Cervical Cancer Stigma Among Caribbean Population: A Descriptive Paper.

Objectives: Cervical cancer prevention practices are desperately low in the Caribbean. This study aims to describe the cervical cancer stigma and to evaluate the influence of the prevention practices among the Caribbean non-patient population in Jamaica, Grenada, Trinidad and Tobago. Methods: A cross-sectional study involving 1,207 participants was conducted using a culturally trans-created Cancer Stigma Scale for the Caribbean context and supplemented with questions on cervical cancer and HPV/HPV vaccine knowledge and beliefs. Data collection took place online from October 2022 to March 2023. Results: Participants are young, single, well-educated, and have stable financial resources. Over a quarter (26.4%) agreed women with cervical cancer are more isolated in their country. Almost half (47%) of respondents agreed cultural background plays a big part in how they feel about illness and getting well. One in six participants believe women with cervical cancer are treated with less respect than usual by others in their country. Conclusion: Cancer stigma of cervical cancer exists in Jamaica, Trinidad and Tobago, and Grenada. Particularly, cultural background and social norms are closely linked to stigma.

Interpretation of coefficients in segmented regression for interrupted time series analyses.

Background: Segmented regression, a common model for interrupted time series (ITS) analysis, primarily utilizes two equation parametrizations. Interpretations of coefficients vary between the two segmented regression parametrizations, leading to occasional user misinterpretations. Methods: To illustrate differences in coefficient interpretation between two common parametrizations of segmented regression in ITS analysis, we derived analytical results and present an illustration evaluating the impact of a smoking regulation policy in Italy using a publicly accessible dataset. Estimated coefficients and their standard errors were obtained using two commonly used parametrizations for segmented regression with continuous outcomes. We clarified coefficient interpretations and intervention effect calculations. Results: Our investigation revealed that both parametrizations represent the same model. However, due to differences in parametrization, the immediate effect of the intervention is estimated differently under the two approaches. The key difference lies in the interpretation of the coefficient related to the binary indicator for intervention implementation, impacting the calculation of the immediate effect. Conclusions: Two common parametrizations of segmented regression represent the same model but have different interpretations of a key coefficient. Researchers employing either parametrization should exercise caution when interpreting coefficients and calculating intervention effects.

Prevalence and management of type 2 diabetes among Chinese Americans.

AIMS: This study examines: (a) the prevalence rate of type 2 diabetes mellitus (T2DM) in Chinese Americans (CAs); (b) the influence of acculturative status (i.e. generational status and linguistic fluency) on T2DM prevalence; (c) and differences in diabetes management between CAs and Non-Hispanic Whites (NHWs). METHODS: We used 2011-2018 data from the California Health Interview Survey (CHIS) to analyze the prevalence rate and management of diabetes among the CAs. Chi-squares, linear regressions, and logistic regressions were used to analyze the data. RESULTS: After controlling for demographic, socioeconomic, and health behaviors, there were no significant differences in the T2DM prevalence rate between CAs overall or of varying acculturative statuses compared with NHWs. However, there were differences in diabetes management, with first-generation CAs being less likely to exam glucose daily, have medical care plans developed by medical providers, or have confidence in controlling diabetes compared to NHWs. CAs with limited English proficiency (LEP) were less likely to perform self-monitoring of blood glucose or have confidence in managing their diabetes care compared to NHWs. Finally, non-first generation CAs were also more likely to take diabetes medication compared to NHWs. CONCLUSIONS: Although the prevalence rate of T2DM was found to be similar between CAs and NHWs, significant differences were found in diabetes care and management. Specifically, those who were less acculturated (e.g. first generation and those with LEP) were less likely to actively manage and have confidence in managing their T2DM. These results highlight the importance of targeting immigrants with LEP in prevention and intervention efforts.

Does neighborhood or residence influence continued smoking among cancer patients: a spatial-ecological and descriptive analyses brief report.

PURPOSE: Continued smoking after a cancer diagnosis is causally linked to cancer-specific and all-cause mortality. Additionally, smoking, in particular after a cancer diagnosis, increases risk for poor therapeutic outcomes, chronic disease and even COV19 infection. METHODS: In order to better understand and address continued smoking among cancer patients, this research applied geospatial mapping analysis to explore the potential association of dedicated smoke/vape shops density and smoking among cancer patients. RESULTS: Our findings suggest that there is an association between dedicated smoke/vape shops density and continued tobacco product use among cancer patients who live in areas with greater numbers of smoke/vape shops and higher percentage of African Americans and low socioeconomic persons. In the City of Hope-Antelope Valley Center region with an average of 1.4 dedicated smoke/vape shops per sq ml, cancer patients continue to smoke at a rate of almost 10%. This rate is almost twice the 5.2% cancer patient smoking rate of the main cancer center with an average of < 1 dedicated smoke/vape shops per sq ml. CONCLUSION: Our study may inform cessation-related research, practice and policies so that researchers, clinicians and policymakers are well-aware of these disparities in dedicated smoke/vape shops proliferation that is disproportionately affecting minority patient, in particular cancer population.

Spatial and Descriptive Analysis of Smoke and Vape Shop Locations Focusing on A Cancer Center Neighboring Catchment Area.

Tobacco products cause about 1 in 5 deaths premature deaths each year. With increased retailing of both tobacco and electronic nicotine delivery systems (ENDS) products, cancer centers such as City of Hope are prioritizing tobacco and ENDS control. Therefore, we conducted formative geospatial analyses of dedicated smoke and vape shops linked to neighborhood demographic characteristics. The objective of the study was to analyze local data on smoke and vaping shop locations by age, socio-economic status, and racial/ethnic group. Our geospatial analysis used aggregate data from the U.S. Census, Google Maps, and Yelp. Geospatial maps were created using ArcGIS Pro with American Community Survey and U.S. Census 2010. The distributions of exclusive tobacco and vaping shop locations data were overlaid with data from the U.S. Census 2010 to generate maps of the relative geographic distributions of shops across varying area demographic characteristics. Results showed that a higher concentration of exclusive smoke and vaping shops were in areas with a higher concentration of ethnic minorities and lower income and lower status neighborhoods. These findings suggest that laws and licensing should be evaluated to regulate the placement of these shops to reduce and even prevent targeting of minorities and other vulnerable populations.

Racial disparities in diabetes prevalence among cancer patients.

Introduction: Cancer inequity is one of the most critical public health issues faced by ethnic minorities and people of lower socioeconomic status. The disparate burden of cancer is caused by poor access to care and inadequate delivery of cancer treatment, as well as comorbid and co-occurring conditions. Diabetes is a common and serious comorbid condition of cancer. Methods: To better understand diabetes prevalence among diverse cancer patients, this study analyzed and described characteristics of cancer patients with diabetes from local-level Service Planning Area (SPA) data using City of Hope Comprehensive Cancer Center data, and United States national-level data from The National Health Interview Survey. Results: Findings from national level data showed that patients in racial/ethnic minority groups had a higher occurrence of being diagnosed with diabetes, especially for non-Hispanic Blacks (OR=1.76, 95% CI=1.51, 2.03) and Hispanic/Latino individuals (OR=1.34, 95% CI=1.18, 1.52). Cancer patients who are older, ethnic minority, overweight/obese and with lower educational levels were more likely to have co-occurring diabetes. SPA-level patient data found similar results. Discussion: In response to our findings and other reports, clinicians and health system including health coverage organizations should routinely assess cancer patients for cooccurring chronic illnesses, in particular diabetes. Interventions improving coordinated care that integrates oncology, endocrinology and primary care, targeting cancer patients --especially racial/ethnic minorities, overweight/obese, and older patients who are at increased risk for diabetes -- ought to be considered as best practice Whole Person care. With coordinated care management, ethnic disparities in cancer may be better addressed and reduced. Additionally, policymakers can contribute by enacting policies improving access to and coverage of integrated oncology, chronic disease prevention, and associated specialty care i.e., endocrinology to equalize quality care for ethnic minority, lower educated, overweight/obese and older cancer patients who are more likely to suffer greater comorbidity, and inadequate oncology and coordinated care to reduce disparities.