Latinos and Cancer Information: Perspectives of Patients, Health Professionals and Telephone Cancer Information Specialists

Semi-structured interviews were conducted with 16 Latino cancer patients diagnosed in California; 10 health professionals from the San Francisco Bay Area and Fresno, California; and 10 Cancer Information Services (CIS) information specialists from the regional offices handling calls from Spanish-speakers. Interview guides were designed by the investigators to answer three main research questions: 1) How do Latinos obtain information about cancer and what types of information do they access?; 2) What sources of cancer information do they seek out and find credible?; and 3) What are the barriers and facilitators to Latinos obtaining cancer information? Stakeholders generally viewed health professionals as the most credible source of cancer information. All groups regarded family and friends as important sources of information. Patients and health professionals tended to differ on the value of print materials. Although patients found them generally useful, health professionals tended to view them as inadequate for meeting the informational needs of their Latino patients due to the challenge of low health literacy. Health professionals also tended to undervalue internet resources compared to patients and CIS specialists. All stakeholders viewed language, ethnic discordance and the impact on patients of the initial diagnosis as barriers to effective communication of cancer information. Health professionals and CIS specialists, but not patients, mentioned low literacy as a barrier. Our findings underscore the importance of the physician-patient relationship as a point of intervention to address the unmet informational and psychosocial needs of Latino cancer patients

Experimenting with Cigarettes and Physical Activity Among Mexican Origin Youth: A Cross Sectional Analysis of the Interdependent Associations Among Sensation Seeking, Acculturation, and Gender

Sensation seeking tendencies tend to manifest during adolescence and are associated with both health-compromising behaviors and health-enhancing behaviors. The purpose of this study is to evaluate the relationship between sensation seeking and physical activity, a health-enhancing behavior, and between sensation seeking and experimenting with cigarettes, a health compromising-behavior, among a cohort of Mexican origin adolescents residing in the United States with different levels of acculturation. Methods: In 2009, 1,154 Mexican origin youth (50.5% girls, mean age 14.3 years (SD = 1.04)) provided data on smoking behavior, physical activity, linguistic acculturation, and sensation seeking. We conducted Pearson's chi(2) tests to examine the associations between categorical demographic characteristics (i.e. gender, age, country of birth and parental educational attainment) and both cigarette experimentation and physical activity and Student's t-tests to examine mean differences on the continuous variables (i.e. sensation seeking subscale) by the behaviors. We examined mean differences in the demographic characteristics, acculturation, and both behaviors for each of the sensation seeking subscales using analysis of variance (ANOVA). To examine relationships between the sensation seeking subscales, gender, and both behaviors, at different levels of acculturation we completed unconditional logistic regression analyses stratified by level of acculturation. Results: Overall, 23.3% had experimented with cigarettes and 29.0% reported being physically active for at least 60 minutes/day on at least 5 days/week. Experimenting with cigarettes and being physically active were more prevalent among boys than girls. Among girls, higher levels of sensation seeking tendencies were associated with higher levels of acculturation and experimentation with cigarettes, but not with physical activity. Among boys, higher levels of sensation seeking tendencies were associated with higher levels of acculturation, experimenting with cigarettes and being physically active. Conclusions: Our results suggest that interventions designed to prevent smoking among Mexican origin youth may need to address social aspects associated with acculturation, paying close attention to gendered manifestations of sensation seeking.National Cancer Institute CA105203, CA126988Caroline W. Law Fund for Cancer PreventionDan Duncan Family Institute for Cancer Prevention and Risk AssessmentCenter for Health Promotion and Disease Prevention Research in Underserved Population

Asian Americans’ Cancer Information Seeking, Fatalistic Belief, and Perceived Risk: Current Status and Relationships with Cancer Prevention and Detection Behaviors

This study pursues four research goals: (1) to examine Asian Americans and Asian ethnic groups’ (i.e., Chinese, Filipinos, Japanese, Koreans, Vietnamese) information seeking, fatalistic belief, and perceived risk of cancer, in comparison to non-Hispanic Whites; (2) to identify characteristics of Asian Americans who seek cancer information, hold fatalistic cancer belief, and perceive cancer risk; (3) to assess cancer prevention and detection behavior gaps between Asian Americans and Whites, and (4) to explore whether such gaps can be explained by cancer information seeking, fatalistic belief, and perceived risk. Data from 2011-2014 Health Information National Trends Surveys (HINTS) were analyzed. Asian Americans and most Asian ethnic groups were less likely to seek cancer information and perceive their cancer risk as lower than Whites. However, Asian Americans were less likely to hold some fatalistic beliefs (i.e., everything causes cancer, there are too many cancer prevention recommendations) than Whites. Asian Americans’ odds of engaging in breast cancer screening, physical activity, vegetable intake, and sun protection increased when cancer information seeking, fatalistic belief, and perceived risk of cancer were controlled

Use of Internet for General and Dental Health along Acculturation Features in a Sample of Mexican Americans

The objectives of this study were to explore self-reported Internet and electronic platforms used to search for and store medical and dental information among people of Mexican origin. A sample of adults self-identified as European American (250) and as Mexican American (255), residing in Central Indiana, answered a one-time survey that included technology use questions and measured acculturation via the Psychological-Behavioral Acculturation Scale. Overall use of information technologies was estimated through an Information and Communication Technology score. Overall, participants with higher scores searched online for general and oral health information at higher rates than those with lower scores. Younger Mexican Americans and those with higher use scores were more likely to search online for general health information, as were those more psychologically and behaviorally acculturated. Interestingly, Mexican Americans were more likely than European Americans to search online for dental health information. All participants demonstrated high interest in accessing and storing their own health information especially on paper format; storage in other places, such as personal computers, smartphones, or USB flash drives, was less endorsed. Most participants would allow spouses access to their health records; however, there were significant differences between both population groups regarding access given to physicians, dentists and other family members, with Mexican Americans reporting more restrictions. Our findings provide initial information on differential use pattern of electronic health resources among Mexican Americans and suggest that new information technologies reach population groups traditionally underserved; such features may help address disparities in general and dental health

Internet Use for Health Information among American Indians: Facilitators and Inhibitors

Our research team explored Internet use among a heterogeneous American Indian (AI) population to determine Internet use in relation to health information seeking behaviors. Participants examined an AI culturally-tailored tobacco website as an example to explain what they wanted in an AI Internet health site. Using community-based participatory research, we conducted 10 focus groups with non-college AI men and women (N=96), stratified by age (18-29, 30-49, and 50 and over) to better understand their perceptions of Internet use and health information needs. We found that Internet use varied greatly among all strata. Participants referenced WebMD© more than any other website, but participants were not pleased with the design and navigation. When examining the sample website, participants across strata stressed that recreational and traditional tobacco use should be discussed. Participants in all strata desired a simple website design with easy to read text accompanied by images. In order to gain and maintain cultural respect, participants stated that web designers should be aware that some images hold cultural meaning, particularly tobacco. Baseline data are needed for AI’s use of the Internet to obtain health information; this research is helpful to address health inequalities among AI, particularly access to web-based health information

Knowledge and Beliefs about Cancer in African American Population

Cancer is the second most common cause of death in the United States, taking the lives of one in four Americans each year (American Cancer Society [ACS], 2015). A total of 1,658,370 new cancer cases and 589,430 deaths from cancer were projected to occur in the United States in 2015 (ACS, 2015). In 2013, approximately 176,630 new cancer cases and 64,880 deaths from cancer were projected to occur in African American communities. The majority of diagnoses were cancers of the prostate, lung, colon, rectum, breast, and colorectal region (ACS, 2013). For most cancers, African Americans have the highest death rate, and shortest survival rate, of any racial or ethnic sub-groups (ACS, 2013). Individual perception, knowledge, beliefs, and awareness systems can influence the cancer evaluation process and the ability to fight the disease. The health belief model (HBM) is a conceptual framework used to explain an individual’s behavior based on the individual’s belief or perception. This paper reports on an analysis of a sample of self-identified African American respondents to the Health Information National Trends Survey (HINTS) data HINT4 cycle3, to explore an association of African Americans’ knowledge, beliefs and the processes of cancer information-seeking behavior based on the HBM and demographic information. The results showed that African Americans with a higher level of education were significantly more likely to access common sources of cancer information. Perceived benefits and cues-to-action were significantly associated with the common sources of cancer information sought whereas perceived susceptibility, perceived severity, perceived barrier, and self-efficacy were not. African Americans’ perceptions and beliefs of cancer may be enhanced through health education, mass media campaigns, and a wider availability of health information online

Gender Differences in Smoking Among an Urban Emergency Department Sample.

BackgroundUrban emergency department (ED) patients have elevated smoking and substance use compared with the general population. We analyzed gender differences in smoking among an urban ED sample and assessed the contribution of substance use, demographic, and couple factors.MethodsWe conducted a secondary analysis of data obtained from a cross-sectional, observational survey (N = 1037 participants) on drinking, drug use, and intimate partner violence (IPV). Gender-specific logistic regression models for current (past 30-day) smoking and multinomial regression models for smoking intensity (light: ⩽5 cigarettes per day [CPD]; moderate: 6 to 10 CPD; heavier: >10 CPD) were estimated.ResultsSmoking prevalence was higher among men than women (35.5% vs 18.9%; P < .001). Substance use (frequency of intoxication, marijuana, amphetamine, and cocaine use), demographic (food insufficiency, unemployment), and couple-related factors (having a spouse/partner who smoked, IPV involvement, being in a same-gender couple) were differentially associated with current smoking and level of intensity among men and women.ConclusionsEmergency department staff should consider the impact of polysubstance use, food insufficiency, unemployment, and whether both partners in the couple smoke when screening patients for smoking and formulating cessation treatment plans. Women in same-gender relationships and those who have experienced IPV involvement may require additional referral

Online Health Information Seeking Behaviors of Hispanics in New York City

Hispanics are the fastest-growing minority group in the United States, but they are the most underserved population in terms of access to online health information. The specific aims of this descriptive, correlational study were to examine factors associated with online health information seeking behaviors of Hispanics and to examine the association between online health information seeking behaviors and health behaviors. The study sample (n=4,070) was recruited from five zip codes in the Washington Heights/Inwood community of New York City for the Washington Heights Inwood Informatics Infrastructure for Comparative Effectiveness Research project. Survey data were collected via interview by bilingual community health workers in three settings: a community center affiliated with Columbia University, households and other community settings, and New York-Presbyterian Ambulatory Care Network clinics. Data were analyzed using logistic and linear regressions. In regards to survey respondents' situational, sociodemographic, and literacy factors (health literacy, computer literacy) associated with their online health information seeking behaviors and those of their household members, the study found that that worse health status (OR=0.42, p<0.001), lack of hypertension (OR=0.60, p<0.01), a high level of education (OR=3.04, p<0.001), and computer literacy (OR=3.78, p < 0.001) were positively associated with respondents online health information seeking behaviors. Health literacy was only positively associated (OR=2.13, p<0.001) in a subsample of respondents (n=2,680) in which it was measured by one item related to understanding written health information. Respondents' factors significantly associated with online health information seeking by household members were: female gender (OR=1.60, p<0.01), younger age (OR=0.75, p<0.01), married (OR=1.36, p<0.01), higher education (OR=1.80, p<0.001), higher computer literacy (OR=2.24, p<0.001), in worse health status (OR=0.592, p<0.001), and presence of serious health problems (OR=1.83, p<0.01). Controlling for factors found to be significant in Aim 1, respondents' online health information seeking behaviors were hypothesized to be positively associated with fruit consumption, vegetable consumption, physical activity, and hypertension medication adherence and negatively associated with alcohol consumption. Hypotheses related to fruit consumption (p<0.05), vegetable consumption (p<0.05), and physical activity (p<0.01) were supported. This study contributes to the understanding of Hispanics' online health information seeking behaviors and provides the foundation for informatics and public health interventions

Race, Online Health Resources and their Contribution to Health Disparities

With increasing usage of the Internet for a variety of activities, including health information seeking, there is opportunity for the technology to have a pivotal impact on reducing health disparities. Using a Fundamental Causes framework (Link and Phelan 1997), this thesis explores whether or not Internet usage for health information seeking reduces racial health disparities. Using data from the Pew Research Center this study examined active and passive health information seeking and the impact they have on health outcomes among blacks, whites, and Hispanics. The health conditions included self-rated health, high blood pressure, diabetes, lung disease, and heart disease. The results indicate participating in active or passive health information seeking had little or no impact on decreasing the chronic health conditions. Additionally, the results show participating in active or passive health seeking activities has a mixed impact on decreasing chronic health conditions across racial groups

Correlates of Sun Protection Behaviors in Racially and Ethnically Diverse U.S. Adults

Although skin cancer incidence is highest among non-Hispanic Whites, minority populations are often diagnosed with more advanced stage disease and are more likely to experience poor outcomes. Fewer people of color do not practice primary prevention of skin cancer according to recommendations, but public health education and interventions to promote sun protection behaviors have consistently targeted non-Hispanic Whites. This study examines performance of sun protection behaviors in a multiethnic sample and whether demographic, lifestyle and psychosocial predictors of these behaviors differ by race and ethnicity. In this study, a probability-based sample of 1742 adults completed an online survey in 2015. Main outcomes of interest included sunscreen use, wearing a sleeved shirt, and seeking shade. We stratified the sample into racial/ethnic groups (White, Black, Hispanic, Asian) and investigated demographic, lifestyle and psychosocial correlates of these behaviors in each group. Differences in adjusted estimates from each behavior-specific model were tested across strata. Racial/ethnic groups were significantly different in regards to sunscreen use and wearing a sleeved shirt, but similarly engaged in seeking shade. Results from multivariate ordered logistic regression models for each behavior revealed important demographic, lifestyle and psychosocial predictors and the importance of some demographic correlates varied between racial/ethnic groups. This study provides insight into the practice and correlates of skin cancer prevention among a multiethnic sample. Our findings suggest that targeting public health education efforts and interventions to promote sun protection in minority populations may be a beneficial approach to addressing heightened skin cancer morbidity and mortality in these groups