Multiethnic Community Research Articles

Extensive genetic admixture between Tai-Kadai-speaking people and their neighbours in the northeastern region of the Yungui Plateau inferred from genome-wide variations

BackgroundYungui Plateau in Southwest China is characterized by multi-language and multi-ethnic communities and is one of the regions with the wealthiest ethnolinguistic, cultural and genetic diversity in East Asia. There are numerous Tai-Kadai (TK)-speaking populations, but their detailed evolutionary history and biological adaptations are still unclear.ResultsHere, we genotyped genome-wide SNP data of 77 unrelated TK-speaking Zhuang and Dong individuals from the Yungui Plateau and explored their detailed admixture history and adaptive features using clustering patterns, allele frequency differentiation and sharing haplotype patterns. TK-speaking Zhuang and Dong people in Guizhou are closely related to geographically close TK and Hmong-Mien (HM)-speaking populations. Besides, we identified that Guizhou TK-speaking people have a close genetic relationship with Austronesian (AN)-speaking Atayal and Paiwan people, which is supported by the common origin of the ancient Baiyue tribe. We additionally found subtle genetic differences among the newly studied TK people and previously reported Dais via the fine-scale genetic substructure analysis based on the shared haplotype chunks. Finally, we identified specific selection candidate signatures associated with several essential human immune systems and neurological disorders, which could provide evolutionary evidence for the allele frequency distribution pattern of genetic risk loci.ConclusionsOur comprehensive genetic characterization of TK people suggested the strong genetic affinity within TK groups and extensive gene flow with geographically close HM and Han people. We also provided genetic evidence that supported the common origin hypothesis of TK and AN people. The best-fitted admixture models further suggested that ancestral sources from northern millet farmers and southern inland and coastal people contributed to the formation of the gene pool of the Zhuang and Dong people.

Multicultural and fun campus strategy

Globalization and increasing global uncertainty, cultural diversity has become one of the main factors affecting life. The difficulty of recruiting students due to the campus' rigidity in adopting cultural diversity is a big loss. The steps for campus reform in adopting multi-culturalism need a strategy implemented by campus leaders to look forward. This paper aims to reveal the important factors that need to be implemented in the campus to get to the Multicultural Campus (CM). The method of writing this paper uses a qualitative approach which is supported by various conclusions from various multicultural research reports. In addition to the support of research reports, this paper is also a qualitative study of the implementation of CM that has been successfully carried out at the Muhammadiyah Education University of Sorong. The result is a CM creation strategy scheme by applying several important factors, namely vision, commitment, strategy and implementation. CM implementation includes Multicultural Campus Culture Creation, Multicultural Study and Development Center, CM Regulations, Multicultural Campus Facilities. In addition, there needs to be government support and multi-ethnic communities

Disparities in lung cancer screening in a diverse urban population and the impact of a community-based navigational program.

6555 Background: Lung cancer (LC) is the leading cause of cancer death in the US in both men and women; causing 25% of all cancer deaths. Annual lung cancer screening (LCS) with a low-dose CT (LDCT) in high-risk individuals (aged 50-80 with a >20 pack-year smoking history) decreases LC deaths by 20% and is recommended by USPSTF. Despite the efficacy, uptake of LDCT remains low at 6% nationally, and 13% in Rhode Island. Patient (pt) and provider perceived barriers, along with racial, ethnic and socioeconomic disparities widen the gap. We evaluated the implementation of a LCS navigation program at an urban community health center (CHC) with a multiethnic, socioeconomically underserved population. Methods: A bilingual (English and Spanish speaking) pt navigator was integrated into routine clinic practice at a large primary care CHC group, across 4 sites, starting in January 2022. The navigator’s role was to assess pt and provider awareness of the LCS process, assess for systemic barriers, and provide navigational support for the LDCT process. Pts eligible for LCS at the CHC from 1/2022 to 12/2022 were retrospective examined; 50 to 80 years and a >20 pack-year smoking history. The navigator administered a questionnaire to assess barriers to LDCT and demographic variables. Results: A total of 360 eligible pts were seen across the CHC practice in 2022, of which 149 (41.4%) agreed to undergo LDCT after counseling and shared decision making and 28% of these (n 101) completed LDCTs. 153 of the eligible pts completed the survey questionnaire. Of these, 50% were females; 40% were Hispanic/Latinx, 40% were non-Hispanic/Latinx and 22% declined to answer. Majority, 61% were white, 10% African American/Black and 28% declined to answer. A sizeable proportion were non-English speaking (34%) and resided in cities with Rhode Island’s lowest per-capita incomes (Pawtucket 48%), Central Falls (32%) and North Providence/Providence (10%). In assessing barriers to LCS, 46% of pts were not aware of the LCS process and 44% were unaware that LCS was covered by health insurance; 58% of eligible pts did not recall their PCP discussing LCS. Of the LDCTs resulted available at the time of analysis, 84% were Lung RADS-1 and 16% Lung RADS-4 category. Conclusions: Our study highlights the unique barriers to LCS in an urban multiethnic community. While access to LCS remains an issue, pt awareness of the lung cancer screening process was the major barrier. A patient navigation program is critical to the success of LCS in a community, by providing education to patients and providers and the necessary logistical support needed in the LDCT process. With a community based navigational program, we demonstrate a significant increase in lung cancer screening rates in our population to 28% as compared to the state LCS rate of 13%. (Supported by the Robert A. Winn Diversity in Clinical Trials Career Development Award).

A longitudinal study on the prevalence of iron deficiency anemia in the multiethnic communities of Jhargram, West Bengal

Anemia is a significant public health concern in India, with an esti-mated prevalence of 38% to 82% in non-pregnant females and 18% to 59% in males. Destitution, poor nutrition, illiteracy, unhealthy practices, obliviousness, and inadequate health service is the significant reasons for the higher rate of IDA in the tribals of India. The objective of the present study was to estimate the disease burden in Binpur-I and II, Jhargram blocks in West Bengal, India. The research was planned as a multiethnic community-based investigation that includes age and sex-specific gradation of anemia with iron status (SF, SI, TIBC). 910 participants (female: 529 and male: 381) were enrolled in the study. Overall, 67.47% of individuals were diagnosed with anemia (female: 42.74% and male: 24.73% ). According to severity, 29.12%, 27.14%, and 11.2% of individuals were moderate, mild, and severely anemic. Results also showed that IDA is prevalent among all age groups irrespective of sex, with the highest rates in the 40.1 - 60 age group (female). The higher prevalence of the geriatric population could be due to chronic disease, iron deficiency, and genetic polymorphisms, which require future investigations.

Implementation of a diabetes prevention programme in a multi-ethnic community in primary care in England: An evaluation using constructs from the RE-AIM Framework

AimsTo implement a diabetes prevention programme in primary care MethodsThe programme was implemented for 12 months in two neighbouring towns, served by eight general practices. Practices requested a referral pathway involving an external administrator running electronic searches and sending postal invitations. If interested, people called and booked a place on the programme. Practices were also provided with resources to refer people directly. Six Educators were trained to deliver the programme. The RE-AIM constructs “Adoption”, “Reach” and “Uptake” were assessed. ResultsAll practices engaged in the searches and postal invitations. Overall, 3.9 % of those aged ≥ 25 years had an HbA1c level indicative of non-diabetic hyperglycaemia (NDH) and were invited. Overall uptake (attended as percentage of invited) was 16 % (practice range 10.5–26.6 %) and was highest in two practices where the invitation was followed by a telephone call. Four people were referred directly by their practice. Groups at risk of being excluded were the Bengali population and those unable to attend because of issues such as health, mobility and frailty. ConclusionsComprehensive electronic searches meant everyone previously diagnosed with NDH was invited to attend. Follow-up telephone call improved uptake and providing practices with resources to make these calls themselves would likely increase uptake further.

The impact of linguistic racism and coloniality on Sri Lankan English studies: the case of Burgher English

ABSTRACT This paper argues that descriptions of Sri Lankan English (SLE) are influenced by ideologies of linguistic racism and coloniality through an examination of the possible reasons for their neglect of Burgher English – an underprivileged variety of SLE spoken by a minority community. Although descriptions of SLE identify different categories of the variety, they neglect the language use of the Burghers, despite the fact that they are the only ethnic community for a large majority of whom English serves as a first language. The paper claims that descriptions of SLE are interested in elevating the language use of the elite and anglicized sections of the racially dominant Sinhalese instead of focusing on understanding and depicting how diverse people of the multiethnic and multicultural Sri Lankan speech community such as the Burghers of Sri Lanka adapt it to suit their needs and contexts. Demonstrating the possible influence of linguistic racism and colonial ideologies on descriptions of SLE, the paper posits that the unique structural features rendering Burgher English to be perceived as sub-standard could be understood through the theoretical lens of postcolonial performativity which would help appreciate the creativity and diversity of the variety instead of devaluing it as sub-standard.

Preserving and Promoting Indigenous Languages of Ethnic Minorities in Bangladesh: A Strategic Planning Framework

Bangladesh is a country with multi-ethnic communities. The majority of the population is Bengali-speaking Bengalese. Around fifty indigenous communities are the rest of the population who have other indigenous languages. Because of the narrow scope, any languages in such conditions have a chance of extinction. For a vibrant and harmonious multi-ethnic society, linguistic and cultural diversities require respect and recognition. Besides, these languages possess epistemic values and are considered sources of primitive knowledge. The government of the People’s Republic of Bangladesh has taken an affirmative initiative to preserve indigenous language and culture. To meet this goal, preservation and promotion of indigenous languages is imperative. By Article 23(A) of its constitution, its education policy of 2010 and its law ‘Small Ethnic Groups Cultural Institutes Act of 2010’ indigenous language rights are restored. Following the government decision, the National Curriculum and Textbook Board publishes primary school textbooks in five indigenous languages. But these are not enough to keep all the indigenous languages alive. Many more actions are necessary to facilitate the constitutional declaration of indigenous language development like publishing textbooks in more indigenous languages, indigenous language teachers’ training and other initiatives. This paper attempts to fill the gap between initiatives taken by the government and the actual necessity of full-fledged affirmative action as it is necessary as the source of the indigenous knowledge. It primarily depends on the literature, official documents and interviews of the respected stakeholders. The outcome of this study is important for the national integration of the countries like Bangladesh that possess a multi-ethnic, pluralistic society.

Probiotic Properties of Lactic Acid Bacteria Isolated from the Spontaneously Fermented Soybean Foods of the Eastern Himalayas

Spontaneously fermented soybean foods with sticky-textured and umami-flavor are popular delicacies of multi-ethnic communities of the Eastern Himalayas. Even though species of Bacillus have been reported earlier as pre-dominant bacteria, we hypothesized that some lactic acid bacteria (LAB) present in these unique soy-based foods may exhibit probiotic properties. Hence, the present study is aimed to evaluate some probiotic attributes of LAB. A total of 352 bacterial isolates from spontaneously fermented soybean foods of the Eastern Himalayas viz., kinema, grep-chhurpi, peha, peron namsing and peruñyaan were preliminarily screened for survival in low pH, bile salt tolerance, and cell surface hydrophobicity. Finally, eight probiotic LAB were selected and identified, based on the 16S rRNA gene sequencing, as Pediococcus acidilactici Ki20 and Enterococcus faecium Kn19 (isolated from kinema), E. faecalis Gc21 (grep-chhurpi), P. acidilactici Ph32 (peha), E. faecium Pn11 and E. faecalis Pn37 (peron namsing), E. lactis Py03, and E. lactis Py08 (peruñyaan). In vitro probiotic attributes, E. faecium Kn19 (73.67 ± 1.05) and P. acidilactici Ph32 (79.71 ± 0.13%) recorded higher survival ability in acid and bile salt test, respectively. Furthermore, attachment ability of isolates to hydrocarbons showed ≥80% adhesion property with E. faecalis Gc21 (90.50 ± 10.14%) marked the highest degree of hydrophobicity, and P. acidilactici Ki20 showed the higher auto-aggregation and co-aggregation property. LAB strains were able to produce antibacterial activity against pathogenic bacteria. Genetic screening revealed the presence of genes responsible for acid tolerance (groEl, clpL), bile salt tolerance (apf, bsh), adhesion (msa, mub1), and bacteriocin producing genes for pediocin (pedA, pedB) and enterocin (entA, entB). The present study highlighted the probiotic potentials of LAB strains isolated from Himalayan naturally fermented soybean foods that may be developed as a starter or co-starter culture for controlled and optimized fermentation of soybeans.

MP-453090-5 SUDDEN CARDIAC ARREST AS THE FIRST MANIFESTATION OF HEART DISEASE IN THE GENERAL POPULATION

The subgroup of individuals who present with sudden cardiac arrest (SCA) as the first manifestation of heart disease (FM-SCA) present the greatest challenge to effective clinical risk stratification, but population-based data in the current era is lacking. We hypothesized that improved awareness and access to health care has resulted in a reduction in prevalence of FM-SCA. We compared the prevalence secular trends of FM-SCA in two geographically distinct US populations and evaluated distinguishing characteristics. Consecutive cases of SCA were ascertained prospectively from 2 large ongoing US studies, the Oregon Sudden Unexpected Death Study (OreSUDS, Portland OR, USA, 2002-2018) and Prediction of Sudden Death in Multi-ethnic Communities (PRESTO, Ventura CA, USA, 2015-2022), total population 1.85 million residents. All out-of-hospital SCA events attended by emergency medical services were determined following an established multi-source ascertainment and adjudication process, and a detailed review of the comprehensive lifetime clinical records was conducted for each individual. Both SCA survivors and non-survivors were included. FM-SCA cases were defined as SCA with no prior heart disease diagnosis. A multi-variable model using combined data from both cohorts was used to identify distinguishing characteristics of FM-SCA vs. other SCA. A total of 3390 SCA cases (age 64.3 ± 18.8, female 34%) were identified in OreSUDS and n=2318 (age 71.6 ± 15.7, female 36%) in PRESTO. In OreSUDS, prevalence of FM-SCA was 39% (n=1282, age 58.6 ± 21.7, 32% female) and decreased modestly over time (Figure; 37% in 2002-06 to 33% in 2014-18; p=0.001 for trend). In PRESTO, overall prevalence of FM-SCA was 41% (n=949, age 68.3 ± 17.6, 33% female) and did not change significantly over time (Figure; 2015-2022; p=0.06 for trend). In multivariate comparisons of FM-SCA vs. other SCA performed in the subset of individuals with healthcare visits, younger age, male sex and lower rates of diabetes, hypertension, seizure disorder, chronic obstructive pulmonary disease and chronic renal insufficiency were associated with FM-SCA (p <0.0001). There was a modest reduction in prevalence over time, but 33-41% of individuals continued to present with FM-SCA and were distinguished by younger age, male sex and lower rates of co-morbid conditions. These findings suggest the need to develop and investigate user-friendly and cost-effective pre-screening methods to reduce FM-SCA in the general population.

DH-452784-4 AN ELECTROCARDIOGRAPHY-BASED DEEP LEARNING ALGORITHM FOR IDENTIFICATION OF INDIVIDUALS AT INCREASED RISK OF SUDDEN CARDIAC ARREST

Sudden cardiac arrest (SCA) is a major public health problem with significant need to improve screening methods for detection of high risk. Recently developed ECG-based deep learning (DL) models have shown high accuracy for detection of selected heart disease conditions. To train and validate a 12-lead ECG-based DL algorithm for detection of increased SCA risk. Individuals who suffered out-of-hospital SCA were prospectively ascertained in the Portland, Oregon, metro area (The Oregon Sudden Unexpected Death Study, catchment population ∼1 million, 2002-onwards). A total of 1,838 12-lead ECGs from 1,796 cases obtained by health care providers prior and unrelated to the individual SCA events were digitized and employed to develop an ECG-based DL model for prediction of SCA risk (training, validation, and testing). External validation was performed in 717 ECGs from 714 SCA cases (The Ventura Prediction of Sudden Death in Multi-ethnic Communities study, catchment population ≈850,000, 2015-onwards). Two separate control group samples were obtained from 1,350 ECGs taken from 1,325 clinically matched individuals. Compared to SCA cases in the internal dataset, individuals in the external dataset were older, and more often female or Hispanic. The prevalence of prior myocardial infarction and heart failure was lower among SCA cases in the external cohort. The DL model achieved an AUC of 0.887 (95% CI 0.857-0.915) for detection of SCA cases in the internal test dataset compared to control patients in the held-out test cohort. Despite the demographic and clinical differences, the model was successfully validated among external SCA cases with an AUC of 0.821 (95% CI 0.791-0.850). The DL model performed significantly better than a previously developed and validated conventional ECG electrical risk score, which achieved an AUC of 0.705 (0.661-0.749) in the internal cohort and 0.742 (0.710-0.774) in the external cohort. An ECG-based DL model distinguished SCA cases from clinically matched control subjects with high accuracy, performing better than a conventional ECG risk model. These findings suggest that this DL model has potential for further evaluation as a screening tool for SCA risk.

Abstract #1403921: Characteristics of Children and Adolescents with Hashimoto’s Thyroiditis in a Multiethnic Community Hospital

Hashimoto's thyroiditis (HT), an autoimmune thyroid disorder, is the most common cause of acquired hypothyroidism in children and adolescents. HT is familial with female predominance. It has peak incidence in school-aged children and adolescents. It is most common in Whites and Asians and in those with other autoimmune conditions. In addition to goiter, poor linear growth and disruption of pubertal development are common. The diagnosis is made by presence of thyroid autoantibodies (Abs) and can be confirmed by heterogeneous echogenicity on sonogram. There is increased risk for papillary thyroid carcinoma (PTC) in HT. The aim of this study was to explore the characteristics of pediatric patients with HT in a multiethnic community hospital where the majority of patients are Hispanic and Asian. A retrospective review was conducted. Patients 0-21 years with HT seen in Pediatric Endocrine Clinic at Flushing Hospital Medical Center between 2013 and 2021were included. Data extracted from EHR included demographics, clinical findings, comorbidities, thyroid function tests, thyroid autoantibodies, sonogram findings, fine needle aspiration (FNA) results and treatment. The sample was characterized using descriptive statistics. Of 114 patients identified with HT, 80 (70%) were female. The mean age at time of diagnosis was 12.6+4.2 years. Of 66 patients with documented ethnicity, 59% were Hispanic. Family history of thyroid dysfunction was present in 35%. The most common presenting complaint was goiter (47%). Elevated thyrotropin was present in 86%. Comorbidities included diabetes (5%), celiac disease (2%) and vitiligo (2%). Both anti-thyroglobulin antibodies (anti-Tg Abs) and anti-peroxidase (anti-TPO) Abs were present in 60%, anti-TPO Abs only in 22% and anti-Tg Abs only in 9%. All patients had thyroid sonogram: 64% revealed heterogeneous echogenicity, 4% homogeneous echogenicity and 32% normal. Both nodules and cysts were reported in 12%, nodules only in 24%, and cysts only in 9%. No patient met criteria for FNA. All patients with overt hypothyroidism or nodules/cysts were prescribed levothyroxine. Our patients were mostly of Hispanic ethnicity, an underrepresented population in previous studies. Female to male ratio was almost 4:1 with mean age of 12.6 years, concurring with known epidemiology. Hypothyroidism and goiter were common. Having both anti-TPO Abs and anti-Tg Abs was more common than having only one Abs. Thyroid sonogram was confirmatory in two-thirds. Nodules and cysts were common but did not lead to FNA. Future research exploring associations with development of PTC will require extended follow up.

Caring for Different Economic Conditions to Maintain the Social Integration of Multi-Ethnic Farmers

This study examines the concern for differences in economic conditions in maintaining the social integration of multi-ethnic farmers. Data collection was carried out by interviewing informants. The selection of informants is carried out using the snowball method, that is, finding key informants who have knowledge of the differences in social conditions, the process of social integration of farmers, then key informants indicate other informants. The results showed that differences in economic conditions were based on wealth/area of rice field ownership, ownership status, labor, production and income, marketing, savings and investment, consumption patterns, and capital. This leads to inequalities and knowledge gaps, differences in the ability to cope with the problems of the production process. The solution of caring for each other can maintain the social integration of multi-ethnic farmers. Social integration of society is characterized by mutual care, order, interdependence, uniformity of thinking, the importance of social order. Strategies of maintaining social integration through concern for different economic conditions, training individuals to accept each other, adjust habits, open up, respect each other and recognize each other. The contribution of the results of this study is beneficial for multi-ethnic communities with different socioeconomic conditions in living a sustainable life together

Integrasi Nasional dalam Novel Kanak-Kanak Terpilih

This objective of this study is to analyse national integration in two children’s novels, Rahsia Dhia (2014) by Zainun Mustapha and Iqbal Membina Jaya (2015) by Radzemah Bolhassan. This study was carried out based on previous literary reviews that reveal the application of national integration in children’s literature, especially novels, is less emphasised by the authors based on the notion that children’s novels are simple, relaxing and entertaining. Literature is one of the mediums that can serve as a vehicle for national integration in society especially children. Therefore, the inculcation of national integration in children’s novels should be given due consideration by the novelist so that the material presented is not only enjoyable to read, but knowledgeable and didactic, fostering the spirit of solidarity among children which is appropriate in the Malaysian multiethnic community. Furthermore, this study will utilise the ideas of the theory of literary sociology as an analytical framework. The findings show that the stories contained in the two novels examined, demonstrate the inculcation of national integration elements in children’s novels and loaded with messages educating children. The findings of the study also show that the themes used in the two novels are influenced by social, economic, political and educational changes and as well as historical factors that occur in Malaysia.

90-Days Outcomes In Patients With Minor Strokes Or Transient Ischemic Attacks Discharged On Single Vs Dual Anti Platelet-Therapy In the Middle East (P7-5.019)

<h3>Objective:</h3> To compare the 90-day outcome in patients with minor stroke (MIS) or transient ischemic attack (TIA) who were discharged on single versus dual anti-platelet therapy after index event in the multiethnic Middle Eastern community. <h3>Background:</h3> Recent studies have shown that dual antiplatelet therapy (DAPT) with clopidogrel and aspirin is effective for secondary prevention after minor ischemic stroke (MIS) or transient ischemic attack (TIA). However, there is paucity of data from middle east regarding role of such intervention and outcome of these patients <h3>Design/Methods:</h3> We inquired all Ischemic stroke and TIA patients from our prospectively collected stroke database admitted since January 2014. We separated them into two groups-discharged on single(SAP) vs DAPT. High risk group for recurrence was defined as patients with ABCD2 score of ≥ 4 or more and NIHSS ≤ 3 at index event. We assessed the outcome as measured with modified Rankin Score (mRS), recurrent ischemic stroke, and other vascular events. <h3>Results:</h3> The data provided yielded 1357 (16.8%) patients with TIAs and 6725 (83.2%) with MIS. Of these only 35% (1481/4219) of high risk patient were discharged on DAPT (38.5% of TIA patients and 30.0% MIS patients). DAPT was initiated within 24 hours of arrival at hospital in 86.3% of patients (p&lt;0.001) with a mean duration of 12.5 ±15.6 hours (p&lt;0.001). Poor outcome (mRS 3–6) (27.9% vs 15.1%, p&lt;0.001), and increased mortality (2.2% vs 1.1%, p&lt;0.001) was more significant in patients discharged on SAP versus DAPT. <h3>Conclusions:</h3> The rates of DAPT in patients with TIA and MIS is low. Patients with high risk TIA and MIS discharged on DAPT has better outcome at 90-days in ethnically diverse group of patients in the Middle East. <b>Disclosure:</b> Ms. Naveed has nothing to disclose. Dr. Akhtar has nothing to disclose. Dr. Shuaib has nothing to disclose. Dr. Al Jerdi has nothing to disclose.

People powered research: what do communities identify as important for happy and healthy children and young people? A multi-disciplinary community research priority setting exercise in the City of Bradford, United Kingdom (UK)

BackgroundInvolving communities in research priority setting can increase the relevance and efficiency of research, leading to better health outcomes. However these exercises often lack clarity in how communities are involved and the extent to which priorities are acted upon is unclear. Seldom-heard groups, for example ethnic minorities may experience barriers to participation. We report methods and outcomes of an inclusive co-produced community research priority setting exercise within the multicultural and deprived city of Bradford, UK. The aim was to identify priorities for keeping children happy and healthy and was undertaken by the Born in Bradford (BiB) research programme to inform future research agendas.MethodsA 12 member multi-disciplinary, multi-ethnic community steering group led the process using a modified James Lind Alliance approach between December 2018-March 2020. Research priorities were collected through a widely distributed paper and online survey. Respondents were asked to list three important things to keep children i) happy, ii) healthy and what needs to change to improve either health or happiness. Free text data were coded iteratively by community researchers, and shared priorities were co-produced in a series of workshops and meetings with the community steering group and community members.ResultsFive hundred eighty-eight respondents to the survey identified 5748 priorities, which were coded into 22 themes. These covered a range of individual, social and wider socioeconomic, environmental and cultural priorities. Diet/nutrition and exercise were most commonly identified as important for health, including what needs to change to improve health. For happiness, home life and family relationships, listening to children, and education/activities were the most commonly identified. Community assets were identified as important to change for both health and happiness. From the survey response the steering group developed 27 research questions. There were mapped onto existing and planned research agendas within BiB.ConclusionsCommunities identified both structural and individual factors as important priorities for health and happiness. We demonstrate how communities can be involved in priority setting using a co-productive approach in the hope this can be used as a model for others. The resulting shared research agenda will shape future research to improve the health of families living in Bradford.

Abstract 1930: Community outreach and engagement to increase colorectal cancer screening in ethnic minority communities

Abstract PURPOSE: Colorectal cancer (CRC) is preventable with screening, yet remains the second leading cause of cancer deaths in the U.S. Nationally, CRC screening substantially declined during the COVID-19 pandemic and is underutilized by ethnic minorities and in safety-net systems. Therefore, City of Hope partnered with Federally Qualified Health Centers (FQHCs) and community and faith-based organizations to improve CRC screening among medically underserved communities. METHODS: Between October 2020 and October 2022, we implemented a multi-component intervention that included community outreach and education (a multi-ethnic multimedia campaign and community training adapted from the NCI Screen2Save (S2S) program) and clinic-based interventions (provider/staff training and patient education). Intervention reach and training participant surveys were assessed. Within our four FQHC sites, we also compared clinic-level CRC screening rates among age-eligible patients before (June 2021) and after implementation of the clinic-based intervention (June 2022). RESULTS: Our reach assessment showed that our multi-ethnic multimedia campaign reached 35.4 million impressions, our S2S education training reached 300 diverse community members, and our provider/staff training reached 150 medical providers. Among the 100 providers surveyed, &amp;gt;80% felt confident they could get their patients to complete their CRC screening test and follow-up care. For the clinic-based intervention component, our baseline sample included 11,259 age-eligible patients across the four FQHC sites. Overall CRC screening rates increased from 45% to 52% before vs. after the intervention implementation period. The site with the highest CRC screening rate (&amp;gt;62%) maintained steady rates over the observation period, whereas three sites with lower baseline rates showed greater pre-post improvements (average 15 percentage-point increase). CONCLUSIONS: An overall increase in CRC screening rates was achieved across FQHCs, despite clinic staffing challenges during the COVID-19 pandemic. Intervention implementation is ongoing with attempts to document individual, clinic improvements by race/ethnicity. Keyword 1: Cancer risk Keyword 2: Cancer detection Citation Format: Kimlin Ashing, Marisela Garcia, Trilokesh Kidambi, Gregory Idos, Sophia Yeung, Charleen Mikail, Magaret Martinez, Scott Kim, Kim Tran, Paul Gregerson, Paul Round, Cherry Lee, Pei-Chi Wu, Nancy Chen, Stephen Denq, Narissa Nonzee. Community outreach and engagement to increase colorectal cancer screening in ethnic minority communities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1930.

"The Rising of the Indians"; or, The Native American Revolution of (16)'76

In 1676, some imperial observers saw a hemispheric "Rising of the Indians" in the Caribbean and North America that threatened the colonial project, a fear largely forgotten today. Applying the heuristic of a widespread Native American revolution of 1676 to King Philip's War, Bacon's Rebellion, the Kalinago wars, and the Pueblo Revolt challenges the ways that historians have framed these events—often as discrete occurrences, often as failures to stave off settler colonialism. A broader chronological and geographic perspective offers a means to reconsider precipitants, results, and Indigenous peoples' goals in resistance. Four common emergent properties—slavery, mobility, the creation of pan-Indian, multiethnic communities, and cultural revitalization—connected these near-simultaneous events across space and shaped their outcomes. While historiography centers the Pueblo Revolt as a uniquely successful rebellion, other Native American groups managed to expel or circumscribe European colonizers' presence and power in the short and long term because of these uprisings. In ways often overlooked by scholars, the Kalinagos, the Wabanakis, the Susquehannocks, and the Haudenosaunee succeeded (at least for a time) alongside southwestern Native nations in maintaining sovereignty and limiting empire, while cultural renewal central to resistance sustained Wampanoag and Narragansett communities through brutal occupation.

MP77-05 PROSTATE CANCER TRENDS AMONG INDIVIDUAL ASIAN AND PACIFIC ISLANDERS (AAPI) POPULATIONS IN HAWAII

You have accessJournal of UrologyCME1 Apr 2023MP77-05 PROSTATE CANCER TRENDS AMONG INDIVIDUAL ASIAN AND PACIFIC ISLANDERS (AAPI) POPULATIONS IN HAWAII Lauren Muramoto, Brenda Hernandez, and Tom Feng Lauren MuramotoLauren Muramoto More articles by this author , Brenda HernandezBrenda Hernandez More articles by this author , and Tom FengTom Feng More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003351.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Asians and Pacific Islanders (AAPIs) are often grouped together as a single racial demographic when reporting prostate cancer trends despite the heterogeneity within this community. Hawaii’s multi-ethnic community poses a unique environment to study the epidemiology of prostate cancer. We examine differences in incidence and mortality of prostate cancer among AAPIs within Hawaii. METHODS: Data were obtained from the Hawaii Tumor Registry Cancer at a Glance 2014-2018 report. All reported rates were age adjusted per 100,000 to the 2000 US standard population. Differences in incidence and mortality rates were compared among the major AAPI groups: Chinese, Filipino, Japanese, and Native Hawaiian. RESULTS: Prostate cancer is the most common cancer diagnosed in men in Hawaii with an incidence of 22.8% and responsible for 9.6% of cancer related deaths from 2014-2018. Incidence rates among the four major AAPI groups were not statistically different (Figure 1a). Despite this, mortality rates were significantly lower in Chinese (5.5 per 100,000) and Japanese (8.7) compared to Filipinos (16.4) and native Hawaiians (21.6, p<0.05, Figure 1b). Native Hawaiians had the lowest incidence rate (80.2) but had the highest mortality rates among Asians (21.6 per 100,000). Filipinos, despite having similar incidence as Chinese and Japanese, had much higher mortality rates (p<0.05) and the highest proportion of advanced prostate cancer 34.7% at diagnosis. CONCLUSIONS: Hawaii’s diversity plays an important role in reporting cancer incidence and mortality among AAPI. Differences could be related to access to care, genetics, education level or lifestyle related exposures. These data support the need to disaggregate AAPI subpopulations to better understand individual prostate cancer risk profiles. Further research is needed to determine these differing factors among AAPI ethnicities affect prostate cancer risk and outcomes. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1103 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lauren Muramoto More articles by this author Brenda Hernandez More articles by this author Tom Feng More articles by this author Expand All Advertisement PDF downloadLoading ...

Examining multilevel influences on parental HPV vaccine hesitancy among multiethnic communities in Los Angeles: a qualitative analysis

BackgroundHuman papillomavirus (HPV) vaccine hesitancy is a growing concern in the United States, yet understudied among racial/ethnic minority parents. We conducted qualitative research to understand parental HPV vaccine hesitancy and inform community-specific, multilevel approaches to improve HPV vaccination among diverse populations in Los Angeles.MethodsWe recruited American Indian/Alaska Native (AI/AN), Hispanic/Latino/a (HL) and Chinese parents of unvaccinated children (9–17 years) from low-HPV vaccine uptake regions in Los Angeles for virtual focus groups (FGs). FGs were conducted in English (2), Mandarin (1), and Spanish (1) between June-August 2021. One English FG was with AI/AN-identifying parents. FGs prompted discussions about vaccine knowledge, sources of information/hesitancy, logistical barriers and interpersonal, healthcare and community interactions regarding HPV vaccination. Guided by the social-ecological model, we identified multilevel emergent themes related to HPV vaccination.ResultsParents (n = 20) in all FGs reported exposure to HPV vaccine information from the internet and other sources, including in-language media (Mandarin) and health care providers (Spanish). All FGs expressed confusion around the vaccine and had encountered HPV vaccine misinformation. FGs experienced challenges navigating relationships with children, providers, and friends/family for HPV vaccine decision-making. At the community-level, historical events contributed to mistrust (e.g., forced community displacement [AI/AN]). At the societal-level, transportation, and work schedules (Spanish, AI/AN) were barriers to vaccination. Medical mistrust contributed to HPV vaccine hesitancy across the analysis levels.ConclusionOur findings highlight the importance of multilevel influences on parental HPV vaccine hesitancy and decision-making and the need for community-specific messaging to combat medical mistrust and other barriers to HPV vaccination among racial/ethnic minority communities.

Law Governance on Cultural Value for Regaining Bandar Senapelan Image as Kampung Melayu: A Review

The rapid development in a space of urban and economic changing shows a big gap in cultural value preservation. Bandar Senapelan with its cultural value consist of both urban and industrial development for Pekanbaru city has its potential to promote a wide range of diversities in occurance and growth of the capital. The history, landscape, even commercial, laid on the land called Bandar Senapelan. Due to its strategic location, attached to Siak River, the district has widely known for its initial born for Pekanbaru city history, diversity in multi ethnic community, and the trade centre for Central Sumatera’s rapid economic growth. The district’s potential and background was to encroaching and humiliating to be ignored. The city regional plan or (RTRW) statute by the government has not mention in detail the necessity of Bandar Senapelan to be a protected cultural site which should be preserve and conserve. There are several article written by law that confusing and need to be re-review. The image of the district as people has known it as Kampung Melayu slowly threatened. This paper will analyse the level of awareness with regard to cultural landscape conservation and protection in Pekanbaru policy from Pekanbaru RTRW statute. The research methodology will be done with qualitative analysis and descriptive method from relevant theory and studies. Both tangible and intangible identification will be reviewed to achieve the worthwile protection for the region to be conducted.