Edgar Munoz

Edgar Munoz
The University of Texas Health Science Center at San Antonio | UT HSC · Institute for Health Promotion Research

Statistician; MS Epidemiologist; CBDS

About

98
Publications
8,119
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854
Citations
Additional affiliations
January 2007 - present
The University of Texas Health Science Center at San Antonio
Position
  • Statistician Senior

Publications

Publications (98)
Article
Full-text available
Background Patient navigation (PN) is a promising yet underused approach to address Hispanic/Latino (H/L) cancer survivors' unmet supportive care needs. The authors conducted a randomized trial to evaluate the effect of a culturally tailored PN program with the LIVESTRONG Foundation's Cancer Navigation Services (PN‐LCNS) on reducing unmet needs in...
Article
Background: Hormone therapy (HT) is highly effective for nearly all breast cancer patients with hormone receptor-positive tumors, which are about 80% of all breast cancer diagnoses. Long-term use of HT reduces cancer recurrence rates and cuts the risk of mortality nearly in half during the second decade after diagnosis. Despite proven benefits, 33%...
Article
South Texas (STX), spanning from San Antonio to the Texas-Mexico border, includes 25 rural counties, with 96% designated as primary care shortage areas, are notably the nation’s poorest and most medically underserved regions in the United States. Hispanic/Latinos (H/Ls) in the U.S. face challenges related to social determinants of health (SDoH), co...
Article
Background: Despite major advances in tobacco control and treatment, tobacco use remains the single largest preventable cause of morbidity and mortality in the US. Smoking prevalence is highest among Texas young adults (ages 18-29), especially those with lower education and income and those living in rural areas, like Latinos. About 19.2% of Latino...
Article
Full-text available
Purpose The aim of this study was to characterize the prevalence of cardiometabolic comorbidities (i.e., diabetes, peripheral vascular disease, myocardial infarction, congestive heart failure, cerebrovascular disease) among Hispanic/Latino cancer survivors and examine the impact of cardiometabolic comorbidities on health-related quality of life (HR...
Article
Background: Physicians have unparalleled access to smokers. It is estimated that over 70% of smokers visit a physician every year, which provides a powerful opportunity to promote tobacco cessation by asking about smoking behaviors and providing cessation advice and counseling to tobacco users at every visit. In general, smokers consider a physicia...
Article
Background: Knowledge gained through cancer clinical trials (CTs) has been proven critical to preventing, diagnosing and treating the disease, and providing the evidence base for clinical practice. Major advances in cancer treatment, which are essential for improving patients’ outcomes, come from investigations of new therapeutic agents in CTs. Des...
Article
Background: Adjuvant hormonal therapy (HT) is highly effective and appropriate for nearly all women with hormone receptor-positive tumors, making such treatment the most widely prescribed therapy for patients with this type of breast cancer. Despite its proven benefits in reducing cancer recurrence and improving survival, HT adherence is suboptimal...
Article
Full-text available
Purpose We aimed to identify subgroups of Hispanic/Latino (H/L) cancer survivors with distinct health behavior patterns and their associated sociodemographic, medical, and psychosocial characteristics. Methods Baseline data were used from a randomized clinical trial evaluating the efficacy of an enhanced patient navigation intervention in H/L canc...
Preprint
Full-text available
Purpose We aimed to identify subgroups of Hispanic/Latino (H/L) cancer survivors with distinct health behavior patterns and their associated sociodemographic, medical, and psychosocial characteristics. Methods Baseline data was used from a randomized clinical trial evaluating the efficacy of an enhanced patient navigation intervention in H/L cance...
Article
Full-text available
Purpose Behavioral interventions have been used with breast cancer survivors (BCS) in cancer pain management and post-treatment quality of life (QOL) studies. We studied the effects of an anti-inflammatory dietary intervention on QOL in BCS. Methods One hundred fifty-three overweight and obese (body mass index [BMI] ≥ 25 kg/m²), early stage (0-III...
Article
Full-text available
El comportamiento de la pandemia de COVID-19 durante los tres picos registrados en Cali ha sido heterogéneo y la severidad de los contagios y decesos ha variado durante el tiempo. Cali con 2.2 millones de habitantes es la tercera ciudad mas poblada de Colombia, registra a la fecha (21-11-21) 285 mil casos confirmados y 7,474 muertes por la infecció...
Article
Promoting coronavirus vaccination is deterred by misinformation, ranging from elaborate conspiracy theories about sinister purposes to exaggeration of side effects, largely promulgated by social media. In this pilot study, we tested the effects of different messages on actions leading to vaccination. Two theory-based advertisements were produced fo...
Conference Paper
Background: The successful use of hormone therapy (HT) has contributed to improved 5-year cause-specific breast cancer survival rates, and evidence shows that long-term use produces a larger reduction in recurrence and mortality, with nearly 50% reduction in breast cancer mortality during the second decade after diagnosis. Despite the proven benefi...
Article
Full-text available
Background Gastric cancer disproportionately affects Latinos, but little is known about regional effects and risk factors. We compared primary incidence, late-stage diagnosis, and risk factors for gastric adenocarcinoma (GCA) from 2004 to 2016 in Latinos and non-Latinos in the United States, Texas (TX), and South Texas (STX). Methods We collected...
Article
Given how smart phones, internet services, and social media have shown great potential for assisting smoking cessation, we constructed a Facebook chat application based on our previous work with SMS texting services. This report summarizes findings from 2,364 Spanish-speaking young adults recruited through Facebook advertising in South Texas during...
Article
Full-text available
We thank Dr. Colebunders for his comments regarding our manuscript. Our study was an ecological study prompted by the low frequency of cases and deaths from the SARS-CoV-2 COVID-19 virus in some African countries. We agree with Dr. Colebunders that other factors could explain the observed association between APOC countries and COVID-19 mortality. H...
Preprint
BACKGROUND Quitxt is a mobile smoking cessation service delivered through text messaging (SMS) and Facebook Messenger chat. Cigarette smoking and alcohol use are well known to be concomitant behaviors, however there is a lack of studies related to recruitment of smokers for mobile cessation services at places where alcohol is consumed, such as bars...
Article
Full-text available
Background: Cigarette smoking and alcohol use are well known to be concomitant behaviors, but there is a lack of studies related to recruitment of smokers for mobile cessation services at places where alcohol is consumed, such as bars and clubs. Adapting recruitment strategies to expand the reach of cessation programs to where tobacco users are lo...
Conference Paper
p>Background: The successful use of hormone therapy (HT) has contributed to improved 5-year cause-specific breast cancer survival rates and evidence shows that long-term use produces a larger reduction in recurrence and mortality, with nearly 50% reduction in breast cancer mortality during the second decade after diagnosis. Despite the proven benef...
Article
Full-text available
In an attempt to evaluate the contribution of symptoms, functionality and health perception on health-related quality of life of 80 women with breast cancer that underwent chemotherapy for disease treatment was studied. In this study cohort, retrospective data was extracted after the application of the questionnaires QLQ-C30 and QLQ-BR23 for qualit...
Conference Paper
Background: Adjuvant hormonal therapy (HT) is highly effective and appropriate for nearly all women with hormone receptor-positive tumors, making such treatment the most widely prescribed therapy for patients with this type of breast cancer. Despite its proven benefits in reducing cancer recurrence and improving survival, HT adherence is suboptimal...
Conference Paper
Background: Quitxt is an evidence-based mobile text messaging service for smoking cessation promoted in South Texas via social media advertising. A group analysis of 798 Quitxt participants with a mean age of 29.3 found that 21% of the enrollees reported abstinence at 7 months. This confirmed that a text and mobile media service specifically design...
Conference Paper
Background People living in the Mays Cancer Center (MCC) catchment area face greater cancer-related disparities and face a greater risk of developing liver and cervical cancer. Other priority cancers include colorectal, prostate, and breast cancer. All five major metropolitan cities in the catchment area have lower use of preventive screening servi...
Article
Full-text available
Introduction: The low frequency of cases and deaths from the SARS-CoV-2 COVID-19 virus in some countries of Africa has called our attention about the unusual behavior of this disease. The ivermectin is considered a drug of choice for various parasitic and viral diseases and shown to have in vitro effects against SARS-CoV-2. Aims: Our study aimed...
Article
Full-text available
BACKGROUND Bladder cancer (BC) poses an enormous burden on health care systems. Latinos in Texas (TX) were underrepresented in previous studies on racial/ethnic disparity of BC in the US. OBJECTIVE To examine whether BC incidence and survival rates differ among Latinos compared to non-Latino whites (NLW) in South TX, TX, and the US SEER. METHODS...
Article
Full-text available
Introduction: Breast cancer survivorship is a life-long process involving challenges to health-care communities and individuals, especially Latinas. Patient Navigation has shown some success in meeting these challenges. The purpose of this study was to compare the effects of an enhanced Patient Navigation program (Intervention; PN+) vs Control (PN...
Chapter
Despite improvements in the socioeconomic conditions of Latin American, the homicide rates in the region have not declined as expected. Data from World Health Organization and the United Nations Office on Drug and Crime show that this region has the highest homicide rate in the world. This analysis describes the regional homicide trends, explores h...
Conference Paper
Introduction: Colorectal cancer (CRC) is one of the most commonly diagnosed and one of the leading causes of cancer deaths in both Latino men and women. Latino adults also have disproportionately lower CRC screening rates than their white peers. Methods: To improve CRC education and screening rates, we at UT Health San Antonio used a variety of cul...
Article
Objetivo Describir la distribución espacio-temporal del COVID-19 en la ciudad de Cali durante el primer mes de epidemia. Métodos Se realizó un análisis exploratorio de datos espaciales, compuesto por un análisis de densidad de Kernel y se verificó la presencia de patrones espaciales por medio de la función K de Ripley. Resultados La distribución...
Article
Full-text available
Objetivo Predecir el número de casos de COVID-19 en la ciudad de Cali-Colombia mediante el desarrollo de un modelo SEIR. Métodos Se utilizó un modelo determinista compartimental SEIR considerando los estados: susceptibles (S), expuestos (E), infectados (I) y recuperados (R). Los parámetros del modelo fueron seleccionados de acuerdo a la revisión d...
Article
Full-text available
Objetivo Describir la distribución espacio-temporal del COVID-19 en la ciudad de Cali durante el primer mes de epidemia.Métodos Se realizó un análisis exploratorio de datos espaciales, compuesto por un análisis de densidad de Kernel y se verificó la presencia de patrones espaciales por medio de la función K de Ripley.Resultados La distribución espa...
Chapter
Full-text available
In South Texas, smoking rates among young Latino adults aged 18–29 are high (23.2%–25.7%). This is a serious public health problem, yet few are reached by services to help them quit smoking. Cellular phones have an extraordinary potential for assisting smoking cessation by providing access to peer modeling and social reinforcement for behavior chan...
Article
Full-text available
Background After a diagnosis of prostate, breast, or colorectal cancer, Latinos experience higher mortality rates and lower health‐related quality of life (HRQOL) in comparison with other ethnic/racial groups. Patient navigation (PN) and lay community health workers or promotores are effective in increasing cancer screening and early‐stage diagnosi...
Conference Paper
Introduction: Despite overall decrease in incidence of cancers in U.S., kidney cancer is one out of the only seven cancers with increasing incidence. Limited research has been conducted using national, state-wide, and regional data, especially comparing racial and ethnic disparities in incidence and outcomes for kidney cancer. Methods: Kidney cance...
Conference Paper
Introduction: Despite overall decrease in incidence of cancers in U.S., kidney cancer is one out of the only seven cancers with increasing incidence. Limited research has been conducted using national, state-wide, and regional data, especially comparing racial and ethnic disparities in incidence and outcomes for kidney cancer. Methods: Kidney cance...
Article
Full-text available
PurposeThe aim of this study was to elucidate the prevalence of unmet supportive care needs in Hispanic/Latino cancer survivors and examine the association between unmet needs and patient-provider communication, satisfaction with cancer care, and cancer-specific symptom burden. Methods Hispanics/Latinos diagnosed with breast, prostate, or colorecta...
Article
Full-text available
Purpose The goal of this education and culinary-based dietary intervention was to increase adherence to a Mediterranean-style, anti-inflammatory dietary pattern in breast cancer survivors (BCS) by promoting the consumption of anti-inflammatory foods, herbs, and spices. Methods Overweight and obese, early-stage, BCS were randomized to the Intervent...
Presentation
The increasing diversity of the nation brings opportunities and challenges for healthcare providers, healthcare systems, researchers and policy makers to create and deliver culturally competent services that meet the needs of each individual and improves overall health of the community. Promotoras are a unique group of community health workers (CHW...
Presentation
We describe our strategies for developing partnerships and engaging Latino communities to promote and implement Screen to Save. We focused on one-on-one patient encounters at the clinic level, community-wide outreach events, training and incorporating promotoras, showcasing messages via social media platforms such as Salud America!, and broadcastin...
Article
Full-text available
Adjuvant endocrine hormonal therapy (EHT) is highly effective and appropriate for nearly all breast cancer patients with hormone receptor-positive tumors, which represent 75% of all breast cancer diagnoses. Long-term use of EHT reduces recurrence rates and nearly halves the risk of death during the second decade after diagnosis. Despite the proven...
Article
Full-text available
Latinos lag behind other racial/ethnic groups in pursuit of master's and doctoral degrees in public health and the health sciences. Éxito! is modeled after the Minority Training Program in Cancer Control Research (MTPCCR), which found that Latino participants went on to doctoral programs at a lower rate (12%) than African American (36%) and Asian p...
Article
Background: Higher incidence and lower survival rates have been linked to racial/ethnic and socioeconomic (SES) disparities in patients with pancreatic cancer. However, systematic evaluation of the interaction between race/ethnicity, SES, comorbidities and type of surgical procedures to predict outcomes associated with pancreatic cancer are missing...
Article
Introduction: Acute leukemia is an important cause of morbidity and mortality with differences in incidence and outcomes between patients of different ethnic backgrounds. We conducted this study to examine the ethnic disparities in incidence of ALL as well as other types of acute leukemia in the Latino population in South Texas. Methods: Data were...
Article
Full-text available
Minority representation in clinical trials is vital for researchers to assess differential effects in outcomes of therapies on biological and genetic characteristics among groups. This study assessed the effect of Choices, a bilingual multi-component intervention, on perceived understanding of clinical trials, agreement with stages of decision read...
Article
Background: The objective of the current study was to examine how modifiable factors such as satisfaction with cancer care and self-efficacy impact health-related quality of life (HRQOL) among Latino cancer survivors. Methods: Latinos previously diagnosed with breast, prostate, or colorectal cancer (N = 288) completed questionnaires (Patient Sat...
Article
Full-text available
Chronic Helicobacter pylori (H. pylori) infection is a major gastric adenocarcinoma (GA) risk factor. GA disproportionately affects U.S. Hispanics compared with non-Hispanic Whites (NHWs). Since H. pylori infection studies in Hispanics are few, infection rates in Hispanic and NHW men in Bexar County were compared, and relationships with ethnicity a...
Article
To realize the promising potential of services delivered via smart phones to help young adults quit smoking at a high level of cost-efficiency, we constructed a texting and mobile media system that was promoted in South Texas via social media advertising and other recruitment channels. During the 6-month service period described here, enrollments w...
Article
Full-text available
Chronic Helicobacter pylori (H. pylori) infection is a major gastric adenocarcinoma risk factor. Gastric adenocarcinoma (GA) disproportionately affects U.S. Hispanics compared to non-Hispanic whites (NHWs). Since H. pylori infection studies in Hispanics are few, infection rates in Hispanic and NHW men in Bexar County were compared, and relationship...
Article
U.S. breast cancer survivors (BCSs) are expected to increase to 4 million in the next 5–10 years. Cancer recurrence risk is highest among obese survivors. Inflammatory (Pro-I) biomarkers including C-reactive protein (CRP), Interleukins -3, -6, and -8 (IL-3, IL-6, IL-8), and Tumor Necrosis Factor (TNF)–α have been associated with cancer recurrence r...
Article
U.S. breast cancer survivors (BCSs) are expected to increase to 4 million in the next 5-10 years. Cancer recurrence risk is highest in obese survivors. Inflammatory (Pro-I) biomarkers including C-reactive protein (CRP), Interleukins -3, -6, and -8 (IL-3, IL-6, IL-8), and Tumor Necrosis Factor (TNF)-α have been associated with cancer severity and re...
Article
Background: Breast cancer is the leading cancer among women of Hispanic origin. It is expected to continue to be the leading cancer as the US Hispanic population grows towards 31% of all US citizens by 2060. Hispanic women (Latinas) experience significant disparities in breast cancer services resulting in lower breast cancer survival rates than the...
Article
Background: U.S. breast cancer survivors (BCSs) are expected to increase from 3 to 4 million in the next 5-10 years. Cancer recurrence risk is highest in obese survivors. Pro-inflammatory biomarkers including C-reactive protein (CRP), Interleukins -3, -6, and -8 (IL-3, IL-6, IL-8), and Tumor Necrosis Factor (TNF)α have been associated with cancer s...
Article
Evidence shows that variations in the degree and type of a message's emotional arousal, particularly disgust, can influence message impact on smokers' interest in quitting and likelihood of seeking help. Negative emotional appeals are widely used to attract attention of Latino audiences, but positive appeals, especially those designed to increase s...
Article
Smoking among Latino young adults (18-29) in South Texas is high (23.2% to 25.7%), representing a serious public health problem. Yet few are reached by services to help them quit smoking. Young adult Latinos are heavy users of mobile devices for texting and access to mobile media. These have an extraordinary theoretical potential for assisting smok...
Article
Latinos in South Texas (STX) are disproportionately diagnosed with Hepatocellular Carcinoma (HCC) compared to non-Hispanic whites (NHW) and Latinos in the U.S. The aims of this study were to characterize behavioral and clinical risk factors contributing to HCC incidence in our STX population. Methods: Controls and cases (104:51) were recruited from...
Article
Full-text available
Purpose: This study examined interest in and attitudes toward genetic testing in 5 different population groups. Methods: The survey included African American, Asian American, Latina, Native American, and Appalachian women with varying familial histories of breast cancer. A total of 49 women were interviewed in person. Descriptive and nonparametr...
Article
For Latina women, breast cancer is the leading cancer and we expect this trend to continue as the US Hispanic population expands. Latinas generally have lower survival rates for most cancers, even after accounting for differences in age and stage distribution, which may reflect less access to timely, high-quality treatment. Despite these challenges...
Article
Background: Without adequate minority representation in clinical trials, researchers cannot assess differential effects in outcomes or ensure the safety of therapies across a range of biological and genetic characteristics among groups, nor can they ensure generalizability of trial results. In response, this theory-based educational intervention ai...
Article
Background: Latino cancer survivors experience an unequal burden of unmet needs following treatment. These include issues involving psychological issues, health care, wellness and ultimately, survival. Study Design: Redes En Acción: The National Latino Cancer Research Network and LIVESTRONG partnered to conduct a randomized control trial utilizing...
Article
s: Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; November 9-12, 2014; San Antonio, TX Background: Patient Navigation has evolved to reduce cancer health disparities by eliminating barriers to diagnosis, treatment, and survivorship services. Attempts have been made to describ...
Conference Paper
Helicobacter pylori (H. pylori) infection is a common risk factor (RF) for gastric adenocarcinoma. Although the infection is highly prevalent worldwide, US rates vary. Recent analysis of 286 Hispanic and non-Hispanic white men in a prospective cohort found significant associations between H. pylori-positive (+) serology and Hispanic ethnicity. This...
Conference Paper
Purpose: Latino cancer survivors experience an unequal burden of unmet needs after treatment, which compromise their health care and wellness; experts recommend providing psychosocial services as an integral part of quality cancer care. Methods: Redes En Acción: The National Latino Cancer Research Network and LIVESTRONG partnered to conduct a ran...
Conference Paper
Introduction: Chronic Helicobacter pylori (H. pylori) infection is the most common gastric carcinoma (GC) risk factor. GC more commonly affects U.S. Hispanics than non-Hispanic whites (NHWs). No study has recently examined this infection in South Texas Hispanics, a population facing multiple health disparities. This pilot project aimed to determine...
Conference Paper
Introduction: Between 1995 and 2010 there have been 1.4 million incident cancer cases in Texas. While Hepatocellular Carcinoma (HCC) accounted for a small proportion (ranked 21st in incidence), it ranked 9th by cause of death attributed to the tumor. Mortality rate was 68%, with average overall survival time 16.6 months. Unlike most cancers, HCC ha...
Conference Paper
Gastric cancer (GC) is the second-leading cause of cancer-related deaths in most Western countries. US Hispanics have higher rates of GC compared to the general population. The purpose of this study was to comprehensively compare Latinos to non-Hispanic white (NHW) for all primary gastric malignant tumor incidence and trends from 1995 to 2010, in t...
Article
Background: Breast cancer is the leading cause of cancer deaths in Latinas, primarily due to screening and treatment disparities. Patient navigation has emerged as an effective means to reduce these disparities, although how this is achieved is insufficiently documented. Methods: We analyzed navigator logs of activities conducted on behalf of 42 na...
Article
Full-text available
Background A previous study showed Hepatocellular Carcinoma (HCC) rates to be higher among Latinos in Texas and highest among South Texas Latinos compared to other non-Hispanic whites (NHW) and other Latinos in the United States (U.S.). We used more recent data to assess trends in HCC among Texas Latinos and to reassess the elevated HCC incidence r...
Article
Full-text available
Background: Inclusion of minorities in clinical research is an essential step to develop novel cancer treatments, improve health care overall, understand potential differences in pharmacogenomics and address minorities' disproportionate cancer burden. However, Latinos and other minority groups continue to be critically underrepresented, particular...
Article
Full-text available
The interaction of clinical and patient-level challenges following a breast cancer diagnosis can be a significant source of health care disparities. Failure to address specific cultural features that create or exacerbate barriers can lead to less-than optimal navigation results, specifically in Hispanic/Latino women. To address these disparities, t...
Conference Paper
Full-text available
Breast cancer is the leading cause of cancer deaths in Latinas. Time from cancer diagnosis to treatment initiation is critical in optimizing care. Patient navigation (PN) is a potentially effective means of promoting timely breast cancer treatment, yet efficacy is insufficiently documented. Redes En Accin: The National Latino Cancer Research Netw...
Conference Paper
Background: Genetic testing for breast cancer may facilitate better-informed decisions regarding cancer prevention, risk reduction, more effective early detection, and better determination of risk for family members. Despite these potential benefits, Latinas lack awareness of genetic testing for breast cancer susceptibility. Among women who are tes...
Conference Paper
Introduction. From 2007-2009, new cancer diagnoses declined for men, but remained stable for women and increased slightly for children. Hepatocellular carcinoma (HCC) is an exception: incidence has increased in all groups. Moreover, HCC among South Texas Latinos has traditionally been higher than all other U.S. Latinos. This study compares incidenc...
Conference Paper
Background: Without adequate minority representation in clinical trials, researchers cannot assess differential effects in outcomes or ensure the safety of therapies across a range of biological and genetic characteristics among groups, nor can they ensure generalizability of trial results. In response, this theory-based educational intervention ai...
Book
Full-text available
This book is a roadmap of the exact health disparities that burden the health of South Texas residents, especially Hispanics, compared to the rest of Texas and nation. This type of knowledge has the potential to fuel and motivate researchers and public health leaders to create and shape interventions to reverse those health disparities. Most notabl...
Conference Paper
Full-text available
BACKGROUND: Breast cancer is the leading cause of cancer deaths in Latinas. Time from cancer diagnosis to treatment initiation is critical in optimizing cancer care. Patient navigation is a potentially effective means of promoting timely treatment of breast cancer, yet efficacy is insufficiently documented. Redes en Accion here evaluates a cultural...
Article
Breast cancer is the leading cause of cancer-related deaths in Latinas, chiefly because of later diagnosis. The time from screening to diagnosis is critical to optimizing cancer care, yet the efficacy of navigation in reducing it is insufficiently documented. Here, the authors evaluate a culturally sensitive patient navigation program to reduce the...