Research Interests:
117 Background: Disease stage at the time of diagnosis is the most important determinant of prognosis for lung cancer. Despite demonstrated effectiveness of lung cancer screening (LCS) in reducing lung cancer mortality, early detection... more
117 Background: Disease stage at the time of diagnosis is the most important determinant of prognosis for lung cancer. Despite demonstrated effectiveness of lung cancer screening (LCS) in reducing lung cancer mortality, early detection continues to elude populations with the highest risk for lung cancer death. Consistent with the national rate, current screening rate in Alabama is dismal at 4.2%. While public awareness of LCS may be a likely cause there are no studies that have thoroughly evaluated current knowledge of LCS within the Deep South. Therefore, we measured (LCS) knowledge before and after receiving education delivered by Community Health Advisors (CHAs) among high-risk individuals living in medically-underserved communities of Alabama and to determine impact of psychological, demographic, health status and cognitive factors on rate of lung cancer screening participation. Methods: Participants were recruited from one urban county and six rural Black Belt counties (charact...
Research Interests:
Lung cancer is the leading cause of cancer mortality in the USA. In the rural Black Belt region of Alabama, high rates of lung cancer incidence and mortality coupled with disproportionate lack of access to health services stresses the... more
Lung cancer is the leading cause of cancer mortality in the USA. In the rural Black Belt region of Alabama, high rates of lung cancer incidence and mortality coupled with disproportionate lack of access to health services stresses the need for navigating high risk and disproportionately affected groups towards successfully obtaining lung cancer screenings. We utilized our well-accepted Community Health Advisor (CHA) model for education and awareness. This study seeks to evaluate the results of the Alabama Lung Cancer Awareness, Screening, and Education (ALCASE) training on CHAs, program evaluation, and lessons learned. A total of 202 participants were eligible and enrolled for CHA training. One hundred thirty CHAs were included for the final analyses. Descriptive statistics were computed; differences in pre-test and post-test scores were compared across demographic characteristics of the participants using paired t-test/one-way ANOVA. Of the 130 CHAs, 46% were 65 years or older; 98% were African Americans, and 87% were female; 17% of participants were cancer survivors. The mean post-test scores were 2.2 points greater than mean pre-test scores, and the difference was significant (mean (SD): pre-test = 20.8 (2.8) versus post-test = 23 (2.2); p = 0.001). No notable difference in pre-test and post-test scores were observed by CHA's demographic characteristics except by their county of residence or work (p = 0.0019). We demonstrate the capability and value of successfully recruiting and training motivated community members to be able to serve educators to better reach medically underserved and historically excluded communities.
Research Interests:
Urinary incontinence is a multifaceted condition with many causes, presentations, and treahnents. As a result, a variety of treatments have been developed to address behavioral, physiological, environmental, medical, and su rgical aspects... more
Urinary incontinence is a multifaceted condition with many causes, presentations, and treahnents. As a result, a variety of treatments have been developed to address behavioral, physiological, environmental, medical, and su rgical aspects of the problem. The choice of treatment method depends upon many factors, including the specifi c type of incontinence, its cause, the skills and training of the p rofessional providing the therapy, the physical and mental capabilities of the patient, and the desires of the patient. The 1988 NIH Consensus Conference on Urinary Incontinence in Adults concluded that "In general, the least invasive procedure should be tried first" (Consensus Conference, 1989, p. 2689). This chapter will describe the current sta tus of the major conservative approaches to incontinence: behavioral treatment, electrical stim ulation, and pharmacologic therapy. Older patients with incontinence can be divided into two general categories: Those who are dependent o...
Research Interests:
Background The rates of physical inactivity and related cancer incidence and mortality are disproportionately high in the Deep South region in the United States, a rural, medically underserved region with a large African American... more
Background The rates of physical inactivity and related cancer incidence and mortality are disproportionately high in the Deep South region in the United States, a rural, medically underserved region with a large African American population compared with the rest of the nation. Given this region’s lower rates of literacy and internet access, interactive voice response (IVR) system–automated telephone-based interventions have the potential to help overcome physical activity intervention barriers (literacy, internet access, costs, and transportation) but have yet to be extended to rural, underserved populations, such as in the Deep South. Thus, extensive formative research is being conducted to develop and beta test the Deep South IVR System–Supported Active Lifestyle intervention in preparation for dissemination in rural Alabama counties. Objective This paper aims to describe the design and rationale of an ongoing efficacy trial of the Deep South IVR System–Supported Active Lifestyle...
Research Interests:
Background: The Center to Reduce Cancer Health Disparities (CRCHD), National Cancer Institute (NCI), launched Screen to Save, NCI's Colorectal Cancer Outreach and Screening Initiative to promote awareness and knowledge of colorectal... more
Background: The Center to Reduce Cancer Health Disparities (CRCHD), National Cancer Institute (NCI), launched Screen to Save, NCI's Colorectal Cancer Outreach and Screening Initiative to promote awareness and knowledge of colorectal cancer in racial/ethnic and rural populations. Methods: The initiative was implemented through CRCHD's National Outreach Network (NON) and Comprehensive Partnerships to Advance Cancer Health Equity (CPACHE) programs. NON is a national network of Community Health Educators (CHEs), aligned with NCI-designated Cancer Centers (CCs). CPACHE are partnerships between a CC and a minority-serving institution with, among other components, an Outreach Core and a CHE. In phases I and II, the CHEs disseminated cancer-related information and implemented evidence-based educational outreach. Results: In total, 3,183 pre/post surveys were obtained from participants, ages 50 to 74 years, during 347 educational events held in phase I. Results demonstrated all racia...
Research Interests:
Research Interests:
Research Interests:
The nutrition environment, including food store type, may influence dietary choices, which in turn can affect risk of obesity and related chronic diseases such as CHD, diabetes and cancer. The objective of the present study was to... more
The nutrition environment, including food store type, may influence dietary choices, which in turn can affect risk of obesity and related chronic diseases such as CHD, diabetes and cancer. The objective of the present study was to elucidate the extent to which healthy foods are available and affordable in various rural food outlets. A subset of the nutrition environment was assessed using the Nutrition Environment Measures Survey in Stores (NEMS-S). The NEMS-S instrument assessed the availability and price of healthy foods (e.g. low-fat/non-fat milk, lean meats and reduced-fat dinner entrées) compared with less healthy counterparts (e.g. whole milk, non-lean meats and regular dinner entrées). The NEMS-S also assessed the quality of fresh fruits and vegetables. Availability, prices and quality of healthy foods were compared between grocery stores ( 24) and convenience stores ( 67) in nine rural counties in Alabama. Mean availability subscale score (possible range 0 to 30; higher scor...
Research Interests:
The Deep South Network for Cancer Control (DSNCC), initiated in 2000, is a dual-state, community-based participatory research infrastructure composed of academic and community partners committed to reducing cancer disparities among... more
The Deep South Network for Cancer Control (DSNCC), initiated in 2000, is a dual-state, community-based participatory research infrastructure composed of academic and community partners committed to reducing cancer disparities among underserved African Americans in 12 designated counties of the Alabama Black Belt and the Mississippi Delta, 2 historically underserved areas of the country. Local residents trained as Community Health Advisors as Research Partners implemented a 3-tier community action plan (CAP) focused on promoting cancer screening, physical activity, and nutrition. Breast, cervical and colorectal cancer screening, healthy eating habits, and physical activity levels increased among many, but not all, African American women in the 12-county DSNCC coverage area. Seeking to improve our reach to include participants who reported they had never heard of the DSNCC or participated in the CAP, we conducted in-depth conversations with community residents about reasons for select...
Research Interests: Health Promotion, Participatory Action Research, Health Equity, Medicine, Community Based Participatory Research, and 13 moreHumans, Female, Psychological Intervention, Mississippi, African Americans, Middle Aged, Adult, Public health systems and services research, Neoplasms, Community Networks, Alabama, Family and Community Health Nursing, and Delivery of Health Care
For 10 years, the Deep South Network for Cancer Control (DSNCC) focused on training and deploying community health advisors (CHAs) to promote cancer screening and healthy lifestyle through education/outreach activities. In 2009, the... more
For 10 years, the Deep South Network for Cancer Control (DSNCC) focused on training and deploying community health advisors (CHAs) to promote cancer screening and healthy lifestyle through education/outreach activities. In 2009, the request for application (RFA) for renewal of the DSNCC required a controlled research intervention. Converting from education/outreach to research proved more problematic than expected. The objective of this article was to describe the challenges and solutions during this conversion and to describe the importance of education/outreach to community infrastructure. This is a qualitative assessment of the challenges and solutions encountered in conducting a controlled weight loss trial in a community setting in which education/outreach had been the priority.Lesson Learned: The DSNCC provides a model for overcoming the unique challenges of converting a longstanding education/outreach program into a controlled research program. Although multiple challenges we...
Research Interests: Participatory Action Research, Health Education, Medicine, Community Based Participatory Research, Community Health Workers, and 9 moreHumans, Minority Groups, United States, Community Education, Outreach, Neoplasms, Community Networks, Guidance and Counseling Intervention Programs, and Early detection of cancer
Introduction and Purpose: Despite the benefits of physical activity, many cancer survivors fail to meet activity recommendations. Moreover, African American cancer survivors are less active than other survivor racial/ethnic groups. To... more
Introduction and Purpose: Despite the benefits of physical activity, many cancer survivors fail to meet activity recommendations. Moreover, African American cancer survivors are less active than other survivor racial/ethnic groups. To address this disparity, we designed an intervention (Wii Can). Wii Can combines the appeal of emerging technology (Nintendo Wii) with the strength of social support from community health advisors (CHAs). The purpose of the current abstract is to describe the recruitment and retention of CHAs and African American cancer survivors to Wii Can. Methods: CHAs from the NCI-funded Deep South Network (DSN) for Cancer Control were identified and recruited to participate. CHAs completed training to deliver a 12 week intervention to increase physical activity in survivors. The intervention was based on Self Determination Theory. African American colorectal cancer survivors 45 to 75 years old who were not physically active, were recruited primarily through a hospi...
Research Interests:
African American women in the Deep South of the United States are disproportionately obese, a condition strongly influenced by their social environment. The objective of this study was to characterize the prevalence of social support from... more
African American women in the Deep South of the United States are disproportionately obese, a condition strongly influenced by their social environment. The objective of this study was to characterize the prevalence of social support from family and friends for healthy eating and exercise in rural communities. This study is an analysis of a subgroup (N = 195) of overweight and obese African American women from a larger ongoing weight loss trial (N = 409) in rural communities of the Alabama Black Belt and Mississippi Delta. The Social Support and Eating Habits Survey and Social Support and Exercise Survey were used to measure support from family and friends for healthy eating and exercise, respectively. Linear regression was conducted to determine the association between social support factors and body mass index (BMI). Concurrently prevalent in our sample were encouraging support for healthy eating (family, median,14.0; range, 5.0-25.0; friends, median, 13.0; range 5.0-25.0) and dis...
Research Interests:
Research Interests: Health Promotion, Environmental Health, Physical Activity, Built Environment, Preventive medicine, and 15 moreMedicine, Humans, Descriptive Statistics, Audit, Female, Mississippi, Exercise, Public health systems and services research, Curriculum and Pedagogy, Environment Design, Active Living, Rural Area, Alabama, Public Policy, and Leisure Activities
The Deep South Network for Cancer Control (DSN), a multistate partnership comprised of academic and community partners used community-based participatory approaches to recruit and train volunteer Community Health Advisors trained as... more
The Deep South Network for Cancer Control (DSN), a multistate partnership comprised of academic and community partners used community-based participatory approaches to recruit and train volunteer Community Health Advisors trained as Research Partners (CHARPs) to develop a community action plan to address cancer and other health disparities among African Americans. DSN is 1 of 25 NCI Community Network Programs funded to further reduce cancer health disparities through community-based participatory education, training, and research among racial/ethnic minorities and underserved populations. This presentation discusses the utilization of the Community Health Advisors model for cancer prevention and control; illustrate capacity building of underserved minorities members; and development and implementation of a Community Action Plan (CAP) to improve cancer screening. Also, the presentation illustrates CBPR applied to develop a multi-level (CAP) focusing on individuals, organizational sys...
Research Interests:
Research Interests: Health Behavior, Gerontology, Consumer Behavior, Medicine, Logistic Regression, and 15 moreHumans, Demographics, African American, Walking, Female, American, Health Status, African Americans, Middle Aged, Questionnaires, Adult, Public health systems and services research, Neoplasms, Curriculum and Pedagogy, and milestone
Research Interests:
... 2 , Agnes Hinton, DrPH, RD 3 , Theresa A. Wynn, Ph.D. 2 , Rhoda Johnson, Ph.D. 4 , Isabel Scarinci, Ph.D., MPH 2 , Claudia Hardy 1 , and Freddie White-Johnson 3 . (1) Comprehensive Cancer Center, University of Alabama at Birmingham,... more
... 2 , Agnes Hinton, DrPH, RD 3 , Theresa A. Wynn, Ph.D. 2 , Rhoda Johnson, Ph.D. 4 , Isabel Scarinci, Ph.D., MPH 2 , Claudia Hardy 1 , and Freddie White-Johnson 3 . (1) Comprehensive Cancer Center, University of Alabama at Birmingham, 1802 Sixth Avenue South, NP 2555 ...
Research Interests:
Research Interests:
Research Interests:
Research Interests: Health Care, Health Disparities, Physical Activity, Colorectal cancer, Community Based Participatory Research, and 19 moreCommunicative action, Humans, African American, Female, Male, Cancer Screening, Work in Progress, Mississippi, Universities, Fruit and vegetables, African Americans, Progress, Middle Aged, Lessons Learned, Neoplasms, Participatory Approach, National Cancer Institute, Alabama, and Colorectal Neoplasms
Disparities in cancer survivorship exist among specific populations of breast cancer survivors, specifically rural African American breast cancer survivors (AA-BCS). While effective survivorship interventions are available to address and... more
Disparities in cancer survivorship exist among specific populations of breast cancer survivors, specifically rural African American breast cancer survivors (AA-BCS). While effective survivorship interventions are available to address and improve quality of life, interventions must be culturally tailored for relevance to survivors. Here, we report the results of our formative research using focus groups and in-depth interview to better understand unique rural AA-BCS survivorship experiences and needs in the Alabama Black Belt. Surveys were used to gather sociodemographic and cancer treatment data. Fifteen rural AA-BCS shared their experiences and concerns about keeping their cancer a secret, lack of knowledge about survivorship, lingering symptoms, religion and spirituality, cancer surveillance, and general lack of survivorship education and support. Rural AA-BCS were unwilling to share their cancer diagnosis, preferring to keep it a secret to protect family and friends. Quality-of-l...
Research Interests:
... Groesbeck Parham, MD; Claudia Hardy, MPA; Freddie White-Johnson, MPPA INTRODUCTION ... The per capita income in most of these areas hovers around $12,000 and approximately 60% of the popula-tion is African-American. ...
Research Interests:
Background: The Deep South Network for Cancer Control (DSN) is a community-based participatory research (CBPR) collaboration that focuses on improving the access to and utilization of evidence-based interventions for reducing cancer... more
Background: The Deep South Network for Cancer Control (DSN) is a community-based participatory research (CBPR) collaboration that focuses on improving the access to and utilization of evidence-based interventions for reducing cancer disparities primarily cervical, breast, and colorectal cancers. The Deep South Network has developed a comprehensive Community Action Plan (CAP) to address cancer disparities in traditionally minority, underserved communities in Alabama and Mississippi, both rural and urban areas. Methods: The components of the CAP were developed through formalized workgroups and extensive dialogues with community health advisors, academic researchers, and local community partners ranging from elected officials and church leaders to nonprofit community organizations. As a result of this process, 4 targeted intervention categories for reducing cancer disparities were identified for implementation 1) advocacy, 2) physical activity, 3) nutrition, and 4) cancer awareness and...
... Groesbeck Parham, MD; Claudia Hardy, MPA; Freddie White-Johnson, MPPA INTRODUCTION ... The per capita income in most of these areas hovers around $12,000 and approximately 60% of the popula-tion is African-American. ...
Research Interests:
Research Interests: Health Care, Health Disparities, Physical Activity, Colorectal cancer, Community Based Participatory Research, and 18 moreCommunicative action, Humans, African American, Female, Male, Cancer Screening, Work in Progress, Mississippi, Universities, Fruit and vegetables, African Americans, Progress, Middle Aged, Lessons Learned, Neoplasms, Participatory Approach, National Cancer Institute, and Alabama
Research Interests:
The study had 2 objectives: (1) to gather the observations of community health advisors (CHAs) on the role of social support in the lives of African Americans; and (2) to develop a lay support intervention framework, on the basis of the... more
The study had 2 objectives: (1) to gather the observations of community health advisors (CHAs) on the role of social support in the lives of African Americans; and (2) to develop a lay support intervention framework, on the basis of the existing literature and observations of CHAs, depicting how social support may address the needs of African American patients with heart failure. Qualitative data were collected in semistructured interviews among 15 CHAs working in African American communities in Birmingham, Alabama. Prominent themes included the challenge of meeting clients' overlapping health care and general life needs, the variation in social support received from family and friends, and the opportunities for CHAs to provide multiple types of social support to clients. CHAs also believed that their support activities could be implemented among populations with heart failure. The experience of CHAs with social support can inform a potential framework of a lay support intervention among African Americans with heart failure.