Laura Szalacha

• EdD
• Arizona State University

Background Southeast Asian immigrant women in the U.S. have high rates of breast and cervical cancer, yet they are the least likely of all racial/ethnic groups to get screened. To address this disparity, we adapted the evidence-based Tailored Intervention Messaging System© (TIMS©), which uses tailored messages and navigation by culturally and lingu...

Background Cancer is the leading cause of death for Southeast Asian women in the U.S. Southeast Asian women have significantly high rates of breast and cervical cancers, yet are least likely to obtain regular mammography and Pap testing of all racial/ethnic groups in the U.S. Objectives The purpose of this study is to compare a tailored navigation...

Background Guidelines call for pregnant people to be screened for depression and anxiety. Screening may be particularly important for pregnant Black individuals who are reported to be more likely than non-Hispanic White pregnant people to experience prenatal stress, anxiety, and depressive symptoms. The purpose of this study was to determine if dep...

Background: Dissemination strategies to reach underserved and minority populations to promote screening for colorectal cancer (CRC) is key to reducing disparities. We conducted a study to examine a tailored messaging approach to navigate individuals from communities (i.e., lower income, less access to care, underscreened) to clinics to receive CRC...

Purpose Although screening for colorectal cancer (CRC) lowers mortality and morbidity and is generally cost-effective, little is known about the cost-effectiveness of screening promotion. Design Cost-effectiveness analysis alongside a group-randomized trial. Setting: Multicultural, underinsured communities in the Phoenix, Arizona, area. Subjects...

Introduction Genomic/precision medicine offers a remarkable opportunity to improve health and address health disparities. Genomic medicine is the study of genes and their interaction with health. Precision medicine is an approach to disease prevention and treatment that considers individual variability in genes, environment and lifestyle. Conclusio...

Background American Indians (AI) experience major colorectal cancer (CRC) screening disparities with commensurate inequity in CRC mortality and other outcomes. The purpose of this report is to describe the methods and early results of adapting a previously successful intervention for the AI community. Methods The educational content and delivery s...

Objective To describe the effect of a language-concordant health coaching intervention for Spanish-speaking patients with limited English proficiency (LEP) and uncontrolled Type 2 Diabetes (T2D) on glycemic control, anxiety, depression, and diabetes self-efficacy. Methods 64 patients with T2D were randomly assigned to a control or intervention gro...

A simulation-based learning experience (SBLE) is known to improve emotional skills. Arksey and O'Malley's (2005) framework and the preferred reporting items for scoping reviews were used. Databases included PubMed, PsycINFO, and Scopus for randomized controlled trials examining the impact of utilizing SBLE to promote emotional competence among heal...

Fatigue and pain are the most frequently reported symptoms among advanced‐stage cancer patients. Although physical activity (PA) is known to improve the aforementioned symptoms, few patients demonstrate the physically active behavior that adheres to the clinical guidelines regarding PA. The current article presents an exemplar that used the Nationa...

Purpose: The main objective of this study was to utilize an artificial neural network in an exploratory fashion to predict self-management behaviors based on reported symptoms in a sample of stable patients with chronic obstructive pulmonary disease (COPD). Design and methods: Patient symptom data were collected over 21 consecutive days. Symptom...

Background: Chronic illness management is increasingly carried out at home by individuals and their informal caregivers (dyads). Although synergistic in concept, the nuances of dyadic congruence in caring for patients with heart failure are largely unexamined. Aims: The purpose of this study was to examine the role of dyadic-type congruence on pati...

Background Emotionally distressed pregnant minority women experience multiple adverse outcomes, including pre-eclampsia, preterm birth, operative deliveries and low birth weight. Although the United States Preventive Services Task Force recommends screening in pregnant women, many practices do not screen because efficacious interventions and system...

Background: Cardiac toxicity in patients with cancer results from treatment-related damage to the cardiovascular system by chemotherapy, targeted agents, or thoracic radiation. Cardio-oncology patients with co-occurring cancer and cardiovascular disease frequently experience fatigue. Exercise is recommended in clinical guidelines to manage fatigue...

This concurrent mixed method study examined barriers to cervical cancer screening (CCS) among Cambodian and Lao women and mother-daughter communication about women's health, cervical cancer, and screening. We conducted seven focus groups with purposeful samples of Cambodian and Lao women in the Midwest. The participants completed a survey on health...

Background Colorectal cancer screening remains suboptimal among poor and underserved people. Purpose We tested the effectiveness of a community-to-clinic navigator intervention to guide multicultural, underinsured individuals into primary care clinics to complete colorectal cancer screening. Methods This two-phase behavioral intervention study wa...

Introduction: The effects of either menthol flavor cigarettes or total urinary menthol on biomarkers of nicotine dependence, addictive and carcinogenic exposure, and behavioral measures may inform differences and similarities of these two approaches. Methods: Stratified recruitment by cigarette (menthol flavor or regular cigarettes) and race (Af...

Objective This study reports on the psychometric properties of the 11-item Perceived Wellness Culture and Environment Support Scale (PWCESS) and its relationship with employee healthy lifestyle beliefs and behaviors. Methods Faculty and staff (N = 3959) at a large public university in the United States mid-west completed the PWCESS along with heal...

In this focus group study, we identified issues associated with sensory overload from medical technology alarms/alerts for intensive care unit nurses. Participants indicated that alarms from cardiopulmonary monitors, ventilators, and intravenous pumps contributed the most to sensory overload and, yet, these alarms were also deemed the most helpful....

Non-academic members of research teams, such as community members, can perceive traditional human subjects protection training as lacking in cultural relevance. We present a case exemplar of the development of a human subjects protection training for research staff with limited English proficiency and/or no or limited research experience. Seven mod...

Background We examined the relationships among experiences of interpersonal violence, mental health, and sexual identity in a national sample of young adult women in Australia. Methods We used existing data from the third (2003) wave of young adult women (aged 25–30) in the Australian Longitudinal Study on Women’s Health (ALSWH). We conducted bivar...

Objectives: The purpose of the study was to determine (1) recruitment feasibility; (2) intervention adherence; (3) intervention acceptability; and (4) the preliminary effects of touch or foot massage interventions on anxiety during a magnetic resonance imaging (MRI). Design: A quasi-experimental design was used. Intervention: Foot massage and...

One in 3 patients is estimated to experience health care-related harm during hospitalization. This descriptive, cross-sectional study used the Safety Attitudes Questionnaire to measure interprofessional staff perceptions of safety and teamwork climate and a retrospective, modified Global Trigger Tool chart review methodology to measure unit-level p...

Sustained high levels of activated polymorphonuclear leukocytes (PMNs) and PMN-derived proteases in the microenvironment of chronic venous leg ulcers (CVLUs) are linked to chronic inflammation and delayed healing. Uncontrolled PMN activity eventually destroys newly developed tissue and degrades critical growth factors. The bioactive components of f...

Information technology provides new avenues to increase opportunities to deliver HIV/STI prevention interventions in a confidential, sensitive, and engaging manner for youth. While technology-based HIV/STI interventions show promise in preventing HIV/STI among different populations, few have targeted young Latinas. This pilot study examined the fea...

Despite common assumptions that non-paid family caregivers of Mexican descent benefit spiritually from their roles according to cultural familistic norms, there is also evidence of caregiver stress resulting in depression. Depression has the potential to seriously affect caregivers' health and their ability to continue to provide care. The current...

Background: Timing of birth is a major determinant of newborn health. African American women are at increased risk for early birth, particularly via the inflammatory pathway. Variants of the IL1RN gene, which encode the interleukin-1 receptor antagonist (IL-1Ra) protein, are implicated in early birth. The biological pathways linking these variable...

Introduction: Regular screening facilitates early diagnosis of colorectal cancer (CRC) and reduction of CRC morbidity and mortality. Screening rates for minorities and low-income populations remain suboptimal. Provider referral for CRC screening is one of the strongest predictors of adherence, but referrals are unlikely among those who have no cli...

The Hmong in the U.S. who emigrated from Southeast Asia, an area where hepatitis B is endemic, experience high rates of hepatitis B infection and liver cancer compared to nonHispanic whites. This exploratory study examined the Hmong’s perceptions of risk of hepatitis B infection. We interviewed 83 Hmong women and men living in Oregon. In bivariate...

Unlabelled: While pediatric anti-obesity lifestyle interventions have received considerable attention, few show sustained impact on body mass index (BMI). Using the Information-Motivation-Behavioral Skills Theory as a framework, we examined the effects of a satiety-focused mindful eating intervention (MEI) on BMI, weight and mindful awareness. Me...

Background: Lower participation rates in mammography and Papanicolaou test are common among Latinas compared with other ethnic groups. Suboptimal screening rates are attributed to lack of knowledge, access to services, and cultural influences. Objective: The purpose of this study is to qualitatively examine an alternative framework for examining...

Self-report is the most common means of obtaining mammography screening data. The purpose of this study was to assess the accuracy of minority women's self-reported mammography by comparing their self-reported dates of mammograms with those in their medical records from a community-based randomized control trial. We found that out of 192 women, 116...

Background: Although findings from studies indicate that evidence-based practice (EBP) results in high-quality care, improved patient outcomes, and lower costs, it is not consistently implemented by healthcare systems across the United States and globe. Aims: The purpose of this study was to describe: (a) the EBP beliefs and level of EBP impleme...

Identifying key factors influencing healthy lifestyle behaviors in university faculty and staff is critical in designing interventions to improve health outcomes and reduce health care costs. A descriptive study was conducted with 3,959 faculty and staff at a Midwestern, U.S. University. Key measures included perceived worksite culture, healthy lif...

ProblemDespite the increasing prevalence of mental health disorders in university students, few receive needed evidence-based treatment.Objective The purpose of this study was to assess the feasibility and preliminary effects of a seven-session online cognitive-behavioral skill-building intervention (i.e., COPE, Creating Opportunities for Personal...

We sought to examine cancer diagnosis, cancer treatment, and related risk factors among Australian, middle-aged, exclusively heterosexual women compared with sexual minority women (SMW; mainly heterosexual, bisexual, mainly lesbian, and lesbian). Secondary data analysis of the Australian Longitudinal Study of Women's Health for women born in 1946 t...

PurposeThere is a growing demand for nurse practitioners (NPs) within academic medical centers (AMCs) because of physician shortages and increased need for access to care. In order to retain these NPs, it is important to assess their role perception and satisfaction. The purpose of this study was to evaluate these concepts and their relationships t...

A high percentage of Korean American (KA) women have never had a mammogram, which puts them at greater risk for late-stage breast cancer. The aim of this study was to compare health beliefs and spousal support about breast cancer and screening between KA women with and without a history of mammogram completion. Cross-sectional data were obtained fr...

Specialists have long known that involvement in bullying in any capacity (as the victim or as the perpetrator) is associated with higher rates of suicidal ideation and behavior, but evidence about which bullying subtype is at greatest risk is more mixed. This online resource presents an authoritative review of the science demonstrating the links be...

Purpose: Fatigue is the most common and distressing symptom reported by cancer patients during and after treatment. Tumor growth increases oxidative stress and cytokine production, which causes skeletal muscle wasting and cardiac dysfunction. The purpose of this study was to determine whether treatment with the antioxidant ubiquinol improves muscl...

Chronic psychological stress impairs antibody synthesis following influenza vaccination. Chronic stress also increases circulating levels of proinflammatory cytokines and glucocorticoids in elders and caregivers, which can impair antibody synthesis. The purpose of this study was to determine whether psychological stress increases ex vivo cytokine p...

Background: The purpose of this study was to identify beliefs about breast cancer, screening practices, and factors associated with mammography use among first-generation immigrant Muslim women in Chicago, IL. Methods: A convenience sample of 207 first-generation immigrant Muslim women (Middle Eastern 51%; South Asian 49%) completed a culturally...

Purpose/Objectives: To assess the efficacy of Korean Immigrants and Mammography—Culture-Specific Health Intervention (KIM-CHI), an educational program for Korean American (KA) couples designed to improve mammography uptake among KA women. Design: A two-group cluster randomized, longitudinal, controlled design. Setting: 50 KA religious organizations...

Objectives: Racial discrimination experiences can negatively affect health. This study examined perceived discrimination and its relationship with mental health and substance use among Asian American and Pacific Islander (API) undergraduate and graduate students. Participants: A total of 113 API students aged 18-35 completed the study during Feb...

Although nurses are educated to take outstanding care of others, they themselves often have poor health outcomes, including high rates of depression and obesity, which are associated with stressful work environments. Furthermore, a high percentage of new graduate nurses leave their positions in the first year of employment, resulting in exorbitant...

Early and rapid growth in Infants is strongly associated with early development and persistence of obesity in young children. Substantial research has linked child obesity/overweight to increased risks for serious health outcomes, which include adverse physical, psychological, behavioral, or social consequences.Methods/design: The goal of this stud...

Objective: Sexual-minority women are at heightened risk for a number of mental health problems, including hazardous alcohol consumption, depression, and anxiety. We examined self-medication and impaired-functioning models of the associations among these variables and interpreted results within a life course framework that considered the unique soc...

Background: South Asians are a rapidly increasing population in the United States. Little is known about influences on their cancer screening behaviors, an important prerequisite to designing culturally appropriate education. Objective: The purpose of this study was to evaluate rates and correlates of colorectal cancer (CRC) screening, knowledge...

Indoor air pollution from poorly vented cookstoves negatively influences human health. In developing countries, women's and children's primary home responsibility leads to them endure most related health problems. New stoves can improve their health and overall wellbeing. Most demonstration/research projects assess effectiveness with Indoor air pol...

Mind-body practices that blend physical movement or postures with a focus on the breath and a meditative state to achieve deep states of relaxation have recently been characterized as a category of exercise called meditative movement and include practices such as Yoga, Tai Chi, and Qigong. Critical components of such practices have not been adequat...

Objectives Obesity in children has risen over the past four decades, especially among ethnic minority populations. This AHRQ funded study is a comparative effectiveness trial of web-based training on the current recommendations for prevention and treatment of childhood obesity with and without technology decision support. The purpose of this pres...

OBJECTIVE: To test the hypothesis that Hands-on Automated Nursing Data System (HANDS) “big picture summary” can be implemented uniformly across diverse settings, and result in positive registered nurse (RN) and plan of care (POC) data outcomes across time. DESIGN: In a longitudinal, multisite, full test study, a representative convenience sample of...

Purpose: This study examined Asian American and Pacific Islander (AAPI) young adults’ sexual behaviors and factors associated with these behaviors. Background: Sexual behaviors in young adults have become a global health concern because of the negative consequences of risky sexual behaviors including HIV/STI, unplanned pregnancies, and their asso...

This study identifies unique psychosocial characteristics among African American men that put the men at risk for non-adherence to colorectal cancer (CRC) screening (colonoscopy, sigmoidoscopy, and fecal occult blood tests (FOBT)). Subgroups sharing similar psychosocial characteristics may be targeted with specific intervention strategies aimed at...

South Asian (SA) immigrants (from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) constitute the fastest growing of all Asian American immigrants to the United States, with a growth rate of 106% from 1990 to 2001. Data are lacking on health behaviors of this population subgroup, including cancer-related information. : The p...

Early-stage diagnosis of colorectal cancer is associated with high survival rates; screening prevalence, however, remains suboptimal. This study seeks to test the hypothesis that participants receiving telephone-based tailored education or motivational interviewing had higher colorectal cancer screening completion rates compared to usual care. Prim...

Purpose. The purposes of this study were to (a) determine whether actual weight, biological sex, and race/ethnicity were related to differences of weight perception, nutrition and activity knowledge, perceived difficulty, attitudes, and choices about living a healthy lifestyle in adolescents; and (b) describe the relationships among these variables...

Purpose: Examine longitudinal changes in colon cancer-related beliefs and knowledge and their prediction of post-intervention screening behavior. Background: Early diagnosis of colorectal cancer (CRC) is associated with high survival, and studies on increasing screening rates focus on changing behavior through manipulating beliefs and knowledge....

Purpose: This qualitative study aimed to gain an in-depth understanding of Chinese American adolescents’ perceived parenting styles and how parenting styles might influence adolescents’ psychosocial health. Background: Asian Americans are one of the fastest growing minority groups in the U.S of which Chinese is the leading group. Evidence suggest...

Purpose: The purpose of this qualitative study was to describe the knowledge, beliefs, and behaviors related to HIV risk and prevention among men who have sex with men (MSM) in Mumbai, India. Background: Greater than 3 million individuals are estimated to be infected with HIV in India. Current epidemiological trends suggest that without a concert...

we sought to compare physical and mental health status, health service use, and satisfaction among young Australian women of varying sexual identity; and to explore associations of all of these variables with satisfaction with their general practitioner (GP). data are from the youngest cohort of women in the Australian Longitudinal Study on Women's...

Aims: Although research shows that sexual minority women report high rates of lifetime sexual victimization and high rates of hazardous drinking, investigators have yet to explore the relationships between sexual victimization and hazardous drinking in this population. In addition, because the rates of these problems may vary within the sexual min...

We examined relationships between self-structure and known precursors for alcohol problems in 9-12 year old primarily Black and Latino youth (N=79). Parental alcohol problems and being female predicted few positive and many negative self-cognitions and a future-oriented self-cognition related to alcohol ('drinking possible self'). Nineteen percent...

A growing body of research amply documents health disparities related to substance abuse among sexual minority women. However, relatively little research has examined risk factors or predictors of substance use in this population and even less has explored differences among sexual minority subgroups. Using data from 8850 women aged 25-30 years in t...

Unlabelled: The aim of this mixed methods exploratory study was to describe pediatric nurses' cognitive representations (CRs) of the assessment and management of children's pain and to determine the relationships between their CRs and their choices about pain assessment and morphine administration. We recruited a convenience sample of 87 nurses ca...

Racism may be a factor contributing to poor health and health care disparities in minority children through multiple mechanisms, including effects on psychological and physical wellbeing. Little is known about the experiences of racism that children encounter in their lives. This study describes the occurrences of perceived racism in children, incl...

Experiences of racial discrimination have been demonstrated to be related to racial and ethnic disparities in mental and physical health and healthcare. There has been little study, however, of the relationship between racism and health in children, and few psychometrically valid and reliable instruments to measure Perceptions of Racism in Children...

In this sexually transmitted infection (STI) prevention study, we compared the efficacy of the Well Woman Program (WWP), a nurse practitioner-directed, culturally specific, intensive intervention, to minimal intervention (MI), brief lecture, and referral to usual care, in a community-based randomized controlled trial. African American women having...

A pre-post test, two-group study was conducted to examine the effects of a culturally competent targeted intervention titled GO EARLY Save Your Life on the breast cancer and early screening-related knowledge and beliefs and mammography use among 180 Korean American (KA) women aged 40 years or older who had not had mammograms within the past 12 mont...

Most research on immigrant acculturation has been conducted with cross-sectional samples, using statistical designs that may not capture different trajectories for the components that contribute to this complex concept. The purpose of this study was to examine change over time in acculturation for 226 women from the former Soviet Union who had live...

In this study, we investigated the relationships between school context and heterosexual adolescents’ social reasoning regarding same-sex sexuality and sexual prejudice. One thousand seventy- six adolescents (Female, n=648; Male, n=428) attending two high schools that differed in the degree to which they implemented practices to increase the safety...

Within the United States, protecting the rights of lesbian, gay, bisexual, and transgender (LGBT) students in school elicits much controversy and debate. On one side is the argument that all students should be able to receive an education free from discrimination, harassment, and harm. On the other side is the argument that by protecting LGBT stude...

Increasing colorectal cancer screening (CRCS) can have a substantial positive impact on morbidity and mortality. The purpose of this report is to describe the development and feasibility testing of a computer-based, theory-guided educational program designed to increase CRCS. This mixed-methods study used focus groups and subsequent randomized cont...

Objective: This article focuses on design, training, and delivery of motivational interview (MI) in a longitudinal randomized controlled trial intended to assess the efficacy of two separate interventions designed to increase colorectal screening when compared to a usual care, control group. One intervention was a single-session, telephone-based M...

This study describes the physical activity behavior of Korean immigrant women and examines the relationships among leisure-time physical activity (LTPA) behavior, background, and intrapersonal correlates of behavior in Korean immigrant women in the United States using a cross-sectional survey design. A convenience sample of Midwestern Korean immigr...

We examined the relationship of 2 dimensions of sexual orientation--sexual identity and sex of partners--with self-reported behaviors and experiences to identify factors that may place adolescent females at risk of HIV/AIDS. We gathered data on sexually experienced female high school students from 4 waves of a population-based survey. We used logis...

The health belief model (HBM), prodigiously researched, has enjoyed sustained popularity amid evolving social norms, theories and models, and the recent developments of advanced technology influencing health behavior change (→ Health Communication; Planned Social Change through Communication). Developed by US Public Health Service social psychologi...

Studies of alcohol use among lesbians have typically used convenience samples with uncertain generalizability or general population samples with small numbers of lesbians. Here we compare rates of high-risk and problem drinking in a large sample of Chicago-area lesbians and a national sample of age- and education-matched urban heterosexual women. D...

Background: Sexually transmitted infections (STIs) represent an epidemic in the United States, an unparalleled source of dire health consequences disproportionately affecting African American women. Few STI behavioral intervention studies, using laboratory-confirmed STIs as outcome measures, have been designed specifically for African American wome...

This study characterizes several aspects of emerging ethnic identity in childhood and its associations with interethnic group social preferences. Understanding these processes is important, as early interethnic group social practices may form a foundation for later interethnic group attitudes and behaviors in adolescence. Children of Cambodian, Dom...

This study examined the relationships between childhood and family background variables, including sexual and physical abuse, and subsequent alcohol abuse and psychological distress in adult lesbians. Structural equation modeling was used to evaluate relationships between childhood sexual and physical abuse and parenting variables and latent measur...

This paper aims to give voice to the lived experience of faculty members who have encountered racial or ethnic discrimination in the course of their academic careers. It looks at how they describe the environment for minorities, how they manage discrimination and what institutions and majority-member faculty can do to improve medical academe for mi...

Negotiation and its use in academic medicine have not been studied. Little is known about faculty experience with negotiation or its potential benefits for academe. Barriers to negotiation and how they can be addressed, especially for faculty without perceived skill in negotiation, are unknown. To better understand the problems that such faculty ex...

Although research on alcohol use among women has increased dramatically during the past several decades, relatively few studies have focused on lesbians, and almost none have included sufficient numbers of older lesbians or lesbians of color to permit comparative analyses. Using data from the Chicago Health and Life Experiences of Women Study (CHLE...

Sexual minority adolescents—those self-identifying as lesbian, gay, or bisexual (LGB) or with same-sex desires or sexual experiences—report higher rates of victimization and suicidality than their heterosexual peers, yet little empirical research has examined school factors associated with these risks. This study used data from the Massachusetts Yo...