Reservations to Participate in Biospecimen Research among Pacific Islanders

Background and Significance: Despite high rates of chronic diseases like cancer, diabetes and cardiovascular disease, Pacific Islanders (PIs) are underrepresented in clinical and genetic studies designed to identify the physiological causes of poor health outcomes. There are limited genetic data and biospecimen samples from PIs under study. This paper described why PIs have reservations about donating their biospecimen samples for research. Methods: Data were drawn from a pilot study designed to assess the knowledge, attitudes and beliefs surrounding biospecimen research among PIs in southern California. Utilizing a community-based participatory research approach, community and academic partners collected quantitative and qualitative data from a total of 60 PI adults with a mean age of 61 years (SD 13 years). Results: “Fear”, “God or Spirituality” and “Lack of Information or Knowledge” were the most cited reasons for not participating in biospecimen research. Respondents younger than age 65 years expressed more concerns about donating their biospecimen samples than those older than age 65 years (p<0.012). No significant gender differences were found (p=0.84). Conclusion: Our results emphasize the need to conduct relevant and appropriate biospecimen education among minority communities in order to address misconceptions and build support to increase PI and other minority participation in biospecimen-related studies

Time delays in the diagnosis and treatment of malaria in non-endemic countries: a systematic review

Background Delays in diagnosis and treatment for malaria are associated with an increased risk for severe disease and mortality. Identifying the extent of patient and health system delay can provide a benchmark against which interventions to reduce delays can be measured. Methods We performed an electronic search in PubMed, EMBASE, Web of Science and LILACS for studies reporting time to diagnosis and treatment after return from travel, onset of symptoms and seeking healthcare in non-endemic countries. Additionally, theses, conference proceedings and nationally reported surveillance data were also searched for information on time delays. There were no language restrictions and all the studies were assessed for methodological quality. Results Data from 69 papers out of 1719 identified records published between 2005 and 2017 were extracted; our findings show that median diagnosis delays of four or more days are common and patient delays accounted for a large proportion of diagnostic delay. There were limited data available on medical diagnostic delay. Conclusion Patient delays accounted for a large proportion of the overall diagnostic delay; however the retrospective nature of the studies could have overestimated patient delay since previous healthcare contacts were not included. Additionally, the high frequency of studies reporting a clinically significant delay is a major concern

Community Commentary: Cultural Considerations for Breast and Cervical Cancer Education among Marshallese Women in the Continental U.S.

The Marshallese community of Orange County California is a part of a highly mobile population that migrates between Hawai‘i, Arkansas, Washington, and California. In Orange County, the Marshallese community is primarily centered on faith-based organization in the city of Costa Mesa. Culture and language strengthen the bonds between different Marshallese communities across the U.S., and churches serve as conduits for communication between groups. Culture also places an important role in guiding behavior pertaining to health and social interaction. For instance, as in many other cultures, Marshallese men and women do not speak to each other about health, particularly reproductive health, in an open social setting. In Orange County, one female Marshallese health educator promotes breast and cervical cancer screening by talking informally with women, usually in faith-based settings and in-home visits. This community commentary describes the key cultural considerations and strategies used by the health educator to reach and educate the community

Balancing community and university aims in community-based participatory research: a Pacific Islander youth study.

BackgroundCommunity-based participatory research (CBPR) holds the promise of improving the planning, conduct, and long-term translation of research findings into community settings.ObjectivesThis 2-year, exploratory study applied CBPR structures and processes to the identification of individual, cultural and community factors associated with obesity among Pacific Islander (PI) youth in Southern California.MethodsWe describe the CBPR principles and strategies used by a community-university partnership to develop, implement, and report on the findings from assessments of obesity, physical activity, and nutritional intake among PI youth.ResultsAlthough CBPR planning processes led to successes in community-based youth recruitment and retention, we learned key lessons regarding implementation of tailored assessment protocols, often involving problems arising from the university side of the CBPR collaborative.ConclusionCBPR has its strengths and limits; more studies are needed that report on processes to increase our understanding of how to balance research rigor with community sustainability