PATN?? EN AKSYON: ADDRESSING CERVICAL CANCER DISPARITIES IN LITTLE HAITI
N Erin, Assist Prof Epidemiology & Public Health
University Of Miami School Of Medicinecity: Miami country: United States (us)
Grant 5R21CA148658-02 from National Cancer Institute
Abstract: Patnh en Aksyon (Partners in Action) is a well-established campus community partnership between the University of Miami and key Haitian community-based organizations in South Florida. Over the past four and a half years, Partnership members have been actively engaged in a Community-based Participatory Research (CBPR) initiative to address the disproportionate burden of cervical cancer in Little Haiti, the predominately Haitian neighborhood in Miami. Cervical cancer incidence and mortality rates in Little Haiti are significantly higher than elsewhere in the Miami metropolitan area, including other, low income, minority neighborhoods. As part of our effort to attenuate this disparity, we have learned about twalet deba, a feminine hygiene practice designed to cleanse, dry, and tighten the vagina for disease prevention and enhanced sexual pleasure of male partners. We believe, though have not yet empirically verified, that this practice may actually increase susceptibility to Human Papillomavirus (HPV), the principal cause of cervical cancer. The proposed research aims to fill this gap in understanding. We have planned a two-year exploratory study that integrates mixed methodologies. Indigenous Community Health Workers, or Ajan Fanm, will collect all study data. Integrating the Ajan Fanm into our study design is consistent with the tenets of CBPR and essential for achieving study aims, given their intimate knowledge of cultural norms related to the discussion of health and other sensitive topics. In the first phase of research, the Ajan Fanm will employ participant observation and in-depth interviewing techniques to better understand the socio-cultural significance of twalet deba, and how this practice is intricately tied to male-female relationships, lay perceptions of health and illness causation, and sexuality. Information learned from these data will inform the second phase of the proposed research. In this phase of inquiry, the Ajan Fanm will interview 250 Haitian women, and teach them to use a simple self- sampling device to collect a cervical specimen for HPV testing and cytology. This device has similar efficacy to the Pap smear, but it can be self-administered in the privacy of one´s home, circumventing socio-cultural concerns about modesty prevalent among Haitian women. The cervical specimens will be evaluated by a certified pathologist for cytologic changes and tested for HPV using the Hologic/Third Wave Invader assay. In this exploratory study, our primary objective is to improve understanding about twalet deba and its potential association with HPV to inform future research and intervention that may attenuate the excess risk of cervical cancer in Little Haiti and other medically underserved, ethnic enclaves. Patne en Akyson (Partners in Action) is a well-established campus-community partnership between the University of Miami and key Haitian community-based organizations in South Florida. For the past four and a half years, Partnership members have been actively involved in an ongoing Community-based Participatory Research (CBPR) initiative to address the excess burden of cervical cancer in Little Haiti, the predominately Haitian neighborhood in Miami. Cervical cancer incidence and mortality rates are significantly higher in Little Haiti than elsewhere in the Miami metropolitan area. The proposed study aims to examine whether twalet deba, a feminine hygiene practice commonplace throughout Little Haiti, is associated with an increased risk of Human Papillomavirus (HPV), the principal cause of cervical cancer. Consistent with the tenets of CBPR, this study reflects the collective input of Patne en Akyson´s academic and community members, and our shared commitment to positive social change
Keywords: Address; Age; Age-Years; Area; Attenuated; base; Biological Assay; cancer health disparity; cancer risk; Cervical; Cervical dysplasia; Chemicals; Communities; community based participatory research; Community Health; Cytology; Data; design; Devices; disorder prevention; Educational process of instructing; Etiology; Female; Feminine; Florida; Frequencies (time pattern); Future; Haiti; Health; Home environment; Human Papillomavirus; Hygiene; improved; Incidence; Indigenous; Intervention; Interview; Knowledge; Learning; Low income; male; Malignant neoplasm of cervix uteri; medically underserved; member; Methodology; Methods; metropolitan; Minority; Mortality Vital Statistics; Neighborhoods; Pap smear; Participant; Pathologist; Perception; Phase; pleasure; Population; Predisposition; Privacy; Process; public health relevance; Research; Research Design; Research Personnel; research study; Risk; Sampling; Self-Administered; Sexuality; Social Change; Specimen; Techniques; Testing; Universities; Vagina; Woman
Relevance: Patne en Akyson (Partners in Action) is a well-established campus-community partnership between the University of Miami and key Haitian community-based organizations in South Florida. For the past four and a half years, Partnership members have been actively involved in an ongoing Community-based Participatory Research (CBPR) initiative to address the excess burden of cervical cancer in Little Haiti, the predominately Haitian neighborhood in Miami. Cervical cancer incidence and mortality rates are significantly higher in Little Haiti than elsewhere in the Miami metropolitan area. The proposed study aims to examine whether twalet deba, a feminine hygiene practice commonplace throughout Little Haiti, is associated with an increased risk of Human Papillomavirus (HPV), the principal cause of cervical cancer. Consistent with the tenets of CBPR, this study reflects the collective input of Patne en Akyson´s academic and community members, and our shared commitment to positive social change
Project start date: 2010-04-01
Project end date: 2012-03-31
Budget start date: 1-APR-2011
Budget end date: 31-MAR-2012
PFA/PA: PAR-08-076
5R21CA148658-02 (2011): $142518
Sponsored Links Excellgen http://Excellgen.com
Grants awarded to N Erin
N Erin, Assist Prof Epidemiology & Public Health
University Of Miami School Of Medicinecity: Miami country: United States (us)
Abstract: Section N3 Community Outreach Core, Core Leader- Dr. Erin Kobetz The vision ofthe South Florida Centerfor Reducing Cancer Disparities.(SUCCESS) is that through increased cervical cancer screening we can eliminate cervical cancer disparities in our community. By doing so, we would also contribute nationally towards our nation´s ongoing effort towards the ultimate elimination of cancer disparities. To goals of this core are to support community outreach activities that would achieve this goal
Keywords: Address; Affect; Area; Awareness; Behavior; Behavioral; cancer education; cancer health disparity; Cervical Cancer Screening; Church; Communication; Communities; community based participatory research; Community Health; Community Networks; Community Outreach; Community Participation; County; Custom; Detection; Development; Disease; disorder prevention; Ethnicity aspects; Florida; follow-up; Goals; Haiti; Health Fairs; Health Policy; Health Promotion; improved; Incidence; Indigenous; Intervention; Locales; Malignant neoplasm of cervix uteri; Media Campaign; Methodology; Mortality Vital Statistics; Nationalities; Needs Assessment; outreach; outreach program; Plague; Population; Prevention; Process; Program Development; programs; Religion; Resources; Screening procedure; Social Change; Social Network; Socioeconomic Status; Structure; Vision; Woman; Work
Budget start date: 1-SEP-2011
Budget end date: 31-AUG-2012
5U54CA153705-02_7677 (2011): $236175
MARIETTA COMMUNITY ACTIVELY RESEARCHING EXPOSURE STUDY
N Erin, Adjunct Assistant Professor
University Of Cincinnaticity: Cincinnati country: United States (us)
Grant 5R01ES016531-04 from National Institute Of Environmental Health Sciences
Abstract: Manganese (Mn) is an essential element, yet is neurotoxic in excess. Despite the fact that infants and young children may be at greater risk for Mn neurotoxicity than adults, very few studies have evaluated the effect of chronic Mn exposure on child development. Marietta, Ohio, a rural Appalachian community, has been home to the only metal refinery in the US and Canada for over 50 years. In response, the community formed Neighbors for Clean Air (NCA). The University of Cincinnati (UC) has been asked by NCA to assist them in understanding their exposure and related health effects, if any. For this project, Marietta Community Actively Researching Exposure Study (CARES), the community has defined the research agenda, determining the research questions, objectives, specific aims and identifying resources available within the community to conduct the research. Members of the community will be engaged in all facets of the research project, including environmental sampling, neurobehavioral assessment, project coordination, and collection of biological specimens. The primary objectives of this application are to examine biological indicators of Mn exposure in children and understand the effects of chronic manganese exposure in children. UC will provide training, oversight and expertise in environmental health research, to address the following hypothesis Exposure to Mn during early childhood is significantly associated with neurodevelopmental deficits in high exposed children ages 7-8 years compared to an age matched low/unexposed group. In order to test the hypothesis, the following community-driven specific aims will be accomplished. Specific Aim 1 Assess environmental Mn exposure within a high Mn exposure community, Marietta, OH and a low Mn exposure community, Cambridge, Ohio. Specific Aim 2 Evaluate comparisons of the neurobehavioral effects in children exposed to Mn in a high Mn exposure community, Marietta, OH and a low Mn exposure community, Cambridge, Ohio. Specific Aim 3 Evaluate comparisons of the neuromotor effects in children exposed to Mn exposure community, Marietta, OH and a low Mn exposure community, Cambridge, Ohio. Given the unique susceptibility of children to toxicant exposure and the opportunity to study Mn exposure in a chronically exposed community, we anticipate this project to significantly impact local and national public health policy related to Mn exposure. Exposure to manganese (Mn) can result in neurological deficiencies, and here is great potential for global exposure to Mn in the form of MMT, an anti-knock agent to replace lead in gasoline. The Marietta Community Actively Researching Exposure Study (CARES) is a community-based study designed to explore the health effects of long term Mn exposure in children. Exposure to manganese (Mn) can result in neurological deficiencies, and here is great potential for global exposure to Mn in the form of MMT, an anti-knock agent to replace lead in gasoline. The Marietta Community Actively Researching Exposure Study (CARES) is a community-based study designed to explore the health effects of long term Mn exposure in children
Keywords: 0-11 years old; 0-6 weeks old; 21+ years old; 3, 4-Dihydroxyphenethylamine; 4-(2-Aminoethyl)-1, 2-benzenediol; Aching muscles; Address; Adult; adult human (21+); advocacy organizations; Affect; Age; Air; air monitoring; Air Pollution; Alcohol, Methyl; Alloys; Ammonia; Animal Feed; animal food; Animals; Apoptosis; Apoptosis Pathway; Aspiration, Respiratory; Attention; Automobile Driving; Awareness; Awarenesses; base; Biochemical; Biological; biomarker; Blood; Blood - brain barrier anatomy; Blood-Brain Barrier; Brain; Breathing; Buccal Cavity; Canada; Carbinol; Cavitas Oris; Cell Death, Programmed; Censuses; Central Nervous System; Cephalalgia; Cephalgia; Cephalodynia; Cephalodynias; Child; Child Development; Child Youth; children; Children (0-21); Chinese; Chinese People; Chronic; clinical data repository; clinical data warehouse; Code; Coding System; Cognitive; Collection; Common Rat Strains; Communities; Complex; conference; County; Cranial Pain; Cyclohexanes; Data; Data Banks; Data Bases; data repository; Databank, Electronic; Databanks; Database, Electronic; Databases; Deposit; Deposition; Development; Dietary Manganese; Differentiation and Growth; dissemination research; Distress; Dopamine; Dose; drinking water; driving; Drivings, Automobile; Dust; Dysfunction; early childhood; Effects, Longterm; Elements; Embryonic Tissue, Placenta; Encephalon; Encephalons; Environmental Exposure; Environmental Factor; Environmental Health; Environmental Health Science; Environmental Protection Agency; Environmental Protection Agency (U.S.); environmental risk; Environmental Risk Factor; environmental toxicant; Environmental Toxin; EPA; Exhibits; Exposure to; exposure to metal; Eye Burns; Fear; ferrite; ferromagnets; ferrospinel; Fertilizers; Fetus; Financing, Personal; Fright; Functional disorder; Future; Gasoline; Gustation; Hair; Head and Neck, Buccal Cavity; Head and Neck, Pharynx; Head Pain; Headache; Health; health care policy; Health Policy; heavy metal lead; heavy metal Pb; Hemato-Encephalic Barrier; Home; Home environment; Human; Human, Adult; Human, Child; Human, General; Hydrogen Oxide; Hydroxytyramine; Industry; Infant; Infant and Child Development; Infant, Newborn; Inhalation; Inhaling; inspiration; Inspiration, Respiratory; interest; Knowledge; Language Tests; Lead; Literature; Location; Long-Term Effects; Mammals, Rats; Man (Taxonomy); Man, Modern; Manganese; Manuals; Marketing; Mathematics; Measures; meetings; member; Memory; Mental disorders; Mental health disorders; mental illness; Metal exposure; Metallic Tastes; Metals; Methanol; Methods; Mexico; Mn element; Modeling; Moods; Motor; Mouth; Muscle discomfort; Muscle Fatigue; Muscle pain; Muscle pain/fibrositis; Muscle sorenesss; Muscular Fatigue; Myalgia; Myalgia unspecified; Myalgic; Myodynia; Myoneuralgia; Myosalgia; Nail plate; Nails; Nasal; Nausea; Neighborhoods; Neonatal; Nervous System, Brain; Nervous System, CNS; Neural Development; Neuraxis; neurobehavior; neurobehavioral; neurodevelopment; Neurodevelopmental Deficit; Neurologic; Neurological; neuron toxicity; neuronal toxicity; neuropsychiatric; neuropsychiatry; neurotoxic; neurotoxicant; neurotoxicity; Neurotoxins; newborn human (0-6 weeks); Newborn Infant; Newborns; newspaper article; Newspaper Article; Newspaper Article (PT); Newspaper Article [Publication Type]; Nose; Nose, Nasal Passages; Odors; Ohio; Olfaction; Olfactions; Oral; Oral cavity; Outcome; Parkinsonian; Parkinsonian Condition; Parkinsonian Diseases; Parkinsonian Disorders; Parkinsonian Syndrome; Parkinsonism; particle; Particle Size; Particulate; pathophysiology; pathway; Pathway interactions; Pb element; Performance; personal finances; Personal Financing; Pharyngeal structure; Pharynx; Pharynxs; Physiopathology; Pilot Projects; pilot study; Placenta; Placenta-Tissue, Cells; Placentoma, Normal; Placentome; Plants; Plants, General; Policies; Pollution; Population; Predisposition; preventional intervention strategy; Preventive Intervention; Process; Psychiatric Disease; Psychiatric Disorder; psychological disorder; psychomotor reaction time; Public Health; public health medicine (field); Quality Control; R01 Mechanism; R01 Program; Rat; Rattus; Reaction Time; recruit; Recruitment Activity; Regulation; relational database; Relative; Relative (related person); Reporting; Research; Research Design; Research Grants; Research Project Grants; Research Projects; Research Projects, R-Series; Research Resources; Research Specimen; Resources; respiratory; Respiratory System, Nose, Nasal Passages; response; Response RT; Response Time; Reticuloendothelial System, Blood; Risk; RPG; Rural; sample collection; Sampling; scientific accomplishments; scientific advances; Scientific Advances and Accomplishments; Sensory; Smell; Smell Perception; Sore Throat; Source; Specimen; specimen collection; Steel; study design; Study Section; Study Type; Susceptibility; symposium; Symptoms; Taste; Taste Perception; teeth; Testing; Throat; Time; Tooth; Tooth structure; Toxic Environmental Agents; Toxic Environmental Substances; toxic exposure; Toxicant exposure; Training; Tremor; United States Environmental Protection Agency; Universities; Unspecified Mental Disorder; Visual; Washington; Water; Wood Alcohol; youngster
Project start date: 2008-04-01
Project end date: 2013-02-28
Budget start date: 1-MAR-2011
Budget end date: 29-FEB-2012
PFA/PA: PAR-07-283
5R01ES016531-04 (2011): $429828
5R01ES016531-03 (2010): $498056