Community-based Intervention Research Articles

Intervention model in reducing the unmet need for contraception: a systematic literature review on technology-based, community, and health worker interventions

The unmet need for contraception is a serious public health problem, and efforts to reduce the unmet need for family planning are a challenge due to the many and complex factors that contribute to the unmet needs. The aim of this study was to systematically review scientific evidence on intervention models that effectively reduce the unmet need for contraception. This study used a systematic review to identify relevant scientific articles. The article search was based on the PICO approach and used a database from https://www.scopus.com/, https://www.sciencedirect.com/, https://pubmed.ncbi.nlm.nih.gov/, https://www.mdpi.com/, https://www.jstor.org/, https://www.nature.com/, https://link.springer.com/. The reviewed material was full-text articles and open-access articles published from 2013 to 2023. Data extraction included author, country, type of intervention, research design, sample, and main research findings. Twelve studies were included in our qualitative synthesis. Technology-based interventions, such as mobile phone instant messaging apps, were implemented in countries like Tajikistan, Bolivia, and Mozambique. Community-based interventions included the Community Family Health=Family Wealth program in Uganda, the Tékponon Jikuagou (TJ) program in Benin, and the Married Adolescent Girls Club (MAG club) and Participatory Women's Group Intervention in Bangladesh. Health worker-led interventions involved community health volunteers in Nepal, postpartum contraceptive counseling, contraceptive counseling for all ages, structured counseling for childbearing couples in Indonesia, and the "Consult and Choose" client-centered family service in Jordan. The findings underscore that varying intervention models can significantly enhance contraceptive use, tailored to specific cultural and regional contexts. These interventions, therefore, hold substantial implications for public health practices aiming to address and reduce the global unmet need for contraception. This systematic review provides valuable insights into the effectiveness of diverse interventions and suggests avenues for public health strategies to expand contraceptive access and use globally.

Abstract B110: A community-based educational intervention to improve colorectal cancer screening

Abstract Background: Colorectal cancer (CRC) is the 3rd leading cause of cancer death in the US. Early detection through screening increases survival and decreases mortality. Approximately 59% of eligible adults in the US are up to date on CRC screening with lower rates in minoritized communities. We report on a tailored a CRC screening educational intervention focused on improving CRC screening rates in the Black, Latinx, and Chinese immigrant communities that we serve. Methods: An educational intervention utilizing NCI’s Screen to Save CRC colorectal cancer educational materials was tailored through key contact interviews and focus groups with Black, Latinx, and Chinese immigrant communities and made available in Spanish/English/Mandarin. Invitations to participate were primarily disseminated through weekly email blasts to adults (persons age18+). A pre- and post-intervention survey was used to assess patient knowledge and intentions to screen. Persons completing the post-survey received a FIT test for CRC screening with a FIT. We used McNemar test to compare the results pre- and post-survey. Results: Of the 300 participants who completed the post-survey, 117 (39%) were male, and 183 were female (61%). 231 identified as white non-Latinx (77%), 48 (16%) Black, 3 (9%) Asians. 241 (80.3%) completed college. 186 (62%) had received CRC screening—176 (95%) by colonoscopy, 31 (17%) by fecal immunochemical test FIT prior to enrollment. 240 (80%) were eligible for FIT by age. 137 (83%) were interested in receiving FIT. Primary reasons for not pursuing FIT test included choosing to pursue a colonoscopy or having had a recent normal colonoscopy. 88 expressed interest pursuing FIT; 66 (75%) participants signed FIT consent form, and 41 (62%) completed FIT. Knowledge regarding CRC screening improved for the following questions: CRC starts in liver (p=0.0082), small intestine (p<0.0001) and colon and/or rectum (p=0.0027), “FIT checks the stool for fat (p<0.0001), tumors (p<0.0001) and polyps (p=0.0067),” “Risk factors for CRC are poor diet (p=0.0019), smoking/tobacco use (p=0.0148), lack of physical activity(p=0.0012),” “Lynch syndrome is a disorder that runs in families and increases my chances of developing CRC (p<0.0001)” and “Increasing my physical activity will not lower my chances of developing CRC (p=0.0019).” 153 (60.24%) said the education session was great and 91 (36.25%) said it was good. When asked if they would recommend this education session to family and friends, more than 80% of participants agreed. Conclusions: CRC education video helped increase patient knowledge regarding CRC, specifically about risk factors and improved knowledge regarding FIT as a CRC screening modality. Citation Format: Iqra Siddiqui, FNU Nikita, Ana Maria Lopez. A community-based educational intervention to improve colorectal cancer screening [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B110.

Abstract B144: Conceptual framework on health behaviors and experiences of Sub-Saharan African immigrant prostate cancer survivors

Abstract Background: Sub-Saharan African immigrants (SSAI) in the United States (US) constitute one of the fastest-growing segments of the immigrant population. Between 2010 and 2018, the SSAI population in the US increased by 53%, significantly outpacing the 12% growth rate for the overall foreign-born population in the US during that period. We define SSAI as the 2 million individuals living in the US originally from the region of the African continent located south of the Saharan desert. Despite their growing numbers, little is published about the extent to which SSAI adapt to health behaviors more common in the US or remain immersed in the values, beliefs, and practices reflective of their country of origin. Importantly, no study has comprehensively examined the social determinants of health factors among this population and its influence on health-seeking behaviors and decision-making regarding prostate cancer care and treatment. Aim: This study seeks to better understand the lived experiences, unmet needs and the impact of migration on the quality of life of SSAI cancer survivors in the US. Methods. We employ a qualitative approach guided by grounded theory. Selective sampling was used to identify potential participants from a database obtained via the Florida and Minesota cancer registries. We proceeded to conduct in-depth interviews with 16 cancer survivors recruited from the two caner registries. Results. We developed a conceptual framework illuminating the full range of social, behavioral, environmental, and structural factors associated with the experiences of SSAI prostate cancer survivors. From the data, the post diagnosis experiences of study participants can be categorized into three domains: 1) health behaviors; 2) treatment decision and antecedents; 3) challenges of being an immigrant. Characteristics of health behaviors include using informal care teams for social support and second opinions before treatment. Selective disclosure of diagnosis, changes to diet, exercise and searching for information about the diseases were other manifestation of behavior. While some participants made decisions about treatment soon after diagnosis, others took a more deliberative approach and relied on faith and family for social support. Some challenges in terms of being an immigrant include knowledge gaps about the US health system, lack of health insurance and transportation to hospital during treatment. Implication for public health practice. Some of the unmet needs of study participants include transportation cost to and from hospital for radiotherapy and other treatment and reducing the high out of pocket cost for co-payment and drugs. The knowledge deficit about navigating the US health system can be addressed through community-based intervention in partnerships with immigrant groups, advocacy organizations and faith-based organizations. The focus of this intervention should be to educate and empower SSAI men on how to navigate the US health system and be more assertive about their health needs and desires for treatment during doctor’s visit. Citation Format: Ernie Kaninjing, Gladys Asiedu, Kaitlin Van Voorhis, Daniel Lee, Rakinya Hinson, Mary Ellen Young. Conceptual framework on health behaviors and experiences of Sub-Saharan African immigrant prostate cancer survivors [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B144.

Abstract B062: Physical Activity in African American Prostate Cancer Survivors and a Comparison of Self-report versus Accelerometer-Derived Measurement

Abstract Authors: Shannon Reed, Margaret Tovar, MPH, Paula Papanek, PhD, Patricia Sheean, Deepak Kilari, MD, Katie Bylow, MD, PhD, Whitney Morelli, PhD, Melinda Stolley, PhD Background: The Men Moving Forward intervention examines a lifestyle intervention's effects on body composition among Black/African American prostate cancer survivors (AAPCS). AAPCS. To assess PA, self-report and objective measures are being used. Studies use self-report measurements due to their simplicity and low cost, however, the congruent validity of self-report PA is often questioned. This study describes PA and strength training and also compares self- report PA to accelerometry-derived PA among AAPCS at baseline. Methods: AA men with non-metastatic PC were recruited to participate in a randomized, waitlist control trial testing the efficacy of a lifestyle intervention. The 16-week group and community-based intervention was developed with and for AAPCS and is grounded in the ACS Nutrition and Physical Activity Guidelines for Cancer Survivors. Participants completed the Godin Leisure Time Physical Activity Questionnaire (GLTPAQ) which queries about moderate and vigorous activities. The study added a question about the frequency of strength training. Participants also wore a GT3X accelerometer (Actigraph) for 7 days. Only men who wore the actigraph for at least 10 hours across 4 days were included in this analysis. Troiano 2008 cut points were used to measure moderate-vigorous PA (MVPA). Pearson’s correlation was used to assess linear correlation between objectively measured and self-reported MVPA. Statistical significance was set at p<0.05. Results: 73 AAPCS with a mean age of 65.8 years ± 6.9 were included in the analyses. Mean Godin score was 23.32 +16.80 (insufficient activity) with 45.2% classified as active (Godin score >24) and 54.8% as insufficiently active (Godin score<23). 30.2% strength trained at least twice weekly. Actigraph data showed a mean of 101.19 minutes per day of MVPA and that 73.68% of participants did not meet the guideline for 150 minutes per week of MVPA. The analysis revealed a weak positive correlation (r = 0.274, p = 0.019) between actigraph-recorded MVPA and self-reported MVPA. Conclusion: Study results suggest AAPCS overestimate their MVPA using the GLTPAQ when compared to accelerometry. Notably, a significant proportion did not meet the recommended level of physical activity. These findings underscore the importance of including objective measures of PA and the value of programming that is intentionally inclusive of AAPCS. To better support validity and reliability, participant perceptions of PA time and intensity may require improved clarification and description in studies relying solely on SR questionnaires. Citation Format: Shannon Reed, Margaret Tovar, Paula Papanek, Patricia Sheean, Deepak Kilari, Whitney Morelli, Katie Bylow, Melinda Stolley. Physical Activity in African American Prostate Cancer Survivors and a Comparison of Self-report versus Accelerometer-Derived Measurement [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B062.

Abstract B048: Qualitative analysis of fieldnote and interview data for planning a food bank- based breast cancer screening intervention

Abstract Among individuals and communities with low-income, the experience of food insecurity is associated with greater delays in recommended mammography screening and late-stage breast cancer at diagnosis. Community-based interventions that address barriers to breast cancer screening in diverse communities of women with food insecurity can increase screening uptake, ultimately improving cancer health equity. In partnership with Sacramento Food Bank and Family Services (SFBFS), the largest non-profit provider of social services in Sacramento County, this study identified barriers and facilitators to implementing a breast cancer screening intervention in a food distribution setting, assessing the preliminary acceptability and logistical feasibility of the proposed intervention. Qualitative data about food bank distribution events and the clients served was collected over 24 weeks using participant observation with semi-structured fieldnotes and interviews, then analyzed via directed content analysis guided by the well-defined domains and determinants in the Consolidated Framework for Implementation Research (CFIR) and coded using Dedoose software. Fieldnotes were completed for 12 community food distribution events, and 20 stakeholder interviews were conducted with purposefully sampled food bank staff (N=10) and female clients (N=10) who regularly attend events. The results of this qualitative analysis identified barriers and facilitators to implementation in all CFIR domains, describing current workflows for food distribution events and existing health education efforts, capacity, client engagement logistics and modes of delivery, and resources available or needed to support implementation. Prominent CFIR determinants included characteristics of individuals, specifically the innovation recipients’ capability and motivation to receive a breast cancer screening intervention in this context. Participants often pointed out their awareness of important preventative behaviors such as nutrition while also acknowledging barriers such as time constraints, accessibility of breast cancer screening services, and culturally-specific health beliefs and practices. Determinants in the outer setting, inner setting, innovation characteristics, and process that relate to the overall theme of sustainability were identified as potential barriers including financing, the availability of resources, internal and external pressure to change, and the process of engaging with clients while they are at the food distribution event. Facilitators included buy-in from SFBFS leadership and staff, and the benefit of collaborating with reputable local partners. Intervention format should include tailored messaging that is culturally appropriate and empowers individuals to obtain recommended screening. Content of the intervention should provide interactive assistance that facilitates local support for screening eligibility and services. Overall, there was consensus that promoting breast cancer screening in the food distribution setting was beneficial and welcomed by all stakeholders. Citation Format: Charlotte L. Kerber, Julie HT Dang, Daniel J. Pasillas-Pablo, Jocelyn T. Canty, Laura Fejerman. Qualitative analysis of fieldnote and interview data for planning a food bank- based breast cancer screening intervention [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B048.

Abstract B038: Developing and refining a digital skin cancer intervention among Hispanics

Abstract Background: Over the last 20 years, the incidence of melanoma in Hispanic populations has increased by 20%. The mortality rate of Hispanics is higher compared to non-Hispanic whites. In general, compared to NHW, Hispanics diagnosed with melanoma are younger, have thicker tumors, and have worse survival rates. Skin cancer can be prevented with regular sun protection, and early detection can improve skin cancer outcomes. This study aimed to refine and develop a culturally relevant mobile-based skin cancer prevention intervention for Hispanics through group and individual interviews. Methods: Three focus groups of Hispanics at risk for skin cancer and eight individual interviews with key stakeholders, including healthcare providers and community leaders, were conducted via Zoom. Participants were shown culturally relevant messages developed from previous community interviews and provided further feedback to improve and enhance both the messages and intervention design. The interviews lasted for 60-90 minutes and participants received up to $70 electronic gift cards as an incentive. Results: The focus group (two in English and one in Spanish) participants (n=18), aged 18 to 60 years (M=30). Of these participants, 61.1% were female (n=11), and half reported having an educational level lower than a bachelor's degree. Additionally, more than half of the group indicated a household income below $50,000. Among the eight individual interviews with healthcare providers and community leaders, the participants aged from 18 to 56 and reported being family workers, student group leaders, church leaders, and nurses. Emerging themes from the interviews included: 1) messages and images developed from previous community interviews were relatable and informative; 2) the majority favored visuals with text, and preferred a combination of human and cartoon images; 3) information related to general sun protection and skin examination, such as melanoma and SPF needed to be included, as well as information regarding health literacy such as how to effectively find health information and communicate with a health care provider; 4) some common misconceptions, such as the effectiveness of sunscreen on dark skin and reapplication times, were identified. Additionally, participants expressed hesitancy about undergoing skin examination by oneself and/or a doctor, highlighting the importance of providing more detailed guidance to address misperceptions and enhance adherence. Gender differences in adhering to skin protection measures were evident, with women demonstrating greater commitment despite men's higher melanoma rates and sun exposure, emphasizing the need for targeting of men. Conclusions: Participants expressed satisfaction with the intervention's relevance and informativeness for skin cancer education and promoting preventive behaviors. Insights and new ideas regarding intervention design gained from both the interviews will refine the final intervention, enhancing its cultural relevance and effectiveness in preventing skin cancer among the Hispanic community. Behavioral and Social Science: Community-based Interventions Citation Format: Niu Zhaomeng, Karen Dhami, Yonaira Rivera, Emily Peters, Jemima Baskar, Carolina Lozada, Carolyn Heckman. Developing and refining a digital skin cancer intervention among Hispanics [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B038.

Abstract B082: Design Studios for Health to identify distinct outreach events and interventions to reduce the burden of cancer among Hispanic/Latino and Black adults in a major southwestern metropolitan region

Abstract Introduction: Cancer is the second leading cause of death in Arizona. While there was a 7% decrease in cancer mortality among Arizonans from 2016-2020, more work is needed to decrease cancer incidence and mortality among racial and ethnic minorities, including Black and Hispanic/Latino populations. Further, it is critical to engage community members to identify cancer-related priorities, brainstorm feasible and acceptable community-based interventions, and co-create community-academia-healthcare solutions to reduce cancer disparities. Methods: The team conducted a series of Design Studios for Health (DSH) – guided listening sessions to foster community involvement, facilitate knowledge exchange, and identify the priorities and concerns for cancer prevention and control in the Black and Hispanic/Latino communities. Each DSH session included introductions, information dissemination, and breakout sessions with a moderator and a notetaker. The first DSH sessions were held in February 2024 via Zoom, one for Black community members (n=14) and one for Hispanic/Latino community members (n=14). In March 2024, an in-person DSH aimed to bring together all previous participants from both communities (n=27). This session deepened collaborations and knowledge exchange, building on insights from the initial sessions. The iterative nature of DSH ensured continuous refinement and co-creation of precision health solutions based on feedback and the data collected. Results: DSH participants identified the following cancer priorities: breast, skin, cervical, prostate, colorectal, and stomach cancers. They emphasized the need for community-shared information on survivorship resources, prevention (shared via social media), symptoms, costs, payment options, resource guides for community health workers, and guidance on navigating medical and insurance payments. Recommendations for academic partners included offering workshops and educational seminars on cancer prevention, using university space to host community cancer prevention events, alternating event locations in the metropolitan region to reach multiple underserved communities, hosting community fairs with multiple cancer education and screening opportunities, forming community advisory boards focused on cancer prevention and control, and organizing local forums to share cancer prevention and control resources. To support local organizations and health education outreach, they recommended creating additional training on cancer, e.g. for community health workers, to enhance public dissemination. Future directions: Based on these findings, our team is developing interactive, virtual, games-based cancer education to help dispel myths about cancer prevention and control. We are collaborating with community health workers to increase the accessibility of cancer prevention, screening, and resource education at pop-up cancer screening events (October and November 2024) held in areas of Phoenix serving low-income, racially, and ethnically diverse communities. Citation Format: Alexis M. Koskan, Maricarmen Vizcaino, Maissa Khatib, Tina M. Brown, Dorothy D. Sears. Design Studios for Health to identify distinct outreach events and interventions to reduce the burden of cancer among Hispanic/Latino and Black adults in a major southwestern metropolitan region [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B082.

Abstract A124: An examination of trust in biomedical research among the Witness Project’s community health workers

Abstract The Witness Project® (NWP) was established in 1991 and has maintained its status as one of NCI’s Evidence Based Cancer Control Program (EBCCP) for decades. NWP is a self-sustaining, culturally competent, grass roots level community-based intervention program that uses breast and cervical cancer survivors known as Witness Role Models and Community Health Workers (CHW). With many locations in unserved communities throughout the United States, NWP provides relevant cancer related education and navigates minority residents through successful completions of cancer related screenings. Health disparities are a longstanding problem due in part to underrepresentations of historically underserved populations in research. Increasing minority and underserved individuals’ participation in research has great disparity mitigating potential. A team of newly trained Black and Hispanic NWP CHW (n=25) will be created as part of a larger multiphase preliminary pilot study designed to increase diverse individuals’ participations in research within Roswell Park’s catchment area. Design, Measures, Setting, and Participants. The primary objective of this cross-sectional study is to assess Black and Hispanic CHW’s trust in biomedical research. Secondary objectives are to explore the feasibility and acceptability of 1) NWP CHW training, and 2) an informal educational intervention about the importance of minority representations in research and it potential to mitigate health disparities. CMWs will complete the Perceptions of Research Trustworthiness (PoRT) scale to evaluate their trust and distrust in biomedical research before and after viewing the informal educational intervention. Preliminary Results and Planned Analyses At the time of abstract submission nineteen CMWs have completed their NWP and CITI training and PoRT assessments. Fifteen CHWs were Black (78.9%) and four Hispanic (21.1%). When all 25 CMWs are trained we will calculate overall and individual item Trust and Distrust subscale scores. Regarding feasibility and acceptability of the CHW training and the informal education intervention, semi structured interviews will provide qualitative feedback and independent samples t-test will be used to compare pre-and post-informal education intervention PoRT scores. Citation Format: Julia Devonish, Martin Mahoney, Elizabeth Bouchard, Cassy Dauphin, Abshiro Ali, Veronica Meadows, Jomary Colon, Dee Johnson. An examination of trust in biomedical research among the Witness Project’s community health workers [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A124.

Abstract B052: Exploring supplement utilization patterns among African American prostate and breast cancer survivors

Abstract Introduction: The American Cancer Society (ACS) defines dietary supplements as “vitamins and minerals, herbs and other botanicals, amino acids, enzymes, and more.” ACS advises against supplement use for cancer prevention, with no suggestions for survivors. Regardless, 64-81% of cancer survivors and 14-32% of recently diagnosed cancer patients in the U.S. will begin taking supplements to improve health outcomes. Despite this prevalence, few studies have examined supplement use in African American cancer survivors, and studies that have been done include small samples. This project examines supplement use across two genders and two cancer types within a population group historically underrepresented in research. Given the dearth of research to date, this project adds novel findings to the literature and informs future research.Objectives: This study describes supplement use in African American breast and prostate cancer survivors engaged in lifestyle intervention trials, identifies potential correlates of supplement use; and compares supplement use between the two populations. Methods: Men Moving Forward (MMF) is an ongoing lifestyle intervention study for African American prostate cancer survivors. Moving Forward (MF) is a completed lifestyle intervention study that included African American breast cancer survivors. Both studies examine the efficacy of a community-based intervention that promotes adherence to the American Cancer Society Nutrition and Physical Activity Guidelines. At baseline, study participants completed interviews that included a measure of supplement use including type, dose, frequency, and reason for use. Supplements were then categorized by type (e.g., Vitamin D, Vitamin B12) and descriptive analyses were conducted to examine most common types of supplements used, potential correlates of use, and to compare the two cancer survivor groups. Results: 114 men currently enrolled in the MMF study, and 223 women enrolled in MF completed the supplement use measure. Average ages of participants are 66.2 years (SD=7.5) for MMF and 57.5 years (SD=10.1) for MF. Supplement use was common, with 64.0% of MMF participants and 65.9% of MF participants using at least one supplement at baseline. Mean number of supplements was 1.62 (SD=1.9) for MMF and 1.76 (SD=2.0) for MF. The most used supplements were the same across survivor groups: Vitamin D (37.7% MMF, 38.1% MF), Multivitamins (27.2% MMF, 32.7% MF) and Omega-3 Fatty Acids (8.8% MMF, 19.3% MF). Age, education, and income will be explored as predictors of usage. Conclusions: Supplement use was prevalent among both survivor groups, consistent with national data for adult cancer survivors who report supplement use. However, our sample had higher usage rates compared to Non-Hispanic Black US adults without cancer (39.3% of men, 56.2% of women) from the 2023 National Health Statistics Report. Understanding supplement use in cancer survivors can identify potential risks and benefits of use, enhance patient-provider communication, and improve the quality-of-care patients receive. Citation Format: Carlene Kranjac, Estefania Alonso, Margaret Tovar, Sandra Contreras, Iwalola Awoyinka, Patricia Sheean, Melinda Stolley. Exploring supplement utilization patterns among African American prostate and breast cancer survivors [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B052.

A hospital and community-based violence intervention program for Black & Latino youth and their caregivers.

Black and Latino youth are disproportionately affected by trauma from community violence, but to date, few data support the benefit of evidence-based treatments for these youth or of including peer support to engage these youth in mental health services. From 2018 until 2020, a hospital and community-based violence intervention program in Philadelphia pilot tested the integration of home and community-based Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) with peer services and case management for youth impacted by community violence. This study describes the implementation of this intervention. Data was gathered by querying the program's database. The Child Post Traumatic Stress Symptom Severity Scale (CPSS-SR-5) and the Short Mood and Feelings Questionnaire (SMFQ) were utilized to evaluate the participants' pre- and post-intervention assessment of PTSD and depression. The sample (N = 50) consisted of Black and Latino youth, mean age 14. Twenty-nine (58%) completed TF-CBT, and 82% met peer and case management goals. Youth who completed therapy showed significant improvement in both PTSD and depression symptoms at post-test. To our knowledge, this is the first study describing the implementation of home and community-based TF-CBT with peer support and case management. The study's limitations and need for further research are discussed.

Research protocol for bridging research, accurate information and dialogue (BRAID)-clinical trials: a mixed-methods study of a community-based intervention to improve trust and diversify participation in clinical trials.

Cultural beliefs, personal experiences, and historic abuses within the healthcare system-rooted in structural racism-all contribute to community distrust in science and medicine. This lack of trust, particularly within underserved communities, contributes to decreased participation in clinical trials and a lack of representation in the data. Open dialogue about community concerns and experiences related to research participation and medical care processes can help build trust and change attitudes and behaviors that affect community health. This protocol outlines an approach to increase trust in science and clinical trials among communities in the Bronx, New York that are typically underrepresented in research data. Bridging Research, Accurate Information and Dialogue (BRAID) is a two-phased, evidence-based community engagement model that creates safe spaces for bilateral dialogues between trusted community messengers, and clinicians and scientists. The team will conduct a series of BRAID Conversation Circles on the topic of clinical trials with local trusted community messengers. Participants will be members of the community who are perceived as "trusted messengers" and can represent the community's voice because they have insight into "what matters" locally. Conversation Circles will be audiotaped, transcribed, and analyzed to identify emergent challenges and opportunities surrounding clinical trial participation. These key themes will subsequently inform the codesign and co-creation of tailored messages and outreach efforts that community participants can disseminate downstream to their social networks. Surveys will be administered to all participants before and after each Conversation Circle to understand participants experience and evaluate changes in knowledge and attitudes about clinical trials, including protections for research participants the advantages of having diverse representation. Changes in motivation and readiness to share accurate clinical trial information downstream will also be assessed. Lastly, we will measure participants dissemination of codesigned science messages through their social networks by tracking participant specific resource URLs of materials and videos posted on a BRAID website. This protocol will assess the effectiveness and adoptability of an innovative CBPR model that can be applied to a wide range of public health issues and has the potential to navigate the ever-changing needs of the communities that surround health systems.

The Role of Public Health in Managing Chronic Diseases

Chronic diseases such as heart disease, cancer, diabetes, and respiratory illnesses are among the leading causes of morbidity and mortality worldwide. This study examines the critical role of public health in managing and preventing chronic diseases, focusing on comprehensive, interdisciplinary methods. Public health initiatives are mostly preventive, emphasizing lifestyle changes, community-based interventions, policy formulation, and technological advances such as telemedicine and mobile health apps. The paper also looks at the epidemiology of chronic diseases, emphasizing the importance of addressing socioeconomic causes and adopting tailored, culturally competent therapies to effectively manage the chronic disease load. Keywords: Public health, chronic disease management, epidemiology, prevention, community-based interventions.

The Role of Public Health in Promoting Healthy Lifestyles

This study investigates the essential part that public health plays in encouraging healthy lifestyles to reduce the growing burden of chronic diseases, mental health issues, and drug abuse. Public health initiatives seek to eliminate health inequities and promote overall well-being by promoting health education, disease prevention, and community-based interventions. The review discusses essential measures such as health promotion, epidemiological data use, and local government initiatives to promote healthy behaviours. The review concludes that public health aims to achieve long-term health benefits for all population segments through a multidimensional approach that includes education, policy lobbying, and community participation. Keywords: Public health, health promotion, disease prevention, chronic diseases, health disparities.

Changes in Catalan Adolescents’ Agility over Two Decades: A Temporal Trend Study

Physical fitness is considered an important indicator of health in adolescents. Despite the recognized benefits of regular physical activity, recent studies indicate a decline in physical fitness among adolescents, including agility, a key component of fitness often overlooked in research. This study aimed to investigate trends in agility among urban Catalan adolescents over two decades. A total of 1439 students, aged 13–15 years, participated in the 8 × 10 m shuttle run test between 2002 and 2022. The results revealed a significant decline in agility performance across both boys (F(3,839) = 392, p < 0.001, ηp2 = 0.584) and girls (F(3,593) = 414, p < 0.001, ηp2 = 0.677) over time, with notable differences observed between consecutive five-year periods. The findings underscore the urgency of addressing declining physical fitness among adolescents and advocate for enhanced physical education programs and community-based interventions to promote regular physical activity. Recognizing the importance of agility and other aspects of physical fitness in adolescent health, policymakers, educators, and healthcare professionals are urged to collaborate on initiatives to mitigate the risk of future health issues. Further research is recommended to explore the multifaceted influences on adolescent physical fitness and develop targeted interventions to improve overall health outcomes in this population.

Addressing the Dual Challenges of Substance Abuse and HIV/AIDS in Uganda via Innovative Approaches

Uganda has made significant strides in combating HIV/AIDS, yet the concurrent rise in substance abuse presents a complex public health challenge that exacerbates the burden on individuals and healthcare systems. The intersection of substance abuse and HIV/AIDS intensifies health risks and complicates treatment efforts, particularly among vulnerable populations such as youth, sex workers, and men who have sex with men. This review explores the intricate relationship between substance abuse and HIV/AIDS in Uganda, examining the socioeconomic and cultural factors that contribute to this dual epidemic. It also highlights the mental health implications, barriers within the healthcare system, and the critical role of community-based interventions. Furthermore, the review emphasizes the importance of innovative approaches in prevention and treatment, including personalized medicine, pre-exposure prophylaxis (PrEP), medication-assisted therapy (MAT), and the integration of mental health services. The potential of digital health tools, such as telemedicine, is also explored as a means to enhance access to care. Additionally, the review underscores the significance of international organizations and partnerships in supporting local efforts to address these challenges. By integrating these innovative strategies, this review aims to inform policymakers, healthcare practitioners, and community leaders on effective interventions to reduce the prevalence of substance abuse and HIV/AIDS in Uganda and improve health outcomes for affected populations. Keywords: Dual challenges, Substance abuse, HIV/AIDS, Uganda, innovative approaches.

Community-Based Intervention for Hearing Loss: Impact of Hearing Screening Programme in Ondo West Local Government Area

Introduction: The spectrum of hearing loss as a public health condition has continued to increase globally both in its pathological as well as demographic status. Consequently, a vast majority of people especially in Nigeria and other low income countries suffer from one psychological, economic, social and cognitive disadvantage of hearing loss to another. Aim: The aim of this study was to investigate the impact of hearing screening programmes as a means of Community-based intervention for hearing loss. Methods: Subjects in the study are patients who submitted for a free hearing screening programme within the months of March and May 2022, organized by the department of Ear, Nose and Throat, University of Medical Sciences Teaching Hospital, Ondo State, Nigeria. The hearing screening was carried out by Otorhinolaryngologist, Audiologists and Speech Therapists using, Otoscope, Tuning Forks, HearWHO mobile app, a well-structured questionnaire etc. Results: Of 356 patients who were screened, 80 presented with hearing related disorders such as hearing loss, tinnitus, canal blockage, polyps, otitis media and otitis externa. Interventions were administered accordingly, on either free or subsidized scale to patients. It was deduced that the majority of these patients would not have presented for hearing screening if it was not a free Community-based programme. Conclusion: Community-based hearing screening programmes enhance early identification of hearing disorders and commencement of hearing healthcare interventions especially in low income countries.

Evaluating the effectiveness of a community-based health promotion intervention on knowledge improvement regarding low birth weight and its determinants among antenatal couples in Sri Lanka

BackgroundImprovement of the knowledge of pregnant mothers and their partners related to low birth weight (LBW) is a vital factor in preventing LBW and reducing its prevalence.ObjectivesImplement and evaluate the effectiveness of a community based health promotion intervention on pregnant mothers and their partners to increase knowledge on birth weight and its determinants. The second objective is to determine the difference of the birth weight after implementing the intervention.MethodsA quasi experimental study design was used, and the setting was 806 pregnant mothers, 403 each in two districts. In 26 ANCs, twenty six initial training sessions were conducted as a group, with an average of three hours for each session. Three follow up sessions were conducted in each ANC over 04 months (in total 104 sessions). All sessions were conducted in groups of 10 to 20 antenatal couples. The pregnant mothers and their partners completed interviewer-administered questionnaires. Pre and post data were analysed based on four major knowledge categories using statistical methods. The McNemar’s Chi Square test; Chi Square test, Fisher’s Exact test, Paired t test, Student’s independent sample t test, Wilcoxon Signed Ranks test and Mann Whitney U test methods were applied as appropriate.ResultsBoth mothers and their partners in the intervention group (IG) reached significantly higher gains in knowledge than in the comparison group (CG). The participants who got the lowest scores for knowledge, at the pre assessment, in IG, also improved more than the CG {mothers (p = 0.002) and partners (p = 0.007)}. The mean birth weight shows that the IG has significantly improved for both mothers (p < 0.001) and partners (p = 0.013) with low knowledge scores (< 50% of total).ConclusionsKnowledge about birth weight and its determinants among pregnant mothers and their partners improved significantly.

Long-Term Change in BMI for Children with Obesity Treated in Family-Centered Lifestyle Interventions

Introduction: Several evaluations of lifestyle interventions for childhood obesity exist; however, follow-up beyond 2 years is necessary to validate the effect. The aim of the present study was to investigate long-term weight development following children participating in one of two pragmatic family-centered lifestyle interventions treating childhood obesity. Methods: This real-life observational study included Danish children 4–17 years of age classified as having obesity. Data from 2010 to 2020, from two community-based family-centered lifestyle interventions (designated hereafter as the Aarhus- and the Randers-intervention) were merged with national registers and routine health check-ups, including height and weight. Adjusted mixed effect models were used to model changes in body mass index (BMI) z score. We performed exploratory analyses of the development in BMI z-score within stratified subgroups of children treated in the interventions before investigating potential effect modifications induced by sex, age, family structure, socioeconomic, or immigration status. Results: With a median follow-up of 2.8 years (interquartile range: 1.3; 4.8), 703 children participated in an intervention (445 the Aarhus-intervention; 258 the Randers-intervention) and 2,337 children were not invited to participate (no-intervention). Children in both interventions experienced a comparable reduction in BMI z-scores during the first 6 months compared to the no-intervention group (Aarhus-intervention: −0.12 SD/year and Randers-intervention: −0.25 SD/year). Only children in the Randers-intervention reduced their BMI z-score throughout follow-up (Aarhus-intervention vs. no-intervention: 0.01 SD/year; confidence interval [CI]: −0.01; 0.04; Randers-intervention vs. no-intervention: −0.05 SD/year; CI: −0.08; −0.02). In subgroup comparisons, combining the two interventions, family income below the median (−0.05 SD/year, CI: −0.02; −0.09), immigrant background (0.04 SD/year, CI: 0.00; 0.07), or receiving intervention less than 1 year (0.04 SD/year, CI: 0.00; 0.08) were associated with a yearly increase in BMI z score. In addition, effect modification analyses did not observe any interaction by sex, age, family structure, socioeconomic, or immigration. Conclusions: Although the more dynamic intervention with longer duration obtained and sustained a minor reduction in BMI z score, the clinical impact may only be modest and still not effective enough to induce a long-term beneficial development in BMI in children with obesity.

Community-Based Violence Intervention in the Aftermath of Homicide: Community Violence Prevention Specialists’ Proximity to and Perspectives on Community Safety and Healing

Communities impacted by homicide endure profound loss and trauma, yet the voices of those intimately acquainted with navigating its aftermath are often overlooked and undervalued. In this study, we center the perspectives of community violence prevention specialists (CVPS) to understand the role of community-based violence intervention (CVI) in the aftermath of homicide and identify essential needs for fostering holistic and sustainable safety and healing following homicide. Qualitative data collected from in-person, semi-structured focus groups and interviews between March 2022 and April 2023 with 45 CVPS in Baltimore, Milwaukee, and Sacramento were coded and thematically analyzed. We identified various intersecting ways in which CVPS have unique proximity to and perspective on homicide via personal histories and community relationships, crisis response, preventative peacemaking and community healing, understanding violence drivers, CVI implementation challenges, and policy advocacy. Their perspectives reveal nuanced insights into the dynamics of homicide and its prevention. CVI plays a critical role in the aftermath of homicide, and CVPS have invaluable expertise navigating its multi-tiered dynamics, positioning them as strategic responders to homicide and as experts in identifying community needs and solutions specific to violence recovery. Their voices, work, and wellbeing deserve investment and close attention.

A systematic review of Personal-Disclosure Mutual-Sharing (PDMS) interventions among sport groups

ABSTRACT Personal-Disclosure Mutual-Sharing (PDMS) is a communication-based intervention used for team building. The aim of this study was to systematically review the efficacy of PDMS research conducted among sport groups. Specifically, this review: (a) explored the influence of PDMS on individual and group-level outcomes; (b) evaluated the quality of methods, designs, and measures used to test PDMS interventions; (c) reviewed how PDMS interventions have been developed, implemented, and evaluated in applied practice; and (d) proposed recommendations for future applied practice and research. Published manuscript searches were conducted using four electronic databases before additional published and unpublished manuscript searches were conducted via Google scholar, Open Grey, and email requests to published PDMS authors. Eighteen studies met the eligibility criteria and comprised qualitative, quantitative, and mixed method designs. Although the results indicated Relationship-Orientated PDMS was most used, PDMS types increased various individual (e.g. self-understanding) and group-level outcomes (e.g. social identity). Methodological limitations such as a lack of control measures, and divergent methods of applied practice indicate mixed evidence for the targeted changes being a consequence of PDMS which limits current understanding of the intervention’s efficacy. Consequently, we propose recommendations to reduce internal validity concerns and outline considerations to enhance applied PDMS practice.