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James Lyndon McCracken, Daniela B Friedman,
Heather M Brandt,
Swann Arp Adams,
Sudha Xirasagar,
John R Ureda,
Rachel M Mayo,
Kimberly Comer,
Miriam Evans,
Delores Fedrick,
Jacqueline Talley,
Madeline Broderick,
James R Hebert
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ABSTRACT: The South Carolina Cancer Prevention and Control Research Network (SC-CPCRN) implemented the Community Health Intervention Program (CHIP) mini-grants initiative to address cancer-related health disparities and reduce the cancer burden among high-risk populations across the state. The mini-grants project implemented evidence-based health interventions tailored to the specific needs of each community. This study aims to support the SC-CPCRN's goals of moving toward greater dissemination and implementation of evidence-based programs in the community to improve public health, prevent disease, and reduce the cancer burden. Three community-based organizations were awarded $10,000 each to implement one of the National Cancer Institute's evidence-based interventions. Each group had 12 months to complete their project. SC-CPCRN investigators and staff provided guidance, oversight, and technical assistance for each project. Grantees provided regular updates and reports to their SC-CPCRN liaisons to capture vital evaluation information. The intended CHIP mini-grant target population reach was projected to be up to 880 participants combined. Actual combined reach of the three projects reported upon completion totaled 1,072 individuals. The majority of CHIP participants were African-American females. Participants ranged in age from 19 to 81 years. Evaluation results showed an increase in physical activity, dietary improvements, and screening participation. The success of the initiative was the result of a strong community-university partnership built on trust. Active two-way communication and an honest open dialogue created an atmosphere for collaboration. Communities were highly motivated. All team members shared a common goal of reducing cancer-related health disparities and building greater public health capacity across the state.
Journal of Cancer Education 05/2013; · 0.76 Impact Factor
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ABSTRACT: Clinical trials (CTs) have the potential to provide the most advanced medical treatments and screening options and help medically underserved individuals, including those in rural communities, obtain the medical care they need. Despite the need for access to care, CT participation remains low in rural communities. This study examined what individuals in both rural and urban communities of a Southeastern state know and think about CTs. Nineteen focus groups and eight interviews were conducted statewide with a total of 212 men and women. Discussions assessed participants' beliefs, perceptions, and sources of information about CTs, and their willingness to participate in a CT. Focus group and interview transcripts were analyzed qualitatively for themes. Urban and rural participants expressed similar beliefs about CTs. Common misperceptions were that CTs were intended for people who could not afford care and that completing a survey or participating in a focus group constituted a CT. Rural residents believed that CTs involved deception more often than urban residents, and they were less willing than urban residents to participate in a CT in the future. Urban residents more frequently discussed their distrust of the medical system as a reason for not wanting to participate. Many individuals expressed that their participation would depend on whether their doctor recommended it or whether the trial would benefit a family member's health. Findings have important implications for health communication. Messages should be developed to address misperceptions of rural and urban communities and convey the importance of CT participation to promote and protect the health of their communities.
Journal of Community Health 03/2013; · 1.28 Impact Factor
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ABSTRACT: The use of promotoras de salud is an increasingly widespread delivery approach for community-based health education and promotion programs targeting obesity-related lifestyle behaviors for Hispanic populations. Addressing a gap in the literature, this research examined the sustainability of promotora-led initiatives from the perspectives of those who plan, implement, and evaluate these programs. We conducted 24 in-depth interviews with program planners representing 22 promotora programs focused on Hispanic women's health in 10 states. Findings illustrated program planners' opinions regarding the components, logistics, and barriers to promotora program sustainability. Several participants challenged the notion of promotora program sustainability by reframing the issue as promoting individual promotoras' well-being and social mobility rather than maintaining their role in the program over time. Implications for community health planning, management, and policy include developing sustainability strategies during program planning stages and implementation of policies to more effectively integrate promotoras into existing health care systems at local, state, and national levels.
Journal of public health management and practice: JPHMP 01/2013; · 0.96 Impact Factor
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ABSTRACT: INTRODUCTION: Limited research has examined primary care providers' communication with patients about maintaining cognitive functioning. Our study's objective was to compare the perceptions of consumers and primary care providers related to beliefs and communication practices about lifestyle behaviors beneficial for overall health and for maintaining cognitive functioning. METHODS: In 2009, we submitted 10 questions to Porter Novelli's HealthStyles survey and 6 questions to their DocStyles survey. We compared consumers' (n = 4,728) and providers' (n = 1,250) beliefs, practices, and information sources related to maintaining health and cognitive functioning. We made comparisons using nonparametric statistics. RESULTS: Approximately 76% of consumers considered their health to be good or very good; 73.4% were concerned or very concerned about the possibility that their memory may worsen with age. Women were significantly more concerned than men, and white consumers were more concerned than black and Hispanic consumers. Consumers reported they believed that intellectual stimulation (86.6%), physical activity (82.6%), and healthful diet (82.5%) prevented or delayed cognitive impairment. Providers reported advising patients to reduce cognitive impairment risk through physical activity (85.9%), intellectual stimulation (80.3%), and social involvement (67.4%). Few consumers (7.8%) reported receiving this information from providers but reported learning about strategies to maintain memory, primarily from television (50.1%), magazines (44.1%), and newspapers (33.7%). CONCLUSION: Providers reported advising patients about how to reduce risks of cognitive impairment. Consumers reported receiving this information from other sources. Findings suggest a need to examine and assess media messages and to better understand patient-provider communication about cognitive functioning.
Preventing chronic disease 01/2013; 10:E58. · 1.82 Impact Factor
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ABSTRACT: INTRODUCTION: To facilitate national efforts to maintain cognitive health through public health practice, the Healthy Brain Initiative recommended examining diverse groups to identify stakeholder perspectives on cognitive health. In response, the Healthy Aging Research Network (HAN), funded by the Centers for Disease Control and Prevention (CDC), coordinated projects to document the perspectives of older adults, caregivers of people with dementia, and primary care providers (PCPs) on maintaining cognitive health. Our objective was to describe PCPs' perceptions and practices regarding cognitive health. METHODS: HAN researchers conducted 10 focus groups and 3 interviews with physicians (N = 28) and advanced practice providers (N = 21) in Colorado, Texas, and North Carolina from June 2007 to November 2008. Data were transcribed and coded axially. RESULTS: PCPs reported addressing cognitive health with patients only indirectly in the context of physical health or in response to observed functional changes and patient or family requests. Some providers felt evidence on the efficacy of preventive strategies for cognitive health was insufficient, but many reported suggesting activities such as games and social interaction when queried by patients. PCPs identified barriers to talking with patients about cognitive health such as lack of time and patient reactions to recommendations. CONCLUSION: Communicating new evidence on cognitive health and engaging older adults in making lasting lifestyle changes recommended by PCPs and others may be practical ways in which public health practitioners can partner with PCPs to address cognitive health in health care settings.
Preventing chronic disease 11/2012; 9:E169. · 1.82 Impact Factor
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ABSTRACT: Objective. Program planners work with promotoras (the Spanish term for female community health workers) to reduce health disparities among underserved populations. Based on the Role-Outcomes Linkage Evaluation Model for Community Health Workers (ROLES) conceptual model, we explored how program planners conceptualized the promotora role and the approaches and strategies they used to recruit, select, and sustain promotoras. Design. We conducted semi-structured, in-depth interviews with a purposive convenience sample of 24 program planners, program coordinators, promotora recruiters, research principal investigators, and other individuals who worked closely with promotoras on United States-based health programs for Hispanic women (ages 18 and older). Results. Planners conceptualized the promotora role based on their personal experiences and their understanding of the underlying philosophical tenets of the promotora approach. Recruitment and selection methods reflected planners' conceptualizations and experiences of promotoras as paid staff or volunteers. Participants described a variety of program planning and implementation methods. They focused on sustainability of the programs, the intended health behavior changes or activities, and the individual promotoras. Conclusion. To strengthen health programs employing the promotora delivery model, job descriptions should delineate role expectations and boundaries and better guide promotora evaluations. We suggest including additional components such as information on funding sources, program type and delivery, and sustainability outcomes to enhance the ROLES conceptual model. The expanded model can be used to guide program planners in the planning, implementing, and evaluating of promotora health programs.
Ethnicity and Health 10/2012; · 1.64 Impact Factor
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ABSTRACT: Training is an essential component of health programs that incorporate promotoras de salud (the Spanish term for community health workers) in the delivery of health education and behavioral interventions to Hispanics. During training sessions, promotoras are exposed to information and skill-building activities they need to implement the health programs. This analysis was one component of a broader study which explored program planners' approaches to recruiting and training promotoras to deliver and sustain health promotion programs for Hispanic women. The purpose of this study was to examine promotora-curriculum and training processes used to prepare promotoras to deliver health programs. The authors examined transcripts of 12 in-depth interviews with program planners and conducted a content analysis of seven different training materials used in their respective promotora programs. Interview themes and narratives included program planners' varying conceptualizations of promotora-training, including their personal definitions of "training the trainer," the practice of training a cadre of promotoras before selecting those best fit for the program, and the importance of providing goal-directed, in-depth training and supervision for promotoras. The content analysis revealed a variety of strategies used to make the training materials interactive and culturally competent. Study implications describe the importance of planners' provision of ongoing, goal-directed, and supervised training using both appropriate language and interactive methods to engage and teach promotoras.
Health Promotion Practice 09/2012;
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ABSTRACT: African American men report poorer health than do White men and have significantly greater odds for developing chronic diseases partly because of limited physical activity. Understanding how to encourage healthy behaviors among African American men will be critical in the development of effective physical activity messages and programs. Guided by principles of cultural sensitivity and social marketing, this research examined middle-aged and older African American men's recommended strategies for promoting physical activity to African American men of their age. The authors report results from 49 interviews conducted with middle-aged (45-64 years) and older (65-84 years) African American men in South Carolina. Four groups of African American men were recruited: middle-aged active men (n = 17), middle-aged inactive men (n = 12), older active men (n = 10), older inactive men (n = 10). Themes related to marketing and recruitment strategies, message content, and spokesperson characteristics emerged and differed by age and physical activity level. Recommended marketing strategies included word of mouth; use of mass media; partnering with churches, businesses, and fraternities; strategic placement of messages; culturally appropriate message framing; and careful attention to selection of program spokespersons. Findings will help in the marketing, design, implementation, and evaluation of culturally appropriate interventions to encourage physical activity among middle-aged and older African American men in the South.
Journal of Health Communication 07/2012; · 1.61 Impact Factor
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Tisha M Felder,
Heather M Brandt,
Cheryl A Armstead,
Philip P Cavicchia,
Kathryn L Braun,
Swann A Adams, Daniela B Friedman,
Sora Tanjasiri,
Susan E Steck,
Emily R Smith,
Virginie G Daguisé,
James R Hébert
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ABSTRACT: Community-based participatory research (CBPR) initiatives such as the National Cancer Institute's Community Networks Program (CNP) (2005-2010) often emphasize training of junior investigators from underrepresented backgrounds to address health disparities. From July to October 2010, a convenience sample of 80 participants from the 25 CNP national sites completed our 45-item, web-based survey on the training and mentoring of junior investigators. This study assessed the academic productivity and CBPR-related experiences of the CNP junior investigators (n = 37). Those from underrepresented backgrounds reported giving more presentations in non-academic settings (nine vs. four in the last 5 years, p = 0.01), having more co-authored publications (eight vs. three in the last 5 years, p = 0.01), and spending more time on CBPR-related activities than their non-underrepresented counterparts. Regardless of background, junior investigators shared similar levels of satisfaction with their mentors and CBPR experiences. This study provides support for the success of the CNP's training program, especially effort directed at underrepresented investigators.
Journal of Cancer Education 04/2012; 27(3):409-17. · 0.76 Impact Factor
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ABSTRACT: To explore associations between physical activity (PA) literacy and psychosocial constructs for providing instrumental social support for youth PA.
Ninety-one foster parents completed surveys assessing PA literacy (overall and specific), perceptions of child PA, coordination, PA enjoyment, psychosocial variables: positive/negative beliefs, normative beliefs, perceived behavioral control (PBC), and self-efficacy.
Race, negative beliefs, PBC, and foster parent sport involvement were associated with specific PA literacy. Race and education were associated with overall PA literacy.
Lower PA literacy is associated with greater negative beliefs and lower perceived control suggesting greater perceived barriers and lower perceived support for/among African Americans and those with less education.
American journal of health behavior 03/2012; 36(2):179-92. · 1.31 Impact Factor
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ABSTRACT: We examined beliefs about promoting cognitive health among Filipino Americans who care for persons with dementia, their awareness of media information about cognitive health, and their suggestions for communicating such information to other caregivers. We conducted three focus groups (25 participants). The constant comparison method compared themes across focus groups. Caregivers most frequently described cognitive health benefits of social engagement and leisure; next in emphasis were benefits of healthy diets. There was less emphasis on physical activity. Participants had heard from television that avoiding smoking, alcohol, and drugs might promote cognitive health. Ways to inform others about cognitive health included information in Filipino newspapers, and handouts in Filipino languages, distributed in Filipino stores, workplaces, community organizations, and health care facilities. Findings suggest an opportunity to develop public health messages promoting cognitive health that are in-language, published in ethnic-specific media, and that are culturally appropriate for Filipino and other Asian Americans.
The International Journal of Aging and Human Development 01/2012; 75(3):273-96. · 0.62 Impact Factor
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JAMES N. LADITKA,
SARAH B. LADITKA,
RUI LIU,
ANNA E. PRICE,
BEI WU, DANIELA B. FRIEDMAN,
SARA J. CORWIN,
JOSEPH R. SHARKEY,
WINSTON TSENG,
REBECCA HUNTER,
REBECCA G. LOGSDON
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ABSTRACT: We studied concerns about cognitive health among ethnically diverse groups of older adults. The study was grounded in theories of health behaviour and the representation of health and illness. We conducted 42 focus groups (N=396, ages 50+) in four languages, with African Americans, American Indians, Chinese Americans, Latinos, Whites other than Latinos (hereafter, Whites) and Vietnamese Americans, in nine United States locations. Participants discussed concerns about keeping their memory or ability to think as they age. Audio recordings were transcribed verbatim. Constant comparison methods identified themes. In findings, all ethnic groups expressed concern and fear about memory loss, losing independence, and becoming ‘a burden’. Knowing someone with Alzheimer's disease increased concern. American Indians, Chinese Americans, Latinos and Vietnamese Americans expected memory loss. American Indians, Chinese Americans and Vietnamese Americans were concerned about stigma associated with Alzheimer's disease. Only African Americans, Chinese and Whites expressed concern about genetic risks. Only African Americans and Whites expressed concern about behaviour changes. Although we asked participants for their thoughts about their ability to think as they age, they focused almost exclusively on memory. This suggests that health education promoting cognitive health should focus on memory, but should also educate the public about the importance of maintaining all aspects of cognitive health.
Ageing and Society 09/2011; 31(07):1202 - 1228. · 1.16 Impact Factor
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Daniela B Friedman,
Vicki M Young,
Darcy A Freedman,
Swann Arp Adams,
Heather M Brandt,
Sudha Xirasagar,
Tisha M Felder,
John R Ureda,
Thomas Hurley,
Leepao Khang,
Dayna Campbell,
James R Hébert
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ABSTRACT: The South Carolina Cancer Prevention and Control Research Network, in partnership with the South Carolina Primary Health Care Association, and Federally Qualified Health Centers (FQHCs), aims to promote evidence-based cancer interventions in community-based primary care settings. Partnership activities include (1) examining FQHCs' readiness and capacity for conducting research, (2) developing a cancer-focused data sharing network, and (3) integrating a farmers' market within an FQHC. These activities identify unique opportunities for public health and primary care collaborations.
Journal of Cancer Education 09/2011; 27(1):59-61. · 0.76 Impact Factor
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ABSTRACT: We examined messages that the websites of the top cable news companies (MSNBC, FOX, and CNN) conveyed about cognition between January 2007 and March 2010. Drawing on agenda-setting theory, this work assessed the frequency, prominence, and attributes of cognitive topics in messages targeting an aging audience.
We used quantitative content analysis to examine the frequency and prominence of cognitive topics and cognitive goals, as well as how the cognitive discussions were framed. Chi-square analyses were conducted to compare cognitive health information discussed in news items that did and did not target an "aging audience." Qualitative analysis of the aging audience subgroup was used to further examine age-associated cognitive messages.
Within the 229 cognitive items identified, we found significantly more coverage of cognitive functioning and unspecified dementia and significantly less coverage of cognitive disease not dementia, specified dementia, and accidents or injury for the aging audience. Our qualitative analysis of news items aimed at an aging audience documented a focus on maintaining functioning and avoiding decline through various individual lifestyle behaviors. However, contextual information about level of cognition to be maintained, particular cognitive functions targeted, specific norms about cognitive aging, and how cognitive function is determined was lacking.
Our research points to a communication gap in the delivery of academic research findings to a lay audience through online journalism. We suggest more clarity by researchers in defining cognitive concepts and measurement of cognitive function for journalistic translation and public consumption.
The Gerontologist 09/2011; 52(3):367-82. · 2.48 Impact Factor
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ABSTRACT: The promise of human papillomavirus (HPV) vaccines rests with the ability to promote widespread uptake especially among populations at high risk of cervical cancer and other associated disease outcomes. The purpose of this study was to examine health beliefs and culturally specific influences of HPV vaccine acceptability among African American college females. Approximately 76 percent of participants reported HPV vaccine acceptability. Predictors of acceptability included: higher perceived benefit and lower racial pride. Findings can be used to inform development of campus-based HPV educational approaches to promote widespread HPV vaccine acceptability and safer sex practices among African American college females.
Journal of Health Psychology 07/2011; 17(2):217-26. · 1.22 Impact Factor
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ABSTRACT: Purpose – The purpose of this study is to assess the effectiveness of a disaster preparedness communication curriculum for public health graduate students' understanding and use of communication strategies for reaching vulnerable groups with preparedness messages. Design/methodology/approach – A training module was piloted in a health communication seminar in 2008 (n=9 students) and 2009 (n=15 students). The interactive module included lectures, videos, case study discussions, and disaster plan and message development. Students gave presentations to a panel of risk communication specialists from the university and state health department. Findings – Analysis of Likert-type pre/post-survey items showed significant improvement in students' knowledge about disaster communication and confidence regarding use of communication principles to develop clear messages (p<0.05). In response to open-ended questions, students reported enjoying the “practical experience of developing messages” and learning the “importance of media and health professionals working together”. Research limitations/implications – This pilot evaluation involved a relatively small sample of students. Although students were assured that all survey responses would remain anonymous, social desirability may have played a role in their written responses. Practical implications – The educational module appears to be effective in engaging public health students in disaster communication strategies for reaching vulnerable populations. Studying effective communication strategies well before a disaster situation occurs will help to anticipate community-specific communication needs and reduce concern. Originality/value – The instructional approach and content developed could be adapted for training health care and public health professionals to communicate effectively in planning for and responding to disaster situations.
Disaster Prevention and Management 06/2011; 20(3):238-250. · 0.34 Impact Factor
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ABSTRACT: Farmers' markets are community health promotion interventions that increase access to fresh fruits and vegetables. As farmers' markets continue to develop, it is important to strategically locate them in settings that are accessible to populations disparately affected by health disparities. One potential setting is a community health center. The goal of this analysis is to extend existing research on community readiness to identify indicators of preparedness among community health centers for establishing onsite farmers' markets. The sampling frame for the readiness assessment included all community health centers in South Carolina (N = 20) representing 163 practice sites. Data collection included two brief online surveys, in-depth key informant interviews, and secondary analysis of contextual data. Five themes related to readiness for establishing a farmers market at a community health center were identified: capacity, social capital, awareness of health problems and solutions, logistical factors, and sustainability. Findings from this study provide guidance to researchers and community health center staff as they explore the development of environmental interventions focused on reducing diet-related health conditions by improving access to healthy foods.
Journal of Community Health 06/2011; 37(1):80-8. · 1.28 Impact Factor
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ABSTRACT: Physical activity may promote cognitive health in older adults. Popular media play an important role in preventive health communication. This study examined articles discussing associations between physical activity and cognitive health in top-circulating magazines targeting older adults. 42,753 pages of magazines published from 2006 to 2008 were reviewed; 26 articles met inclusion criteria. Explanations regarding the link between physical activity and cognitive health were provided in 57.7% of articles. These explanations were generally consistent with empirical evidence; however, few articles included empirical evidence. Physical activity recommendations were presented in 80.8% of articles; a wide range was recommended (90-300 min of physical activity per wk). Socioeconomic status and education level were not mentioned in the text. Results suggest an opportunity for greater coverage regarding the role of physical activity in promoting cognitive health in popular media. Magazine content would benefit from including more empirical evidence, culturally sensitive content, and physical activity recommendations that are consistent with U.S. guidelines.
Journal of aging and physical activity 04/2011; 19(2):147-68. · 2.09 Impact Factor
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ABSTRACT: Little is known about prostate cancer (PrCA) screening information on participatory, interactive, and consumer-generated websites collectively referred to as Web 2.0. A content analysis was conducted of PrCA resources on four highly trafficked Web 2.0 social bookmarking sites. A total of 127 webpages were analyzed. Most content was from news websites (48.9%) and blogs (37.8%). PrCA screening was mentioned on 95.3% of pages; only 30.7% discussed the prostate-specific antigen test. Less than half (43.8%) mentioned current screening guidelines. PrCA content is inconsistent on Web 2.0 sites. Future research should assess the readability and usability of Web 2.0 cancer resources.
Journal of Cancer Education 03/2011; 26(1):188-93. · 0.76 Impact Factor
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ABSTRACT: Messages promoting physical activity (PA) to maintain cognitive health (CH) may increase PA and enhance CH among older persons. This study examined older adults' perceptions of PA and CH. We conducted 10 focus groups with irregularly active older Black and White women and men (N = 55), ages 65 to 74 in South Carolina. Constant comparison methods compared themes by gender and race/ethnicity groups. Most participants perceived cognitive decline as a severe threat, and they were primarily concerned about losing their independence. Most reported feeling susceptible to cognitive decline. Although most recognized the link between PA and CH, several White men said the association was not clear. Participants recommended a wide range of PA amounts needed to achieve CH benefits. Many suggested that evidence of PA benefits for CH would enhance message credibility. Participants suggested messages be paired with social support to increase PA. Results suggest a need for evidence-based, credible communication promoting PA and CH.
Health Education & Behavior 02/2011; 38(1):15-24. · 1.54 Impact Factor
