BACKGROUND: Inclusion of diverse groups of participants in cancer clinical trials is an important methodological and clinical issue. The quality of the science and generalizability of results depends on the inclusion of study participants who represent all populations among whom these treatment and prevention approaches will be used. METHODS: We conducted a systematic review using OVID as the primary source of reports included. Based on 304 peer-reviewed publications, diversity in the inclusion and reporting of study participants during a decade of cancer treatment and prevention trials (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010) is summarized. Recommendations are made for improvements in the science and reporting of cancer clinical trials. RESULTS: Of the 277 treatment trials and 27 prevention trials included in this report, more than 80% of participants were white and 59.8% were male. In the recent decade, race and sex are rarely used as selection criteria unless the trial is focused on a sex-specific cancer. 1 Their results were not encouraging. We report an update of that study, focused on identifying changes in enrollment in cancer treatment and prevention clinical trials a decade later (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010).It is understood that cancer treatment and preventive efforts are not generalizable to the entire treatable population. Historically, however, the majority of studies assessing the effectiveness of cancer treatment and prevention has been conducted using white men.1 An improved understanding of the differences between subgroups (race/ethnicity and sex) is critical to improving the risk/benefit profile for a wide range of chemotherapeutics and prevention efforts.Though much effort had been devoted to planning and implementation of programs aimed at reducing health disparities, the 2002 paper reported that minorities were still unlikely to be enrolled in clinical trials. There were 105 treatment trials that reported including both men and women, representing 42,355 participants; 38.6% of the participants were women. Results were fairly similar (34.7% of the participants were women) for the prevention studies. Age distribution and sex were reported in more than 90% of the trials (both treatment and prevention), yet race or ethnicity were reported in only 35.1% of the included treatment trials and 53.6% of the prevention trials. Within the 57 treatment trials (with 45,815 participants) which reported race or ethnicity, 10.5% of participants were reported as African American, and fewer than 1% were reported as Hispanic, Asian, or Native American. There was even less racial and ethnic diversity within the prevention trials: only 5.5% of participants were African American, 1.7% were Hispanic, and fewer than 1% were Asian or Native American.

Objectives To examine how the National Cancer Institute-funded Community Network Program (CNP) operationalized principles of community-based participatory research (CBPR). Methods Based on our review of the literature and extant CBPR measurement tools, scientists from nine of 25 CNPs developed a 27-item questionnaire to self-assess CNP operationalization of nine CBPR principles. Results Of 25 CNPs, 22 (88%) completed the questionnaire. Most scored well on CBPR principles to recognize community as a unit of identity, build on community strengths, facilitate co-learning, embrace iterative processes in developing community capacity, and achieve a balance between data generation and intervention. CNPs varied in extent to which they employed CBPR principles of addressing determinants of health, sharing power among partners, engaging community in research dissemination, and striving for sustainability. Conclusions Although tool development in this field is in its infancy, findings suggest that fidelity to CBPR processes can be assessed in a variety of settings.

The transmission of sexual images and messages via mobile phone or other electronic media (sexting) has been associated with a variety of mostly negative social and behavioural consequences. Research on sexting has focussed on youth, with limited data across demographics and with little known about the sharing of private sexual images and messages with third parties. The present study examines sexting attitudes and behaviours, including sending, receiving, and sharing of sexual messages and images, across gender, age, and sexual orientation. A total of 5805 single adults were included in the study (2830 women; 2975 men), ranging in age from 21 to 75+ years. Overall, 21% of participants reported sending and 28% reported receiving sexually explicit text messages; both sending and receiving 'sexts' was most common among younger respondents. Although 73.2% of participants reported discomfort with unauthorised sharing of sexts beyond the intended recipient, of those who had received sext images, 22.9% reported sharing them with others (on average with 3.17 friends). Participants also reported concern about the potential consequences of sexting on their social lives, careers, and psychosocial wellbeing. Views on the impact of sexting on reputation suggest a contemporary struggle to reconcile digital eroticism with real-world consequences. These findings suggest a need for future research into negotiations of sexting motivations, risks, and rewards.

In a community-based sample of Hispanic women, this study examines differences in relation to level of acculturation in knowledge about the Pap examination, fear/fatalism towards cancer, and cervical cancer screening behaviors. Respondents were randomly chosen from 11 churches in the Phoenix metropolitan area (n = 566) and were categorized into three acculturation levels: low (35.2%), bicultural (26.3%), and high (38.5%). Interviews focused on family history of cancer as well as knowledge about cancer and utilization of screening techniques for breast and cervical cancers. OLS regression and probit analyses were conducted to examine the role of acculturation in differentiating. Hispanic subgroups in relation to knowledge, beliefs, and behaviors regarding cervical cancer. Findings of the present study indicate that Hispanic women in the Phoenix metropolitan area are utilizing cervical cancer screening services with over 90 percent of women in all three acculturation groups ever having had a Pap exam and more than 50 percent having had the examination during the past year. However, results also indicate that of the Hispanic subgroups examined, lower acculturated Hispanic women have less knowledge about Pap smears and exhibit lower utilization rates for cervical cancer screening. These results suggest that lower-acculturated Hispanic women comprise the subgroup of Hispanics that is at greatest risk of presenting with advanced stages of cervical cancer. Results have implications for cancer screening and education programs for Hispanic women as well as implications for health care professionals who serve this population.

An integrative mixed-methods analysis examined traditional beliefs as associated with beliefs about self-care during pregnancy and with alcohol abstinence among young adult women from two rural U.S.-Mexico border communities. Quantitative (measured scale) variables and qualitative thematic variables generated from open-ended responses served as within-time predictors of these health-related outcomes. A weaker belief that life is better in big cities was associated with stronger self-care beliefs during pregnancy. Also, a weaker belief that small towns offer tranquil environments was associated with total abstinence from alcohol. Regarding the Hispanic Paradox, these results suggest that a critical appreciation of cultural traditions can be protective, as this avoids stereotypical or idyllic views of urban or rural lifeways, and promotes self-protective beliefs and behaviors.Keywords family traditions; rural lifestyle; mixed methods; Hispanic paradox; alcohol use The "Hispanic Paradox"Among women from rural communities, traditional lifeways (traditionalism) may promote certain healthy outcomes (Coe, Attakai, Papenfuss, Giuliano, Martin, & Nuvayestewa, 2004); by contrast, a loss of cultural traditions during the process of acculturative change may promote disease or disorder. Recent Hispanic health research has identified an Hispanic paradox among low-acculturated Hispanics/Latinos,1 that is characterized by unexpectedly lower rates of adverse health outcomes observed among the least acculturated Mexican immigrants relative to their more acculturated Mexican American peers. This paradox has been observed within three health-related areas: the perinatal health of Hispanic/Latina women, mortality rates from cardiovascular disease, and rates of psychiatric disorder (Vega et al., 1998).Perinatal studies of low-birth-weight infants (Balcazar, Krull, & Peterson, 2001; FuentesAfflick, Hessol, & Pérez-Stable, 1999;Gould, Madan, Qin, & Chavez, 2003) NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript to more acculturated and affluent Mexican American women. Similarly, in communitybased studies of diagnosed psychiatric disorders, low-acculturated migrant Mexican farmworkers, when compared with native-born Mexican Americans and with non-Hispanic White Americans, exhibited the lowest rates of psychiatric disorder (Alderete, Vega, Kolody, & AguilarGaxiola, 2000). Some investigators have argued that methodological flaws produce these paradoxical effects (Palloni & Morenoff, 2001;Smith & Bradshaw, 2006), whereas others have argued that observed confounds do not obviate these paradoxical effects (Morales, Mara, Kington, Valdez, & Excarce, 2002). The recent assertion by Smith and Bradshaw (2006) that the Hispanic paradox does not exist is based on a study that uses a Spanish surname as a proxy measure for Hispanic ethnicity and also defines health advantage narrowly by using mortality as their major health outcome. Unfortunately, several of these studies have not examined deeper aspects of culture, ...

BackgroundAfrican American (AA) women face unique sociocultural barriers to physical activity (PA) engagement. Such barriers may contribute to their low PA levels and high cardiometabolic disease burden. One particular barrier reported among AA women in recent research is that being physically active can have an undesirable effect on the hairstyles and hair maintenance of many AA women. However, the underlying mechanisms contributing to this barrier have not been fully elucidated. The purpose of this study is to explore hairstyle maintenance as a barrier to PA among AA women and to identify effective strategies to overcome this barrier in the design of a culturally relevant PA intervention.MethodsA qualitative study design was used. Data were collected from the focus groups comprising 23 sedentary and obese AA women (median age = 38.1 years, median body mass index = 39.8 kg/m2). Content analysis was used to analyze these focus group data.ResultsThree key themes emerged from the qualitative narratives of participants: (1) impact of perspiration on hair and hairstyle maintenance, (2) image and social comparisons, and (3) solutions to overcome hair-related barriers to PA. For impact of perspiration and hairstyle maintenance, participants described how perspiring while engaging in PA negatively impacts many of their hairstyles. Participants further discussed how time and monetary burdens associated with PA-related hairstyle maintenance further contributed to this issue. Findings for the theme of image and social comparison focused on how an AA woman’s hairstyle is an important part of the image and the social comparisons made by non-AAs regarding the hairstyles and maintenance practices of AA women. For solutions to hairstyle maintenance barriers, participant described a variety of potential styling techniques that may help alleviate PA-related maintenance concerns, including braids, locks, and natural hairstyles. However, no styling technique was uniformly endorsed by all study participants.ConclusionFindings highlight the significance of hair in the AA community and provide further insight on appropriate intervention design strategies to overcome this sociocultural barrier to PA. Future research is needed to corroborate and further expand on our findings.

The prospective cohort study examined whether Ecuadorian women with early pregnancy nausea and vomiting (NVP) are more likely to develop food aversions and cravings, and if so, whether the specific foods identified as aversive or craved are the same as those predicted by the popular maternal-embryo protection hypothesis (MEPH). Consistent with MEPH predictions, women with NVP were more likely to report increased odor sensitivity and aversions for some predicted "toxic" foods and more likely to crave fruits. However, other hypothesis predictions were not supported. The relationship of food aversions and cravings with NVP appears more complicated than that explained by the MEPH.

The fundamental aim of this study was to identify factors crucial for the development of effective cancer prevention programs for American Indian (AI) populations. Toward that end, we developed an instrument to assess the influence of traditionalism on health risks such as smoking, consumption, and obesity. A population-based survey was conducted among 559 randomly selected women living on the Hopi reservation aged 18 years and older, from July through December 1993. To construct a traditionalism score, we conducted focus groups in the community. A multidimensional approach was adopted by assessing three dimensions of native culture: language usage; cultural participation, or participation in such activities as Hopi ceremonies; and percentage of life spent off-reservation. A mean score of the three dimensions was computed for each respondent. High levels of traditionalism were significantly associated with disease protective behaviors, such as practicing traditional Hopi activities to keep healthy (OR = 3.07), and significantly inversely associated with disease risk factors such as smoking (OR = 0.26) and obesity (OR = 0.60) independent of age, marital status, and education. As these data provide a strong rationale for the promotion of traditions in public health programs aimed at decreasing rates of chronic disease among AI women, we conclude this paper with a discussion of the importance of traditionalism and how it might be accurately assessed.