A Case Study in Academic-Community Partnerships: A Community-Based Nutrition Education Program for Mexican Immigrants.

Hispanics are the largest U.S. immigrant group and Mexican Americans are the largest U.S. Hispanic population. Hispanics, particularly Mexican Americans, are among the highest risk groups for obesity, placing them at increased risk for cardiovascular disease and certain types of cancer. Obesity lifestyle interventions incorporating Motivational Interviewing techniques and specific adaptations for the population of interest can have a significant impact on reducing health risks. This paper presents a community-engaged, culturally-sensitive nutrition and dietary counseling intervention conducted between 2016 and 2018 at the Consulate General of Mexico in New York City and reports preliminary findings regarding participant satisfaction and self-reported changes in eating and exercise habits. In addition, it describes the community and academic partners' roles and processes in program development, discusses strengths and challenges posed by a multi-sector partnership and describes adaptations made using the Behavioral Model for Vulnerable Populations to increase the program's sustainability and potential for scalability.

The Nutrition Benefits Participation Gap: Barriers to Uptake of SNAP and WIC Among Latinx American Immigrant Families.

To examine nutrition benefit under-enrollment in Latinx American immigrant families, we administered a survey to 100 adults attending a NY Latinx American community serving organization. We used a logistic regression approach to analyze misinformation impact on enrollment, and examined non-enrollment explanations, among participants in whose families a child or pregnant or breastfeeding woman appeared SNAP- or WIC-eligible. Among households (N = 51) with ≥ 1 SNAP-eligible child, 49% had no child enrolled. Reasons included repercussion fears (e.g. payback obligation, military conscription, college aid ineligibility, child removal, non-citizen family member penalties), and logistical barriers. In multivariable regression models, having heard the rumor that SNAP/WIC participation makes unauthorized status family members vulnerable to being reported to the government was associated with an 85% lower enrollment rate (OR 0.15, CI 0.03, 0.94). Misinformation impedes nutrition benefit participation. A multi-level intervention is necessary to inform potential applicants and providers regarding eligibility criteria and erroneous rumors, along with an informed discussion of the risks versus benefits of using resources, especially as public charge criteria change.

Adaptation of a Cancer Clinical Trials Education Program for African American and Latina/o Community Members.

The pilot study reported in this article culturally and linguistically adapted an educational intervention to promote cancer clinical trials (CCTs) participation among Latinas/os and African Americans. The single-session slide presentation with embedded videos, originally developed through a campus-community partnership in Southern California, was chosen for adaptation because it was perceived to fit the CORRECT model of innovation (credible, observable, relevant, relatively advantageous, easy to understand, compatible, and testable) and because of the potential to customize any components not identified as core, allowing them to be revised for cultural and linguistic alignment in New York City. Most of the 143 community participants (76.2%) were female; most (54.6%) were older than 59 years. More than half (78.3%) preferred to speak English or were bilingual in English and Spanish. A large proportion (41.3%) had not completed high school. Knowledge and perceived benefits and barriers regarding CCT showed small, though statistically significant, increases. There were no statistically significant group differences for changes in mean knowledge, perceived benefits, or perceived barriers when examined by ethnicity, education level, language, or other included sociodemographic variables. However, a small, but statistically significant difference in perceived barriers was observed when examined by country of origin, with the foreign born score worsening 0.08 points (SD = 0.47, p = .007) on the 5-point Likert-type scale administered posteducation compared to preeducation. Participants' open-ended comments demonstrated the acceptability of the topic and intervention. This adaptation resulted in an intervention with the potential to educate African American and Latina/o general community members in a new geographic region about the purpose, methods, and benefits of CCTs.

Predicting Colonoscopy Completion Among African American and Latino/a Participants in a Patient Navigation Program.

Patient navigation (PN) effectively increases screening colonoscopy (SC) rates, a key to reducing deaths from colorectal cancer (CRC). Ethnic minority populations have disproportionately low SC rates and high CRC mortality rates and, therefore, especially stand to benefit from PN. Adapting the Health Belief Model as an explanatory model, the current analysis examined predictors of SC rates in two randomized studies that used PN to increase SC among 411 African American and 461 Latino/a patients at a large urban medical center. Speaking Spanish but not English (odds ratio (OR), 2.192; p < 0.005), having a higher income (OR, 1.218; p < 0.005), and scoring higher on the Pros of Colonoscopy scale (OR, 1.535; p = 0.023) independently predicted colonoscopy completion. Health education and PN programs that increase awareness of the benefits of getting a colonoscopy may encourage colonoscopy completion. In the context of language-appropriate PN programs for African American and Latino/a individuals, those with lower incomes and English speakers may require additional education and counseling to support their decision-making around colonoscopy.

Patient-, provider-, and system-level factors in low adherence to surveillance colonoscopy guidelines: implications for future interventions.

PURPOSE: Patients with a history of advanced adenomas are at increased risk of developing colorectal cancer (CRC), yet rates of adherence to current surveillance colonoscopy guidelines are poor. We determined rates of referral and adherence to 3-year interval surveillance colonoscopy in patients with advanced adenomas and identified modifiable factors as possible intervention targets to improve surveillance referral and adherence in these at-risk patients. METHODS: We reviewed electronic medical records (EMR) of patients (N = 103) who had pathology findings on screening colonoscopy that warranted a 3-year surveillance colonoscopy. We abstracted demographics, surveillance colonoscopy completion rate, documentation of initial pathology in the "Problem List" of the EMR, and timing and nature of visits to a primary care physician (PCP). RESULTS: Only 22 (21.4 %) patients had a record of surveillance colonoscopy completion. Among non-completers, 50.6 % of patients had no PCP visit within a year of their surveillance due date, 19.8 % saw a PCP and were not referred, and 29.6 % saw a PCP and were referred to either a gastroenterology consultation or a surveillance colonoscopy. Pathology found on initial screening was noted in the Problem List of 77.3 % of completers but only 33.3 % of non-completers (p ≤ 0.001). CONCLUSIONS: Possible targets for interventions include using EMRs to improve physician communication and encouraging patients to have timely PCP visits and follow-through after colonoscopy referral. Clinical studies in this area have the potential to improve outcomes for patients by reducing CRC mortality through early detection.