142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Defining neighborhood clusters in a multilevel study of barriers to cervical cancer prevention, detection, and treatment among Latinas in Los Angeles

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 11:30 AM - 11:50 AM

Nan Zhao, MPH , Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA
Anna Loraine Agustin , Special Service for Groups/Saath, Los Angeles, CA
Sheila Murphy, PhD , Annenberg School of Communication, University of Southern California, Los Angeles, CA
Sandra Ball-Rokeach, PhD , Annenberg School of Communication, University of Southern California, Los Angeles, CA
Paula Amezola, MPH , Annenberg School for Communication and Journalism and Keck School of Medicine, University of Southern California, Marina del Rey, CA
Studies using multilevel modeling to analyze neighborhood health effect typically define neighborhoods based on contiguous units with arbitrarily drawn boundaries (e.g. census tracts).  This approach may not necessarily reflect the cultural, institutional and physical characteristics of neighborhoods, hence biasing the results.  Based on previous work of the Metamorphosis Project (http://www.metamorph.org/), we developed a novel approach to define neighborhoods in such a way that responds to this challenge, and captures residents’ everyday communication environment where decisions related to health--such as cervical cancer prevention, detection, and treatment--are shaped and acted upon.  From April 2012 to December 2013, 1660 Latina aged 21-50 and living in Los Angeles County participated in a quantitative survey on knowledge, attitudes, and behaviors with respect to cervical cancer.  Using Geographic Information Systems (GIS), we began with identifying the spatial distribution of participants, followed by a review of data and maps from various sources such as Metamorphosis, US Census, Mapping LA (http://maps.latimes.com/neighborhoods/), and Healthy City (http://www.healthycity.org/) as well as land use maps (http://cityplanning.lacity.org/). We then conducted hot spot analysis to examine the clustering of socioeconomic and demographic characteristics within the natural catchment areas of participants.  This multistep process yielded 25 distinctive neighborhood clusters that will be used for multilevel analysis of barriers and facilitators to cervical cancer related behaviors for our study population. This innovative approach improves current methods of defining neighborhoods and limits the bias associated with aggregating dissimilar units in studying not only cervical cancer related outcomes, but also health in general.

Learning Areas:

Assessment of individual and community needs for health education
Diversity and culture
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Discuss an innovative approach to define neighborhood clusters for multilevel analysis of neighborhood health effect. Identify community level factors to better understand Latina’s cervical cancer related knowledge, beliefs, and behaviors, as well as health issues more generally.

Keyword(s): Cancer and Women’s Health, Behavioral Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: For the past 2 years, I have been working on the overarching project that produced the data for this study. I am a significant contributor to its survey construction, method development in defining neighborhood clusters, focus groups, and field observation. I am currently pursuing my doctoral degree in health communication, with a specific focus on the dynamics and complexity of the relationship between geographic communities, residents, and health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.