Carolina Crespi

© 2015 American Association for Cancer Research. Background: In the United States, Korean immigrants experience a disproportionately high burden of chronic hepatitis B viral infection and associated liver cancer compared with the general population.However, despite clear clinical guidelines,HBV serologic testing among Koreans remains persistently suboptimal. Methods: We conducted a cluster-randomized trial to evaluate a church-based small group intervention to improve HBV testing among Koreans in Los Angeles. Fifty-two Korean churches, stratified by size and location, were randomized to intervention or control conditions. Intervention church participants attended a single-session small-group discussion on liver cancer and HBV testing, and control church participants attended a similar session on physical activity and nutrition. Outcome data consisted of self-reported HBV testing obtained via 6-month telephone follow-up interviews. Results: We recruited 1,123 individuals, 18 to 64 years of age, across the 52 churches. Ninety-two percent of the sample attended the assigned intervention session and 86% completed the 6-month follow-up. Sample characteristics included were as follows: mean age 46 years, 65% female, 97% born in Korea, 69% completed some college, and 43% insured. In an intent-to-treat analysis, the intervention produced a statistically significant effect, with 19% of intervention and 6% of control group participants reporting a HBV test. Conclusion: Our intervention was successful in achieving a large and robust effect in a population at high risk of HBV infection and sequelae. Impact: The intervention was fairly resource efficient and thus has high potential for replication in other high-risk Asian groups.

© 2015 American Cancer Society. BACKGROUND: Ethnic minorities, especially African Americans and Latinos, bear a disproportionate burden of colorectal cancer, as reflected in incidence, cancer stage, and mortality statistics. In all ethnic groups, first-degree relatives of CRC cases are at an elevated disease risk. However, underuse of CRC screening persists and is particularly evident among minority groups. The current study tested a stepped intervention to increase CRC screening among an ethnically diverse sample of FDRs of CRC cases. METHODS: A statewide cancer registry was used to recruit CRC cases and through them their FDRs. Relatives who were not current on CRC screening were randomized to intervention or usual-care control arms. The stepped intervention consisted of ethnically targeted and individually tailored print materials followed by telephone counseling for those unscreened at 6 months. RESULTS: The study sample of 1280 individuals consisted of 403 Latino, 284 African American, 242 Asian, and 351 white FDRs. Statistically significant effects were observed for the cumulative print plus telephone intervention at 12 months and the print intervention alone at 6 months. The effect of the print intervention alone versus the cumulative interventions was not statistically significantly different. Stratified analyses indicated that the intervention was effective among white, Latino, and Asian individuals, but not among African-Americans. CONCLUSIONS: Overall, the intervention was effective in increasing screening rates. Oversampling racial/ethnic minorities allowed for the examination of effects within subgroups, revealing no effect among African American individuals. This finding illustrates the importance of including sufficient numbers of participants from diverse ethnic subgroups in intervention research to enable such stratified analyses. Cancer 2015;121:2951-2959.

© 2015 Jacobs Institute of Women's Health. Introduction: Mixtecs and Zapotecs are indigenous populations from Mexico. Many are unable to read and write, and speak only their native nonwritten languages, Mixteco and Zapoteco. About one-half of California's indigenous farm worker population is estimated to be Mixteco-speaking, and about 20,000 Mixtecs and a smaller number of Zapotecs live in Ventura County. Objectives: A community-academic partnership conducted mixed-methods research with the aims of 1) collecting preliminary data on women's health needs, 2) training promotoras to assist with this effort, and 3) engaging community members and obtaining their input through community dialogues. Methods: Promotoras who were bilingual in Spanish and either Mixteco or Zapoteco were trained to conduct surveys that included questions on breast feeding and receipt of breast and cervical cancer screening examinations. Barriers to and facilitators of women obtaining these cancer screening tests were discussed in small groups. Results: In 2013, 813 Mixtec and Zapotec women completed surveys. Although most women reported breast feeding, and receipt of a pelvic examination and a breast examination, only 44% of women 40years and older had ever heard of and 33% had ever had a mammogram. Community members recommended offering free mammograms on the weekend by female providers, having women accompanied by promotoras who can translate, conducting door-to-door outreach, advertising cancer screening on the radio and providing small incentives to women. Discussion: Trained bilingual promotoras can assist in increasing the capacity of indigenous communities to conduct collaborative research by engaging community members and collecting local data.