1A-1: Adherence to Cervical Cancer Screening Guidelines Among Latina Immigrant Women in Coastal South Carolina

John Luque¹, Caroline Davila¹, Yelena Tarasenko², Nicole Knight^3
1Medical University of South Carolina, Charleston, SC, USA; ²Georgia Southern University, Statesboro, GA, USA; ³The George Washington University, Charleston, SC, USA

Abstract: Background: The Hispanic population in South Carolina grew by 148%between 2000 and 2010 and is currently around 5%of the state population. The purpose of this pilot study was to examine the association between utilization of cervical cancer screening by foreign-born Latina women with acculturation, self-efficacy for cervical cancer screening, and barriers to healthcare. Methods: Latina immigrant women were recruited in person to complete the survey at multiple community sites. Women received a Spanish-language informational brochure with contact information of screening clinics and cervical cancer education. This research presents preliminary data from a sample of 120 women. The one-way ANOVA test was used to examine associations between cervical cancer screening interval (<1 year, 1–3 years, >3 years, or never) and three validated scales. Results: The study participants were primarily from Mexico (71%), but some were from Central and South America. The women had been living in the USA for an average of 14 years (SD= 7.5). For the acculturation scale, lower acculturated women were less likely to have been screened in the last 3 years (p=0.05). Women scoring higher on the cervical cancer self-efficacy scale (α = 0.88) were more likely to have been screened within the last year or 1–3 years (p = 0.04). Women scoring higher on the barriers scale (α = 0.89) were less likely to have been screened within the last 3 years, although this association was marginally non-significant (p = 0.06). Discussion: Previous studies have demonstrated a link between acculturation, self-efficacy, and barriers to cervical cancer screening to Pap test receipt. This research adds to that literature with a survey of immigrant Latina women. Our results indicate barriers to screening for some women in this immigrant community still exist. More cervical cancer screening information dissemination work is needed because of language barriers and lack of access to locally relevant health information. Learning Objectives: The participant shall be able to (1) identify two or more barriers to cervical cancer screening among Latina immigrant women and (2) name at least one psychosocial construct associated with cervical cancer screening. References: Cooper, C. P., Saraiya, M., & Sawaya, G. F. (2015). Acceptable and Preferred Cervical Cancer Screening Intervals Among U.S. Women. Am J Prev Med, 49(6), e99-107. doi:10.1016/j. amepre.2015.04.025. Mann, L., Foley, K. L., Tanner, A. E., Sun, C. J., & Rhodes, S. D. (2015). Increasing Cervical Cancer Screening Among US Hispanics/Latinas: A Qualitative Systematic Review. J Cancer Educ, 30(2), 374-387. doi:10.1007/s13187-014-0716-9.

1A-2: Using a Tailored Report to Stimulate Capacity-Appropriate Evidence-Based Cancer Education in African-American Churches

Cheryl Holt¹, Erin Tagai², Sherie Lou Santos², Jimmie Slade³, Roxanne Carter³, Mary Ann Scheirer⁴, Muhiuddin Haider^5
1University of Maryland, College Park, MD, USA; ²University of Maryland, School of Public Health, Department of Behavioral and Community Health, College Park, MD, USA; ³Community Ministry of Prince George’s County, Upper Marlboro, MD, USA; ⁴Scheirer Consulting, Princeton, NJ, USA; ⁵University of Maryland, School of Public Health, Institute for Applied Environmental Health, College Park, MD, USA

Abstract: Background/Purpose: Like any organization, churches’ characteristics (e.g., size, staffing, leadership, their physical structure) vary tremendously and are closely associated with organizational capacity. In the present context, we are interested in capacity for cancer education activities in African-American churches which are frequent targets for health promotion interventions aimed at disparity reduction. Because health promotion interventions vary greatly in their complexity and the resource demands, it is important that a reasonable match be obtained between a church’s capacity and the requirements of the intervention. Description: We describe the process by which we used our Faith Based Organization Capacity Inventory (FBO-CI) to assess organizational capacity in 13 African-American churches in three areas: (a) staffing and space, (b) health promotion experience, and (c) external collaborations. We used a community-engaged process to develop a strength-based feedback mechanism to provide the capacity data back to the church leadership, along with recommendations for evidence-based cancer education and other health promotion interventions based on (1) the church’s capacity and (2) the stated health topic interests of the church. Evaluation: We developed a tailored church capacity report that aims to provide sensitive and appropriate feedback on the church’s strengths, areas for further development, and linkages to evidence-based interventions as a way for the churches to build their health ministries. We also considered the role of church health policy in the report. Usefulness: We discuss implications for institutionalization or integration of health into the structural aspects of the church ministry as a way to foster sustainability of cancer education programs. Learning Objectives: Learning objective 1: The participant shall be able to discuss the need for assessing organizational capacity to match appropriate cancer education evidence-based interventions. Learning objective 2: The participant shall be able to describe the process of developing a strength-based feedback mechanism to provide organizational capacity data back to church/organization leadership. References: Ayton D, Carey G, Joss N, Keleher H, Smith B. Exploring the partnership networks of churches and church-affiliated organisations in health promotion. Aust J Prim Health. 2011;18(2):148-57. De Marco M, Weiner B, Meade SA, Hadley M, Boyd C, Goldmon, M, et al. Assessing the readiness of Black churches to engage in health disparities research. J Natl Med Assoc. 2011;103(9-10):960-7.

1A-3: Increasing Latino Representation in Cancer Control Research: the Éxito! Latino Cancer Research Leadership Training Program (2010–2015)

Amelie Ramirez, Kipling Gallion, Arely Perez
University of Texas Health Science Center at San Antonio-Institute for Health Promotion Research, San Antonio, TX, USA

Abstract: Background/Purpose: The field of cancer control continues to lack Latino representation. Latinos do not pursue master’s or doctoral degrees in public health and the health sciences at the same rate as Whites or other racial groups [1, 2]. Exito! Latino Cancer Research Leadership Training is a 5-year program funded by the National Cancer Institute to increase the number of Latinos pursuing a doctoral degree and a career in Latino cancer health disparity (CHD) research. Description: Annually, up to 20 master’s-level students or master’s-level health professionals are selected to participate an intensive 5-day Summer Institute (SI) lead by recognized leaders Latino CHD research where attendees receive resources, tips, and motivation to apply to and complete a doctoral program. A smaller subset of SI attendees competes for ten 6-month internships in research related to Latino CHD. Evaluation: From 2010 to 2015, we recruited 100 SI participants and awarded 21 internships. Program goals and objectives were evaluated through five surveys: pre/ post-institute surveys, pre/post-internship, and an annual alumni survey. Findings from the SI experience demonstrated significant improvement in attendees’ confidence towards applying to a doctoral program in the next 5 years, as well as an improvement in academic self-efficacy. Survey findings for internships demonstrated significant improvements in students’ research skills. Thirty percent of the alumni have applied to a doctoral program and 21% are currently enrolled. Sixty-nine percent of doctoral students indicated they would pursue a career directly related to cancer after obtaining a degree. Usefulness: Exito! results indicate an improvement in confidence and capacity to pursue and complete a doctoral degree leading to careers in cancer control research of master’s-level students and master’s-level health professionals. Exito! provides the mentorship and encouragement necessary to increase the pipeline of Latino cancer health disparity researchers. Learning Objectives: The participant shall be able to detect the need to increase the pipeline of Latino cancer health disparity researchers. The participant shall be able to compare levels of confidence in student’s ability, academic self-efficacy, and desire to pursue a doctoral degree and career in cancer control research. References: ASPH. 2011. Association of Schools of Public Health: Annual Data Report. Lopez, Mark, and Richard Fry. 2013. Among recent high school grads, Hispanic college enrollment rate surpasses that of whites | Pew Research Center.

1A-4: African-American Parents’ and Daughters’ HPV Vaccination Acceptance: an Inquiry Grounded in Culture

Kayoll V. Galbraith¹, Julia Lechuga², Coretta M. Jenerette¹, LTC Angelo D. Moore (Ret.)³, Mary H. Palmer¹, Jill Hamilton^4
1School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; ²The University of Texas at El Paso, El Paso, TX, USA; ³Moore & Moore Healthcare Consulting, LLC., Cumberland, NC, USA; ⁴School of Nursing Johns Hopkins University, Baltimore, MD, USA

Abstract: Background: The HPV vaccination literature supports the role of culture on African-Americans’ HPV vaccination acceptance. However, the evidence in support of the role of culture on this health behavior is limited. Purpose: This study explored the influence of culture on African-American parents’ and daughters’ (12-to-17 years old) HPV vaccination acceptance using the PEN-3 model. Methods: Grounded theory techniques and quantitative descriptive statistics were used in this study of African-American parents (n = 30) and daughters (n = 34), residing in the Southeastern and Northeastern USA. Results: Among parents and daughters, positive attitudes and beliefs that promoted HPV vaccination focused on the HPV vaccine having cervical cancer and STD prevention benefits, being safe, and that all girls should be HPV vaccinated. Negative attitudes and beliefs that prevented HPV vaccination focused on concerns about safety, side effects, newness of vaccine, and that HPV vaccine initiation forces parents to engage in conversations about sex during pre-adolescent years. For a majority a parents and daughters, HPV vaccination was viewed as separate from their religious beliefs. However, for other parents and daughters, HPV vaccination acceptance was a decision intertwined with their religious beliefs and based on individual lifestyle choices. While parents and daughters used support networks when deciding to accept HPV vaccination, they received advice not always based on accurate information but based on fears, institutional mistrust, and mixed messages from the media. Parents also reported dissatisfaction with the quality of HCP communication about HPV as preventing HPV vaccination acceptance. Discussion: This study highlights important cultural factors that influence African-American parents’ and daughters’ HPV vaccine acceptance. It also highlights culturally appropriate factors that facilitate parents’ and daughters’ HPV vaccine acceptance, as well as specific areas of concern. The findings of this study can be used to inform acceptable and sensitive HPV education and communication interventions to address HPV vaccination acceptance and uptake among African-Americans. Learning Objectives: (1) The participants should be able to identify at least two distinct factors that prevent HPV vaccine acceptance among African-American parents and adolescent girls. (2) The participants should be able to identify at least two cultural factors that promote HPV vaccine acceptance among African-American parents and adolescent girls. (3)The participants should be able to describe ways in which the information in this presentation could be useful in practice and cancer communication research to encourage higher HPV vaccine acceptance among African-American parents and adolescent girls. References: Hamlish T, Clarke L, Alexander KA. Barriers to HPV immunization for African American adolescent females. Vaccine. 2012; 30(45):6472-6476. Sanders Thompson, V. L., Arnold, L. D., & Notaro, S. R. (2012). African American parents’ HPV vaccination intent and concerns. Journal of Health Care for the Poor and Underserved, 23(1), 290-301. doi:10.1353/hpu.2012.0007 [doi]. Thomas, T. L., Strickland, O., Diclemente, R., & Higgins, M. (2013). An opportunity for cancer prevention during preadolescence and adolescence: Stopping human papillomavirus (HPV)-related cancer through HPV vaccination. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 52(5 Suppl), S60-68. doi:10.1016/j. jadohealth.2012.08.011 [doi]

1A-5: Online Health Information Seeking and eHealth Literacy Among Latinos Receiving Care in Community-Based Clinics

Enmanuel Chavarria, Shannon M. Christy, Stacy N. Davis, Liliana Gutierrez, Rania Abdulla, Clement Gwede, Cathy Meade
Moffitt Cancer Center, Tampa, FL, USA

Abstract: Background/Purpose: Colorectal cancer (CRC) is the second leading cause of cancer deaths among Latinos in the USA. A proven approach to decrease mortality is to increase screening rates. Reliable online Spanish language information resources that improve awareness of the need for CRC screening are increasing. Yet, online resources are beneficial only if individuals have adequate eHealth literacy (eHL)—the ability to seek, find, understand, and appraise health information from electronic sources and apply gained knowledge to address a health problem. (Norman & Skinner, 2006) Characteristics of those seeking online health information (OHI) and correlates of eHL in a sample of medically underserved Latinos are reported. Methods: Participants (N = 76) were Latinos accessing care at community-based clinics who preferred to receive their health information in Spanish, aged 50–75, at average CRC risk, non-adherent to CRC screening guidelines, and enrolled in a randomized controlled trial to increase CRC screening. The Spanish translated eHealth Literacy Scale (eHEALS) (Paramio Perez et al., 2015) was administered to assess knowledge, comfort, and perceived skills at finding, evaluating, and applying OHI to health problems. The eHEALS score ranges from 8 to 40. A score of 30 or less is considered low eHL. Results/Findings: Most participants were female (67 %) and of Mexican origin (63 %). Majority of participants, 71 % (n = 54), did not search for OHI. Participants that did not search for OHI tended to be men (χ² (1, N = 76) = 5.202, p = .023), have higher religiosity (r = −.386, p < .001), higher social influence beliefs (r = −.284, p = .013), and lower education (r = .656, p < .001). Of those seeking OHI, the mean eHL score was 29.72 (SD 6.60) and 36 % had low eHealth literacy. Those with low eHealth literacy tended to have higher religiosity (r = −.440, p = .041). Discussion: Findings indicate most did not seek OHI. Future eHealth literacy research should explore ways to increase OHI seeking. Online cancer screening interventions may not reach all; therefore, multiple modalities are recommended. Learning Objectives: The participant will gain knowledge in terms of (1) defining eHealth literacy and (2) recognizing the need for addressing eHealth literacy in order to enable access to online health information for medically underserved populations to ultimately create health behavior change (including modifying cancer screening behaviors) through online health interventions. References: 1. Norman CD, Skinner HA. eHealth literacy: Essentials skills for consumer in a networked world. Journal of Medical Internet Research. 2006;8(2). 2. Paramio Perez G, Almagro BJ, Hernando Gomez A, Aguaded Gomez JI. [Validation of the eHealth Literacy Scale (eHEALS) in Spanish University Students]. Rev Esp Salud Publica. 2015;89(3):329-338.