LACRC
About the LACRC | Coalition Members | Research | Investigators | Publications Internships & Training | Calendar & Newsletters | Resources| Contact Us
Areas of Research
The LACRC has conducted two major research projects with our community partners to determine cancer control needs and priorities.
In the first, our clinical partners developed and conducted a descriptive study describing the current level of control occurring in their patient population.
In the second project, LACRC members expressed a need to understand the optimal channels and topics for communication to increase cancer-related knowledge and promote health behaviors as a prerequisite to designing educational campaigns that could be used in all 9 community clinic sites. The LACRC evaluated the information needs, information seeking styles and cancer knowledge of Latinos in the DC metropolitan area to fill key gaps in our knowledge about cancer information needs and communication styles of Central and South American Latinos. We developed a survey entitled, “Su Voz, Su Salud” (“Your Voice, Your Health”) using CBPR. We identified topics of interest to the LACRC community clinics and discussed the data that would be most useful to develop education campaigns and interventions to address the cancer control needs of their populations.
Recruitment and Assessment of Male Latino Smokers: A Pilot Study
(Maria Lopez-Class: ml473@georgetown.edu)
We realized that we needed to reach Latino men and approach the question of smoking and nicotine dependence in new ways to have an accurate picture of smoking in this population and to design effective interventions that could successfully recruit this traditionally hard to reach group. The Pilot study survey measures: general health, demographics, current smoking, smoking history, addiction level, prior quit methods, acculturation, stress, and depression. In addition, we are measuring the costs associated with each recruitment channel, including staff time, travel time, participant time, evaluating the costs per person recruited and survey completed for each strategy.
Recruiting Latino Smokers via the Internet: The Feasibility of Online Advertising (Amanda Graham: agraham@americanlegacy.org)
Tobacco use is a major preventable cause of cancer and disease burden among Latinos in the U.S. The rapid growth of the Latino population means there will be an increase from 7 million to over 16 million Latino smokers by 2050 if smoking rates remain unchecked. Millions of Latino smokers are now using the Internet and web—based cessation programs have a growing evidence base of efficacy. Recruitment of Latino smokers to web-based cessation studies has been difficult and little is known about effective recruitment strategies. This mixed-method study aims to develop and test the effectiveness of online banner advertising in recruiting online Latino smokers to a free, bilingual smoking cessation website.
Cultural Basis of Energy Balance Behaviors
(Maria Lopez–Class: ml473@georgetown.edu)
The LACRC is developing and validating a scale of cultural constructs that affect cancer-related health behaviors, with a focus on energy balance and cancer prevention. Dr. Lopez–Class will be using anthropological methods to identity cultural domains and to develop survey items. The resultant survey will be tested in an independent sample of Latinos to evaluate concurrent and predictive validity, intra—item correlation and test—re—test reliability. The final scale will then be used to test the need for cultural tailoring of energy balance interventions.
Perceived Risk of Breast Cancer among Latinas Attending Community Clinics: Risk Comprehension and Relationship with Mammography Adherence
(Kristi Graves: kdg9@georgetown.edu)
Latinas, especially new immigrants, have lower breast cancer screening rates than other race and ethnic groups. The purpose of this project was to describe breast cancer risk perceptions, determine risk comprehension, and evaluate mammography adherence among Latinas. Results were published in Cancer Causes and Control in 2008.
The Patient Navigation Research Program
(Jeanne Mandelblatt: mandelbj@georgetown.edu,
Elmer Huerta: elmer.e.huerta@medstar.net)
The patient navigation program is an NCI—funded initiative from the Center for Reducing Cancer Health Disparities. The LACRC is participating in the Washington, DC site through recruitment at two of our sites— Dr. Huerta’s “Preventorium” at Washington Hospital Center and the Capital Breast Care Center. Dr. Mandelblatt of the LACRC is chairing the Cost—Effectiveness Committee and will be using modeling to estimate the costs and benefits of the program.
Beliefs and Perceptions of Chemotherapy Among Latinas
(Barbara Kreling: bk72@georgetown.edu)
Breast cancer is a leading cancer among US Latino women (“Latina”), but this group has poorer survival than Caucasians, even after considering stage. A portion of this excess mortality may be due to under-use of chemotherapy. The goal of this study was to explore factors facilitating or impeding use of chemotherapy in Latinas. This work also provided important data for a second study to examine how Latino cultural context affects survivorship (see below).
“Latina a Latina“
(Vanessa Sheppard: vls3@georgetown.edu)
As the Latino population ages and acculturates to US lifestyles, rates of breast cancer are expected to increase. Together with the large increase in the numbers of Latinos in the US, over the coming decades these demographic forces will result in a sizeable increase in the number of Latino women seeking treatment for breast cancer. However, we have little information about the treatment making needs of this group and few interventions to enhance the quality of this phase of cancer control. In this project we worked with a breast cancer survivorship advocacy organization (Nueva Vida) to develop and pilot a decision support intervention for newly diagnosed Latino breast cancer patients.
Quality of Life in Latina Breast Cancer Survivors
(Kristi Graves: kdg9@georgetown.edu)
A previous CNP pilot on the unmet needs of Latino breast cancer survivors was leveraged under the current CNP to obtain funding from the Komen Foundation and conduct follow-up research to further document survivorship issues in this population. The purpose of this project is to describe how breast cancer impacts the quality of life (QOL) of Latinas, especially how cultural factors, socio—economic status and beliefs and values affect the QOL of survivors.
The Worst Thing About Hospice Is That They Talk About Death: Hospice Decisions And Experience Among Latino And Non-Latino Cancer Caregivers
(Barbara Kreling: bk72@georgetown.edu)
Hospice care is promoted as a model for improving end of life care and decreasing burden on caregivers. However, hospice use is low in Latinos and little is known about how Latinos make hospice decisions and experience hospice, once enrolled. In this pilot, we collaborated with a community hospice to describe hospice experiences and evaluate whether cultural factors affected the experience. This study identifies a significant dilemma; that is, how to discuss hospice with a patient and family who prefer not to discuss a terminal prognosis. Given the strong cultural norms about death and dying, the results suggest that a peer lay health worker might be an appropriate model to deliver information about hospice services and to provide support to caregivers of terminally ill Latino cancer patients.
A Randomized Trial of a Lay Health Worker Intervention to Increase Knowledge about Hospice among Latino Cancer Caregivers
(Barbara Kreling: bk72@georgetown.edu)
At present, about 44.4 million Americans of all races and ethnicities provide informal end of life care each year at a cost of $257 billion. End of life research indicates that hospice care results in better pain management and fewer symptoms for the patient and less stress for caregivers than hospitals or unsupported informal home care. Unfortunately hospice use is low overall, with only about one-third of individuals dying of cancer using hospice services. There are also race/ethnic disparities in hospice use. For example, Latinos, who presently make up 15% of the US population, only constitute 2% to 6% of cancer patients using hospice services. In this study, we aim to educate Latino cancer caregivers about hospice.
