Purpose This study aims to investigate how healthcare providers (HCPs) promote physical activity (PA) to child and adolescent cancer survivors. Methods Semi-structured interviews were conducted with HCPs ( n = 16; women n = 12; men n = 4) who provide care for cancer survivor youth (age 3 to 18). Participants represented 7 professions, including child life specialists, oncologists, nurse practitioners, physical therapists, and social workers. A reflexive thematic analysis was conducted to explore the techniques that HCPs use to promote PA for this patient population and ways PA promotion can improve. Results HCPs use five strategies to promote PA to cancer survivor youth: (1) broadening the definition of PA, (2) tailoring PA recommendations, (3) including families, (4) connecting patients to programming, and (5) promoting patient motivation. Conclusions This research highlights techniques that HCPs use to promote PA to young cancer survivors and reveals the need for additional ways to support HCPs to improve PA promotion for child and adolescent cancer survivors. While HCPs emphasized the importance of PA for this patient population, they navigate barriers that limit the quality of PA discussions. Implications for cancer survivors Further research should explore interventions to improve PA promotion and PA participation among child and adolescent cancer survivors. By understanding the perspectives of HCPs, patients, and their families, PA promotion strategies can be improved, and more programs that support both patients and practitioners may be developed. Supplementary Information The online version contains supplementary material available at 10.1007/s11764-022-01218-8.

Purpose: Colorectal cancer (CRC) screening is significantly lower in the Hispanic community compared to non-Hispanic whites. Qualitative research has suggested that cultural attitudes towards cancer may be a potential barrier to screening. The purpose of the study was to quantitatively examine explicit stereotypes about CRC and CRC screening within the Hispanic community using the stereotype content model. Methods: A one-time online cross-sectional survey was administered to individuals self-identifying as Hispanic living across the United States. Based on participant preference, the survey was completed in English or Spanish. In counterbalanced order, participants were asked to read brief paragraphs about a control target, a target with CRC, and a target undergoing colonoscopy CRC screening. The target was a Hispanic individual assigned a gender-neutral name. Other than the one sentence with CRC-related information in the CRC and CRC screening paragraphs, all the paragraphs were identical describing the individual, their family, and their hobbies. After each paragraph, participants were asked to rate the target on validated surveys assessing warmth and competence, two indicators of explicit stereotypes. Data was analyzed using linear mixed-effects models, which were fitted to evaluate the effect of each target on warmth and competence, controlling for age, gender, race, Hispanic heritage, cancer exposure, and randomization. Results: The target condition was not statistically significantly associated with the Warmth and Competence outcomes when the models were fitted considering only the main effects. However, in the presence of interactions the condition was associated with the outcomes. Specifically, the analysis yielded a significant fixed effect for the interaction between target condition and participant age, such that younger participants had greater perceptions of warmth [F(2, 511.93)=7.045, p=0.001] and competence [F(2, 522.73)=11.129, p<0.001] towards the target undergoing cancer screening. The analysis also yielded a further significant effect for the interaction between target condition and Hispanic heritage with differences in perceptions of warmth between those born in the USA and participants born in Central and South America or in Europe [(F(2, 520.16)=2.299, p=0.02)]. Conclusion: Findings highlight the importance of understanding the heterogeneity within the Hispanic community when seeking to address stigma towards CRC. First, there are differences in explicit perceptions based on generation, suggesting the need for age-appropriate cancer prevention initiatives. Second, the findings demonstrate the need to account for diverse cultural perspectives of cancer screening based on country of origin. Thus, this research supports the importance of respecting the diversity within the Hispanic community and tailoring cancer prevention interventions accordingly. Citation Format: Bianca Luna-Lupercio, Aidan Foley, Nenette A. Caceres, Ergueen Herrera, Galen Wiens-Cook, Vinicius Calsavara, Zul Surani, Sarah-Jeanne Salvy, Robert Haile, Celina H. Shirazipour. Examining stereotype perceptions of colorectal cancer in the Latino community [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1979.

Background: Hispanic and Black persons are at higher risk for gastric cancer (GC) in the United States, as compared to White counterparts. Economic analyses demonstrate that endoscopy for GC screening may be cost-effective in Hispanic and Black Americans, but no prevention guidelines support gastric cancer screening for these minorities in the U.S. Targeted Helicobacter pylori (H. pylori) testing and treatment may also help to prevent GC. It is unknown how common endoscopic history and H. pylori testing are among Hispanics and Blacks diagnosed with gastric cancer and how this is related to stage at diagnosis and survival. Methods: We employed SEER-Medicare data on Hispanic (n=1,428) and Black (n=1,774) patients diagnosed with GC in 2004-2013. We compared stage of disease by history of gastric imaging and H. pylori testing >18 months prior to GC diagnosis. Qualifying imaging included esophagogastroduodenoscopy, endoscopic ultrasound, upper gastrointestinal series. We tested for differences in proportions by Chi-squared tests and survival differences by log-rank test. We performed Cox regression analyses adjusting for age, sex, residence in large metropolitan areas, neighborhood poverty index, histology, and tumor location to determine the association of prior gastric imaging with survival. Results: Hispanic and Black GC patients shared similar histories of endoscopic imaging (17%, 16% respectively). Hispanics and Blacks who had a history of endoscopy were more likely to be diagnosed at Stage I (41% in both), as opposed to those without endoscopic history (26% and 29%; p<0.0001, p=0.0003 respectively). Hispanics with a history of endoscopy lived longer with GC (12 months) as opposed to those without (9 months, p=0.03), while the survival difference by endoscopic history was not significant among Black patients (9 months vs. 8 months, p=0.06). In survival analysis without adjustment for stage, endoscopic history was associated with a lower rate of death among Hispanics (HR:0.84, 95%CI: 0.72, 0.98) and in Blacks (HR:0.87, 95%CI: 0.76, 0.997). After adjustment for stage of disease, the association between endoscopy and survival disappeared (Hispanic: HR=1.01, 95% CI 0.88, 1.16; Black: HR:1.01, 95% CI 0.86, 1.18). Hispanics were more likely to be tested for H. pylori (9.9%) than Blacks (5.0%). Prevalence of stage I disease at diagnosis was not different by history of H. pylori testing in Hispanics (38% tested vs. 31% non-tested, p=0.16) nor among Blacks (30% tested vs. 28% non-tested, p=0.65). Conclusion: Endoscopic procedures and H. pylori testing are underutilized in elderly Hispanic and Black patients at risk for gastric cancer. Hispanic and Black gastric cancer patients with endoscopic history were more likely to be diagnosed with Stage I disease than those without endoscopic history, leading to a survival advantage. A prospective study examining the benefit of endoscopic screening for early detection of gastric cancer in racial and ethnic minorities at high risk for gastric cancer is warranted. Citation Format: Christie Y Jeon, Yu-Chen Lin, Bianca Luna-Lupercio, Robert Haile. Endoscopic history potentially explains survival differences in Hispanics and Blacks with gastric cancer [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C113.

IntroductionPhysical activity (PA) promotes significant physical and psychosocial benefits for breast cancer survivors. While evidence exists regarding recommendations for the frequency, duration and intensity of exercise that optimise PA benefits for cancer survivors, the role of the environment in achieving optimal outcomes has yet to be determined. This paper presents a protocol for a clinical trial to evaluate the feasibility of a 3-month nature-based walking programme for breast cancer survivors. Secondary outcomes assessed include the impact of the intervention on fitness, quality of life outcomes, and biomarkers of ageing and inflammation.Methods and analysisThe trial is a 12-week single-arm pilot study. Twenty female breast cancer survivors will engage in a supervised moderate intensity walking intervention in small groups in a nature reserve for 50 minutes three times per week. Data will be collected at baseline and end of study, and include assessment of inflammatory cytokines and anti-inflammatory myokines (TNF-α, IL-1ß, IL-6, CRP, TGF-ß, IL-10, IL-13), as well as ageing (DNA methylation, ageing genes) biomarkers; surveys (Patient-Reported Outcomes Measurement Information System-29, Functional Assessment of Cancer Therapy-General, Post-Traumatic Growth Inventory); and fitness assessments (6 min Walk Test, Grip-Strength, One Repetition-Maximum Leg Press). Participants will also complete weekly surveys assessing social support and participate in an exit interview. This is an important first step for future research on the influence of exercise environment on cancer survivor PA outcomes.Ethics and disseminationThis study was approved by the Cedars Sinai Medical Center Institutional Review Board (IIT2020-20). Findings will be disseminated through academic manuscripts, conferences, and community presentations.Trial registration numberNCT04896580.