pilot test showed that the Facebook advertising yielded 481,601 impressions and 1,534 unique users clicked join to view the service9s home page. The invitation to text a code there resulted in 147 enrollments in the service, at a cost of