Upward Communication About Cancer Screening—Adolescent Daughter to Mother

Substantial breast and cervical cancer disparities exist in the United States, particularly among African American women with low social economic status. There is considerable potential for discussions about cancer prevention between mothers and daughters. However, upward communication, from child to parent, remains a relatively novel research area, and it remains unclear how receptive mothers would be to messages from their daughter about cancer, a topic that may be considered culturally inappropriate for daughters to initiate. In this study, we simulated cancer message delivery to daughters and then conducted direct observation of daughters as they recalled and shared the message with their mother or female elder. We found that daughters were able to successfully recall and deliver a cancer appeal to their mother and mothers were generally receptive to this message. Not only did mothers listen to their daughters’ appeals, but also daughters’ knowledge of cancer was considerably improved by the opportunity to educate her female elder. Moreover, daughters’ nonverbal communication suggested a surprisingly relaxed demeanor. The potential of young people to impact the screening behavior of their female elders is very promising in terms of reducing cancer disparities

Lifestyle risk factor related disparities in oral cancer examination in the U.S: a population-based cross-sectional study

Background: Oral cancers account for 3% of annual U.S. cancer diagnosis, 2 in 5 of which are diagnosed late when prognosis is poor. The purpose of this study was to report the population-level prevalence of oral cancer examination among adult smokers and alcohol drinkers and assess if these modifiable lifestyle factors are associated with receiving an oral cancer examination. Methods: Adult participants ≥30 years (n = 9374) of the 2013–2016 cycles of the National Health and Nutrition Examination Survey were included. Oral cancer examination (yes/no), smoking (never, former, current) and alcohol use (abstainers, former, current) were self-reported. Survey-logistic regression estimated odds ratios (OR) and 95% confidence intervals (CIs) of ever and past year oral cancer examination adjusted for age, gender, race/ethnicity, education, income, and time since last dental visit. Results: One third (33%) reported ever been examined for oral cancer, 66% of whom reported an examination in the past year. Adjusted OR (95% CI) of past year examination comparing current and former smokers to non-smokers were 0.51 (0.29, 0.88) and 0.74 (0.53, 1.04) respectively. Similarly, current and former alcohol drinkers relative to abstainers were less likely to report a past year oral cancer examination, OR (95% CI) = 0.84 (0.53, 1.30) and 0.50 (0.30, 0.83) respectively. Conclusion: This study showed that smokers and alcohol users were less likely than abstainers to self-report a past year oral cancer examination. Access to affordable and targeted oral cancer examination within the dental care setting might ensure that these high-risk individuals get timely examinations and earlier diagnosis that might improve prognosis and survival

Factors Distinguishing Positive Deviance Among Low-Income African American Women: A Qualitative Study on Infant Feeding

Background: Positive deviant individuals practice beneficial behaviors in spite of having qualities characterizing them as high risk for unhealthy behaviors. Objective: This study aimed to identify and understand factors distinguishing low-income African American women who breastfeed the longest (positive deviants) from those who breastfeed for a shorter duration or do not breastfeed. Methods: Seven mini-focus groups on infant-feeding attitudes and experiences were conducted with 25 low-income African American women, grouped by infant-feeding practice. Positive deviants, who had breastfed for 4 months or more, were compared with formula-feeding participants who had only formula fed their babies and short-term breastfeeding participants who had breastfed for 3 months or less. Results: Positive deviant women had more schooling, higher income, breastfeeding intention, positive breastfeeding and unfavorable formula-feeding attitudes, higher self-efficacy, positive hospital and Special Supplemental Nutrition Program for Women, Infants, and Children experiences, more exclusive breastfeeding, and greater comfort breastfeeding in public. Short-term breastfeeding women varied in breastfeeding intention and self-efficacy, seemed to receive insufficient professional breastfeeding support, and supplemented breastfeeding with formula. Some showed ambivalence, concern with unhealthy behaviors, and discomfort with breastfeeding in public. Formula-feeding women intended to formula feed, feared breastfeeding, thought their behaviors were incompatible with breastfeeding, were comfortable with and found formula convenient, and received strong support to formula feed. Conclusion: Tapping into the strengths of positive deviants; tailoring interventions to levels of general and breastfeeding self-efficacy; increasing social, institutional, and community supports; and removing inappropriate formula promotion may offer promising strategies to increase breastfeeding among low-income African American women

Community-Based Participatory Research and Sustainability: The Petersburg Wellness Consortium

The principle and practice of sustainability is critical in community-based participatory research. Actively planning for and building community capacity to ensure sustainability is even more critical in research involving underserved populations and underrepresented minorities. The perception of researchers engaging with the community until their research needs have been met, then leaving the community with minimal, if any benefits, has all too often been the reality in these communities. This paper offers a case study of how an independent community consortium was borne from an academic/community research partnership in Petersburg, Virginia. We discuss lessons learned and practice implications as we describe the evolution of, and challenges associated with, cultivating a sustainable independent coalition

A Scoping Review of the Roles, Training, and Impact of Community Health Workers in Oral Health Supplemental Tables

Objective: To synthesize English or Spanish-language literature on community health workers’ (CHWs’) roles, training, and impact in oral health. Basic research design: A scoping review conducted in accordance with the Arksey and O’Malley (2005) methodological framework. Method: Electronic literature searches were conducted in Medline (Ovid), Embase (Ovid), DOSS, CINAHL, Web of Science, and Global Health CAB from inception of the databases to April 2020. Three reviewers independently conducted the title and abstract and full-text reviews. This was followed by data charting by three reviewers and data summarizing by two reviewers. Results: Out of the 36 articles that met the inclusion criteria, most took place in the United States (n=15) with most published between 2012 and 2019 (12). CHWs were incorporated in programs that focused on access to dental care (n=10), oral health promotion only (9), early childhood caries (8), oral health promotion and services (5), and oral cancer screening (4). Common roles included providing oral health education and behavior change motivation to community members, facilitating utilization of dental services, and the delivery of diagnostic and dental services to community members. Training and outcomes were not consistently described across studies. Conclusion: CHWs have been used in oral health programs and interventions across a wide range of locations and contexts. The implementation and scaling-up of oral health CHW programs requires appropriate provision of training as well as community embedded monitoring and evaluation structures based on rigorous methods with clearly defined outcomes

Genetic effects on gene expression across human tissues

Characterization of the molecular function of the human genome and its variation across individuals is essential for identifying the cellular mechanisms that underlie human genetic traits and diseases. The Genotype-Tissue Expression (GTEx) project aims to characterize variation in gene expression levels across individuals and diverse tissues of the human body, many of which are not easily accessible. Here we describe genetic effects on gene expression levels across 44 human tissues. We find that local genetic variation affects gene expression levels for the majority of genes, and we further identify inter-chromosomal genetic effects for 93 genes and 112 loci. On the basis of the identified genetic effects, we characterize patterns of tissue specificity, compare local and distal effects, and evaluate the functional properties of the genetic effects. We also demonstrate that multi-tissue, multi-individual data can be used to identify genes and pathways affected by human disease-associated variation, enabling a mechanistic interpretation of gene regulation and the genetic basis of diseas

Genetic effects on gene expression across human tissues

Characterization of the molecular function of the human genome and its variation across individuals is essential for identifying the cellular mechanisms that underlie human genetic traits and diseases. The Genotype-Tissue Expression (GTEx) project aims to characterize variation in gene expression levels across individuals and diverse tissues of the human body, many of which are not easily accessible. Here we describe genetic effects on gene expression levels across 44 human tissues. We find that local genetic variation affects gene expression levels for the majority of genes, and we further identify inter-chromosomal genetic effects for 93 genes and 112 loci. On the basis of the identified genetic effects, we characterize patterns of tissue specificity, compare local and distal effects, and evaluate the functional properties of the genetic effects. We also demonstrate that multi-tissue, multi-individual data can be used to identify genes and pathways affected by human disease-associated variation, enabling a mechanistic interpretation of gene regulation and the genetic basis of disease

Religiosity and COVID-19: Impact on Use of Remote Worship and Changes in Self-Reported Social Support

Objective: This study examines associations between changes in the use of remote worship services and changes in the types of social support among religious adults during the COVID-19 pandemic. Materials and Methods: Cross-sectional, web survey data (n = 461; 15 May to 6 July 2020) were collected during the COVID-19 pandemic. Multinomial logistic regression models calculated unadjusted odds of increases and decreases of three types of perceived social support from before to during COVID-19 based on remote worship use. Results: Adults who initiated use of remote worship had lower odds of gaining social support for personal problems (OR: 0.38; 95% CI: 0.19, 0.79) and greater odds of reporting less ease of getting practical help from neighbors (OR: 1.77; 95% CI: 1.04, 3.02) compared to adults who never used or stopped using remote worship. Adults who continued using remote worship services were more likely to report less ease of getting practical help from their neighbors (OR: 2.23; 95% CI: 1.17, 4.25) and decreased interest and concern felt from other people (OR: 2.62; 95% CI: 1.24, 5.51) than adults who never used or stopped using remote worship. Conclusions: Adults who initiated and continued using remote worship during the COVID-19 pandemic had poorer perceived social support outcomes relative to adults who never used or stopped using remote services. Despite continued engagement with their religious communities, adults participating in worship remotely may have had residual personal, emotional, and instrumental social support needs that remote worship did not mitigate

Community Members as Recruiters of Human Subjects: Ethical Considerations

Few studies have considered in detail the ethical issues surrounding research in which investigators ask community members to engage in research subject recruitment within their own communities. Peer-driven recruitment (PDR) and its variants are useful for accessing and including certain populations in research, but also have the potential to undermine the ethical and scientific integrity of community-based research. This paper examines the ethical implications of utilizing community members as recruiters of human subjects in the context of PDR, as well as the authors\u27 experience with a variant of PDR in a research project in South Africa. The importance of situating PDR in a comprehensive community engagement process that is responsive to the constraints of science and local needs and interests is emphasized. The paper will have relevance to bioethicists, health researchers, and research regulators concerned about the appropriate use of peer-driven recruitment strategies in health research