A PAP TEST INTERVENTION TO ENHANCE DECISION MAKING AMONG PACIFIC ISLANDER WOMEN
Sora Park Tanjasiri
California State University Fullerton, 2600 Nutwood Ave, Ste 275, Fullerton, Ca 92831
Grant 1R01CA149324-01A1 from National Cancer Institute
Abstract: A Pap Test Intervention to Enhance Decision Making among PI Women Despite the fact that cervical cancer is one of the most preventable of cancers, it remains one of the top five causes of cancer deaths in the U.S. and in California. The Pap test has been shown to be effective in not only detecting cancer but also precancerous cells. Even with the introduction of HPV testing and vaccines, Pap tests represent an important cervical cancer prevention and early detection method for women in this country. Unfortunately, the Pap test is severely underutilized among many ethnic and racial populations, including Pacific Islanders (PIs) who have high rates of cervical cancer incidence and mortality. Cervical cancer incidence and mortality data among specific PI ethnic groups is sparse, with available information underscoring significant cancer health disparities. In California as in the Pacific, cervical cancer is one of the top five causes of cancer deaths. Given the dearth of PI researchers and studies at the NIH level, community-based participatory research (CBPR) holds the potential for engaging community cultural experts alongside cancer health disparities researchers to address their pressing cervical cancer detection needs. This five year cluster unit randomized trial will develop and evaluate a social support intervention targeting both men and women to increase Pap testing decision making and behavior among Chamorro, Samoan and Tongan women age 18-65 years old in Southern California. We aim to 1. Apply CBPR principles and processes for community/university partners throughout the grant period; 2. Develop and pretest two gender-specific and culturally tailored educational interventions for PI women and men. The interventions will be conducted separately by gender, and will employ a video, flipchart, and brochure, along with small-group discussions facilitated by gender-matched community health educators; 3. Develop and validate instruments measuring men´s social support (provided), women´s social support (perceived) and women´s decision making utility; 4. Recruit and randomly assign community-based organizational samples and recruit and follow the cohorts of PI females and males in the intervention and control groups 5. Examine the associations that test the conceptual model regarding social support, decision making utility, and Pap testing intentions and behaviors; 6. Follow the cohort of PI women and men in the intervention vs. control groups to assess the impact of the intervention. Using a longitudinal cohort design, we will identify, recruit, and randomly assign PI members of churches and other community-based organizations to one of two intervention options a) a culturally tailored social support intervention group for women and men consisting of community health educator-facilitated video, flipchart and brochure; or b) a usual care control group, consisting of pre-existing cancer education materials (brochures) for PI women and men delivered by community health educators. We posit that the planned social support intervention will increase men´s provision, and women´s perceptions, of Pap testing social support, leading to increases in women´s prioritization of Pap testing decision making utility and Pap testing behaviors. The proposed study team involves long-standing university and community collaborators, and uses a multiple PI model to institutionalize shared participation and leadership structures. The community side of this CBPR study includes three CBOs with years of experience in health promotion, disease prevention, and collaborative research for their respective PI populations. The university side includes experienced behavioral scientists in CBPR, cancer control and decision making with multiethnic populations. This study will add to the existing science of cancer health disparities by adapting and applying well-established behavioral theories to understand the ways in which collectivist-oriented interventions influence individual women´s cancer screening behavioral changes. Furthermore, this study will illuminate the CBPR engagement aspects necessary to conduct rigorous intervention research in small-size populations. The product of this study will be a culturally-tailored intervention that holds the potential to become a model for other collectivistic populations. Strengths of this study include i) a focus on a major cancer health disparity; ii) development and testing of methods that are applicable to other health disparities; iii) a theoretical focus on decision making (a priority area for NCI regarding translational research); iv) an intervention approach that investigates and develops new strategies to improve cultural tailoring and evaluation; v) a focus on men; and vi) an ethnically diverse team of community and university investigators with an established track record in CBPR research. A Pap Test Intervention to Enhance Decision Making among Pacific Islander Women Pacific Islanders (PIs) experience some of the highest cervical cancer incidence and mortality rates in the U.S., yet little research exists on the ways to address and ameliorate their cancer health disparities. This five year randomized community-based participatory research study will develop and test a social support intervention targeting both PI men and women to increase women´s Pap testing among three populations in Southern California Chamorros, Tongans and Samoans. This study will add to the existing science of cancer health disparities by adapting and applying well-established behavioral theories to understand the ways in which collectivistic-oriented interventions influence individual women´s cancer screening decision making and behaviors. Furthermore, this study will illuminate the CBPR engagement aspects necessary to conduct rigorous intervention research in small-size populations
Keywords: 65+ years old; AHCPR; AHRQ; Address; Age; Agency for Health Care Policy and Research; Agency for Healthcare Research and Quality; Area; Behavior; Behavioral; Behavioral Sciences; Booklets; Brochures; California; Cancer Cause; Cancer Control; Cancer Control Science; Cancer Detection; Cancer Etiology; Cancer Screening for Patients; Cancer of Cervix; Cancer of the Uterine Cervix; Cancers; Cervical Cancer; Cervix Cancer; Cessation of life; Church; Communities; Community Health; Control Groups; Country; Data; Death; Decision Making; Development; Early Diagnosis; Education for Intervention; Educational Intervention; Ethnic group; Evaluation; Female; Female Groups; Gender; Grant; HPV; Hawaiian; Hawaiian population; Health Educators; Health Promotion; Human Papillomavirus; Incidence; Individual; Infectious Human Wart Virus; Instruction Intervention; Intervention; Intervention Strategies; Intervention Studies; Investigators; Leadership; Malignant Cervical Neoplasm; Malignant Cervical Tumor; Malignant Neoplasm of the Cervix; Malignant Neoplasms; Malignant Tumor; Malignant Tumor of the Cervix; Malignant Tumor of the Cervix Uteri; Malignant Uterine Cervix Neoplasm; Malignant Uterine Cervix Tumor; Malignant neoplasm of cervix uteri; Measures; Melanesian; Methods; Modeling; Mortality; Mortality Vital Statistics; NIH; National Institutes of Health; National Institutes of Health (U.S.); Outcome; Pacific Island Americans; Pacific Islander; Pacific Islander American; Pacific Ocean; Pamphlets; Pap Test; Pap smear; Papanicolaou Smear; Papanicolaou Test; Papilloma Virus, Human; Papillomavirus, Human; Perception; Polynesian; Population; Population Sizes; Precancerous Cells; Premalignant Cell; Process; Randomized; Recruitment Activity; Research; Research Personnel; Researchers; Salutogenesis; Samoan; Sampling; Science; Scientist; Screening for cancer; Side; Smears, Cervical; Social support; Structure; Testing; Training Intervention; Translational Research; Translational Research Enterprise; Translational Science; United States Agency for Health Care Policy and Research; United States Agency for Healthcare Research and Quality; United States National Institutes of Health; Universities; Vaginal Smears; Woman; Women`s Group; ing; base; cancer disparity; cancer education; cancer health disparity; cervical cancer prevention; cervical/vaginal smear; cohort; community based participatory research; design; designing; disease prevention; disorder prevention; early cancer detection; early detection; experience; experiment; experimental research; experimental study; group intervention; health disparities; health disparity; human old age (65+); improved; instructional intervention; instrument; interventional strategy; male; malignancy; member; men; men`s; neoplasm/cancer; racial and ethnic; racial/ethnic; randomisation; randomization; randomized trial; randomly assigned; recruit; research study; social support network; theories; translation research enterprise; treatment as usual; vaccine evaluation; vaccine screening; vaccine testing; wart virus
Relevance: A Pap Test Intervention to Enhance Decision Making among Pacific Islander Women Pacific Islanders (PIs) experience some of the highest cervical cancer incidence and mortality rates in the U.S., yet little research exists on the ways to address and ameliorate their cancer health disparities. This five year randomized community-based participatory research study will develop and test a social support intervention targeting both PI men and women to increase women´s Pap testing among three populations in Southern California: Chamorros, Tongans and Samoans. This study will add to the existing science of cancer health disparities by adapting and applying well-established behavioral theories to understand the ways in which collectivistic-oriented interventions influence individual women´s cancer screening decision making and behaviors. Furthermore, this study will illuminate the CBPR engagement aspects necessary to conduct rigorous intervention research in small-size populations
Project start date: 2010-09-23
Project end date: 2015-07-31
Budget start date: 23-SEP-2010
Budget end date: 31-JUL-2011
PFA/PA: PA-08-074
1R01CA149324-01A1 (2010): $557000
Sponsored Links Excellgen http://Excellgen.com
Grants awarded to Sora Park Tanjasiri
WINCART: WEAVING AN ISLANDER NETWORK FOR CANCER AWARENESS, RESEARCH AND TRAINING
Sora Park Tanjasiri
California State University Fullerton, 2600 Nutwood Ave, Ste 275, Fullerton, Ca 92831
Grant 1U54CA153458-01 from National Cancer Institute
Abstract: Weaving an Islander Network for Cancer Awareness, Research and Training (WINCART) The overarching goal of the proposed Center is to contribute to the reduction of cancer health disparities among Pacific Islanders (PIs) in Southern California through an integrated program of research, training, and community education utilizing a multi-level, interdisciplinary, approach that is driven by community based participatory research (CBPR) principles. Building upon the successes of our first Community Network Program (CNP) WINCART Weaving an Islander Network for Cancer Awareness, Research and Training (U01CA114591/WINCART1), this new Center´s programs and cores incorporate the themes of reducing chronic disease mortality and morbidity through lifestyle change (Research Program; Intervention Project), exploring cultural and ethical issues around biobanking to enhance the promise of personalized medicine (Research Program Pilot Project), increasing prevention and early detection through assessment and community education (Community Outreach Program), and training of early career investigators in CBPR methods (Training Program). Experienced community leaders and researchers will facilitate integration across all Center components (Administrative Core). The overarching CBPR principles and processes in WINCART2 derive from those established in WINCART1, and include 1) shared participation by both community and academic researchers in the planning, development, implementation and evaluation of community education, research, and training activities; 2) co-learning between all academic and community partners via joint activities in the Center´s core, programs, and projects; 3) collaboration mechanisms, through the Center Steering Committee and Community Advisory Groups, that ensure fidelity to CBPR tenets among center partners and trainees; and 4) promotion of lasting community benefits across multiple levels of factors associated with PI cancer health disparities. WINCART2 incorporates the multilevel population health approach to address cancer health disparities, and employs new technologies (including distance learning, electronic surveys and intervention systems) for communication within the Center, dissemination to external audiences, and/aci7ztarion of state-of-the-science research, all in the service of reducing cancer health disparities among PIs
Project start date: 2010-09-02
Project end date: 2015-08-31
Budget start date: 2-SEP-2010
Budget end date: 31-AUG-2011
PFA/PA: RFA-CA-09-032
1U54CA153458-01 (2010): $819718
WINCART: WEAVING AN ISLANDER NETWORK FOR CANCER CONTROL
Sora Park Tanjasiri, Asso Prof, Health Science
California State University Fullerton, 2600 Nutwood Ave, Ste 275, Fullerton, Ca 92831
Grant 3U01CA114591-05S1 from National Cancer Institute
Abstract: This award is issued in response to Notice OD-09-060, Recovery Act Administrative Supplements Providing Summer Research Experiences for Students and Science Educators. The California State University, Fullerton proposes to spearhead a university-community consortium to undertake community-based participatory research processes for development of a sustainable network to reduce preventable cancer incidence and mortality among five Pacific Islander (PI) communities (Chamorros, Marshallese, Native Hawaiians, Samoans and Tongans) in Southern California. The specific aims of this project, Weaving an Islander Network for Cancer Awareness, Research and Training (WINCART), are to 1) identify individual, community, and health service barriers to cancer control among PIs; 2) improve access to and utilization of existing cancer prevention and control services; 3) facilitate the development, implementation, and evaluation of community-based participatory research studies; 4) create opportunities to increase the number of well-trained PI researchers through training, mentorship and participatory research projects; 5) sustain community-based education, training and research activities by increasing partnerships with governmental and community agencies, funders, and policymakers; and 6) disseminate research findings to aid in the reduction of cancer health disparities for PIs. WINCART will convene two steering committees (one each for community and research) to coordinate the network activities. Project methods include implementation and evaluation of community awareness activities in each PI population (working with CIS to develop culturally and linguistically appropriate materials), conducting cancer prevention and control research (with a focus on obesity, tobacco, cancer screening, survivorship, and enhanced recruitment of PIs into clinical trials), and recruitment/training/mentorship of PI researchers for the development of pilot other NIH research awards
Keywords: Access to Care; Access to Health Care; Access to Healthcare; Accessibility of health care; Address; Anthropology; Attitude to Health; Availability of Health Services; Award; Awareness; Awarenesses; Behavior; Behavioral Research; Belief; California; Cancer Control; Cancer Control Science; Cancer Information Service; Cancer Screening for Patients; Cancers; Cessation of life; Clinical Trials; Clinical Trials, Unspecified; Communities; Community Health; Community Health Services; Death; Development; Epidemiology; Evaluation; Goals; Hawaiian; Hawaiian population; Health Communication; Health Policy; Health Psychology; Health Services; Health Services Accessibility; Health behavior; Improve Access; Incidence; Individual; Investigators; Malignant Neoplasms; Malignant Tumor; Mentorship; Methods; Mortality; Mortality Vital Statistics; NIH; National Institutes of Health; National Institutes of Health (U.S.); Obesity; Pacific Island Americans; Pacific Islander; Pacific Islander American; Population; Prevention; Preventive Medicine; Process; Public Health; R01 Mechanism; R01 Program; RPG; Research; Research Activity; Research Grants; Research Personnel; Research Project Grants; Research Projects; Research Projects, R-Series; Research Training; Researchers; Samoan; Scientist; Screening for cancer; Screening procedure; Services; Social Service; Social Work; Social work (field); Tobacco; Training; Training and Education; Underserved Population; United States National Institutes of Health; Universities; Work; access to services; access to treatment; adiposity; availability of services; base; cancer disparity; cancer epidemiology; cancer health disparity; cancer prevention; cigarette smoking; clinical investigation; community based evaluation; community based participatory research; corpulence; corpulency; corpulentia; diet and exercise; early cancer detection; experiment; experimental research; experimental study; health attitude; health care availability; health care policy; health care service; health care service access; health care service availability; health services availability; healthcare access availability; healthcare service access; healthcare service availability; malignancy; member; neoplasm/cancer; obese; obese people; obese person; obese population; preventative medicine; psychosocial; public health medicine (field); research study; screening; screenings; smoke cigarette; social; survivorship; tobacco prevention; tobacco use prevention; treatment adherence; under served population; underserved people
Project start date: 2005-05-06
Project end date: 2010-09-30
Budget start date: 13-JUL-2009
Budget end date: 30-SEP-2010
PFA/PA: RFA-CA-05-012
3U01CA114591-05S1 (2009): $44135
5U01CA114591-05 (2009): $496153
3U01CA114591-05S3 (2009): $210448
3U01CA114591-05S2 (2009): $175000
PHYSICAL ACTIVITY & NUTRITION AMONG PACIFIC ISLANDER YOUTH: AN EXPLORATORY STUDY
Sora Park Tanjasiri, Asso Prof, Health Science
California State University Fullerton, 2600 Nutwood Ave, Ste 275, Fullerton, Ca 92831
Grant 5R21HD055192-02 from Eunice Kennedy Shriver National Institute Of Child Health & Human Development
Abstract: Obesity presents an increasingly important modifiable cancer-related risk factor for populations, yet little is known about the ways to prevent and control obesity for ethnically diverse populations. Pacific Islanders experience high rates of obesity and cancer, presenting an opportunity for exploration leading to intervention development and testing, yet they remain invisible and understudied to the academic community. This two year exploratory study seeks to understand the obesity-related influences for Pacific Islander (PI) youth in Southern California. Using a Community-Based Participatory Research (CBPR) approach involving four community-based agencies and three universities, the goals of this project are to 1) to test the feasibility of various quantitative and qualitative data collection activities among Marshallese, Samoan and Tongan adolescents; and 2) estimate the point prevalence of obesity and physical activity. A sub-aim is to explore the distribution of dietary intake in these groups; and 3) explore the predisposing, enabling and reinforcing factors influencing physical activity in this group. The specific aims of the study are a.) Convene quarterly meetings of the Community Advisory Committee (CAC) throughout the conduct of this study to inform the development and implementation of all study methods and community outreach activities; b.) Design and facilitate focus groups with PI adolescents, aged 14-18 years, from three Pacific Islander populations (Marshallese, Samoans and Tongan) to explore influences on obesity and physical activity i. Types of physical activity performed, including location, frequency and purpose; ii. Cultural factors, including identity, acculturation and cultural beliefs; iii. Environmental issues that present enabling opportunities and barriers to adolescents; iv. Individual factors, including predisposing and reinforcing influences; c.) Implement protocols for collection of objective measures of obesity and physical activity among adolescents i. Height and weight for calculations of body mass index; ii. Accelerometer data for calculations of time spent in moderate and vigorous intensity physical activities; d.) Design and/or pretest a survey instrument to assess I. Predisposing and reinforcing influences on adolescent physical activity; (also listed in b iv) ii. Dietary intakes via food frequency questionnaire (FFQ) to allow exploration of relationship between diet, physical activity and obesity among PI adolescents; e.) Implement measurement and survey activities among a community-sample of Marshallese, Samoan and Tongan adolescents in Southern California; f.) Share study results with the CAC and community members to develop future research and intervention plans. The community participatory processes, along with protocols and instruments developed, will help ensure that the preliminary study results can be expanded upon in larger-scale assessment and intervention studies for the future
Keywords: Acculturation; Acculturations; Adolescent; Adolescent Youth; Advisory Committees; BMI percentile; BMI z-score; Belief; Body mass index; California; Cancers; Collection; Communities; Community Outreach; Cultural Assimilation; Data; Data Collection; Development; Diet; Dietary intake; Ensure; Focus Groups; Food; Frequencies (time pattern); Frequency; Future; Goals; Height; Heterogeneity, Population; Individual; Intervention Studies; Location; Malignant Neoplasms; Malignant Tumor; Measurement; Measures; Methods; Nutrition; Nutritional Science; Obesity; Outreach, Community; Pacific Island Americans; Pacific Islander; Pacific Islander American; Physical activity; Population; Population Heterogeneity; Prevalence; Process; Protocol; Protocols documentation; Purpose; Questionnaires; Quetelet index; Rate; Reinforcing Factor; Risk Factors; Samoan; Sampling; Science of nutrition; Survey Instrument; Surveys; Task Forces; Testing; Time; Universities; Weight; Youth; Youth 10-21; adiposity; aged; base; community based participatory research; corpulence; corpulency; corpulentia; design; designing; diverse populations; experience; heterogeneous population; instrument; intervention development; juvenile; juvenile human; malignancy; member; neoplasm/cancer; nutrition; obese; obese people; obese person; obese population; prevent; preventing; therapy development; treatment development
Project start date: 2007-04-10
Project end date: 2010-03-31
Budget start date: 1-APR-2008
Budget end date: 31-MAR-2010
PFA/PA: PAR-05-026
5R21HD055192-02 (2008): $0
Sora Park Tanjasiri
California State University Fullerton
Project start date: 2010-09-23
Project end date: 2015-07-31