Objective The purpose of this study is to understand how cancer risk behaviors cluster in U.S. college students and vary by race and ethnicity. Methods Using the fall 2010 wave of the National College Health Assessment (NCHA), we conducted a latent class analysis (LCA) to evaluate the clustering of cancer risk behaviors/conditions: Tobacco use, physical inactivity, unhealthy diet, alcohol binge drinking, and overweight/obesity. The identified clusters were then examined separately by students’ self-reported race and ethnicity. Results Among 30,093 college students surveyed, results show a high prevalence of unhealthy diet as defined by insufficient fruit and vegetable intake (>95%) and physical inactivity (>60%). The LCA identified behavioral clustering for the entire sample and distinct clustering among Black and American Indian students. Conclusions Cancer risk behaviors/conditions appear to cluster among college students differentially by race. Understanding how risk behaviors cluster in young adults can lend insight to racial disparities in cancer through adulthood. Health behavior interventions focused on modifying multiple risk behaviors and tailored to students’ racial group could potentially have a much larger effect on cancer prevention than those targeting any single behavior.
A partnership formed between Northeastern Illinois University (NEIU) and the Robert H. Lurie Comprehensive Cancer Center of Northwestern University sought to address well-documented cancer health disparities in Chicago by developing a collaborative research, training, and educational infrastructure between a minority-serving institution and a National Cancer Institute designated comprehensive cancer center. With a critical examination of partnership documentation and outputs, we describe the partnership’s community-engaged approaches, challenges, and lessons learned. Northeastern Illinois University and the Lurie Cancer Center engaged in a yearlong partnership-building phase, identified interdisciplinary research teams, formed a governance structure, and identified collective aims. Partnership outcomes included funded inter-institutional research projects, new curriculum, and an annual research trainee program. Significant challenges faced included uncertain fiscal climate, widespread turnover, and dissimilar institutional demands. Lessons learned from this minority serving institution and comprehensive cancer center partnership may be useful for bridging distinct academic communities in the pursuit of ameliorating health disparities.
Recent multi-site trials evaluating the efficacy of patient navigation programs have found only modest effects on reducing follow-up time among patients with abnormal breast and cervical cancer screening tests. However, navigators in these efficacy trials have primarily been situated within a hospital or clinic. We sought to describe the translation of clinic-based patient navigation to communitynested patient navigation and explore how disseminating and scaling patient navigation models to community settings can address complex barriers to care.
Purpose: Recent multi-site trials evaluating the efficacy of patient navigation programs have found only modest effects on reducing follow-up time among patients with abnormal breast and cervical cancer screening tests. However, patient navigators in these efficacy trials have primarily been situated within a hospital or clinic – not nested within the community. We sought to further elucidate the potential impact of patient navigation by exploring how patient navigation initiatives in various community settings can address complex barriers to care. Methods: We present four case studies to provide insight on the value of community-nested navigators in increasing breast and cervical cancer screening and follow-up. Case studies include: (1) a community-level adaptation of patient navigation to Chicago's Chinatown; (2) a community navigation and outreach program in the racially/ethnically diverse Chicago Lawn; (3) a county-wide dissemination of navigation in suburban DuPage County; and (4) a state-wide scaling of a patient navigation model to the Illinois Department of Health and Family Services. Case study data were derived from focus groups, key informant interviews, medical records review, and patient surveys. Results: Case studies describe the roles of community navigators and the challenges of navigating immigrant, non-English proficient patients in particular. Translating clinic-based patient navigators into community navigators to guide women through clinics, specialty referrals, diagnostic/testing sites, and wrap around services (e.g., transportation, housing, support groups, legal counseling) may help alleviate complex barriers to care in resource-thin environments. Conclusion: Community navigators are promising connectors and advocates for health care services delivery and prevention for culturally and linguistically isolated populations as well as communities with limited health care safety net systems. The community, county, and state-wide scaling of patient navigation described in these case studies serve as viable models for future patient navigation initiatives in low-resource settings to reduce cancer disparities. Citation Format: Melissa A. Simon, Laura S. Tom, Erika E. de la Riva, Emily L. Malin. Community navigators for breast and cervical cancer screening and follow up. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A10.
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