Paula Espinoza

A su salud: a quasi-experimental study among Mexican American women.

OBJECTIVES To test the effectiveness of a community intervention program to promote breast and cervical cancer screening. METHOD Low-income Mexican American neighborhoods located in 2 Texas cities were assigned to intervention or comparison conditions. A 2-year community intervention was delivered via local mass media and reinforced by indigenous volunteers. RESULTS There were higher Pap smear completion rates for women under 40 years of age in the intervention community. CONCLUSION Although it is important to address the cultural needs of all Mexican American women, it is also important to understand the tangible environmental barriers faced by the older women.

The Latina Breast Cancer Screening Sacle Beliefs about breast cancer and breast cancer screening

The Latina Breast Cancer Screening (LBCS) was developed to measure Latinas’ culturally-shared health beliefs about breast cancer and breast cancer screening. A 60-item LBCS scale was tested with 288 participants and reduced to 35 items using principal components analyses. The 35-item LBCS scale and other measures were administered to a second sample of 147 participants to establish the scale’s validity and reliability. A six-factor solution suggested six LBCS sub-scales. The LBCS in its entirety displayed strong internal consistency (α =.93) with adequate estimates of convergent, discriminant, and predictive validity. The LBCS scale appears to be a valid and reliable measure.

The national cancer institute’s community networks program initiative to reduce cancer health disparities: Outcomes and lessons learned

Background: We describe reach, partnerships, products, benefits, and lessons learned of the 25 Community Network Programs (CNPs) that applied community-based participatory research (CBPR) to reduce cancer health disparities.Methods: Quantitative and qualitative data were abstracted from CNP final reports. Qualitative data were grouped by theme.Results: Together, the 25 CNPs worked with more than 2,000 academic, clinical, community, government, faith-based, and other partners. They completed 211 needs assessments, leveraged funds for 328 research and service projects, trained 719 new investigators, educated almost 55,000 community members, and published 991 articles. Qualitative data illustrated how use of CBPR improved research methods and participation; improved knowledge, interventions, and outcomes; and built community capacity. Lessons learned related to the need for time to nurture partnerships and the need to attend to community demand for sustained improvements in cancer services.Implications: Findings demonstrate the value of government-supported, community–academic, CBPR partnerships in cancer prevention and control research.

Parallels between the development of therapeutic drugs and cancer health disparity programs: Implications for disparities reduction

There are analogies between the development of therapeutic drugs for cancer and the development of interventions for reducing cancer health disparities. In both cases, it can take between 12 and 15 years for the benefits to become apparent.

The Association of Panic Disorder, Posttraumatic Stress Disorder, and Major Depression With Smoking in American Indians

INTRODUCTION Rates of cigarette smoking are disproportionately high among American Indian populations, although regional differences exist in smoking prevalence. Previous research has noted that anxiety and depression are associated with higher rates of cigarette use. We asked whether lifetime panic disorder, posttraumatic stress disorder, and major depression were related to lifetime cigarette smoking in two geographically distinct American Indian tribes. METHODS Data were collected in 1997-1999 from 1506 Northern Plains and 1268 Southwest tribal members; data were analyzed in 2009. Regression analyses examined the association between lifetime anxiety and depressive disorders and odds of lifetime smoking status after controlling for sociodemographic variables and alcohol use disorders. Institutional and tribal approvals were obtained for all study procedures, and all participants provided informed consent. RESULTS Odds of smoking were two times higher in Southwest participants with panic disorder and major depression, and 1.7 times higher in those with posttraumatic stress disorder, after controlling for sociodemographic variables. After accounting for alcohol use disorders, only major depression remained significantly associated with smoking. In the Northern Plains, psychiatric disorders were not associated with smoking. Increasing psychiatric comorbidity was significantly linked to increased smoking odds in both tribes, especially in the Southwest. CONCLUSIONS This study is the first to examine the association between psychiatric conditions and lifetime smoking in two large, geographically diverse community samples of American Indians. While the direction of the relationship between nicotine use and psychiatric disorders cannot be determined, understanding unique social, environmental, and cultural differences that contribute to the tobacco-psychiatric disorder relationship may help guide tribe-specific commercial tobacco control strategies.

Female and Relationship Devaluation among African American and Latino American Youth: Is What’s Normal Really Normal?

The present study used focus group interviews to examine beliefs and social norms regarding female and relationship devaluation among a sample of economically challenged male African American and Latino American youth (N = 57; aged 15–17 years). Most Latino boys felt women are devalued in relationships because Latina women like to be physically or verbally abused. Among African American male participants, some felt women are devalued because African American women are not trustworthy. However, most African American male participants felt the important women in their lives were devalued by men in relationships because of the women’s verbal abuse of their partners. These findings are important in the development of culturally and linguistically appropriate female valuation campaigns and interventions for African and Latino adolescents.