Although routine screening reduces cervical cancer rates between 60-90%, thousands of women worldwide are diagnosed with the disease on an annual basis due to inadequate screening. Haitian women in South Florida experience a disproportionate burden of cervical cancer with disease rates four times higher than the average for women in Miami. An ongoing community based-participatory research (CBPR) initiative to assess and reduce this burden reveals that a complex interplay of factors contributes to lack of access to screening in this community including socioeconomics, language barriers, and traditional understandings of health and disease. In an effort to address some of these barriers and encourage uptake of primary and secondary cervical cancer prevention strategies, two videos on cervical cancer prevention were created using a CBPR framework. The video screenplays were created by a Haitian screenwriter using evidence-based medical information provided by academic researchers. The films feature Haitian actors speaking a Haitian Kreyòl dialogue with a storyline portraying friends and family discussing human papillomavirus (HPV) disease and vaccination, Papanicolaou (Pap) testing, and cervical cancer. Focus groups held with Haitian women in South Florida suggest the films are engaging, feature relatable characters, and impact knowledge about HPV, cervical cancer development, and current prevention recommendations.

This video project is part of a larger, ongoing Community-based Participatory Research (CBPR) initiative aimed to reduce the burden of cervical cancer among Haitian women living in South Florida. Haitian women in this region, particularly those who reside in Little Haiti, the largest enclave of Haitian settlement in the United States, experience excess cervical cancer incidence and mortality. Since 2004 key community stakeholders, community health workers, and academic investigators from the University of Miami Miller School of Medicine (UMMSM) have worked collaboratively to address this disparity through complementary, community-based primary and secondary prevention efforts. The partnership has also enabled an in-depth exploration of the risk factors and risk conditions that account, in large part, for the high rate of cervical cancer observed in Little Haiti, including socioeconomic marginalization, language barriers, distrust of researchers, humoral conceptions of illness, and immigration status. Successful prevention efforts must address these multiple barriers to ensure timely screening and treatment for cervical cancer among women in Little Haiti. The United States Preventative Services Task Force recommends Pap screening every 3 years for women 21-65 while the Community Preventative Services Task Force recommends the use of small media including videos and printed materials to promote knowledge of and action on cervical cancer screening. Blending these recommendations with the knowledge obtained through nearly ten-years of campus-community collaboration, we created two ten-minute educational films on cervical cancer prevention for a Haitian audience. The films focus on prevention through HPV vaccination and Pap testing. The dialogue is exclusively in Haitian Kreyol with English subtitles. The films were written and produced by a Haitian writer and producer, with significant community input, star Kreyol-speaking actors, and incorporate medical and public health knowledge shared by the UMMSM partners. Reflective of community feedback regarding how to best structure health messages, the films revolve around a storyline of a Haitian family and how they approach a cervical cancer diagnosis and options for screening and prevention. The films address specific issues that have been raised over the course of the CBPR project including clarifying the difference between HPV and HIV, discussing the HPV vaccine and its unfounded association with sexual promiscuity, and the proactive role Haitian men can play in promoting cervical cancer awareness within the community at large. As we enter the dissemination phase of the project, our community advisory board and production team will collaborate to optimize a plan for circulating the videos throughout Little Haiti, including pairing viewing with ongoing screening and vaccination efforts. Via the internet, the videos will be made available to other Haitian audiences throughout the United States and around the world to promote widespread awareness and action on cervical cancer. These videos are a novel approach to cervical cancer prevention among Haitian women that draw on community knowledge to ensure cultural and linguistic relevance. Because Haitian Kreyol is traditionally a spoken language whose orthography was only recently solidified, this video approach shows particular promise in reaching a monolingual Kreyol-speaking audience to better promote cervical cancer prevention efforts in Little Haiti, Haiti, and throughout the Haitian Diaspora. Citation Format: Brigitte Frett, Myra Aquino, Marie Fatil, Michele Fievre, James LaPierre, Dinah Trevil, Olveen Carrasquillo, Erin Kobetz. Utilizing media to reduce the burden of cervical cancer in Little Haiti: A community-based participatory research (CBPR) approach. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B52. doi:10.1158/1538-7755.DISP13-B52

RESUMENIntroducción: la hipertensión arterial en la menopausia está influencia por el descenso de estrógenos que induce disfunción endotelial y aumento del índice de masa corporal. Objetivos: describir los mecanismos fisiopatológicos de la hipertensión arterial en la menopausia y los antihipertensivos recomendados en la actualidad. Metodología: se realizó una revisión bibliográfica en las bases de datos PubMed y SciELO utilizando las palabras claves: hipertensión arterial y menopausia. Resultados: no existen diferencias en la respuesta a los diferentes antihipertensivos y ambos sexos se benefician en la reducción de la morbimortalidad cardiovascular con la disminución de la presión arterial. La efectividad preventiva de complicaciones cardiovasculares con los antihipertensivos no difiere según el sexo y por lo tanto la elección del medicamento no puede basarse en este criterio en mujeres menopáusicas. Conclusión: la deficiencia de estrógeno induce disfunción endotelial y aumento del índice de masa corporal siendo las principales causas de hipertensión en la menopausia. Todos los antihipertensivos están recomendados en la menopausia.Palabras Clave: Hipertensión Arterial, Menopausia.ABSTRACT Introduction: Arterial hypertension in menopause is influenced by the decrease in estrogen that induces endothelial dysfunction and increase in body mass index. Objectives: to describe the physiopathological mechanisms of arterial hypertension in menopause and the currently recommended antihypertensive drugs. Methodology: We conducted a literature review in PubMed and SciELO databases using the key words: arterial hypertension and menopause. Results: There are no differences in the response to different antihypertensive drugs and both sexes benefit in the reduction of cardiovascular morbidity and mortality with the reduction of blood pressure. The preventive effectiveness of cardiovascular complications with antihypertensive drugs does not differ according to sex and therefore the choice of medication cannot be based on this criterion in menopausal women. Conclusions: Estrogen deficiency induces endothelial dysfunction and increase in body mass index being the main causes of hypertension in menopause. All antihypertensive drugs are recommended at menopause.