American Indian Youth: A Residential Camp Program for Wellness

The American Indian Youth Summer Wellness Camp strives to increase physical activity and healthful eating among at-risk southwest American Indian youth. The Wellness Camp is one week in duration and involves youth, aged 10-15 years. Youth who attend camp are self-selected or referred by local tribal health programs. In any given summer, 35-60 youth attend camp. Approximately 20%-33% of youth return from one year to the next. We describe our program to increase healthy lifestyles among American Indian youth at risk for overweight, obesity, diabetes and cardiovascular disease. The Wellness Camp Program includes five primary components: (1) cultural capital, (2) structured education sessions, (3) anthropometric and risk behavior assessments, (4) physical engagement, and (5) health messaging. Within this article, we describe our program to increase healthy lifestyles among American Indian youth at risk for overweight, obesity, diabetes and cardiovascular disease

Anthropometric discriminators of type 2 diabetes among White and Black American adults

BACKGROUND: The aim of the present study was to determine the best anthropometric discriminators of type 2 diabetes mellitus (T2DM) among White and Black males and females in a large US sample. METHODS: We used Atherosclerosis Risk in Communities study baseline data (1987–89) from 15 242 participants (1827 with T2DM) aged 45–65 years. Anthropometric measures included a body shape index (ABSI), body adiposity index (BAI), body mass index, waist circumference (WC), waist:height ratio (WHtR), and waist:hip ratio (WHR). All anthropometric measures were standardized to Z-scores. Using logistic regression, odds ratios for T2DM were adjusted for age, physical activity, and family history of T2DM. The Akaike information criterion and receiver operating characteristic C-statistic were used to select the best-fit models. RESULTS: Body mass index, WC, WHtR, and WHR were comparable discriminators of T2DM among White and Black males, and were superior to ABSI and BAI in predicting T2DM (P < 0.0001). Waist circumference, WHtR, and WHR were the best discriminators among White females, whereas WHR was the best discriminator among Black females. The ABSI was the poorest discriminator of T2DM for all race–gender groups except Black females. Anthropometric values distinguishing T2DM cases from non-cases were lower for Black than White adults. CONCLUSIONS: Anthropometric measures that included WC, either alone or relative to height (WHtR) or hip circumference (WHR), were the strongest discriminators of T2DM across race–gender groups. Body mass index was a comparable discriminator to WC, WHtR, and WHR among males, but not females

Utilizing Environmental Analytical Chemistry to Establish Culturally Appropriate Community Partnerships

In the United States, minority communities are disproportionately exposed to environmental contaminants due to a combination of historically discriminatory based racial policies and a lack of social political capital. American Indian/Alaska Native (AI/AN) communities have additional factors that increase the likelihood of contaminant exposure. Some of these factors include the disparity of social, cultural, and political representation, differences in cultural understandings between AI/AN communities and western populations, and the unique history of tribal sovereignty in the US. Since the 1990s, research from both private and federal organizations have sought to increase research with AI/AN communities. However, although rooted in beneficence, the rift in cultural upbringing can lead to negative outcomes as well as further isolation and misrepresentation of AI/AN communities. Environmental analytical chemistry (EAC) is one approach that provides a means to establish productive and culturally appropriate collaborations with AI/AN populations. EAC is a more holistic approach that incorporates numerous elements and disciplines to understand underlying environmental questions, while allowing direct input from AI/AN communities. Additionally, EAC allows for a myriad of experimental approaches that can be designed for each unique tribal community, to maintain cultural respect and probe individual nuanced questions

Describing a Public-health Summer Camp for Underserved Children: Healthy 2B Me

Healthy 2B Me aims to educate and empower underserved children ages seven to 11 years old to improve their health and well-being through a supportive, educational and entertaining public health-themed summer day camp. Qualitative data collected through camper exit slips, final posters/presentations, and parent surveys were analyzed to identify salient themes demonstrating the impact of camp participation on children's health. Both camper and parent responses suggested improvements in participant knowledge, attitude and behavior in relation to diet, physical activity, sun safety, hand washing, smoking and kindness. This article describes how the Healthy 2B Me camp contributes to our understanding of how to design and assess a health-themed, positive youth-development summer camp for underserved children.18 month embargo; published online: 04 Apr 2019This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Usual Dietary Intake and Adherence to Dietary Recommendations among Southwest American-Indian Youths at Risk of Type 2 Diabetes

A total of six 24-h dietary recalls were conducted in person with American-Indian youths (aged 10-15 y; n = 26) from 3 different Southwest tribes. Three recalls were conducted before the wellness camp, and 3 were conducted after the camp. A series of 2-factor ANOVA were conducted, using a mixed model, to compare the nutrition differences before and after the health camp using a statistical program, R.Arizona Area Health Education Centers Program Career Development Award; Arizona Cancer Center Health Disparities Program; Association on American Indian Affairs; Diabetes Action Research and Education Foundation; Marin Community Foundation; Mayo Clinic Spirit of EAGLESOpen access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Patterns of Cancer Related Health Disparities in Arizona

Cancer incidence rates vary regionally among American Indians (AIs) and Latinos. &nbsp;The goal of this was to identify areas of research necessary to reduce cancer health disparities in AIs and Latinos, the two major racial/ethnic minority groups in Arizona.&nbsp; In an effort to better understand cancer health disparities, cancer incidence rates in AIs and Latinos in Arizona were compared to non-Hispanic Whites (NHWs).&nbsp; Age-adjusted incidence rates (per 100,000) were obtained from the Arizona Cancer Registry and the North American Association of Central Cancer Registries.&nbsp; Spearman’s rank test was used to examine correlation between county-level cancer incidence rates and socio-demographic factors.&nbsp; AIs and Latinos had lower incidence rates of screening for detectable cancers than NHWs.&nbsp; Among older men (age ≥65), however, AIs and Latinos had similar prostate cancer incidence rates to NHWs.&nbsp; Some of less common cancers, such as kidney, stomach, liver, and gallbladder, were more frequently diagnosed in AIs and Latinos than NHWs.&nbsp; AIs and Latinos were more likely to be diagnosed with advanced cancer stage, except for cervical cancer.&nbsp; Correlations between prostate and breast cancer incidence rates and percent urban residents as well as population size were significantly positive.&nbsp; Poverty levels were inversely correlated with colorectal and lung cancer incidence rates.&nbsp; Our review of cancer incidence rates suggests that socio-demographic factors, such as population size (rural/urban) and poverty levels, have influenced cancer detection and incidence rates in Arizona.&nbsp

NACP: Partnership for Native American Cancer Prevention

Cancer trends over a two-decade period show a greater reduction in cancer mortality rates for non-Hispanic Whites than for Native Americans. The Partnership for Native American Cancer Prevention (NACP) was established to address cancer health disparities that impact Native Americans. The partners are Northern Arizona University, the University of Arizona Cancer Center and Arizona’s tribal communities. The activities include outreach, research and cancer education. Overall, NACP seeks to expand capacity for culturally-sensitive and community-relevant research on cancer, and to continue developing respectful collaborations that will empower sovereign Native American communities to define, implement, and achieve their goals for cancer health equity

Racial/ethnic disparities in renal cell carcinoma: Increased risk of early-onset and variation in histologic subtypes

Background Racial/ethnic minority groups have a higher burden of renal cell carcinoma (RCC), but RCC among Hispanic Americans (HAs) and American Indians and Alaska Natives (AIs/ANs) are clinically not well characterized. We explored variations in age at diagnosis and frequencies of RCC histologic subtypes across racial/ethnic groups and Hispanic subgroups using National Cancer Database (NCDB) and Arizona Cancer Registry Data. Methods Adult RCC cases with known race/ethnicity were included. Logistic regression analysis was performed to estimate odds and 95% confidence interval (CI) of early-onset (age at diagnosis <50 years) and diagnosis with clear cell RCC (ccRCC) or papillary RCC. Results A total of 405 073 RCC cases from NCDB and 9751 cases from ACR were identified and included. In both datasets, patients from racial/ethnic minority groups had a younger age at diagnosis than non-Hispanic White (NHW) patients. In the NCDB, AIs/ANs had twofold increased odds (OR, 2.21; 95% CI, 1.88-2.59) of early-onset RCC compared with NHWs. HAs also had twofold increased odds of early-onset RCC (OR, 2.14; 95% CI, 1.79-2.55) in the ACR. In NCDB, ccRCC was more prevalent in AIs (86.3%) and Mexican Americans (83.5%) than NHWs (72.5%). AIs/ANs had twofold increased odds of diagnosis with ccRCC (OR, 2.18; 95% CI, 1.85-2.58) in the NCDB, but the association was stronger in the ACR (OR, 2.83; 95% CI, 2.08-3.85). Similarly, Mexican Americans had significantly increased odds of diagnosis with ccRCC (OR, 2.00; 95% CI, 1.78-2.23) in the NCDB. Conclusions This study reports younger age at diagnosis and higher frequencies of ccRCC histologic subtype in AIs/ANs and Hispanic subgroups. These variations across racial/ethnic groups and Hispanic subgroups may have potential clinical implications.Urology Care Foundation; National Cancer Institute Cancer CenterUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Cancer Institute (NCI) [P30CA023074]; Partnership for Native American Cancer Prevention (NACP) [U54CA143924, U54CA143925]Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Racial and Ethnic Disparities in Renal Cell Carcinoma: An Analysis of Clinical Characteristics

Racial/ethnic minority groups, including Hispanic Americans (HAs) and Native Americans (NAs), have a heavier burden of kidney cancer than European Americans (EAs). We investigated variations in clinical characteristics of HA and NA patients with renal cell carcinoma (RCC) who were previously underrepresented. Clinical records of 294 patients with RCC (151 EAs, 95 HAs, 22 NAs, and 26 others) without prior diagnosis of cancer were reviewed. Logistic regression analysis was performed to understand patients' clinical characteristics. HAs had about 5 years younger average age at diagnosis than EAs (55.8 vs. 60.5 years) and an almost 3-fold increased odds of diagnosis before age 50 years (odds ratio [OR], 2.77; 95% confidence interval [CI], 1.39-5.54). The mean age of diagnosis among NAs was 49.7 years, and NAs had an over 6-fold higher odds of diagnosis at a younger age (OR, 6.23; 95% CI, 2.00-19.46). Clear-cell RCC (ccRCC) was more common in HAs and NAs than EAs. Over 90% of HA patients had ccRCC, whereas only 78.8% of EA patients had ccRCC. HAs had increased odds of diagnosis with ccRCC compared with EAs (OR, 2.79; 95% CI, 1.15-6.80). Among HAs, older patients and patients who spoke Spanish as their primary language were more likely to have advanced stage RCC at diagnosis (OR, 10.48; 95% CI, 1.69-64.89 and OR, 4.61; 95% CI, 1.38-15.40). HA and NA patients with RCC had different clinical characteristics than EA patients. It is necessary to better understand the clinical characteristics of these underserved HA and NA populations with high kidney cancer burden.Open access articleThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]