Abstract
Exploring Potential Communication Strategies for Promoting Hepatitis B Prevention among a Sample of Young Asian American Adults
Julia M. Alber, PhD, MPH1, Chari Cohen, DrPH, MPH2, Giang T. Nguyen, MD, MPH, MSCE, FAAFP3, Sanam F. Ghazvini1 and Brenda Tolentino1
(1)California Polytechnic State University, San Luis Obispo, CA, (2)Hepatitis B Foundation, Doylestown, PA, (3)University of Pennsylvania, Philadelphia, PA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Asian Americans are disproportionately affected by liver cancer compared to other race/ethnicities with the hepatitis B virus (HBV) being the primary contributor of liver cancer among this population. Targeted community-based research has found that young Asian Americans have HBV infection rates of about 10%-20%. While past studies have applied the Health Belief Model to understand factors that impact HBV preventive behaviors, these studies have not focused on young adults. We conducted an online survey with young Asian Americans (N=418), aged 18-29 years old, in order to better understand health information seeking, social media, and HBV-related behaviors and beliefs among this population. Results indicated that the internet was the most common source of health information (69.1%) and that doctors and health organizations were the most trusted source of health information. Reported difficulty finding health information was significantly higher among men (M=3.036, SD =0.821) compared to women (M=2.780, SD=0.843), F(1, 417), p=0.019. Almost all participants (99.8%) reported using social media, and indicated they engaged in health-related behaviors on social media, including reading someone else’s health experience (67.9%) and receiving health information from social media sites (49.3%). Having received the HBV vaccine, engaging in more health-related activities on social media (e.g., finding health information on social media, joining a group), and having a higher mean of information seeking behaviors were significantly related to higher perceived susceptibility, F(12, 265)=8.089, p<0.001. Findings suggest that future research should explore the effectiveness of using social media to reach young Asian American adults to promote HBV awareness and preventive behaviors.
Assessment of individual and community needs for health education Communication and informatics Public health or related education
Abstract
Using the Health Belief Model to Explain Breast Cancer Survivors’ Intentions to Seek the Flu Vaccine: A National Study
Rebecca Earlie Royer, PhD, MPH, CHES1, Amy Thompson, Ph.D., CHES1, Timothy Jordan, M.Ed., Ph.D1 and Stephanie Birkey Reffey, PhD2
(1)University of Toledo, Toledo, OH, (2)Susan G. Komen, Dallas, TX
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: Breast cancer survivors (BCS) are at increased risks from influenza. However, vaccination rates among BCS are significantly lower than the general population. Research is needed to help explain survivors’ vaccination decision-making.
Purpose: To determine if the Health Belief Model (HBM) was useful in explaining BCS’ decision to obtain/not obtain the influenza vaccine.
Method: The study was quantitative, randomized, and mixed method. Participants were female breast cancer survivors, 30-80 years of age, from all regions of the US. Using the HBM, we designed a valid and reliable survey (Cronbach’s alpha coefficients = 0.70 to 0.96).
Results: 462 survivors completed the survey (50%). Respondents were White (89%) 50-69 years old (73%); annual income over $35,000 (62%); and college educated (44%). Nearly 40% said they were “unsure” to “very unlikely” to get the shot this year. Survivors whose physicians recommended the vaccine reported a higher frequency of getting the vaccine (X2 (9) = 88.38, p < 0.001). The HBM explained 56% of the variance in past decision making to get the vaccine (F (5, 456) = 145.79, p < 0.001) and 33% of the variance in behavioral intentions (F (5,455) = 43.82, p < 0.001). However, survivors’ perceived importance of the vaccine explained 44% of the variance in behavioral intention (F (3, 456) = 131.64, p < 0.001).
Conclusion: Influenza vaccination rates among BCS can likely be increased if physicians recommend the vaccine; if survivors are persuaded of the importance of the vaccine; and if the HBM is used as the basis for educational materials.
Planning of health education strategies, interventions, and programs Protection of the public in relation to communicable diseases including prevention or control Provision of health care to the public Public health or related nursing Public health or related research Social and behavioral sciences
Abstract
Transparency, Community Benefit, and Convenience: Student Perspectives on Influenza Vaccination
Zoe Larson
Portland State University, Portland, OR
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: CDC recommendations are for all populations over the age of 6 months to receive annual influenza vaccinations; however, the young adult population consistently falls short of vaccination goals. In order to adequately protect the population from influenza, public health campaigns aim to increase the vaccination rates of the general population, including young adults.
Purpose: The purpose of this study is to explore factors that inhibit and motivate influenza vaccination among college students, using the integrated model of behavioral prediction as a theoretical framework.
Method: Two groups of college students participated in semi-structured focus group discussions. Participants completed a short anchoring survey about their previous experience with the influenza vaccine, current influenza vaccination status, and their reasoning for their vaccination decisions. A moderator led a discussion regarding attitudes, perceived norms, and perceived efficacy regarding influenza vaccination. A poster for a CDC influenza campaign was then shown and discussed regarding relevance and reactions.
Results: Nearly all participants did not receive an influenza vaccination for the current season, but the reasons for not vaccinating differed. There was a great deal of misinformation regarding the influenza vaccine, as well as a desire for more information from medical authorities. Fear of needles was referenced, and inconvenience was also cited as a common barrier that hindered vaccination.
Conclusion: To improve vaccination rates among college students, future campaign efforts should highlight the personal benefits of vaccination, as well as communicating how personal vaccination can keep others safe. Campaigns should be informative as well as convenient.
Assessment of individual and community needs for health education Communication and informatics Other professions or practice related to public health Planning of health education strategies, interventions, and programs Protection of the public in relation to communicable diseases including prevention or control Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Local health department interest in providing HPV vaccine to inmates in county jails: A study of Kansas, Missouri, Iowa and Nebraska
Molly Allison, MPH1, Brynne Musser, BS2, Patricia J. Kelly, PhD, MPH, APRN3 and Megha Ramaswamy, PhD, MPH1
(1)University of Kansas School of Medicine, Kansas City, KS, (2)University of Kansas Medical Center, Kansas City, KS, (3)University of Missouri-Kansas City, Tucson, AZ
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
objective: To assess interest among local health departments in a four-state region in the feasibility and challenges of providing human papillomavirus (HPV) vaccine to inmates in their county’s jail.
background: HPV-related cancers affect adults with criminal justice histories 4-5 times as much as the general population. Implementing jail-based, health department-run HPV vaccine clinics could address low HPV vaccination rates in HSS Region VII and provide better HPV vaccine access to inmates.
methods: From September 2017 to February 2018, a survey was sent via email to 345 county health departments across HHS Region VII. The survey included questions on vaccine services health departments provide, expected challenges in providing vaccines to inmates, and feasibility of implementing an HPV vaccination program in their county’s jail.
results: Though data collection is ongoing, so far 181 counties in HHS Region VII (Kansas, Missouri, Iowa, and Nebraska) have completed the survey resulting in a response rate of 52.4% (181/345 total). Almost 90% of health departments (N = 161) provide HPV vaccine. The top three challenges health departments identified in providing vaccine to inmates included cost, short length of stay for inmates, and medical staff availability. However, 41% (N = 75) of health departments are interested in finding out more about how to implement a heath-department run, jail-based vaccine program.
conclusions: Local health departments might face challenges to providing HPV vaccine to inmates. Findings from this study may inform an approach to establishing sustainable partnerships between local health departments and county jails, which could increase HPV vaccine access for vulnerable populations.
Implementation of health education strategies, interventions and programs Protection of the public in relation to communicable diseases including prevention or control Public health administration or related administration
Abstract
Anti-vaccinationism and social media: The role of virtual connectedness in undermining public health efforts
Ellen Van Druten, MPH, Dominick Sturz, DrPH, MPH, Janet Bonome, DrPH and Ogbochi McKinney, DrPH, MPH
California Baptist University, Riverside, CA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: Vaccinations have been categorized as one of the greatest public health achievements, decreasing communicable disease morbidity and mortality that previously affected thousands of Americans each year. Despite the proven success of vaccinations, a movement of anti-vaccinationism has developed, resulting in a resurgence of vaccine-preventable diseases. Roots of this phenomena can be linked to an increase in nonmedical vaccination exemptions related to concerns regarding vaccine safety and efficacy. Social media has been a vehicle for the perpetuation of these beliefs, impacting health behavior on a national level.
Methods: A cross-sectional study will be conducted to collect observational data on multiple social media websites. Using a keyword search, public posts that discuss anti-vaccination viewpoints will be included in the study sample. Recurring words and phrases in these posts will be recorded and a frequency distribution will be performed in order to quantify the data for analysis.
Results: The data collected from this study will provide crucial information regarding the prevalent language behind anti-vaccination posts present on social media. The identified language will assess the changing health communication patterns throughout the United States as represented by new technologies and social media capabilities.
Conclusions: Social media is a platform for anti-vaccination conversation. Attention is needed from the field of public health to meet the perpetuated misinformation with accurate data regarding vaccinations in order to avoid further outbreaks of vaccine-preventable diseases due to fallacy.
Public health or related education Public health or related research
Abstract
Insights on the Prevention and Treatment of Diabetes among Latinas
Camille Clarke, MD, FACP1, Maud Joachim-Celestin, MD, DrPH1, Marisol Lara, B.S., MPH1, Susanne Montgomery, PhD, MPH, MS1 and Funmilola Babalola, MBBS2
(1)Loma Linda University, Loma Linda, CA, (2)La Sierra University, Riverside, CA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
It is well known that lifestyle factors and conditions such as dietary intake and physical activity significantly contribute to the development of type 2 diabetes. Latinos are currently the largest ethnic minority in the US and among the most affected. There are, however,unique considerations when implementing successful interventions among this population compared to their non-Hispanic Caucasians counterparts. Community health workers (promotores) have been used to engage in culturally relevant programming, however, insights into their recommendations for treatment remains an area to be further explored. Two focus groups (n=15) were held with Latino promotores living in Southern California. These promotores were first generation immigrants from Mexico, Central America and South America. A grounded theory approach guided the questions and analyses. Varying themes emerged as it related to lifestyle practices contributing to diabetes. Specifically, the impact of acculturation and its influence on preferential taste for foods high in sugar content, convenience of food that are known contributors to poor blood sugar control and perceived length of time it would take to prepare healthy meals. Participants further disclosed that though well aware of the impact of sedentary behavior and unhealthy eating, critical physical and emotional/social needs undermined their desires to engage in healthy behavior. For lifestyle-based diabetes treatment and prevention programs to succeed in the Latino community, there is need to promote culturally appropriate interventions that appreciate the effects of acculturation on lifestyle practices known to contribute to poor blood sugar control.
Assessment of individual and community needs for health education Chronic disease management and prevention Diversity and culture Planning of health education strategies, interventions, and programs Public health or related education Public health or related research
Abstract
Reverse Your Risk: Evaluating the Effectiveness of a Local Media Campaign To Increase Prediabetes Awareness in San Diego among High-Risk Communities
Christiane-Rayna Lopez, MPH, Deirdre Browner, MPH, Chesley Blevins, MPH, Kyra Reinhold, MPH, Kristen Smith, MPH, Thomas Coleman, MD, MS and Wilma J. Wooten, MD, MPH
County of San Diego Health and Human Services Agency, San Diego, CA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: In August 2016, the County of San Diego launched “Reverse Your Risk,” a local prediabetes awareness campaign. The campaign was directed towards Black and Latino adults in City Heights and Southeast San Diego and included social media, radio, and shared mailers, a cost-effective approach for direct mail advertising. To evaluate the campaign’s impact, residents from priority communities were surveyed by phone pre- and post-launch.
Approach: A preliminary focus group was conducted to inform campaign messaging. English and Spanish shared mailers were sent to 65,400 households, social media advertising reached 26,976 people, and Spanish radio advertising reached 63,678 adults. Surveys asked about demographics, knowledge of prediabetes risk factors and preventive behaviors, awareness of messaging, and likelihood of seeking information and screening in the future.
Results: Of the 301 respondents, 31% reported hearing or seeing campaign advertising, with 24% aware of specific messaging. Of those surveyed in Spanish, 52% were aware of the campaign compared to 16% surveyed in English. Among self-identified Black respondents, 18% were aware of the campaign, with 10% aware of messaging. There were significant relationships between campaign awareness and knowledge of being overweight as a risk factor, intention to visit a website for information, and having already talked to a doctor about prediabetes screening (p<0.05).
Conclusion: Results indicate that the campaign was not as successful in reaching Black adults in the priority communities as Spanish-speakers. These results can inform future outreach efforts promoting prediabetes awareness, screening, and enrollment into Diabetes Prevention Programs in high-risk communities throughout San Diego County.
Chronic disease management and prevention Communication and informatics
Abstract
Examining the Current Approaches to Cultural Tailoring of the National Diabetes Prevention Program in Los Angeles to Meet the Needs of Underserved Populations
Megala Sivashanmugam, MPH, Gabrielle Green, MPP, Amelia DeFosset, MPH, Jennifer Mosst, PhD, MScPH, MSSW, Laura Baetscher, MPH, MA and Tony Kuo, MD, MSHS
Los Angeles County Department of Public Health, Los Angeles, CA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
The National Diabetes Prevention Program (NDPP) is an evidence based lifestyle program shown to reduce the risk of type 2 diabetes. Currently the NDPP is being scaled and spread across the nation, with a focus on reaching priority populations: groups with a high risk of diabetes who may be less likely to participate in lifestyle change programs. In Los Angeles, priority populations include the Medicare/Medicaid population, and race/ethnic and linguistic minority groups. Culturally-relevant program tailoring that goes beyond translating materials into another language may help expand the reach of the NDPP to these priority populations, and facilitate program effectiveness. However, current practices for culturally-relevant tailoring are generally not well documented and, consequently, best and promising practice standards have not been established.
This presentation will share results from a mixed-methods assessment conducted by the Los Angeles County Department of Public Health examining the current practices for tailoring the NDPP among providers in Los Angeles to be more culturally-relevant to underserved populations, including low-literacy and linguistic minority groups. Methods include a thematic analysis of interviews with NDPP providers (n=12) examining current practices for engaging and retaining priority populations, and provider reflections on key successes and ongoing challenges in this area. Concurrent analysis of quantitative programmatic data (Collected between 2015-2018) will examine NDPP outcomes (e.g. program reach, participant attendance, weight loss) in the context of tailoring practices. The presentation will outline promising tailoring practices, and identify additional strategies and needed resources to further develop culturally-relevant NDPPs in Los Angeles and other jurisdictions.
Chronic disease management and prevention Planning of health education strategies, interventions, and programs
Abstract
Understanding health literacy in the context of cancer preventive behavior among female college students
Essie Torres, PhD, MPH1, Alice Richman, PhD, MPH2, Molly Robinson, MPH1, Keisha Okeiga1 and Cindy Sierra1
(1)East Carolina University, Greenville, NC, (2)East Carolina University, College of Health and Human Performance, Greenville, NC
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: Health literacy influences the utilization of healthcare services including preventative services, such as mammography and Pap smear screenings. Low health literacy has shown to be a contributing factor to lack of preventative cancer screenings for both breast and cervical cancer. We sought to understand the cancer health literacy of female college students and to assess whether this population would be open to the engagement in health behavior discussions with their mother (mother-daughter intervention) as a means to increase health literacy and cancer screening behavior.
Methods: Quantitative surveys were administered to participants to assess breast, cervical, and HPV-related cancer knowledge, eHealth literacy skills, preventive health behavior, readiness for intergenerational health communication, and health information receptiveness. Data collection is ongoing, and the intended sample size is 100 female college students across a southeast university.
Expected Results: The results from this study will assist us to better understand: (1) knowledge about cervical and breast cancer among female college students, (2) ehealth literacy skills among female young adults (3) health communication with mother and other in their social network and (4) current preventive cancer-related behavior among female college students.
Conclusion: Increasing breast and cervical health literacy can impact health decision-making skills and improve prevention health seeking behaviors. The results from this study can inform intervention strategies that can improve intergenerational knowledge of women’s preventive health and impact preventive health seeking behavior throughout the lifespan.
Assessment of individual and community needs for health education Public health or related education
Abstract
Developing a Public Health Education and Information Campaign to Prevent Cannabis Use Among Pregnant and Breastfeeding Women in California
Martha Dominguez, MA, MPH, PhD, Jaynia Anderson, MPH, Mary Martin-Mabry, MA and Michelle Woods, MA
California Department of Public Health, Sacramento, CA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
In 2016, California voters passed a referendum legalizing the retail sale of cannabis to adults 21 years or older. Approximately 4% of California women with a recent live birth reported using cannabis during pregnancy in 2016, with significantly higher rates of use among African-American/Black women (11%). Research shows the active ingredient in cannabis, tetrahydrocannabinol, transmits through the placenta and breast milk and may increase risk of negative health outcomes for the infant. Since California is a large and diverse state with geographic variability of cannabis use throughout the state, history of certain communities disproportionately affected by the criminalization of cannabis, and legal medicinal-use marijuana since 1996, there is no prototypical cannabis user. Early formative research conducted with pregnant and breastfeeding women in California revealed low perceptions or risk of using cannabis while pregnant or breastfeeding, doubts about sufficient scientific research in the area, and skepticism of information provided by government agencies and medical organizations. In order to identify pregnant or breastfeeding women at risk for cannabis use who can benefit from campaign messages and targeted interventions, we conducted a second round of formative research through focus groups and a statewide online survey. Segments of the types of users among pregnant and breastfeeding women were identified by personal values, motivations, and patterns of cannabis use. Using the findings, California’s public health messaging for prevention of cannabis use will target pregnant and breastfeeding women with high risk for cannabis use.
Administer health education strategies, interventions and programs Advocacy for health and health education Assessment of individual and community needs for health education Diversity and culture Planning of health education strategies, interventions, and programs Public health or related research