Community Leaders Research Articles

Fenomena Main Hakim Sendiri dan Dampaknya terhadap Keamanan yang Berujung Pidana

The phenomenon of "vigilante" is still a serious problem in various regions, including Pangkalan Jati Village. This extrajudicial action not only violates social norms, but also has the potential to threaten public order and security. This study aims to analyze the phenomenon of "vigilante" in Pangkalan Jati Village, as well as its impact on environmental security. The method used is a case study with a qualitative approach through in-depth interviews with community leaders, village officials, and victims/perpetrators of "vigilante" actions. The results of the study indicate that factors such as weak law enforcement, public distrust of the authorities, and lack of legal awareness are the main triggers for these actions. The impacts include increasing rates of violence, social divisions, and security instability. As an effort to overcome this problem, legal socialization has been carried out to the community as part of community service activities. This socialization is expected to increase public legal awareness, strengthen trust in the authorities, and encourage the community to resolve problems legally. This study concludes that legal socialization is an important step in preventing "vigilante" actions and creating a safe and conducive environment.

Factors Related to Compliance with HBsAg Screening Among Pregnant Mothers in Bengkulu Province

Background:The low number of Hepatitis B surface antigen (HBsAg) screenings indicates that the people of Bengkulu Province have a limited understanding of the importance of such examinations. In Bengkulu, 1.61% of pregnant women, or approximately 47.550 individuals, are positive for hepatitis B infection. This is partly due to the low rate of HBsAg screening among pregnant women. Objective:To determine the prevalence of HBsAg screening compliance among pregnant women and the factors influencing it. Method:This research utilized a cross-sectional study design. A multistage random sampling method was used to select 488 pregnant women from nine districts and one city in Bengkulu Province. Data analysis was performed using multiple logistic regression. Results:The findings showed a non-compliance rate for the HBsAg test of 77.87% (95% CI: 73.95-81.34). Factors associated with non-compliance included maternal perception (adjusted OR: 7.01, 95% CI: 3.62–13.57), quality of life (adjusted OR: 6.19, 95% CI: 2.98–12.88), husband's support (adjusted OR: 2.16, 95% CI: 1.11–4.18), and health worker support (adjusted OR: 3.68, 95% CI: 1.91–7.08). Conclusion:It is crucial for pregnant women to increase their awareness of the importance of HBsAg screening, supported by their husbands, with additional counseling on the negative impacts of hepatitis B during pregnancy. Cultural perceptions should be addressed to foster more positive attitudes. Enhanced collaboration between health service providers, traditional or community leaders, and the public is necessary to improve overall public health outcomes. Keywords: HBsAg screening compliance; health literacy; quality of life; perception; husband support; health worker support

Collective leadership development in the civic arena

PurposeAs a collective paradigm of leadership emerges in the literature, many community leadership programs still align with leader-centric perspectives. The Kansas Leadership Center’s Leadership Transformation Grant is an exemplar of developing collective leadership in the civic arena. The purpose of this article is twofold: (1) to present the findings of a community-engaged, qualitative research study on the impact of collective leadership development on the practice of civic leadership and (2) to discuss relevant implications learned from reflections on the methodology for the practice of community-engaged research.Design/methodology/approachThis study is a form of engaged research (Van de Ven, 2007) and is consistent with the principles of community-based research (Strand, Marullo, Cutforth, Stoecker, & Donohue, 2003). I took an exploratory approach to this study because the knowledge intersection of collective leadership, civic leadership and leadership development is still emerging and understudied. I explored the individual, group and systems levels as three components of a complex adaptive system (Uhl-Bien, Marion, & McKelvey, 2007). To better understand the dynamic relationship between individual, group and system in this grant team, I employed a three-phase study including methods of deliberative civic engagement, open-ended survey and interview.FindingsFindings illustrate the effectiveness of the grant program on developing a shared language and leadership framework and clarifying leadership goals for participants. Implications include the importance of collective leadership development opportunities that center adaptive challenges and convene participants across levels of leadership and sectors. Additionally, the findings highlight the need to consider authority, identity and culture as central components of the practice of leadership. Reflections on the community-engaged methodology demonstrate the value of learning about leadership practices from the community practitioners to inform community leadership development interventions. Implications include approaching research as iterative and pushing back on academic norms that provide tension in engaged work.Originality/valueLittle research crosses all three boundaries of collective leadership, leadership development and civic leadership literature. This intersection focuses on understanding how collective leadership can contribute to enhancing the practice of civic leadership. The current study is situated within this knowledge gap and explores (1) the experiences of members of a civic group who have (2) participated in leadership development that (3) aligns with a collective leadership paradigm and are (4) trying to make progress on an adaptive challenge.

Advancing pharmacogenomic research in US Hmong populations: prevalence of key single nucleotide variations in California Hmong.

In collaboration with the Minnesota Hmong community, we have previously discovered significant differences in allele frequencies for key Single Nucleotide Variations (SNVs) within Very Important Pharmacogenes (VIPs) between Hmong and East Asians. Recognizing the potential clinical implications of these observed differences, we sought to validate these observations in a Hmong cohort residing in California, the state with the largest Hmong population in the US. Robust validation of these differences would affect motivation for clinicians treating individuals who identify as Hmong to consider pharmacogenomic (PGx) testing as a means to improve clinical decision making when using therapeutic agents in this unique population. Guided by California Hmong community leaders and utilizing the basic approach of community-based participatory research, demographic, clinical information and a buccal swab was obtained from Hmong adults residing in California. A commercial PGx testing panel was performed on these samples and specific allele frequencies of interest were compared between California and Minnesota Hmong. Allele frequency differences between California Hmong, East Asians and Europeans, were also compared. Return-of-PGx-results and presentations of group data were made to members of the Hmong along with PGx educational sessions to help interpret the observations. In 118 California Hmong who completed the study, the allele frequencies for SNV's were similar to previous Minnesota Hmong results. Furthermore, out of the 18 SNVs that were not previously reported in Hmong, allele frequencies were statistically different in 38% (7/18) of SNVs comparing California Hmong to East Asians, and in 77.8% (14/18) SNVs comparing California Hmong to Europeans. These results validate the original study's findings that Hmong people living in different US locations have similar allele frequencies for key PGx genes. Further, for many of these PGx genes, their allele frequencies are significantly different compared to either East Asians or Europeans. Clinicians should consider these important differences when prescribing medications for people who identify as Hmong.

Factors That Impact Effective Public Health Communication With Michigan’s Latinx Population in the Context of COVID-19

The far-reaching impact of the COVID-19 pandemic on Latinx communities is well-documented. This population has higher rates of COVID-19 infection and death compared with non-Latinx White Americans mainly due to long-standing problems related to Social Determinants of Health. Communication about issues such as health threats and safety measures are a vital part of public health, and need to be appropriate to the population of focus. To understand the effectiveness of public health communication to Latinx communities in Michigan during the COVID-19 pandemic, semi-structured interviews ( n = 16) and three focus groups ( n = 24 participants) were conducted virtually in 2021 across counties in Michigan deeply impacted by COVID-19: Washtenaw, Kent, Genesee, and Wayne. Participants shared some facilitating factors that supported effective health communication during the pandemic for their communities. For instance, in their experiences, religious and community leaders were especially effective in communicating information about the pandemic. They also expressed issues with English often being the only language of official communication; the need for bilingual options; and, the need for multiple channels of communication to reach as many people as possible. Participants also highlighted their concerns about inconsistent government communication and politicizing messages as a hindering factor that impacted effective health communication within their communities. Lessons from successes and failures experienced during the COVID-19 pandemic are vital to improving health outcomes for marginalized communities during public health crises. Future responses must ensure that public health communication is appropriate and effective for Latinx communities to better protect them.

Local Wisdom-Based Skills Apprenticeship Process for Women Ex-Migrant Workers in Kediren Village, Magetan District, Indonesia

Kediren Village is a village where most women of productive age from the village are former migrant workers who have minimal skills and knowledge when returning to their hometown. The skills apprenticeship process organized by the Head of Kediren Village aims to reduce the population's poverty rate and unemployment for former migrant workers. Skills apprenticeships organized based on local wisdom can positively impact women who are former migrant workers, including providing additional activities that can be carried out to earn additional income. This research examines the importance of skills apprenticeships for female former migrant workers in Kediren Village. This research uses a qualitative approach with a case study method. The location of this research is Kediren Village, Lembeyan District, Magetan Regency, East Java. The informant criteria included the Kediren village head, chief, female former migrant workers, stakeholders, and community leaders as data sources in the research. Data was collected using in-depth interview techniques, observation, and documentation studies. Data analysis was carried out using the Miles and Huberman interactive model. This research shows that the skills apprenticeship process aimed at female ex-migrant workers can positively impact their ability to make traditional batik to support progress in improving the village economy and for individuals, as well as actively participating in activities organized by the chief executive. Research suggestions are aimed at female former migrant workers to develop the learning they have obtained in their daily activities and as an ongoing entrepreneurial field.

Modeling The Factors Influencing the Intention to use Recycled Shopping Bags in Penang

Objectives: This study investigates the factors that affect the intention of using a recycled shopping bags at hypermarkets and convenience stores among Penang residents. Theoretical Framework: This study applied the Theory of Value-Belief-Norm using the three stated variables: Awareness of Consequences, Personal Norm, and Intention to Use Recycled Shopping Bags. In addition, this study combines aspects from the Theory of Planned Behaviour and includes three additional variables: Subjective Norms, Attitude, and Perceived Behaviour Control. Method: An online questionnaire was used to gather data from 384 residents of Penang. The SmartPLS 4 program was utilized to perform structural analysis in order to examine the correlation between the research variables. Results and Discussions: The results show that all hypothesized variables explain the intention to use recycled shopping bags. Specifically, it has been shown that higher awareness of the environment, more intense personal norms, positive attitude towards the use of recycled bags, support for subjective norms, and higher perceived behavioural control are the most significant factors contributing to a greater intention to use recycled shopping bags. Research Implications: Research The findings of this study provide important recommendations for researchers, governments and retailers to promote the use of recycled shopping bags. Practitioners should emphasize personal responsibility and conduct educational campaigns to increase awareness of personal impacts on the environment. Governments should educate community leaders through education programs and provide resources and incentives for environmental initiatives. Retailers want to create environmentally friendly brand identities, use narrative to promote the benefits of recycled materials, and engage consumers with interactive campaigns. Overall, a multi-faceted approach involving an awareness campaign about plastic bag pollution may improve positive attitudes, social norms, and perceived behavioural control. Ultimately, it increases the use of recycled shopping bags among Penang residents.

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 B024: Be your own fan: Who do you get screened for?: A culturally sensitive and community-vetted colorectal cancer awareness campaign tailored for the Filipino community in Los Angeles County

Abstract Background Colorectal cancer is the second most common cancer among Filipina women and third among Filipino men, especially in Los Angeles County with the second largest concentration of Filipinos and immigrants. Recent trends show that Filipino experience late-stage diagnosis and lower survival rates. Despite the large number of Filipinos working in healthcare industry dedicated to caring for others, many Filipinos neglect to prioritize their own health and well-being. In collaboration with the Art Center College of Design, Cedars Sinai Cancer Center Community Outreach and Engagement (COE) developed a colorectal cancer awareness campaign, "Be Your Own Fan: Who do you get screened for?" aiming to evoke emotion and prompt reflection on the importance of health through storytelling, imagery, and tailored health materials (i.e., traditional hand fan, infographics, t-shirts, tote bags, stickers, photocards). Methods To determine relevance of the health campaign, five 1 hour semi-structured focus groups were conducted both in English or Tagalog via Zoom with n=23 adults ages 18 and over who self-identify as Filipino to provide community input on appropriateness of the messaging, colors, symbols, and community engagement approach. Participants were recruited through snowball sampling at in-person community outreach events, and email distribution. Results Participants represented diverse professions such as nursing, home healthcare/caregiving, public health, and accounting. Majority were 69% middle-aged adults, 57% female, and 4% colorectal cancer survivor. Research findings show that Filipinos take pride in their traditional culture, particularly in the use of Philippine flag colors (red, blue, yellow, and white) in health materials as opposed to other hues or tints. Either English or conversational Tagalog were preferred languages since it may be challenging to represent over 100 different languages spoken by Filipinos. Lastly, featuring stories and images of trusted community figures like healthcare professionals, church and community leaders, and family members are effective in pulling the heartstrings of the Filipinos to empower them to be their own fan/advocate. With this feedback, the campaign has been revised and deployed in the community and preliminary findings with n=77 people reached indicate increased awareness on colorectal cancer and intent to get screened. Conclusion. Developing health campaigns that closely reflect the community they serve can lead to increased awareness, participation, and adherence to health recommendations and behaviors. Citation Format: Reener Balingit, Mark Bondoc, Dong Hee Kim1, Zul Surani. Be your own fan: Who do you get screened for?: A culturally sensitive and community-vetted colorectal cancer awareness campaign tailored for the Filipino community in Los Angeles County [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 B024.

Abstract C007: Building capacity in health clinics and community organizations serving LGBTQ+ communities on tobacco prevention

Abstract Background. Tobacco use remains a significant public health issue, particularly among the LGBTQ+ community. Los Angeles County, which is home to the second-largest LGBTQ+ population in the US, has notably higher prevalence of tobacco use compared to the general population, partly due to targeted marketing by the tobacco industry, social stressors, and discrimination. These factors contribute to higher rates of smoking and tobacco-related health disparities; however, little is known about the capacity of community-based organizations, clinical providers, support staff, and other personnel that work closely with the LGBTQ+ community to provide smoking cessation services. Methods. Cedars Sinai Cancer Center Community Outreach and Engagement (COE) assisted in the facilitation of conducting a needs assessment, Clinical Provider and Staff Survey, to assess the opinions of clinical providers and community leaders about tobacco cessation-related topics related to 1) Building culturally competent tobacco cessation services; 2) Reducing health disparities in tobacco cessation services; 3) Improving access to care (Medicaid/Medi-Cal access and uptake) for diverse populations that are affected by tobacco-related disparities; 4) Improving the utilization of tobacco cessation services. The survey was administered online from December 2022 to April 2023 with providers throughout Los Angeles County. Results. A total of 261 surveys were collected which revealed several key issues at the organization level: they do not prioritize tobacco screening, treatment, or referrals; there is no standardized process for client management; staff have limited knowledge on tobacco prevention and patient navigation; and there is limited staff capacity and funding. To address organizational-focused barriers, COE trained 147 clinical providers and staff from 4 local health clinics and organizations and on capacity building, including the basics of tobacco, evidence-based interventions like "Ask, Advice, Refer," and lung cancer screening. Additionally, to address Client/Patient-Focused Barriers for Organizations, such as: lack of motivation to quit, low perception of the severity of smoking, and a lack of culturally competent or targeted cessation resources, COE staff assisted in navigating resources, ensuring both providers and clients were aware of and could access relevant support services. This involved sharing LGBTQ+ affirming resources, including medical care, behavioral health, and housing, and referred smokers to gender-affirming cessation support groups. Conclusion. The survey highlighted the need to enhance service delivery and support for the LGBTQ+ community. With these findings, our COE staff were able to increase organizational capacity through training and education for clinical providers and staff to enhance their knowledge and skills in tobacco cessation and share gender-affirming resources and navigation, which are crucial towards improving the overall effectiveness of tobacco cessation services for LGBTQ+ populations. Citation Format: Victor Cristanto, Alexandra Caro, Reener Balingit, Zul Surani. Building capacity in health clinics and community organizations serving LGBTQ+ communities on tobacco prevention [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 C007.

Abstract C181: Toward breast health equity: Insights into mammography access across Virginia’s social and structural landscape

Abstract Background: Breast cancer (BC) disparities across race, socioeconomic status, and location, stress the need for equitable access to screening. In Virginia (VA), BC is a major concern, with Petersburg City having the highest mortality rate nationwide. Understanding social and structural factors’ impact on mammography accessibility may provide insights on effectively serving screening-eligible women in VA, particularly those facing greater BC burden. Also, analyzing data at the census tract level is vital for accurate accessibility assessment, mitigating county-level data skewing and disparity concealment. Objective: Examine how social and structural factors (e.g., demographics, transportation, area deprivation) influence mammography facility and unit distribution in VA. Methods: We utilized a comprehensive approach to compile and analyze data at the census tract level. We employed Poisson regression models to predict the number of mammography facilities and units within each tract. The predictor variables included the number of bus stops (VA Transit Routes & Stops GTFS), percentage of Black residents (American Community Survey), area deprivation index (ADI) scores (Neighborhood Atlas®), and vehicle ownership rates (American Community Survey), with the logarithm of the population of females aged 40-74 used as an offset to account for population size. Separate models were built for VA, our catchment area, urban areas within our catchment, and rural areas within our catchment. We exponentiated the model coefficients to obtain relative risks, indicating the multiplicative effect of each predictor on the outcome variable. Results: Study findings highlighted statistically significant disparities in the distribution of mammography facilities and units within VA. Higher ADI scores, indicating greater socioeconomic deprivation, were linked to fewer mammography units. This association was notable in our rural catchment areas (RR = 0.5492), indicating a 45.08% reduction in mammography units, in our catchment area overall (RR = 0.8653), a 13.47% decrease, and in urban catchment areas (RR = 0.8800), a 12.00% decline. Similarly, an increase in the percentage of Black residents was consistently associated with a decrease in the number of mammography units, with a relative risk of 0.8828 within our catchment area, indicating a 11.72% decrease, 0.8793 in urban areas within our catchment, signifying a 12.07% decrease, and 0.9391 statewide, showing a 6.09% decrease. Conclusions: These findings stress the need for targeted resource allocation to enhance mammography access. For instance, findings suggest a specific need for increased mammography units in rural areas and areas with higher percentages of Black women, like Petersburg (67.5% to 94.9% Black population depending on the tract), specifically within our catchment. Implications from these findings provide a unique opportunity to leverage the expertise of residents, community leaders and local representatives to identify where additional resources can be allocated. Citation Format: Bianca D. Owens, Jinlei Zhao, Katherine Y. Tossas. Toward breast health equity: Insights into mammography access across Virginia’s social and structural landscape [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 C181.

Abstract C181: Toward breast health equity: Insights into mammography access across Virginia’s social and structural landscape

Abstract Background: Breast cancer (BC) disparities across race, socioeconomic status, and location, stress the need for equitable access to screening. In Virginia (VA), BC is a major concern, with Petersburg City having the highest mortality rate nationwide. Understanding social and structural factors’ impact on mammography accessibility may provide insights on effectively serving screening-eligible women in VA, particularly those facing greater BC burden. Also, analyzing data at the census tract level is vital for accurate accessibility assessment, mitigating county-level data skewing and disparity concealment. Objective: Examine how social and structural factors (e.g., demographics, transportation, area deprivation) influence mammography facility and unit distribution in VA. Methods: We utilized a comprehensive approach to compile and analyze data at the census tract level. We employed Poisson regression models to predict the number of mammography facilities and units within each tract. The predictor variables included the number of bus stops (VA Transit Routes & Stops GTFS), percentage of Black residents (American Community Survey), area deprivation index (ADI) scores (Neighborhood Atlas®), and vehicle ownership rates (American Community Survey), with the logarithm of the population of females aged 40-74 used as an offset to account for population size. Separate models were built for VA, our catchment area, urban areas within our catchment, and rural areas within our catchment. We exponentiated the model coefficients to obtain relative risks, indicating the multiplicative effect of each predictor on the outcome variable. Results: Study findings highlighted statistically significant disparities in the distribution of mammography facilities and units within VA. Higher ADI scores, indicating greater socioeconomic deprivation, were linked to fewer mammography units. This association was notable in our rural catchment areas (RR = 0.5492), indicating a 45.08% reduction in mammography units, in our catchment area overall (RR = 0.8653), a 13.47% decrease, and in urban catchment areas (RR = 0.8800), a 12.00% decline. Similarly, an increase in the percentage of Black residents was consistently associated with a decrease in the number of mammography units, with a relative risk of 0.8828 within our catchment area, indicating a 11.72% decrease, 0.8793 in urban areas within our catchment, signifying a 12.07% decrease, and 0.9391 statewide, showing a 6.09% decrease. Conclusions: These findings stress the need for targeted resource allocation to enhance mammography access. For instance, findings suggest a specific need for increased mammography units in rural areas and areas with higher percentages of Black women, like Petersburg (67.5% to 94.9% Black population depending on the tract), specifically within our catchment. Implications from these findings provide a unique opportunity to leverage the expertise of residents, community leaders and local representatives to identify where additional resources can be allocated. Citation Format: Bianca D. Owens, Jinlei Zhao, Katherine Y. Tossas. Toward breast health equity: Insights into mammography access across Virginia’s social and structural landscape [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 C181.

Abstract B091: Listen, Empower, Co-Create: Conducting listening sessions to create tailored messages about colorectal health for American Indian communities

Abstract Background We conducted Listening Sessions using a modified version of boot camp translation (BCT), a validated community engaged approach, to engage American Indian community members in the Great Plains and the Pacific Northwest to develop culturally and locally relevant colorectal cancer (CRC) screening messages and materials. Methods CRC is one of the leading causes of cancer death in the US and disproportionally affects American Indian adults. Routine CRC screening leads to earlier diagnosis and prolonged survival from the disease. In partnership with Great Plains Tribal Leaders Health Board (GPTLHB), South Puget Intertribal Planning Agency (SPIPA), and National Association of Chronic Disease Directors, we used a modified BCT approach to obtain feedback from tribal communities to create CRC screening messages and materials. To make the BCT process more meaningful for our partner communities, we reframed the BCT sessions by referring to them as Listening Sessions. The Listening Session engagement process was designed to help community leaders and champions learn about local barriers and gaps in care (listen), share health information in a collaborative way (empower), and develop messages and materials that resonate with and motivate community members to take control of their health (co-create). Eligible tribal community members from GPTLHB and SPIPA were between the ages of 45-75 and able to participate in three Listening Session meetings (one five-hour in-person meeting including expert presentations, brainstorming opportunities, and interactive small group sessions, and two follow-up virtual sessions (one-hour each) to refine messages and materials). Results Common Themes. Both groups emphasized the importance of using a multigenerational approach by including grandchildren and Elders in the messages and materials. Additionally, they highlighted the need for materials to be relatable and culturally relevant by incorporating local cultural imagery and traditions and multigenerational family support .Differing Themes. The GPTLHB findings focused specifically on including Lakota words to reinforce cultural identity, using visuals for colon health education, and incorporating details about healing traditions. The SPIPA findings recommended highlighting intertribal milestones like the canoe journey and incorporating water as a symbol of spiritual healing. Materials and Dissemination Methods. Preferred materials and channels for dissemination were: 1) fact sheets, posters, and visual stories to be distributed in-clinic or at community events, 2) animated videos for CRC screening education to be shown in clinic, 3) live action videos with community member CRC stories to be shown in clinic. Final materials will be available here: www.KPCHR-engage.org Conclusion We conducted Listening Sessions to incorporate participant feedback to develop CRC screening messages and materials and identified preferred dissemination channels for tribal communities in the Great Plains and Pacific Northwest. Citation Format: Jamie Thompson, Jennifer Rivelli, Priyanka Gautom, LaToya Brave Heart, Jamie Nikander, Lorrie Graaf, Gloria Coronado. Listen, Empower, Co-Create: Conducting listening sessions to create tailored messages about colorectal health for American Indian communities [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 B091.

Abstract B074: Qualitative assessment of knowledge gaps and barriers to Hepatitis B and liver cancer screening in high-risk U.S. communities

Abstract Background: Up to 2.4 million people in the US live with chronic hepatitis B (HBV) infection (Wong et al., 2021). Foreign-born communities are most impacted, particularly those from Asia, the Pacific Islands, the Caribbean, and sub-Saharan Africa (Conners et al., 2023). Individuals with unmanaged HBV have a 15-40% lifetime risk of dying prematurely from cirrhosis or hepatocellular carcinoma (HCC) (McMahon, 2009). Low awareness, cultural norms, and misperceptions about HBV, HCC, and their connection contribute to low screening and care rates in affected communities. A more robust and comprehensive understanding of these barriers is needed to design effective awareness campaigns to improve HBV screening and care and prevent HCC. To this end, this study aimed to learn about existing knowledge and misconceptions about HBV and its relationship to HCC in high-risk communities, identify barriers to screening, and use the findings to develop effective communication strategies that raise awareness and dispel myths. Methods: Fifteen focus groups and two key informant interviews with community members, leaders, and public health experts were conducted to assess beliefs and attitudes about HBV and HCC and to identify preferred communication strategies. Results: The link between HBV and HCC remains poorly understood, and myths persist about the transmission and outcomes of both conditions. Multiple barriers to HBV and HCC screening exist, including concerns about insurance and immigration status, language barriers, cultural and religious beliefs, lack of general health literacy, lack of resources to cope with a positive diagnosis, widespread distrust of Western medicine, and fear of stigma and isolation. Ideas for effective communication methods included employing community health educators, primary care providers, ethnic media outlets and personal testimonials for delivery of information, and tailoring communications by community, age, and gender. These findings were used to create a suite of culturally and linguistically appropriate educational materials for use in each of twelve communities. Conclusions: Many challenges to increasing screening persist in groups most impacted by HBV and HCC, including a need for increased awareness about their connection. Community engagement is essential to overcoming these challenges, as are specific, targeted messaging and dissemination to improve the uptake of HBV screening and management. Behavioral and Social Science: Community-based Participatory Research Citation Format: Beatrice Zovich, Fiona Borondy-Jenkins, Suzanne Block, Kate Moraras, Thomas Chen, Chari Cohen. Qualitative assessment of knowledge gaps and barriers to Hepatitis B and liver cancer screening in high-risk U.S. communities [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 B074.

Abstract B080: UC Davis Center for Advancing Cancer Health Equity: A framework for community-led cancer health interventions

Abstract Many racial/ethnic groups in the US experience cancer health disparities, contributing to higher cancer incidence and cancer-related deaths compared to other groups. These are driven by a combination of biological and social determinants of health that affect cancer development and care response across the cancer health continuum. Underserved communities in California, many of which are communities of color, experience combinations of these factors that result in a unique landscape of barriers to cancer care. Because of this, interventions to remove these barriers cannot follow a one-fits-all approach. There is a critical need for community-directed interventions that reflect the cultural and social values of the members of a specific community to effectively identify and eliminate barriers to care. Through the UC Davis Center for Advancing Cancer Health Equity (CACHE), we have developed an infrastructure to design and implement community-directed interventions as a partnership between community members and the cancer research community at UC Davis. CACHE was launched in 2022 with the purpose of conducting community-engaged research to implement multi-level interventions for cancer health equity. CACHE is focused on placing underserved communities located in UC Davis’ catchment area at its center through community member ownership and leadership of the center’s research decision-making process. In this initial phase, the center recruited health professionals and community members throughout Northern California to participate in focus groups that inform the development of the center’s mission and vision, and name. Through these focus groups, our center identified community values and terminology that helped to guide and set expectations for its goals, actions and trust-building with underserved communities. The center establishes lasting community relationships through the development of task forces, whose goal is to identify community cancer health priorities to address through research. Given the significant cancer health disparities for American Indian and Alaska Natives in California, the first task force CACHE established is focused on Native and Indigenous cancer health. It consists of both academic researchers and community and Tribal leaders. Our task force began a cancer health needs assessment in partnership with multiple Tribal Nations and non-profit health center Northern Valley Indian Health. Native and Indigenous community conversations have uncovered cancer health and prevention education, transportation, and medical and research communities’ trustworthiness as barriers. We are now working to expand our understanding of these barriers for research interventions leading to improve Native and Indigenous cancer health. Ultimately, the goal of CACHE and its task forces is to develop community-led interventions to eliminate cancer care barriers in partnership with communities, and move towards cancer health equity for all. Citation Format: Nicole B. Halmai, Sophie Barbu, Angelica Rolon, Inigo Verduzco Gallo, Nanci Chavarria Villa, Guadalupe Carvajal, Luis G. Carvajal- Carmona. UC Davis Center for Advancing Cancer Health Equity: A framework for community-led cancer health interventions [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 B080.

Multifaceted economic impacts of a 500-year flood on gateway communities of Yellowstone National Park

Disasters can have dramatic implications for gateway communities of National Parks, especially local economies that rely on park tourist visitation as their primary source of income. In June 2022, a 500-year flood event impacted Yellowstone National Park (YNP) and gateway businesses, both directly through infrastructure damages (property loss) and indirectly through park closures and post-disaster marketing. We used a combination of approaches to document and explore the relative importance of these diverse sources of economic impacts. First, structured surveys were used to evaluate economic impacts, from the perspective of individual business owners and community leaders in six gateway communities surrounding YNP. Average revenue loss was 48 % during peak tourist season across all communities but averaged 75 % for communities inaccessible to the park. Direct infrastructure damages to businesses were localized; however, even businesses sustaining property losses suggested more severe economic impacts were the result of loss of visitors from park closures and damaging media coverage. Using annual visitation and economic input-output model data, we developed a statistical model to estimate regional economic impacts from the flood. The model corroborated the results of our survey and suggested the flood led to a total loss of $156 million in visitor spending in gateway areas in 2022, exceeding economic losses from the COVID-19 pandemic in 2020. We present some guidelines for building economic resilience in gateway communities, including diversifying sources of income, building social capital, embracing tourist adaptations, and developing coordinated park-gateway-regional messaging and marketing to the media post-disasters.

Community members' perceptions of community health workers in Melusi, Tshwane, South Africa.

Community health workers (CHWs) play an important role in health promotion through health campaigns and home visits, and provide linkage to care and support patient management. In the informal settlements, CHWs identify health challenges and help residents to access healthcare facilities. This study aimed to explore the perception held by the community members regarding CHWs' contribution to health promotion in Melusi informal settlements within the Tshwane district. The study was conducted in Melusi informal settlement situated in Pretoria west in South Africa. Descriptive exploratory qualitative research methods were used, with open and closed-ended questions during individual interview sessions. Participants were purposefully selected in collaborating with the community leaders and using CHWs' data to identify individuals with direct interaction with CHWs. Participants praised CHWs' communication skills, engagement strategies, and ability to provide valuable health services. Community members expected CHWs to provide healthcare services, educational support, advocacy for health issues and guidance on well-being. Barriers such as community resistance, a lack of privacy and difficulties in reaching households were noticed. However, CHWs were commended for their impact on well-being, offering health services, emergency support, food assistance and improved healthcare accessibility. The study indicates that community members have positive perceptions of CHWs. This highlights the significant role of CHWs in promoting health and well-being within the community.Contribution:This study provides insights into community perceptions of CHWs in informal settlements, emphasising their impact on community well-being. It provides a basis for their effectiveness and support in delivering health services in the informal settlement.

Older adults’ perceptions and behaviors on driving: A mixed method study

Understanding older adults' driving behavior based on their personal assessment, along with challenges they encounter when driving will support community leaders and policymakers to develop effective supportive strategies for their safety on the road. This study uses a mixed methodology approach, including a survey and an interview to examine older drivers' perceptions and concerns regarding their driving habits. Collecting data from cities in Texas and Nevada, to achieve diverse perspectives on older adults who live in environments with different land use patterns and road geometry.Using the survey to understand the older adults' self-evaluated driving skills, where most consider themselves very good drivers even though they have some challenges, based on the roads, their reflexes changing over the years, and the impact of their physical and cognitive health. Supplementing the survey results with the interview allows the study to identify older drivers' major challenges including adverse weather, construction sites, and in-vehicle distractions. Supporting that visual and cognitive challenges are limiting older adults’ driving patterns (e.g., not driving at night).To avoid any conflicts with aggressive drivers, the older adults are passively driving, and if accessible, utilizing in-vehicle technologies to increase their safety. However, older drivers suggested that all drivers, particularly younger drivers, should have access to more educational materials. They recommended that older adults' licensing requirements should be evaluated based on their health condition rather than age. Participants’ concern regarding roadway infrastructure elements and driver behavior can be resolved through improvements in road design and driver education.

From Homemakers to Breadwinners to Community Leaders: Migrating Women, Class, and Color, by Norma Fuentes-Mayorga

From Homemakers to Breadwinners to Community Leaders: Migrating Women, Class, and Color, by Norma Fuentes-Mayorga

Rethinking Health Systems Responsiveness in Low- and Middle-Income Countries: Validation Study.

Health systems responsiveness (HSR) is the ability of systems to respond to legitimate non-health expectations of the population. The concept of HSR by the World Health Organization (WHO) includes respect for dignity, individual autonomy, confidentiality, prompt attention to care, availability of basic amenities, choice of provider, access to social support networks, and clarity of communication. The WHO tool is applied globally to assess HSR in low, middle, and high-income countries. We have revised the conceptual framework of HSR following a rigorous systematic review and made it specific for low- and middle-income countries (L&MICs). This study is designed to (1) run the Delphi technique to validate the upgraded conceptual framework of HSR, (2) modify and upgrade the WHO measurement tool for assessing HSR in the context of L&MICs, and (3) determine the validity of the upgraded HSR measurement tool by pilot testing it in Pakistan. The Delphi technique will be run by inviting global public health experts to provide suggestions on the domains and subdomains of HSR specific to L&MICs. Cronbach ɑ will be calculated to determine internal consistency among the participants. The upgraded HSR conceptual framework will serve as a beacon to modify the measurement tool by the research team, which will be reviewed by subject experts for refinement. The modified tool will be pilot-tested by administering it to 1128 participants from primary, secondary, and tertiary care hospitals in Rawalpindi district, Pakistan. Additionally, an "observation checklist" of HSR domains and subdomains will be completed to objectively measure the state of HSR across health care facilities. HSR assessment will be further strengthened by incorporating the perspective of hospital managers, service providers, and policy makers (ie, the supply side) as well as community leaders and representatives (ie, the demand side) through qualitative interviews. The study was started in January 2024 and will continue until February 2025. A multidimensional approach will yield significant quantifiable information on HSR from the demand and supply sides of L&MICs. This study will provide a conceptual understanding of HSR and a corresponding measurement tool specific to L&MICs. It will contribute to global public health literature and provide a snapshot of HSR in Rawalpindi district, Pakistan, with concrete action points for policy makers. DERR1-10.2196/59836.