South Florida Community Research Articles

Abstract A098: Lung cancer disparities among African Americans and other low-income communities in South Florida

Abstract Lung cancer is by far the leading cause of cancer death in the US, accounting for about 1 in 5 of all cancer deaths. Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined. The American Cancer Society estimates that in the US, in 2024, there will be about 234,580 new cases of lung cancer (116,310 in men and 118,270 in women). It estimates there will be around 125,070 deaths from lung cancer (65,790 in men and 59,280 in women). Though these deaths can mainly be attributed to smoking, environmental factors have also had adverse effects on human health and lung cancer. We see an example of this in Florida with agricultural burning, specifically sugarcane burning. Sugarcane is one of the most important cash crops for Florida, around 10% of sugar produced in the United States comes from Florida. However, despite the economic importance of this crop, its harvesting process is controversial creating air pollution that is having adverse health effects on the surrounding communities. This review will discuss the impact of sugarcane burning on African Americans and other low-income communities, and how it’s exacerbating health issues, specifically lung cancer. As well as suggest better alternatives to sugarcane harvesting. Citation Format: Miles Jordan, Steven Erwell, Ben Mwashote, Bereket Mochona. Lung cancer disparities among African Americans and other low-income communities in South Florida [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 A098.

Abstract 4805: Identifying neighborhood hot spots of HPV-associated cancers for targeted interventions of HPV vaccination uptake in underserved communities of South Florida

Abstract Background: Although the incidence of cervical cancer in the US has declined, the incidences of other HPV-associated cancers are on the rise. HPV vaccination is an important primary prevention strategy for reducing the burden of HPV-associated cancers. In South Florida (population over 6 million), the percentage of adolescents aged 13-15 years who completed the recommended HPV vaccine series is 54%, which lags significantly behind the Healthy People 2030 target of 80%. In addition, vaccination disparities exist in South Florida by races/ethnicities and sexes, with non-Hispanic black males having the lowest rate at 27%. To address HPV cancer disparities, we performed a geospatial analysis on the incidence of HPV-associated cancers by sex and races/ethnicity to identify communities in South Florida with high incidence of HPV-associated cancer to target interventions that may improve HPV-vaccine uptake via community outreach and engagement. Methods: The average annual (2010-2019) incidence of HPV-associated cancers in women (cervical, oropharyngeal, vulva, vaginal, and anal) and men (oropharyngeal, penile, and anal) were calculated for Hispanics, Non-Hispanic Whites (NHWs) and Non-Hispanic Blacks (NHB) at the census tract level across South Florida using data from the Florida Cancer Data System (FCDS), the state incident cancer registry. Geospatial hot spot analyses were used to identify clusters of census tracts with high HPV cancer incidence by sex and race/ethnicity. Socioeconomic and cervical screening data of the hot spots were analyzed to identify other neighborhood risk conditions that may be associated with high HPV cancer risk. Results: For Hispanics and NHBs in South Florida, census tract hot spots for male and female HPV cancers appear to overlap in low-income neighborhoods; however, hot spots for NHW males are mostly in medium to higher income areas and do not overlap with hot spots observed for NHW females, likely given that NHW females generally report higher cervical screening rates. Conclusion: There is a positive association between male and female HPV cancer incidence in Hispanic and NHB communities of South Florida, justifying the need for increased HPV vaccination and screening programs in these neighborhoods. While increasing cervical screening rate in the hot spot neighborhoods is urgent for cervical cancer control, increasing gender-neutral HPV vaccination uptake in these communities will not only reduce the incidences of male HPV cancers but also help to accelerate cervical cancer elimination by reducing HPV infection. Citation Format: Ming Lee, Sara Parrott, Rebecca Kaiser, Ridhi Vyas, Danielle Gabuzda, Arianna Vazquez, Daniela Flores Quetant, Nancy Elliott, Valerie Bethel, Amanda Rivera, Brandon Mahal, Raymond Balise, Elizabeth Franzmann, Erin Kobetz. Identifying neighborhood hot spots of HPV-associated cancers for targeted interventions of HPV vaccination uptake in underserved communities of South Florida [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4805.

A qualitative community health assessment of HIV prevention awareness in a semi-rural Latinx seasonal farm working community in South Florida

This article explores HIV awareness and prevention in a Latinx seasonal farmworker community of south Miami-Dade County in the USA. The study took place as part of a larger community assessment that aimed to determine community needs and resources related to substance abuse, violence and HIV in the Latinx seasonal farmworker communities of south Miami-Dade County, with a particular focus on fathers’ and their male sons’ relationships. The study collected data on HIV knowledge and prevention, healthcare-seeking behaviours, cultural norms, and communication barriers about HIV prevention between fathers and sons. Data were collected through in-depth interviews with community leaders, two focus groups with social and health services providers, and four focus groups involving fathers and their adolescent sons. A deductive approach to data analysis was undertaken. Five major themes were identified: (1) HIVrelated knowledge and perception; (2) HIV prevention strategies; (3) barriers and needs for tailored preventive health and care services in the community; (4) stress over sex-related communication; and (5) the dominance of traditional masculine gender norms in the household and the community.

Hurricane Vulnerability and Constrained Choices among Mobile Home Park Residents in South Florida

Abstract South Florida experiences some of the highest coastal hurricane vulnerability in the United States. Mobile home communities in south Florida are particularly vulnerable to hurricanes due to the weaker structural integrity of the home or land and a mix of structural and sociodemographic factors. A mixed-methods study was conducted to assess hurricane risk perceptions, experiences, and decision-making among permanent mobile home park (MHP) residents in Broward and Miami-Dade Counties. Return-by-mail surveys were distributed in July 2016 after several years of nominal hurricane activity in south Florida (and before Hurricane Matthew’s formation in September 2016), and focus groups were conducted at MHPs in May 2018, eight months after Hurricane Irma’s September 2017 landfall. Quantitative analysis of 44 in-person and 57 return-by-mail survey responses revealed that respondents tended to be older, retired, or unemployed and had modest levels of education, with many expressing forms of social- and structural-level hurricane risk before Hurricane Matthew. Qualitative analysis of six focus group discussions conducted after Hurricane Irma revealed that the constraints and vulnerabilities experienced by residents coalesced into several primary themes related to preparation, evacuation, assistance, stress and anxiety, tree concerns, and recovery. Participants specifically highlighted their concerns about tree hazards, damages, and maintenance issues arising before, during, and after hurricanes in MHPs. These results build on the scholarship on hurricane risk by underscoring the structural and social vulnerability of residents living in MHPs that constrain building resilience, adaptive capacity, community restoration efforts, and advocating for policy changes. Significance Statement This study aims to understand local hurricane risk perceptions, experiences, and vulnerabilities among residents of mobile home parks after a decade-long hurricane drought in south Florida and also to understand the barriers residents faced after a major hurricane. A hurricane drought is critical to study because it can erode individual and community-level preparedness. Residents of mobile home parks may experience more flooding, higher winds, tornadoes, and other dangers during hurricanes. Residents also face county-, neighborhood-, and household-level structural vulnerabilities that restrict their options related to hurricane preparedness, safety during a storm, and resilience in its aftermath. Our study uses various forms of data collection to obtain insights from permanent residents of mobile home parks in south Florida. In addition, it discusses the social and economic disadvantages and opportunities that policy makers can address in climate change risk management.

Bite or flight? Behavioral interactions between bark anoles and brown anoles in their nonnative range

AbstractBoth intra‐ and interspecific interactions play crucial roles in defining the structure of ecological communities. However, the specific behavioral processes underlying this structuring are often unclear and must be inferred from contemporary interactions. Rapid spread of nonnative species has resulted in increasingly homogenized communities, and this homogenization provides an excellent opportunity to study the behavioral processes that lead to stable communities of introduced species in novel habitats. Here, we compared the behavior of brown anoles (Anolis sagrei) and bark anoles (A. distichus) when faced with an incursion by an unknown brown anole to examine the intra‐ and interspecific interactions underlying the structuring of novel communities in South Florida, USA. We found that brown anoles were consistently more aggressive toward intruders than bark anoles, and this pattern was accentuated when they encountered intruders of the same sex. Conversely, bark anoles were likely to flee when they encountered intruder brown anoles. We also found that brown anoles were likely to attack intruders regardless of whether they engaged in aggressive behavioral displays while bark anoles were likely to flee regardless of whether the intruder engaged in behavioral displays. Our findings suggest that behavioral interactions could play a significant role in structuring the novel Anolis communities in South Florida and demonstrate the importance of aggressive interactions both within and between species.

(194) Dyspareunia as a Sign of UTI

Abstract Introduction Dyspareunia has been defined by the American College of Obstetricians and Gynecologists as pain with sexual intercourse. While dyspareunia has been described as only a part of the symptomatology spectrum of interstitial cystitis, it has never been used as a primary symptom to diagnose uncomplicated or complicated UTIs. Dyspareunia and lower abdominal pain are the most common symptoms followed by dysuria, urodynia, pollakiuria, urgency, nocturia, tenesmus, headache and fever. Increased awareness of the association of dyspareunia with UTI’s will improve the diagnosis of UTIs. Objective UTI’s are under-diagnosed in emergency rooms, as clinicians increasingly rely on urinalysis rather than symptomatology. The presence of dyspareunia is rarely inquired during an evaluation of the patient. The objective of this research is to inform clinicians that dyspareunia is a common symptom of urinary tract infections. By increasing awareness of the association between UTI’s and dyspareunia, clinicians will include it in the assessment of a patient, rather than relying solely on a urinalysis. Additionally, our objective is to educate the patient population that dyspareunia is not normal, and it is a medical condition that can be resolved and investigated. Methods In 2009-2010, a review of 3,000 charts was conducted to determine the sexual attitudes and behaviors of the female Latin American community in South Florida. Analysis of the data shows a correlation between dyspareunia and urinary tract infections, a finding that has not been described before. Results The association between a UTI and dyspareunia was found to be approximately 80% in premenopausal women of reproductive age. In post menopausal women, UTIs are the second most common cause of dyspareunia following vaginal dryness. Conclusions This analysis has determined that dyspareunia is a significant aspect of the semiology of a UTI, thus clinicians should be aware of this association in order to accurately diagnose UTIs in patients. Disclosure No

The Dermatologic Care Needs of a Rural Community in South Florida.

For patients in rural areas, primary care is often their only access to healthcare services, and skin concerns are among the most common diseases seen in these settings. This study aims to investigate the most common skin conditions, management trends and patterns of referral to dermatology in a rural and underserved community in South Florida. A retrospective chart review was conducted using medical records from the C.L. Brumback Primary Care Clinic in Belle Glade, FL. The most common skin conditions were fungal infections, unspecified dermatitis, pruritus, skin cancer concern, alopecia, and autoimmune skin disorders. The most frequent management strategy was medication prescription followed by specialist referral. Of the 21 percent of patients referred to a specialist, 55 percent of these were to dermatology. The most common diagnoses referred to dermatology were atopic dermatitis and alopecia. Only 20 percent of these patients reported attending their follow-up appointment, and the average distance to referral was 21 miles. Belle Glade is unique in its need for and access to dermatologic care. The lack of access to specialists in rural communities is a public health issue that more studies and outreach initiatives should address.

Time Does Matter: Reduced Internal Medicine Clerkship Clinical Experiences Due to COVID-19.

Introduction The coronavirus disease 2019 (COVID-19) pandemic has affected medical education in many ways.The Association of American Medical Colleges (AAMC) temporarily suspended clinical student rotations, calling for a transition to remote learning. Unfortunately, due to the heavy impact of COVID-19 in our South Florida community, medical students were not able to return to in-person activities for a significant time.During this period,students hadremote clerkship learning activities, didactic sessions, narrative projects, and small-group learning sessions, which were front-loaded using Zoom technology (Zoom Video Communications, Inc.,San Jose, California, United States) and web-based learning tools. Once in-person clinical experiences resumed, the duration of all third-year clerkships for the remainder of the year wasreduced to five weeks to allow for timely graduation.The Herbert Wertheim College of Medicine (HWCOM) Internal Medicine (IM) clerkshiphas traditionally beenan eight-week-long rotation.Other clerkships that varied from six to eight weeks were similarly reduced to five weeks.We hypothesized that the shortened duration of the IM clerkship would have negative impacts on National Board of Medical Examiners (NBME) exam performance and clerkship clinical experiences would likely be affected. Methods We compared the NBME subject exam results and end of clerkship evaluations from the Class of 2021 (CO2021) which had the traditional eight weeks of patient care, with the CO2022, which had only five weeks of in-person patient care.A T-test analysis was performed comparing performance on the NBME medicine clinical subject exam between students who completed the usual eight-week rotation versus those who completed a five-week rotation.We also evaluated the IM clerkship course evaluation and analyzed student responses and ratings to assess any areas that were statistically significant when comparing the traditional eight-week IM clerkship to the shortened five-week clerkship. Results There was no statistically significant difference (t=0.68,p<0.4951) in mean NBME subject exam performance between cohorts. Students who completed the shortened five-week IM clerkship indicated there waslimited volume and diversity of patients, which consequently affected their ability to complete all the required clinical experiences for the IM clerkship.These results indicated a statistically significant difference between the two cohorts (t =3.33, p<.001). Conclusion Students with shortened IM clerkship clinical care time (five weeks) were found to have no significant statistical differences in NBME subject exam performance compared to the traditional eight-week cohorts. However, students felt there was a decreased volume and diversity of patients, and they reported greater difficulties in completing the required clinical experiences, with diminished clinical confidence. Time does matter, and clinical time is very valuable for a student's undergraduate medical education.If another pandemic were to arise, the durationof differentclerkships should be carefully assessed and individualized, and methods to assess and reclaim lost clinical time during the advanced clinical and postgraduate years should be considered.

Exploring Workplace Incivility and Bullying in Healthcare Workers in a South Florida Community Hospital

Introduction: Workplace incivility and bullying are concerning issues in healthcare with detrimental consequences for healthcare workers (HCW) and healthcare organizations. Organizational leaders’ recognition of incivility/bullying within healthcare organizations, and their sources, is imperative to prevent and/or address issues by creating “zero tolerance” work environments. The purpose of this cross-sectional, descriptive study was to explore HCWs’ experiences with incivility and bullying at a South Florida community hospital. Methods: A convenience sample of HCWs at a South Florida community hospital were recruited to voluntarily complete the Nursing Incivility Scale. Results: A sample of 325 HCWs responded to the survey. The results showed general incivility as the highest source across all HCWs, with certified nursing assistants having the highest level of incivility across all sources (general, nurse, supervisor, physician, and patients). Correlative analysis showed statistically significant relationships between several sources of incivility (general, supervisor, physician, and patient; r = .250 to .390) for those reporting past experiences with incivility/bullying, and healthcare role and physician incivility (r = -.224). Independent t tests and one-way ANOVA showed statistically significant differences. Of note, compared to other HCW roles, registered nurses reported physicians as their highest source of incivility. Discussion: Workplace incivility/bullying is a serious issue in healthcare across all disciplines and roles, requiring healthcare organization leaders’ awareness and subsequent interventions to prevent and address its occurrence. The results of this study provide necessary insight for hospital organization leaders as they endeavor to create and nurture “zero tolerance” work environments. Keywords: workplace incivility, workplace bullying, workplace violence, zero tolerance

The Treatment of COVID-19 With Monoclonal Antibody Therapy: Patient-Reported Outcomes.

ObjectiveThere have been many efforts to research and produce treatment modalities for COVID-19. Monoclonal antibodies have been one of the effective treatments since their approval by the US Food and Drug Administration (FDA) under emergency use authorization (EUA) in 2020. This study surveyed COVID-19 patients about their disease course and experience with monoclonal antibody treatment.MethodsPatients who received monoclonal antibody treatment between February 12, 2021, and June 2, 2021, at a South Florida community hospital were enrolled in the study. This included patients over 18 years of age with a confirmed positive COVID-19 test result, with mild to moderate symptoms within 10 days of onset and identified as high risk for progression to severe disease. There were no exclusion criteria. After 30 days, patients were followed up via a structured telephone survey regarding subsequent emergency department (ED) visits for worsening COVID-19 symptoms, need for oxygenation, intubation, and death. Secondary outcomes were adverse effects and patient perceptions.ResultsAmong the 119 patients who received monoclonal antibodies during the established time frame, 93 (78.1%) consented to participate in the telephone survey. Of these, 11.8% had a subsequent visit to the ED for worsening COVID-19 symptoms, 6.5% required oxygen, and 2.2% were admitted to the intensive care unit (ICU). There were no reported intubations or deaths. The vast majority (91.4%) would recommend monoclonal antibody treatment to others.ConclusionPatients who received monoclonal antibody therapy had low rates of subsequent ED visits and rarely required oxygen or ICU admission. The majority of patients would recommend treatment with monoclonal antibodies to others.

Advancing a hyperlocal approach to community engagement in climate adaptation: Results from a South Florida pilot study in two communities

With increasing urgency of local and regional climate adaptation, there is a growing need for governments to identify and respond effectively to the concerns of communities they serve and to align investments. We designed and piloted a novel hyperlocal method for urban adaptation planning combining two social science tools that have been widely but separately used to foster community engagement and strategize solutions. Our not-for-profit community partners facilitated multi-session online workshops with participants from two communities in South Florida with whom they have well-established relationships and in which socio-economic conditions and climate risks represent notable vulnerabilities. The workshops first employed photovoice to elicit individual narratives about climate change impacts; participants then followed a design thinking protocol to critically evaluate the leading concerns they identified and propose adaptation solutions. Geospatial mapping and data tools were provided for participants to gain additional tools and further knowledge. Local planning and resilience officials attended some or all of the workshops as observers and interlocutors, dialoguing with participants. Comparative analysis revealed differences in risk awareness and primary concerns between communities, and further demonstrated that concerns and solutions proposed by members of at-risk neighborhoods do not always align with geospatial data that often drives infrastructure adaptation planning in the region, suggesting that more widespread use of community engaged methods could enhance government climate adaptation responses for local communities.

Accelerating sea-level rise and the fate of mangrove plant communities in South Florida, U.S.A.

Analysis of four South Florida tide gauges, with records ranging from 27 to 116 yrs., indicate the average rate of sea-level rise has accelerated from 3.9 mm yr−1 (1900–2021) to 6.5 mm yr−1 (2000−2021), and 9.4 mm yr−1 over the past decade. Future rates are forecast to accelerate over the duration of this century. A predictive conceptual framework (model) was developed in which the resilience of South Florida mangrove plant communities is solely a function of the rate of sea-level rise and vertical sediment accumulation. The model was verified using historical (e.g., 1900–2021) and recent (e.g., 2000–2021) sediment accumulation rate data derived using three different methodological approaches. Results indicate by 2040–2050 South Florida mangrove plant communities, already subjected to the destabilizing effects of accelerating sea-level rise for decades, will begin a widespread conversion to estuarine conditions. This will initially trigger the formation and expansion of inundation ponds, as is already occurring in the study area. By the end of this century, most mangrove forested areas will be submerged. The loss of other coastal wetlands (e.g., brackish marsh) is also likely because their rates of sediment accumulation are lower than mangrove. The findings of this study are consistent with other resilience projections that have been conducted in South Florida and at the global scale. Several knowledge gaps were identified which must be filled to improve confidence in subsequent forecasts and the outcome of mitigation efforts undertaken to enhance resilience. These include the lack of (1) sediment accumulation data representative of transitional and freshwater wetlands, (2) a robust understanding of post-depositional processes (e.g., compaction) that can compromise resilience through shallow (~1 m) subsidence, and (3) recent sediment accumulation data necessary to determine how South Florida coastal wetlands have responded to a sustained acceleration in the rate of sea-level rise over the last decade.

Leveraging Informal Learning Pedagogies to Empower Coastal Communities for Disaster Preparedness

With the increasing frequency and intensity of hurricanes, people and communities within hurricane-prone zones are often overwhelmed and lack effective preparedness in terms of social connectivity critical for making proactive decisions to survive anticipated disasters. Disaster management agencies traditionally share preparedness guidelines through formal educational and other public media channels (such as academic institutions, articles, and the Federal Emergency Management Agency, etc.) only. However, such formal modalities seldom consider the socio-economic status, cultural background, diversity, and education level of communities. Consequently, vulnerable communities are challenged by poor inclusive accessibility, lack of receptiveness, and responsiveness. An Informal Learning Pedagogy (ILP) for hurricane preparedness can be a practical solution to disseminate knowledge on preparedness and hurricane impacts at the community level through nurturing enthusiasm to learn from one another within the community setting, which causes ripple effects that are more profound within a diverse community. This approach would effectively support educating more people about hurricane preparedness. The main objectives of this study are: 1) to assess the hurricane preparedness awareness of people living in a hurricane-prone coastal community in South Florida, United States; 2) to investigate the applicability of adopting novel ILP mechanisms for a disaster-prone community and; 3) analyze and plan for the development of online community-centered hurricane preparedness training with a primary focus on preparedness, warning, evacuation, and early recovery. Developing training modules focused on disaster preparedness through informal learning environments depends on incorporating actual community requirements, which reflect audience-centered needs as part of enhancing the resilience capacity of coastal communities. As such, in this study, an online questionnaire survey focusing on the validation of the research hypothesis was designed and conducted among South Florida residents. The survey data results indicated that participation in disaster-preparedness training through informal modalities highly depends on the length of an individual’s stay in a disaster-prone zone, anticipated benefits of disaster education, and the availability of online training. This research study contributes to the disaster preparedness and response bodies of knowledge by identifying informal ways of communicating hazard preparedness knowledge to advance the resilience capacities in disaster-prone communities.

Patient acceptance of HIV rapid testing in the dental care setting

ABSTRACT Dental settings are untapped venues to identify patients with undiagnosed HIV who may otherwise lack testing opportunities. Perceived lack of patient acceptance has been a significant barrier limiting dentists’ willingness to offer HIV testing. This study implemented rapid HIV testing in dental settings located in an HIV prevalent region to evaluate patient acceptance. Two South Florida community health centers implemented routine oral rapid HIV testing as part of clinical practice, followed by exit interviews with patients immediately after to determine patient acceptance. The binary primary outcome was patient’s acceptance of the rapid HIV test. Multivariable logistic regression assessed associations between patient characteristics and acceptance. Overall acceptance by dental patients (N = 600) was 84.5%. Patients who were more likely to participate in other medical screenings in dental settings were more than twice as likely to accept the test compared to those who were neutral/less likely (OR: 2.373; 95% CI: 1.406–4.004). Study findings highlight the high patient acceptance of HIV testing in dental settings. Widespread implementation of such testing will require an expanded societal view of the traditional role of the dentist that will embrace the potentially valuable role of dentistry in preventive health screenings and population health.

149 Understanding vaccine hesitancy among underserved communities in South Florida – an effort by the Florida Community-Engaged Research Alliance Against COVID-19 in Disproportionately Affected Communities (FL-CEAL) to address vaccine uptake disparities in the COVID-19 pandemic.

OBJECTIVES/GOALS: The goal of this project is to understand vaccine hesitancy and barriers to COVID-19 vaccine uptake among underserved communities in South Florida, to promote vaccine awareness, and to tailor education and communication based on the findings, in partnership with local community-based organizations. METHODS/STUDY POPULATION: By partnering with local community organizations, leaders, faith groups, and other trusted sources, the FL-CEAL teams will conduct a nationally developed CEAL survey in minority communities in South Florida to understand vaccine hesitancy and barriers, conduct outreach activities such as webinars and virtual townhalls to address hesitancy and promote vaccine uptake, and develop and disseminate educational materials and social media communications based on findings. The communities in South Florida include the Latinx farm working community, Latinx sexual/gender minorities, and Haitian and Black populations in South Florida. RESULTS/ANTICIPATED RESULTS: Early findings have indicated that hesitancy drivers vary among specific communities, while lack of trust is an overall barrier. Over 100 outreach activities have been conducted, including events with subject matter experts and community partners addressing vaccines. A credit-earning Community Health Worker (CHW) curriculum on COVID vaccine hesitancy was created in partnership with the Miami CTSI and the Florida CHW Coalition and has been delivered to over 200 Florida CHWs. The training focuses on evidence-informed best practices for CHWs to increase vaccine acceptance. At least 350 surveys will be conducted to understand beliefs and concerns around COVID-19 vaccines, and tailor education materials and communication strategies. DISCUSSION/SIGNIFICANCE: The FL-CEAL Alliance has successfully leveraged their ongoing state-wide effort at addressing COVID-19 disparities to focus on COVID vaccine hesitancy in minority communities and leveraged data and findings to inform community-specific approaches in addressing some of those barriers.

An ecological assessment of large coastal shark communities in South Florida

Given population declines of many shark species, coupled with increasing conservation efforts and recoveries, there is a need for baseline assessments and continued monitoring of shark populations to support management. The waters of South Florida, USA, are used by a diverse array of sharks that occur among a mosaic of habitats and management zones. Here we conducted standardized drumline surveys from Miami through the middle Florida Keys to examine spatial, seasonal and environmental patterns in shark occurrence, catch per unit effort, composition, and demographic structure. Between 2009 and 2021, a total of 21,755 drumlines were deployed, capturing 3398 sharks, comprising fifteen species. Ginglymostoma cirratum, (n = 1335), Carcharhinus limbatus, (n = 650), Negaprion brevirostris, (n = 314), C. leucas, (n = 253), and Sphyrna mokarran, (n = 238) were the most common species encountered. Overall, the largest shark surveyed was a 450 cm S. mokarran and the smallest shark was a 50 cm Rhizoprionodon terraenovae. At the assemblage level, relative abundance among regions and seasons were generally similar; however clear species-specific patterns of abundance, size structure, and sex-composition were detected by season, region, habitat, and management zones. Of the physical conditions evaluated, habitat type and depth emerged as the most influential parameters affecting abundances and sizes of species captured. While few species exhibited significant differences in catches by management zone, areas with the most restrictive fisheries regulations generally supported higher abundances for which differences were detected. These data serve as a baseline for future monitoring of shark populations in South Florida and assessing their response to environmental change.

Gingles Unraveled: Hispanic Voting Cohesion in South Florida

The Voting Rights Act protects the ability of racial and language minority groups to elect candidates of choice by prohibiting states and localities from diluting those groups’ votes when drawing electoral districts. The Fair Districts provisions of the Florida Constitution include a similar ban on vote dilution, plus further protections against diminishing (retrogressing) existing minority voting strength. A key element of proving vote dilution or retrogression is that the minority group votes cohesively. Historically, minority voting cohesion has often been uncontested or easily proven in VRA suits. But in South Florida, Hispanic citizens are voting less cohesively than they used to. This Article investigates the legal issues that arise when the assumption of cohesion unravels. First, this Article investigates to what extent the Hispanic community in South Florida is cohesive. It then proposes several alternative approaches to the vote dilution and retrogression framework to better align doctrine with the real-world conditions of voters and communities.

A mixed-methods approach to understanding perceptions of hepatitis B and hepatocellular carcinoma among ethnically diverse Black communities in South Florida.

Hepatitis B (HBV), the leading cause of hepatocellular carcinoma (HCC), disproportionately affects minorities. Compared to other races, Blacks more often present with advanced HCC and have decreased survival. We observed higher HBV-associated HCC rates among Blacks than reported nationally. In our center, Haitian Blacks had the highest rates of HBV-associated HCC and shorter survival compared to other Blacks. We investigated knowledge and perceptions regarding HBV and HCC among Blacks born in the United States or Haiti. Using community partnerships, participants were recruited via word of mouth, email, social media or from Hepatology clinic. Focus groups were conducted in Haitian Creole or English and stratified by birthplace, gender and infection status. Discussions were audio-recorded and transcribed verbatim. A constant comparative method was used for data analysis; themes are based on conversational details. There were 55 participants; 49% were male and 27% had chronic HBV. Only 42% of Haitian Blacks knew about HBV prior to participation vs. 78% of African Americans, p 0.03. Both groups expressed that fear, mistrust of the medical establishment, denial and stigma might compel persons to avoid seeking care. Both groups attributed higher rates of late stage HCC diagnosis in Blacks to inadequate financial resources and education. Those with HBV reported confusion regarding their infection and suboptimal communication with healthcare providers. In two communities disproportionately affected by HBV, misconceptions about disease transmission, stigma, low health literacy and decreased access to care may limit detection for HBV. Culturally relevant community-based interventions are needed to increase HBV detection.

Aging and thriving with HIV: a photovoice project with long-term HIV survivors in Miami, Florida

ABSTRACT Background Long-term survivors of HIV in Miami, Florida are facing critical health and social issues as they age with this disease. Methods Using PhotoVoice methodology, nine Latino/a activist-artists were recruited to take pictures depicting their everyday life-challenges to be used in several photography exhibits aimed at informing local policy direction. Results The group identified a positive approach to aging with HIV as a priority at the individual, community and policy level, emphasizing policy alternatives to the negative and disease-ridden stereotypes that embed current discussions on living and aging with HIV. The activists highlight specific community and policy solutions that respond to the growing needs of long-term survivors of HIV/AIDS among Latino communities in South Florida. Conclusions The findings suggest that Miami (and areas with a large HIV-positive population) may benefit from community and policy solutions that take a successful aging approach and build upon the resiliency of this population.

Salient factors among Hispanic parents in South Florida rural communities for vaccinating their children against human papillomavirus

PurposeFew studies have tried to understand the factors related to HPV vaccination among Hispanics living in rural communities in the United States (US). Nationally, HPV vaccination among Hispanics is suboptimal (26.1%) compared to the HealthyPeople 2020 goal of 80% and even more suboptimal in rural communties. This study aimed to determine the salient factors among Hispanic parents for vaccinating their children against HPV and for designing a future HPV prevention intervention for Hispanics. Design and methodsA descriptive qualitative design was used. Saturation was reached after conducting four focus groups with 23 Hispanic parents from rural communities in South Florida. Directed content analysis using the Theory of Planned Behavior (TPB) constructs was used to analyze the transcripts. ResultsAll TPB constructs were identified as salient factors for HPV vaccination including background factors, attitudes towards the behavior, perceived norms, perceived behavioral control, actual control, intention, and behavior. ConclusionsAddressing HPV vaccination by developing educational programs based on the TPB and tailored to meet the needs of Hispanic parents is urgently needed to prevent HPV among Hispanics in rural US communities. This approach can also serve as a directive to target HPV vaccination among Hispanics in other rural areas in the US. Practice implicationsPediatric nurses must proactively promote and recommend the HPV vaccine (HPVV), educate parents on having sex-related discussions with their children, include children in the HPVV education and decision, bundle the HPVV with other child vaccines, and utilize reminder systems to ensure completion of the vaccine series.