Evidence Based Breast Cancer Interventions Targeting Black American Women

poster abstractIn the United States, Black American women tend to have more invasive types of breast cancer at a younger age than White American women, and also tend to have a higher mortality rates than White, Latina, and Asian-American women (DeSantis, 2013). In order to address these issues, public health research has focused on developing early detection programs and increasing mammography availability. Despite these efforts, there has been a continuous rise in the incidence rates among Black American women throughout the United States, suggesting that there have been complications with program execution. This research project examines the evidence based interventions that have been proven to be effective within minority and Black American communities. Research has proven that there are some health interventions that are particularly effective for disadvantaged minorities. Examples include lay education, social network outreach, and culturally appropriate intervention delivery. Research has so far included reviews of current literature and interviews with public health workers who specialize in minority health interventions. Future community health research will explore the possibility of large scale replication in both urban and rural communities, which could lead to an overall decrease in breast cancer incidences population wide

Comparing Virulent Breast Cancer Types in Sub-Saharan African Women and Women of African Descent

poster abstractAfrican American women who are diagnosed with breast cancer have a 41% higher mortality rate than Caucasian women, despite having lower incidence rates. Studies have also shown that African American women tend to have more aggressive tumors than Caucasian women. [American Cancer Society, 2013] While many believe that this disparity is due to poor diet and lifestyles, several studies have indicated that there may be a genetic tendency for these women to have aggressive type tumors, particularly triple negative tumors. This research project explores the genetic predispositions behind higher rates of more virulent forms of breast cancer in women of African descent. It has been hypothesized that the tendency for these women to have these aggressive cancers could be related to their African ancestry. Conclusive evidence of a genetic link between these occurrences could affect the way that all women of the African diaspora are screened and treated for breast cancer. Research has so far included reviews of current literature and interviews with professionals in the field of oncology. Future epidemiologic studies will compare tumor characteristics in women throughout the African diaspora, especially focusing on Afro- Caribbean and African American women. The research would be essential in shedding light on this serious disparity and could lead to higher survival rates for these women

The NeoWarm biomedical device: Assessment of feasibility and cultural acceptability, identification of potential barriers and challenges, and stakeholder mapping

poster abstractIntroduction: Across the globe, approximately 4 million newborns die each year; complications from hypothermia underlie many of these deaths. Regions with fewer resources for neonatal care have higher rates of hypothermia­related death. Kangaroo Mother Care (KMC) is the practice of prolonged skin­to­skin contact to prevent hypothermia among small and premature infants. KMC is cost effective, and proven to reduce hypothermia; however, KMC programs are often discontinued or fail to expand. A built prototype of a biomedical device, called NeoWarm, has been developed to augment KMC initiatives. Identification of potential barriers and facilitators to adoption the NeoWarm technology is urgently needed. Methods: In order to assess the feasibility of NeoWarm, and to identify current barriers to implementation of KMC and NeoWarm, a comprehensive literature review was conducted. Key barriers and facilitators to existing KMC programs in sub­Saharan Africa, Asia, and Latin America were identified. Stakeholder mapping and analysis in relation to the NeoWarm device for three “target countries” within each of these global regions was performed. Potential stakeholders were identified and categorically ranked in terms of influence and relevance. Results: Three key barriers to KMC programs were identified. These included: unacceptability among male stakeholders; lack of support from health care providers and insufficient health infrastructure, leading to fears of tuberculosis and other infections spreading in crowded KMC wards. Comprehensive stakeholder mapping for Kenya, India, and Guatemala revealed a complex web of potential influencers and regulatory processes for adoption of NeoWarm technology. Conclusion: The NeoWarm device may support increased acceptance of KMC among male stakeholders and some health care providers; however, the concerns regarding spread of tuberculosis among KMC mother­baby pairs was an unexpected finding, which will significantly inform subsequent NeoWarm development and testing. Stakeholder mapping and analysis revealed many potential NeoWarm partners within each region whom had not been previously identified

TRIPLE NEGATIVE BREAST CANCER IN AFRICAN AMERICAN WOMEN

poster abstractStudies comparing African American and Caucasian women show that African American women are three times more likely to contract triple negative breast cancer. Triple negative breast cancer cells lack estrogen receptors (ER) ,progesterone receptors (PR) and HER2 receptors, which are all hormones that fuel tumor growth. In triple negative breast cancer, the lack of receptors implies that hormone treatments that are typically used to treat breast cancer will not work. African American women are also more likely to die from contracting breast cancer than any other group. Many researchers have said that possible reasons for the high mortality rate in African American women can include: diet, lifestyle and genetic predisposition. This re-search project will explore the genetic predispositions underlying African American women’s higher rates of more virulent forms of develop breast cancer. I hypothesize that African American women are more likely to develop triple negative breast cancer due to a genetic mutation. This research will also address the genetic and biological reasons why African American women are more susceptible to TNEG cancer cells. Beginning data collection methods for this research will include a literature review and interviews with professionals in the field of oncology. Later investigative methods will include genealogy tests of African American women with breast cancer and performing biopsies to find similarities within the cancer cells

Virulent Breast Cancer in Women of African Descent

African American women who are diagnosed with breast cancer have a 41% higher mortality rate than Caucasian women, despite having lower incidence rates. Studies have also shown that African American women tend to have more aggressive tumors than Caucasian women. [American Cancer Society, 2013] While many believe that this disparity is due to poor diet and lifestyles, several studies have indicated that there may be a genetic tendency for these women to have aggressive type tumors, particularly triple negative tumors. This research project explores the genetic predispositions behind higher rates of more virulent forms of breast cancer in women of African descent. It has been hypothesized that the tendency for these women to have these aggressive cancers could be related to their African ancestry. Conclusive evidence of a genetic link between these occurrences could affect the way that all women of the African diaspora are screened and treated for breast cancer. Research has so far included reviews of current literature and interviews with professionals in the field of oncology. Future epidemiologic studies will compare tumor characteristics in women throughout the African diaspora, especially focusing on Afro- Caribbean and African American women. The research would be essential in shedding light on this serious disparity and could lead to higher survival rates for these women

Acceptability and Feasibility of a Smartphone-Based Real-Time Assessment of Suicide Among Black Men: Mixed Methods Pilot Study

BackgroundSuicide rates in the United States have increased recently among Black men. To address this public health crisis, smartphone-based ecological momentary assessment (EMA) platforms are a promising way to collect dynamic, real-time data that can help improve suicide prevention efforts. Despite the promise of this methodology, little is known about its suitability in detecting experiences related to suicidal thoughts and behavior (STB) among Black men. ObjectiveThis study aims to clarify the acceptability and feasibility of using smartphone-based EMA through a pilot study that assesses the user experience among Black men. MethodsWe recruited Black men aged 18 years and older using the MyChart patient portal messaging (the patient-facing side of the Epic electronic medical record system) or outpatient provider referrals. Eligible participants self-identified as Black men with a previous history of STB and ownership of an Android or iOS smartphone. Eligible participants completed a 7-day smartphone-based EMA study. They received a prompt 4 times per day to complete a brief survey detailing their STB, as well as proximal risk factors, such as depression, social isolation, and feeling like a burden to others. At the conclusion of each day, participants also received a daily diary survey detailing their sleep quality and their daily experiences of everyday discrimination. Participants completed a semistructured exit interview of 60-90 minutes at the study’s conclusion. ResultsIn total, 10 participants completed 166 EMA surveys and 39 daily diary entries. A total of 4 of the 10 participants completed 75% (21/28) or more of the EMA surveys, while 9 (90%) out of 10 completed 25% (7/28) or more. The average completion rate of all surveys was 58% (20.3/35), with a minimum of 17% (6/35) and maximum of 100% (35/35). A total of 4 (40%) out of 10 participants completed daily diary entries for the full pilot study. No safety-related incidents were reported. On average, participants took 2.08 minutes to complete EMA prompts and 2.72 minutes for daily diary surveys. Our qualitative results generally affirm the acceptability and feasibility of the study procedures, but the participants noted difficulties with the technology and the redundancy of the survey questions. Emerging themes also addressed issues such as reduced EMA survey compliance and diminished mood related to deficit-framed questions related to suicide. ConclusionsFindings from this study will be used to clarify the suitability of EMA for Black men. Overall, our EMA pilot study demonstrated mixed feasibility and acceptability when delivered through smartphone-based apps to Black men. Specific recommendations are provided for managing safety within these study designs and for refinements in future intervention and implementation science research. International Registered Report Identifier (IRRID)RR2-10.2196/3124