Rebecca Palacios

The Relation of Social Isolation, Loneliness, and Social Support to Disease Outcomes Among the Elderly

Objectives: This study examined relations between social isolation, loneliness, and social support to health outcomes in a sample of New Mexico seniors. Method: We used random-digit dialing to obtain a random sample of 755 southern New Mexico seniors. Participants answered questions pertaining to demographics, social isolation and loneliness, social support, and disease diagnosis including diabetes, hypertension, heart disease, liver disease, arthritis, emphysema, tuberculosis, kidney disease, cancer, asthma, and stroke. The sample allowed for comparison of Caucasian and Hispanic participants. Results: Correlational and logistic analyses indicated that belongingness support related most consistently to health outcomes. Ethnic subgroup analysis revealed similarities and differences in the pattern of associations among the predictor and outcome variables. Discussion: The results demonstrate the importance of social variables for predicting disease outcomes in the elderly and across ethnic groups.

An Evaluation of the BASICS Alcohol Risk Reduction Model Among Predominantly Hispanic College Students

Although Hispanic college students consume alcohol in equal proportion to other ethnic groups, studies have not examined whether established alcohol-risk-reduction approaches are effective in this population. Accordingly, this study examined effectiveness of the Brief Alcohol Screening and Intervention for College Students (BASICS) risk-reduction model for reducing alcohol consumption and related problems in two samples of predominantly Hispanic college students (N = 206 and 405). The study also examined whether factors such as gender, baseline risk level, and readiness to change moderated program impact. Students first participated in an in-depth assessment of drinking patterns followed by relatively brief intervention including psychoeducation and personalized normative feedback. Behavioral outcomes were assessed six months after the intervention and included alcohol-risk scores, alcohol consumption-related problems, consumption, drinking and driving frequency, and stage of change. Supporting the effectiveness of BASICS, both samples showed significant improvement across all these outcomes. Moderator analyses suggested greater program impact among heavier drinkers and among high in change contemplation at assessment. Overall, the results strongly support use of the BASICS intervention model among Hispanic students. The studys limitations are noted.

Assessing Colorectal Cancer Screening Behaviors and Knowledge among At-Risk Hispanics in Southern New Mexico

Purpose Colorectal cancer (CRC) mortality rates in New Mexico (NM) continue to be higher than national rates. Hispanic CRC mortality rates in NM surpass those of overall Hispanics in the US. This study was designed to characterize and understand factors contributing to low CRC screening rates in this border region. Methods A CRC Knowledge Assessment Survey (KAS) was administered in either English or Spanish to 247 individuals attending community events throughout southern NM. A subset of these individuals completed an online CRC risk assessment survey managed by the National Cancer Institute (NCI). Data analysis tested for significant differences in knowledge, physician-patient CRC interactions, CRC risk level perception, and screening rates across diverse ethnic and age groups. Results Both CRC knowledge and physician-patient CRC interactions were positively associated with participant screening history. Significant age and ethnic differences for CRC knowledge, physician-patient CRC interactions, and screening history in the NM border sample were also seen. Age-eligible Hispanics (50+) as well as those less than 50 years of age had lower CRC knowledge and were less likely to engage in physician-patient CRC interactions than non-Hispanic Whites (NHWs). The age-eligible Hispanics also reported lower CRC screening rates than their NHW counterparts. Conclusions Low CRC knowledge and limited physician-patient CRC interactions appear to contribute to low screening rates in this NM population. Expanding education and outreach efforts for this border population are essential to promote early CRC detection and thereby decrease overall CRC mortality rates.

To Share or Not to Share? A Survey of Biomedical Researchers in the U.S. Southwest, an Ethnically Diverse Region.

Background Cancer health disparities research depends on access to biospecimens from diverse racial/ethnic populations. This multimethodological study, using mixed methods for quantitative and qualitative analysis of survey results, assessed barriers, concerns, and practices for sharing biospecimens/data among researchers working with biospecimens from minority populations in a 5 state region of the United States (Arizona, Colorado, New Mexico, Oklahoma, and Texas). The ultimate goals of this research were to understand data sharing barriers among biomedical researchers; guide strategies to increase participation in biospecimen research; and strengthen collaborative opportunities among researchers. Methods and Population Email invitations to anonymous participants (n = 605 individuals identified by the NIH RePORT database), resulted in 112 responses. The survey assessed demographics, specimen collection data, and attitudes about virtual biorepositories. Respondents were primarily principal investigators at PhD granting institutions (91.1%) conducting basic (62.3%) research; most were non-Hispanic White (63.4%) and men (60.6%). The low response rate limited the statistical power of the analyses, further the number of respondents for each survey question was variable. Results Findings from this study identified barriers to biospecimen research, including lack of access to sufficient biospecimens, and limited availability of diverse tissue samples. Many of these barriers can be attributed to poor annotation of biospecimens, and researchers’ unwillingness to share existing collections. Addressing these barriers to accessing biospecimens is essential to combating cancer in general and cancer health disparities in particular. This study confirmed researchers’ willingness to participate in a virtual biorepository (n = 50 respondents agreed). However, researchers in this region listed clear specifications for establishing and using such a biorepository: specifications related to standardized procedures, funding, and protections of human subjects and intellectual property. The results help guide strategies to increase data sharing behaviors and to increase participation of researchers with multiethnic biospecimen collections in collaborative research endeavors Conclusions Data sharing by researchers is essential to leveraging knowledge and resources needed for the advancement of research on cancer health disparities. Although U.S. funding entities have guidelines for data and resource sharing, future efforts should address researcher preferences in order to promote collaboration to address cancer health disparities.

Hiding the Word: Examining the Relationship Between a New Measure of Religiosity and Sexual Behavior

The relationship between religiosity and sexual behavior has been previously investigated, but researchers have not examined the relationship between the intellectual dimension of religiosity and sexual behavior. In this study, we developed an intellectual measure of religiosity, Hiding the Word (HTW), and examined whether it accounted for variation in the sexual behavior of college students, beyond that for which age and a generic measure of religiosity could account. Results showed, after accounting for age and generic religiosity, HTW made a significant contribution to distinguishing between students who had, and those who had not, engaged in various sexual behaviors. For females, this was the case in three of the five behaviors examined (all except receiving oral sex and participating in unprotected penile–vaginal intercourse at most recent sexual encounter), and for males, two of the four behaviors (sexual intercourse and anal intercourse). HTW was less of a factor in accounting for variation in the frequency of participation. For males, HTW was significant for the frequency of participation in penile–vaginal intercourse, receiving oral sex, and the number of sexual partners in the last month. For females, HTW was significant only for the number of sexual partners in the last month. Thus, religiosity, and specifically HTW, seems to play more of a role in determining whether or not a person has participated in behavior, rather than in the frequency of participation.

Measurement and Design Issues in the Study of Adolescent Sexual Behavior and the Evaluation of Adolescent Sexual Health Behavior Interventions

To improve the quality of research and commentary concerning adolescent sexuality and evaluation of both comprehensive sexuality education and abstinence education programs, this article aims to help readers (1) select appropriate measures to study adolescent sexual behavior, (2) develop appropriate study designs to evaluate adolescent sexual health behavior intervention outcomes, and (3) interpret study results. Examples of measures that have been used in studies are identified. Suggestions are made as to measures that may be better choices. Additionally, different types of designs are highlighted and discussed. Instances in which reports and published articles have incorrectly interpreted the results of research studies are presented.

Development and Validation of an Instrument that Assesses Individual Differences in Threat and Challenge Appraisal

Objective: This paper documents the development and validation of the Appraisal of Challenge or Threat Scale, a measure of individual differences in the tendency to appraise situations as threats or challenges. In addition to avoiding construct confounding inherent in existing measures, the scale assesses appraisal in a manner consistent with the original experimental studies delineating threat and challenge responses to stress.Method: Three studies using survey methods examined the psychometric properties of the scale and its relation to measures of the stress response, coping, and stress-related outcomes.Results: Exploratory and confirmatory factor analysis provided consistent evidence for the scales structure. Correlations provided evidence of validity.Conclusion: The results provide evidence for the factor structure, reliability, and construct validity of the measure of individual differences in the appraisal of stressful events as threats or challenges.

Abstract A40: Promoting colorectal cancer education: A partnership facilitated program evaluation examining generalizability across diverse populations

Background: Colorectal cancer (CRC) is the third leading cause of cancer-related deaths among men and women with over 96,000 new cases and 50,000 individuals expected to die from the disease in 2014. Cancer mortality rates, however, are higher among certain ethnic populations including Hispanics and American Indians/Alaska Natives (AI/AN). Through education and screening, CRC can be successfully detected early and treated before it progresses to advanced stages. The purpose of this study was to evaluate the effectiveness of a partnership-facilitated colorectal cancer education program across different ethnic populations in two U.S. regions. Pre/post design was used to measure changes in CRC knowledge as well as behavioral intentions to obtain screening and share CRC information obtained with others. Methods: The National Cancer Institute9s National Outreach Network (NON) Community Health Educators (CHE) at New Mexico State University (NMSU) and at the Fred Hutchinson Cancer Research Center (FHCRC), a Comprehensive Partnership to Advance Health Equity (CPACHE) program, collaborated to develop an assessment tool that would evaluate the Inflatable Colon (IC) as a CRC educational tool across diverse ethnic populations. Instrument: NON CHE developed a pre/post-test assessment questionnaire based on literature reviews; questions asked about CRC knowledge, intention to obtain screening, and intention to disseminate CRC information. Procedure: In New Mexico, individuals at an educational institution were recruited to participate in this study, whereas participants in Eastern Washington were recruited at community health events. All study participants received the pre-test prior to touring the IC and the post-test after completing the IC tour. Results: A total of 1,286 individuals from Southern New Mexico and Eastern Washington participated in this study, 60% were males. We conducted a repeated measures analysis of covariance, including study site, age, education, insurance, regular doctor, and history of CRC as covariates. Analyses found a significant interaction by race/ethnicity and time, F (2, 1181) = 3.29, p = .04. After adjusting for covariates, there were significant differences in CRC knowledge across race/ethnicity, F (2, 1188) = 2.94, p = .05. Hispanic participants had a significantly greater change in knowledge relative to non-Hispanic whites (NHW). There was also a non-significant trend concerning AI/AN participants and NHW. Hispanic and AI/AN participants had greater change in intentions to obtain a CRC screening in the future relative to NHW. Subsequent post-hoc comparisons revealed that, relative to NHWs, Hispanics reported being more likely to intend to discuss CRC with their parents, p = .02, and grandparents, p = 0.003. AI/AN participants were also less likely to report to intend to discuss CRC with their parents, p = .04. Conclusion: This study examined the generalizability of a partnership-facilitated CRC educational program and assessment tool across different US populations and its effectiveness in increasing CRC knowledge as well as behavioral intention to obtain CRC screening and disseminate CRC information. This study suggests that the IC is an effective educational tool for increasing cancer knowledge and behavioral intentions among diverse ethnic populations. Complementing the IC intervention with access to free CRC screening, such as the FOBT kits, has the potential to address the CRC mortality disparities through the promotion of screening among certain ethnic populations and among those at a higher risk for CRC. Citation Format: Janeth I. Sanchez, Katherine Briant, Yamile Molina, Noah Espinoza, Nathan Marchello, Rebecca Palacios, Beti Thompson, Mary O9Connell. Promoting colorectal cancer education: A partnership facilitated program evaluation examining generalizability across diverse populations. [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 A40.

Abstract A59: The inflatable colon is a unique tool for educating people about colorectal cancer in New Mexico and Washington states

Background: As the second leading cause of cancer-related deaths in the United States (US), colorectal cancer (CRC) may be prevented through screening along with early education to promote screening. In the past decade, an NCI-funded Partnership comprised of New Mexico State University (NMSU), a minority serving institution, and the Fred Hutchinson Cancer Research Center (FHCRC), a comprehensive cancer center, have increased the cancer outreach programs in their respective communities by targeting underserved populations. Purpose: In both sites, education about CRC has taken place during a tour through an Inflatable Colon (IC). In this study, we focus on the similarities and differences among the two sites. Methods: Each site, NMSU and FHCRC, measured gains in CRC knowledge and intention to be screened, but engaged distinct populations and measured site specific outcomes. In New Mexico (NM), study participants included 485 college faculty, staff, and students, 67% female, between 20 and 69 years of age. Ethnic comparisons were limited to non-Hispanic Whites (NHW) (31%) and Hispanics (51%) due to the low sample size for other race/ethnicities in this group. Overall, the NM participants demonstrated significant increases in CRC knowledge and awareness after touring the inflatable colon (p-values In the Yakima Valley of Washington State, pre- and post-surveys were collected from 947 participants (76.4% Hispanic, 12.3% NHW, and 7.8% Native American) who toured the inflatable colon. Of the respondents, 76% were female. Knowledge about CRC increased significantly from pre-test to post-test (p Conclusions: The results from both of these areas showed that using a novel educational tool, such as the walk through colon, can increase CRC knowledge and intention to be screened. Use of the inflatable colon educational tool with both young and age-eligible (> 50 years of age) adults may facilitate the dissemination of CRC information among social networks of both groups of adults. The partnership between the research studies permits comparisons of the results of both studies on a wide array of ethnic- and age-disparate populations. Citation Format: Janet Sanchez, Rebecca Palacios, Katherine Briant, Elizabeth Carosso, Mary O9Connell, Beti Thompson. The inflatable colon is a unique tool for educating people about colorectal cancer in New Mexico and Washington states. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A59. doi:10.1158/1538-7755.DISP13-A59

Abstract 1370: Barriers to sharing biospecimens or biospecimen data among researchers: qualitative findings from a regional survey.

Background: Efforts to identify biological and genetic factors contributing to cancer health disparities have increased the need to access biospecimens from diverse populations. One challenge is the limited number of specimens from diverse populations within existing biobanks. Members of certain racial/ethnic minority groups may be less aware of or less willing to participate in biospecimen donation opportunities. Second, although there are already a large number of established biorepositories nationwide, it remains a challenge for researchers to allocate sufficient, well-annotated tumor tissues to these repositories. As such it is important to determine the perceived barriers and attitudes to sharing data and biospecimens among researchers; and in turn inform programs on ways to increase sharing of limited biospecimens collected from diverse populations. This qualitative study assessed data sharing practices, barriers and concerns of researchers in a 5-state region (AZ, CO, NM, OK and TX). Little is known about the data sharing perceptions of researchers in this region, which is multi-cultural and multi ethnic. Methods: The present qualitative analysis was part of a larger study that assessed researchers’ willingness to participate in a virtual national biorepository. NIH RePORT db was used to identify 605 individuals engaging in research involving biospecimens. Email invitations to complete an online survey were sent with an embedded informed consent, via a secure state-specific link; 119 participants responded. Open-ended questions captured the respondents’ perceived barriers to implementation of a national biorepository; common reasons for refusal of individuals to donate specimens; requirements for collaborating and sharing data; and their concerns if unwilling to share biospecimens/data. A thematic analysis was conducted on these responses using two independent coders. Participants reported a variety of common themes on each of the questions. Results: Most respondents were principal investigators at PhD granting institutions (91.1%), conducting basic (62.3%), translational (43.9%), clinical (8.8%), and epidemiological (5.3%) research. Most were non-Hispanic White (63.4%), males (60.6%). Respondents provided 255 detailed statements. Legal and ethical concerns and requirements for biospecimen sharing were a persistent theme. Methodological concerns were also raised including sample quality, sample size and study design. Sharing biospecimens beyond the home institution was also raised as a barrier to data sharing in a number of contexts. Impact: Determining the perceived barriers and attitudinal factors to sharing data will help generate recommendations to increase researchers’ participation in the scientific data sharing process involving high-quality, multi-ethnic human biospecimens. This will ultimately reduce cancer health disparities. Citation Format: Mai H. Oushy, Rebecca Palacios, Mary A. O9connell. Barriers to sharing biospecimens or biospecimen data among researchers: qualitative findings from a regional survey. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1370. doi:10.1158/1538-7445.AM2013-1370