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assessed as part of the project. Although adolescents in general tend
to overestimate smoking prevalence, our preliminary findings show
unusually high levels of normative misperceptions among participating
adolescents. Consequently, interventions that address correcting
misperceived social norms are imperative to help reduce smoking
rates among Hispanic youth, particularly youth at risk of high school
dropout. Descriptive data related to smoking measures described
above are presented, along with implications for continued research
and prevention programs in the priority population. Additionally, the
community/academic collaboration between our University, an NIH
Research Center, and a community youth program are highlighted as
an example of how such partnerships can facilitate improved research
and programs informed by and tailored for adolescents in border communities
with low education and high poverty rates.
Using Culturally Tailored Health Communications to Address
Disparities in Breast Cancer Screening
Kristin Wallace, MPH, Kaiser Permanente and the University of
Colorado, Denver
Disparities in utilization of mammography contribute to health
inequities in the early detection of breast cancer. In alignment with
Healthy People 2010, our organization is working to align quality
improvement efforts with initiatives aimed at the reduction of health
disparities. One such initiative involves the creation of a culturally
competent communications campaign to increase breast cancer
screening rates for African American and Latina members. We have
developed a scalable and reproducible approach to culturally competent
communications that can be used to evaluate and evolve health
communications practices across a variety of settings. A 2009 analysis
of Kaiser Permanente Colorado’s race, ethnicity and language preference
(RELP) data demonstrated a gap in the use of mammography
across racial/ethnic groups, with African American and Latina members
more likely to be un-screened than their White/other counterparts.
These gaps are consistent with the published literature, which
consistently demonstrates disparities across a variety of geographic
and practice settings. In collaboration with the African American and
Latino Centers of Excellence, the Population and Prevention Services
(PPS) department at Kaiser Permanente Colorado (KPCO) is using
RELP data to inform the delivery of health care services. Program
Design: The stepwise creation of culturally tailored outreach letters
began with the identification of barriers to breast cancer screening
by race/ethnicity, as well as best practices in health communications
and cultural tailoring. Phase one of the pilot included the creation of
a “tailor base” letter informed by best practices in health communications.
This letter was then modified and culturally tailored for African
American and Latina members. We created a user-friendly matrix to
allow for standardization across diverse communications campaigns.
The entire process was informed by literature reviews, best practices,
and input from content and cultural experts. Conclusions KPCO is
committed to excellence in population-based health management. This
pilot has demonstrated that it is possible to create culturally tailored
health communications at a population level. Combining internal
and external data, as well as expert insight, can foster the creation of
a culturally focused communication campaign organized around a
practical, scalable, and reproducible protocol. These methods can be
used to inform tailoring outreach for other populations impacted by
health inequities.
Perspectives on Colorectal Cancer Screening: Hispanics Over Age
Fifty with Health Insurance Coverage in New Mexico (18112)
Maria Otero, BA, Nuestra Salud; Noell Stone, MPH, Department of
Family and Community Medicine, University of New Mexico Health
Sciences Center; Christine Brown, MS, NM Department of Health
Comprehensive Cancer Program; Beth Pinkerton, NM Department of
Health Comprehensive Cancer Program
Background: Colorectal Cancer (CRC) is the 4th most common
cancer diagnosed in New Mexico and the 3rd leading cause of cancer
death. Hispanic men in New Mexico(NM) are at higher risk of
being diagnosed with CRC than other ethnic groups and are more
likely to be diagnosed with later-stage disease than non-Hispanic
Whites. Almost ½ of the Hispanics in NM have never been screened,
compared to 1/3 of non- Hispanic Whites. Having insurance has
been shown to influence screening behavior, although this has not
been shown in New Mexico Hispanics. Theoretical Basis: This project
explored the cultural and contextual issues surrounding non- receipt
of CRC screening among Hispanic men and women over age 50
who are insured and live in NM. Methods: Two focus group discussions
with Hispanics over age 50, one for each sex, explored people’s
knowledge and perceptions about CRC, screening utility, insurance
coverage and the acceptability of various CRC risk-reduction and
prevention interventions. Results: The findings suggest that patients
must be informed of their CRC risk and the importance of screening.
This group of people (especially the women) appeared to expect
a physician to initiate the discussion. The most important source of
information appeared to be family and shared histories of deaths from
the disease. “Family” was described not only as immediate family, but
those in the community including members of their churches or community
centers. These men and women appeared comfortable talking
about CRC although several did acknowledge difficulty with talking
about the symptoms and body parts associated with CRC. Most noted
that coverage of services was not a concern, that insurance issues were
not a reason they would not seek screening. The primary reasons that
some had not sought screening was lack of awareness of severity of
CRC, competing health problems, and not having a conversation with
their provider regarding the pros and cons of the tests available. An
important point to stress with this population would be that a person
does not need to have symptoms to be checked for CRC. These results
suggest that communication from insurance companies encouraging
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SOPHE-NACDD 2011 Joint Academy and Midyear Scientific Meeting