Advantages, Disadvantages, and Lessons Learned in Conducting Telephone Focus Groups to Discuss Biospecimen Research Concerns of Individuals Genetically at Risk for Cancer

Advances in telecommunication technology allow biomedical researchers to explore new, inexpensive opportunities for conducting focus group research. This article reports our experiences using such technology to engage individuals genetically at risk for cancer about biospecimen research. Telephone-based focus groups were conducted with a total of 40 individuals, and participants were asked about their experiences and perceived benefits and limitations of participating in a telephone focus group about biospecimen research. The lessons learned can effectively be applied to other areas of health research. In particular, this method may be most useful to engage individuals who are less apt to speak in public, and/or when there are concerns over privacy if face-to-face discussions methods are used

Acculturation, Body Mass Index, Waist Circumference, and Physical Activity in Mexican Origin Women

Purpose: Longer time in the United States (US) is associated with increased risk of obesity in Hispanic immigrants, particularly for women. Although previous research has established an association between nutrition and acculturation, little attention has focused on physical activity. In this study, we examine the associations between acculturation on Mexican origin women’s body mass index (BMI), waist circumference (WC), and report of moderate to vigorous physical activity (MVPA). Method: Mexican origin women ≥18 years (n=120) from South Carolina (n=60) and Texas Lower Rio Grande Valley (n=60) completed a survey and anthropometric measures. Participants reported MVPA in hours per week, country of birth, age at migration (\u3c16\u3eyears, 16-25 years, and ≥26 years), and language use. Using these latter two as indicators of acculturation, we evaluated associations between acculturation and BMI, WC, and MVPA. Results: Age standardized means for BMI indicated lowest BMI and waist circumference measures among women either with middle-range English language proficiency or who had immigrated to the US between the ages of 16-25; however, the relationship with BMI was more robust. Age standardized means for MVPA show that women who migrated at younger ages (\u3c16\u3eyears) had the lowest MVPA levels, followed by those migrating as younger adults (16-25 years), then adults (≥26 years). Similarly, women with lowest English proficiency levels had the lowest reported MVPA and those with highest English proficiency had highest reported MVPA. Conclusions: The relationship between acculturation and obesity and MVPA is multifaceted. While the relationship between MVPA and the two indicators of acculturation appear to be linear, the direction of association varied by acculturation indicator. Moreover, the association with acculturation indicators and measures of obesity was not linear. The findings from this study have implications in how researchers interpret the relationship between acculturation, obesity and obesity risk factors

Rural Americans’ COVID-19 Vaccine Perceptions and Willingness to Vaccinate against COVID-19 with Their Community Pharmacists: An Exploratory Study

In early 2022 in the U.S., rural adults were the least likely to vaccinate against COVID-19 due to vaccine hesitancy and reduced healthcare access. This study explored the factors influencing rural adults’ COVID-19 vaccine perceptions and their acceptance of pharmacist-administered vaccination. We utilized phone-based semi-structured interviews with 30 adults living in rural regions of one southwestern state and analyzed the data using a team-based thematic analysis approach. Vaccine-willing participants described knowing other people affected by the virus and their desired protection from the virus. They reported trusting scientific institutions and the government to provide safe vaccines. Vaccine-hesitant populations, however, feared that the COVID-19 vaccine development process had been rushed, compromising the safety of these newer vaccines. Although they differed in the news sources they preferred for receiving COVID-19 vaccine information, both vaccine-willing and vaccine-hesitant participants described trusting local authorities, such as healthcare providers and county government officials, to provide accurate COVID-19 vaccine information. Regarding the acceptability of pharmacist-administered COVID-19 vaccinations, all but one participant described their acceptance of this healthcare delivery approach. Future outreach should leverage rural adults’ trust in local sources, including community pharmacists, deemed more convenient access points to healthcare, when addressing vaccine hesitancy

Human Papillomavirus Vaccine Awareness Among HIV-Positive Gay and Bisexual Men: A Qualitative Study

Purpose: This study explores HIV-positive gay and bisexual men's (GBM) understanding of human papillomavirus (HPV) and the HPV vaccine. Methods: Researchers conducted 15 in-depth interviews with HIV-positive GBM between the ages of 18–30 years old. Results: Two participants had received a single dose of the HPV vaccine. Otherwise, the majority of participants had either never heard of the HPV vaccine or they perceived it as a resource for women only. Other commonly cited barriers to getting the vaccine included lack of provider recommendation to complete the vaccine series and vaccine costs. Conclusions: Future provider-driven interventions should focus on increasing HPV vaccine among age-eligible HIV-positive GBM

Anal Cancer Prevention Perspectives Among Foreign-Born Latino HIV-Infected Gay and Bisexual Men

This study explores understanding of primary and secondary prevention of anal cancer among human immunodeficiency virus (HIV)-infected foreign-born Latino gay and bisexual men (GBM). Between August 2015 and December 2016, researchers conducted 33 in-depth, semi-structured interviews with HIV-infected foreign-born Latino GBM. Interview questions sought to determine participants' knowledge and perceived barriers and facilitators to primary and secondary prevention of anal cancer. Researchers analyzed interview transcripts using a qualitative content analysis approach. For primary prevention, men reported a lack of knowledge about the human papillomavirus (HPV) vaccine. However, for secondary prevention, roughly 60% of participants had previously screened for anal dysplasia via anal Papanicolaou (Pap) smear. However, participants reported willingness to screen, and provider recommendation was the most common screening facilitator. Men reported stigma related to their HIV status, sexual orientation, and anal Pap smear procedures as anal cancer screening barriers. Participants reported willingness to use a self-screening anal Pap smear test if it was commercially available. Health providers continue to be the leading source of health information. Therefore, provider recommendation for HPV vaccination and anal cancer screening among age-eligible foreign-born Latino HIV-infected GBM is critical. More work is needed to destigmatize HIV and sexual orientation to influence positive health behaviors among this population. Future intervention research could test the effects of provider-led interventions and also media campaigns aimed at influencing HPV vaccine uptake and anal cancer screening among this population

Rural Americans’ COVID-19 Vaccine Perceptions and Willingness to Vaccinate against COVID-19 with Their Community Pharmacists: An Exploratory Study

In early 2022 in the U.S., rural adults were the least likely to vaccinate against COVID-19 due to vaccine hesitancy and reduced healthcare access. This study explored the factors influencing rural adults’ COVID-19 vaccine perceptions and their acceptance of pharmacist-administered vaccination. We utilized phone-based semi-structured interviews with 30 adults living in rural regions of one southwestern state and analyzed the data using a team-based thematic analysis approach. Vaccine-willing participants described knowing other people affected by the virus and their desired protection from the virus. They reported trusting scientific institutions and the government to provide safe vaccines. Vaccine-hesitant populations, however, feared that the COVID-19 vaccine development process had been rushed, compromising the safety of these newer vaccines. Although they differed in the news sources they preferred for receiving COVID-19 vaccine information, both vaccine-willing and vaccine-hesitant participants described trusting local authorities, such as healthcare providers and county government officials, to provide accurate COVID-19 vaccine information. Regarding the acceptability of pharmacist-administered COVID-19 vaccinations, all but one participant described their acceptance of this healthcare delivery approach. Future outreach should leverage rural adults’ trust in local sources, including community pharmacists, deemed more convenient access points to healthcare, when addressing vaccine hesitancy

Sustainability of promotora initiatives: Program planners’ perspectives

The use of promotoras de salud is an increasingly widespread delivery approach for community-based health education and promotion programs targeting obesity-related lifestyle behaviors for Hispanic populations. Addressing a gap in the literature, this research examined the sustainability of promotora -led initiatives from the perspectives of those who plan, implement, and evaluate these programs. We conducted 24 in-depth interviews with program planners representing 22 promotora programs focused on Hispanic women’s health in ten states. Findings illustrated program planners’ opinions regarding the components, logistics, and barriers to promotora program sustainability. Several participants challenged the notion of promotora program sustainability by reframing the issue as promoting individual promotoras’ well-being and social mobility rather than maintaining their role in the program over time. Implications for community health planning, management, and policy include developing sustainability strategies during program planning stages and implementation of policies to more effectively integrate promotoras into existing healthcare systems at local, state, and national levels

Promotoras de Salud: roles, responsibilities, and contributions in a multisite community-based randomized controlled trial

There is widespread recognition of the cultural and linguistic appropriateness of (a Spanish term for community health workers [CHW]) in health education and outreach among Hispanic communities. Yet, there are significant gaps in the literature regarding the preparation, implementation, and evaluation of ' engagement in research. To address this gap, we examine ' research-related training, roles, responsibilities, and contributions in a community-based participatory research project involving a multisite randomized controlled trial (RCT) of a physical activity intervention for Mexican-origin women in Texas and South Carolina. We identify both benefits and challenges associated with ' engagement as community researchers; examine variations and differences in roles and responsibilities related to the research contexts, sites, settings, and individual characteristics; and discuss implications for research and practice

Program planners' perspectives of promotora

OBJECTIVE: Program planners work with promotoras (the Spanish term for female community health workers) to reduce health disparities among underserved populations. Based on the Role-Outcomes Linkage Evaluation Model for Community Health Workers (ROLES) conceptual model, we explored how program planners conceptualized the promotora role and the approaches and strategies they used to recruit, select, and sustain promotoras. DESIGN: We conducted semi-structured, in-depth interviews with a purposive convenience sample of 24 program planners, program coordinators, promotora recruiters, research principal investigators, and other individuals who worked closely with promotoras on United States-based health programs for Hispanic women (ages 18 and older). RESULTS: Planners conceptualized the promotora role based on their personal experiences and their understanding of the underlying philosophical tenets of the promotora approach. Recruitment and selection methods reflected planners’ conceptualizations and experiences of promotoras as paid staff or volunteers. Participants described a variety of program planning and implementation methods. They focused on sustainability of the programs, the intended health behavior changes or activities, and the individual promotoras. CONCLUSION: To strengthen health programs employing the promotora delivery model, job descriptions should delineate role expectations and boundaries and better guide promotora evaluations. We suggest including additional components such as information on funding sources, program type and delivery, and sustainability outcomes to enhance the ROLES conceptual model. The expanded model can be used to guide program planners in the planning, implementing, and evaluating of promotora health programs

Discussion of First-Degree Relatives’ Colorectal Cancer Risk: Survivors’ Perspectives

Although screening reduces colorectal cancer (CRC) incidence and mortality, screening rates are low, particularly among CRC patients' first-degree relatives (FDRs). Little is known about discussion of family members' risk of CRC among patients and their health care providers or with their FDRs. The purpose of this research, guided by the Protection Motivation Theory, was to assess patients' patterns of disclosure of CRC diagnosis to adult siblings and/or children and discussion of familial risk by healthcare providers. A cross-sectional sample of patients who received care at a comprehensive cancer center was recruited to complete telephone-based interviews related to disclosure of CRC diagnosis to FDRs, recall of physician counseling about familial risk, and patients' perception of CRC risk to FDRs. Sixty-nine patients completed the interview. Most participants (n = 67, 97%) had informed their adult children or siblings of their CRC diagnosis to keep their family informed of their health status (n = 15, 22%) and to encourage FDRs to screen for CRC (n = 14, 20%). More than half of the participants' physicians (n = 38, 55%) discussed FDRs' risk of developing CRC with the patient. However, a substantial proportion of patients reported no physician discussion of this risk (n = 28, 41%). Data from this study may guide the development of interventions to facilitate physician discussion and counseling of CRC patients about their FDRs' risk for CRC. However, future studies should explore whether FDRs are likely to be screened after becoming aware of their family member's diagnosis of CRC