How Trust in Cancer Information Has Changed in the Era of COVID-19: Patterns by Race and Ethnicity.

COVID-19 emerged during an era of heightened attention to systemic racism and the spread of misinformation. This context may have impacted public trust in health information about chronic diseases like cancer. Here, we examine data from the 2018 and 2020 Health Information National Trends Survey (N = 7,369) to describe how trust in cancer information from government health agencies, doctors, family and friends, charitable organizations, and religious organizations changed after COVID-19 became a pandemic, and whether that change varied by race/ethnicity. Statistical methods included chi-square tests and multiple logistic regression modeling. Overall, the proportion of respondents who reported a high degree of trust in cancer information from doctors increased (73.65% vs. 77.34%, p = .04). Trends for trust in information from government health agencies and family and friends varied significantly by race/ethnicity, with substantial declines observed among non-Hispanic Blacks (NHB) only. The odds of reporting a high degree of trust in cancer information from government health agencies and friends and family decreased by 53% (OR = 0.47, 95% CI = 0.24-0.93) and 73% (OR = 0.27, 95% CI = 0.09-0.82), respectively, among NHB, but were stable for other groups. Future studies should monitor whether recent declines in trust among NHB persist and unfavorably impact participation in preventive care.

Perceptions of HPV and cervical cancer among Haitian immigrant women: implications for vaccine acceptability.

INTRODUCTION: Women in Haiti and throughout the Haitian Diaspora shoulder a disproportionate burden of cervical cancer morbidity and mortality. The widespread Human Papillomavirus (HPV) vaccination holds promise for helping to attenuate this disparity. However, previous research has not fully examined Haitian women's perceptions of, and barriers to, HPV vaccination, which is essential for informing future intervention. The current paper aims to fill this gap. METHODS: As part of ongoing Community-Based Participatory Research (CBPR) efforts, we conducted a series of focus groups with Haitian immigrant women in Little Haiti, the predominantly Haitian neighborhood in Miami, Florida, U.S. Focus group questions assessed women's knowledge and beliefs about cervical cancer and HPV, their opinions of vaccines in general, their knowledge and perceptions of the HPV vaccine specifically and health communications preferences for cervical cancer prevention. RESULTS: Among the participants who had heard of HPV, many held misconceptions about virus transmission and did not understand the role of HPV in the development of cervical cancer. Virtually all participants expressed support for vaccines in general as beneficial for health. Some women had heard of the HPV vaccine, primarily as the result of a contemporary popular media campaign promoting the Gardasil® vaccine. Physician recommendation was commonly mentioned as a reason for vaccination, in addition to having more than one sex partner. Women felt the HPV vaccine was less appropriate for adolescent girls who are presumed as not sexually active. Women indicated a strong preference to obtain health information through trusted sources, such as Haitian physicians, Haitian Community Health Workers, and especially Kreyol-language audiovisual media. DISCUSSION: Study findings indicate a need for culturally and linguistically appropriate educational initiatives to promote awareness of HPV and its role in cervical cancer, the importance of vaccination against the virus, explicitly differentiating HPV from HIV and providing specific information about vaccine safety. CONCLUSION: In the U.S., there is a substantial lack of educational information available in Haitian about HPV and cervical cancer. This gap results in missed opportunities to promote disease prevention through vaccination and regular screening. Addressing such gaps is essential for achieving health equity among Haitian immigrant women and other, similarly underserved women, who are disproportionately burdened by cervical cancer.

Neighborhood poverty and self-reported health among low-income, rural women, 50 years and older.

We examined the relationship between neighborhood socioeconomic context and self-reported health among low-income, rural women aged 50+ years, without a history of breast cancer. Tract-level census data were linked to individual level data from the baseline survey of a community trial to increase breast cancer screening rates. Generalized estimating equations were used to analyze data for 1988 women and 56 census tracts. Neighborhood poverty was associated with a greater likelihood of poor self-reported health, adjusted for age, race and socioeconomic status (OR=1.35, 95% CI=1.08-1.68). This effect was greatest for individuals with incomes below the median neighborhood income.

Interest in genetic testing among first-degree relatives of colorectal cancer patients.

PURPOSE: The present study examined colorectal cancer screening behaviors, risk perceptions, and willingness to receive genetic testing to determine colorectal cancer susceptibility. METHODS: We recruited 95 first-degree relatives of colorectal cancer patients, then conducted a brief telephone interview using a structured questionnaire that elicited information on sociodemographics, cancer screening behaviors, risk perceptions, and interest in genetic testing. RESULTS: Among these high-risk individuals who were aged 40 years or older, only 31% reported fecal occult blood testing within the past year and 59% reported undergoing sigmoidoscopy or colonoscopy within the past 5 years. The majority of participants believed their relative risk of colorectal cancer was increased (68%). Eighty-four percent of the participants indicated that they would have a genetic test if one were available. Participants who believed that <50% of colorectal cancers were caused by heredity were more likely to be interested in genetic testing than were participants who believed that 50% or more of colorectal cancers were caused by heredity. Referral source, sociodemographic factors, clinical factors, and perceived personal risk were not significantly associated with interest in genetic testing. CONCLUSION: Our results suggest that the demand for colorectal cancer susceptibility testing may be high among individuals with a family history of colorectal cancer. We also observed that a substantial number of first-degree relatives were not adhering to colorectal cancer screening guidelines. Accurate information on the genetic aspects of colorectal cancer and the benefits and limitations of genetic testing may help relatives of colorectal cancer patients make informed decisions about whether to undergo enhanced screening and genetic testing.

Attitudes toward genetic testing in patients with colorectal cancer.

PURPOSE: The purpose of this study was to examine risk perceptions and interest in genetic testing among African American and White patients with colorectal cancer. DESCRIPTION OF STUDY: In this cross-sectional study, 98 patients with colorectal cancer participated in a brief structured telephone interview. Information was collected on knowledge and risk perceptions regarding colorectal cancer genetics, health behaviors, knowledge about the availability of genetic testing, and interest in genetic testing for colorectal cancer susceptibility. RESULTS: Sixty-one percent of the participants were worried about their relatives' risk of colorectal cancer, and 64% were concerned about being a colorectal cancer susceptibility gene carrier. Although 81% of the participants reported that they had never heard about a genetic test for colorectal cancer susceptibility, 72% stated that they would want to take the test if it were available. Predictors of intention to have a genetic test were younger age, less advanced stage of disease, and more frequent thoughts about colorectal cancer being hereditary. CLINICAL IMPLICATIONS: These results suggest that the demand for genetic testing may be great, despite a general lack of knowledge about colorectal cancer genetics and the potential risks and limitations of testing. Education and counseling about cancer genetics and genetic testing may clarify misconceptions about hereditary colorectal cancer and help patients with colorectal cancer and their family members make informed decisions about whether to undergo testing.