Now that cancer has surpassed heart disease as the top cause of death for Hispanics in the United States, it is even more critical to focus on early detection of cancer in this population. We report the results of a theory-driven education-plus-navigation pilot intervention delivered by bilingual, bicultural community health workers (CHWs) with the goal of increasing cancer screening rates and knowledge among low-income Latinas. CHWs enrolled 691 eligible women, ages 18 to 75 years, considered rarely or never screened for breast, cervical, and colorectal cancer. Eligible women were scheduled for an education session and offered health care navigation support with appointment scheduling and reminder/follow-up calls. CHWs provided education to 535 (77%) eligible women, and arranged mammograms, Pap tests, or stool blood tests for 174 (25%) participants, with another 94 (14%) placed on a waiting list at a local health center. Statistically significant positive changes on knowledge of screening guidelines for breast, cervical, and colorectal cancer, and beliefs/attitudes regarding early detection were observed from pre- to posttest among eligible women who attended an educational session. Results highlight the effectiveness of CHW-directed interventions in recruiting individuals for programs, educating them, and influencing cancer knowledge and screening behavior.

Background: The nation's war on cancer has resulted in great improvements in cancer survival rates with over 12 million cancer survivors in the U.S today. Physical activity (PA) has been shown to reduce the risk for chronic diseases including: heart disease, diabetes, osteoarthritis and osteoporosis and cancer. The benefits of PA for cancer survivors have been studied but only few survivors are physically active at public health recommended levels. Minority groups are even less active. Therefore promoting PA in minority cancer survivors is an important area of community service. Purpose: This community service learning (CSL) project focused on the process of implementing an educational yoga therapy program among cancer survivors aimed to increase: 1) knowledge of PA recommendations among cancer survivors, and 2) well-being through a guided yoga activity for participants. Methods: Participants were recruited from a local non-profit wellness center for women diagnosed with cancer. A total of 4 yoga sessions were conducted. A schedule of classes was provided at the beginning of the program. Participants were contacted bi-weekly via-telephone for yoga session reminders. At the first session, participants received a 25 minute PA educational module and a short demographic, medical history and the health related quality of life Medical Outcomes Short Form (SF-36) Questionnaire. The SF-36 was administered at baseline and post assessments. Descriptive statistics were performed on demographic and SF-36 measures. A paired-sample t-test was used to determine differences at baseline and posttest for the SF-36 scores. Results: A total of 17 women completed the baseline assessments and 13 women completed the post assessments. The majority of the women who participated in the program were Hispanic or Latina (52.9%), followed by Native Hawaiian or Pacific Islander (23.5%) and Asian (5.9%). Among the participating women, 41.2% were breast cancer survivors between 60-69 years of age. Majority of the women were 6 months post treatment (47.1%). Though there were no significant changes in the SF-36 aggregate scores of Physical Component Scale (PCS) (pre M= 37.5 SD= 8.2, post M=35.3 SD= 4.9, p = 0.379 ) and Mental Component Scale (pre M= 43.8 SD= 11.4, post M=43.3 SD= 3.5, p = 0.915), SF-36 physical function (PF) subscale significantly improved (pre M= 36.6 SD= 9.2, post M=40.0 SD= 10.8, p = 0.030) and mental health (MH) subscale improved approaching significance (pre M= 53.7 SD= 12.4, post M=57.9 SD= 5.1, p = 0.079). Discussion: Though the benefits of a physically active lifestyle for cancer survivors are well known, few cancer survivors are active at levels consistent with public health recommendations. Strategies to increase exercise behaviors for cancer survivors in the community setting are needed. Our attempt to implement a CSL exercise program for breast cancer survivors in a community setting resulted in mixed outcomes. Though participants benefited from the exercise in MH and PF subscales of the SF-36, overall aggregate scores and other subscale scores did not improve as expected. However, the PF and MH improvements are consistent with other pilot yoga studies we have done. We also found it challenging to get participants to commit and attend the exercise sessions, especially at post-assessments. However, as expected for those participants that attended, improvements were noted. Conclusion: Research continues to show there is a need to explore methods to increase PA and exercise behaviors in minority cancer survivor communities. As this was a first effort in establishing exercise in this specific community, several key lessons were learned for this CSL project. Further efforts are needed to explore and address the contributing factors to promoting exercise behaviors in these cancer survivor populations. Citation Format: Rose A. Treviño-Whitaker, Delana Gonzales, Christina M. Carmona, Ruth Morris, Susan Ogden, Mariam Ishaque, Daniel C. Hughes. Promoting physical activity among cancer survivors. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr B31.

Latino colorectal cancer screening rates are less than optimal (46.5% have been screened) compared to federal benchmarks (70.5%) and non-Hispanic Whites (60%). Latino men in particular have a 17% lower screening rate compared to non-Latino men. This study used community health workers to recruit Latino men (ages > 50 who have never been screened for colorectal cancer) and offer educational sessions, navigation support, and no-cost stool blood tests and/or colonoscopies. The study partnered with three community-based organizations and a federally qualified health center. To date, we have enrolled 262 eligible men (mean age: 57 + 5.3) who are uninsured (91%), employed (57%), and have an annual household income < $20,000 (77%). Most were born in Mexico (65%), speak Spanish (64%), and have < high school education (63%). Baseline analyses indicate at least 60% of men correctly identified starting age (> 50) and frequency (annual) for stool blood testing. However, 69% equated cancer with death and 35% felt no control over their chances of getting cancer. One hundred thirty two (50%) of enrolled men have received a colorectal cancer screening test. Of the remaining 130, 20 were lost-to-follow-up, refused further follow-up, or missed >3 appointments and the rest reported scheduling conflicts on clinic days. Preliminary analyses suggest that compared to men who have been screened, non-screened men have higher employment rates, are less likely to have seen a doctor in the past year, and exhibit no changes in knowledge/beliefs from baseline to follow-up. Although the study has steadily enrolled and educated men (with support from spouses) on colorectal cancer risk factors, screening guidelines, and the benefits of early detection, our findings are consistent with other studies that find low colorectal cancer screening rates among Latino men. Future research is needed to better understand screening behavior and explore effective methods of increasing screening behavior in Latino men. Citation Format: Cynthia M. Mojica, Yuanyuan Liang, Christina M. Carmona. Latino men enrolled in a clinical and health education collaborative for colorectal cancer screening. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A44.