Search

Background: Approximately 25% of Philadelphia's sexually transmitted infections (STI) cases are among teens aged 15-19. Furthermore, there are increased rates of teen pregnancy in Philadelphia compared to other Pennsylvania counties. Lack of comprehensive sexual health education can leave youth vulnerable to various STIs and teen pregnancy. Proud Teens of Philly (PTOP) is a comprehensive sexual health education program for youth aged 12-19 to promote healthy choices and ultimately reduce sexual health disparities in Philadelphia. Methods: Participants were recruited from a network of partner sites such as public and charter schools, churches, and community-based organizations to attend eight 1-hour virtual synchronous sessions. An evidence-based comprehensive curriculum, Making Proud Choices (MPC), which aims to reduce risky behaviors was utilized. Pre- and post-surveys that examine intention to have sex, perceived susceptibility to STIs/HIV, and attitudes toward sex, condom use, and STIs were administered to 246 youth. Paired samples t-tests were used to evaluate changes before and after the program. Results: There were significant increases in positive attitudes towards condom use (pre=26.54, post=27.73, t=-2.18, p=0.03), more negative attitudes towards STIs/HIV (pre=7.62, post=6.65, t=5.22, p Citation Format: Ra'Ann Merceir, Jade Truehart, Aisha Bhimla, Yin Tan, Jane Sileo, Lin Zhu, Min Qi Wang, Sabrina Liao, Julia Trout, Priya Nigam, Ellen Kim, Aimee Bogan, Grace X. Ma. An evidence-based sexual health education program to reduce STI and teen pregnancy rates in Philadelphia [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B059.

Background: Rates of sexually transmitted disease (STD) and teen pregnancy are much higher in Philadelphia than the national average. Proud Teens of Philly (PTOP) is a sexual health program aimed at reducing the high teen birth rate and STD cases in Philadelphia. The program provides sexual health education to high-risk youth ages 12-19 in the Greater Philadelphia area. The materials used to implement the PTOP program, “Making Proud Choices”, is an evidence-based curriculum that was reviewed and tailored for its cultural and age appropriateness, and medical accuracy. Methods: During the second year of the program, PTOP was implemented virtually and in-person to 411 youth in Philadelphia schools and community-based organizations. Community-based participatory research (CBPR) strategies and systems thinking approach were used in site and participant recruitment, program implementation, and evaluation. The educational content consisted of 8 modules of the “Making Proud Choices” curriculum. Pre and post surveys were administered to participants at the first and last implementation sessions, respectively. During Year 2, 391 pre-surveys and 208 post-surveys were collected. Results: There were significant increases in knowledge about fluids that transmit HIV (pre=23.47 post=25.07 t=4.65 p= Citation Format: Jade A. Truehart, Ra'Ann Merceir, Aisha Bhimla, Yin Tan, Sabrina Liao, Min Qi Wang, Jane Sileo, Maya Allen, Grace X. Ma. Increasing sexual transmitted diseases and promoting condom use among youth: Evaluation of year 2 data from the Proud Teens of Philly (PTOP) program [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B033.

Introduction: Chronic Hepatitis B (CHB) Virus disproportionately affects Asian Americans, where they represent 6% of the total United States (U.S.) population but make up 58% of Hepatitis B Virus (HBV)-linked hepatocellular carcinoma (HCC) cases. HBV is the leading risk factor for developing HCC. Vietnamese and Chinese Americans suffer from disproportionate amounts of HBV infections as they represent foreign born immigrants that have come from countries with endemic HBV levels. The consequences of non-adherence to medication among is increased virological failure and a higher risk of disease progression to CHB leading to conditions such as cirrhosis as well as HCC. Understanding what factors contribute to medication adherence can be crucial for providing appropriate support for maintaining long-term treatment adherence and sustaining a virological response through interventions and strategies for high-risk populations affected by HBV. This study aims to examine the sociodemographic and psychosocial predictors of low versus medium/high adherence to medication among a community-based sample of Chinese and Vietnamese HBV infected patients. Methods: Study participants were comprised of 382 Asian American CHB patients, including 298 (78.01%) Chinese Americans and 84 (21.99%) Vietnamese Americans. Study participants were recruited between March 2019 to March 2020 and were enrolled through multiple recruitment approaches in the Greater Philadelphia Area and New York City regions. This presentation reports data from the study baseline survey with measures that included medication adherence measured by the Morisksy Medication Adherence Scale, knowledge regarding HBV diagnosis, prevention and treatment, motivation of HBV medication treatment, self-efficacy about HBV medication treatment, depression, and socioeconomic status. Multivariable logistic regression model was used, controlling for recruitment source and clustering by site. Results: Multivariable logistic regression analysis revealed that with regards to sociodemographic predictors, living longer in the U.S. (OR=4.46; 95% CI: 1.23, 16.14; p=0.023), and greater English proficiency characterized as speaking English well or very well were associated with greater odds of medium/high medication adherence (OR=0.31; 95% CI: 0.10, 0.89; p=0.030). With regards to psychosocial predictors, greater knowledge about HBV diagnosis, prevention, and treatment was associated with greater odds of medication adherence (OR=1.46; 95% CI: 1.16, 1.83, p=0.025). Additionally, greater depression score was associated with lower odds of medium/high medication adherence (OR=0.88; 95% CI: 0.78, 0.98, p=0.025). Conclusion: The study findings suggested a need for intervention regarding medication treatment and tertiary prevention and management of CHB among underserved Asian Americans. Furthermore, the association between depression and medication adherence suggests the need for psychological interventions to enhance mental health outcomes and quality of life to potentially improve or maintain medication adherence. Citation Format: Aisha Bhimla, Lin Zhu, Wenyue Lu, Sarit Golub, Chibuzo Enemchukwu, Elizabeth Handorf, Yin Tan, Minhhuyen T. Nguyen, Min Qi Wang, Grace X Ma. Knowledge, motivation, and mental health: Factors associated with adherence to Hepatitis B medication among underserved Asian Americans [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-035.

Background: Of the estimated 26 million new diagnosis of sexually transmitted infections (STIs) each year, youth aged 15 – 24yo constitute half of these. The most common STI, Human Papillomavirus (HPV), is the primary cause of cervical, anal, and oropharyngeal cancers. Racial and ethnic minority youth are at increased risk for STIs such as HPV. Lack of access to comprehensive sexual health education leave youth vulnerable to STI's which increase their risk of certain cancers. This study describes characteristics of participants regarding engagement in sexual behaviors and knowledge and attitudes towards STI protection. Methods: Proud-Teens of Philly (PTOP), an evidence-based program, was implemented in youth (n=212) aged 12-19 years in Philadelphia County recruited from a network of partner sites. Program implementation occurred over nine one-hour virtual sessions. The program aimed to reduce risky sexual behaviors by promoting healthy choices and increasing knowledge of sexual health. Participants completed a pre-survey administered online prior to starting the program. Results: Participants' average age was 14.2 years old, 49.2% of participants identified as Hispanic/Latino, and (21.2%) of participants were Non-Hispanic Black, followed by Non-Hispanic white (30.7%). At baseline, 12.8% of participants have been or are currently sexually active, and about half felt strongly about delaying sexual behavior (52.8%). Findings revealed gaps in communication about barrier protection with sexual partners. While 82.0% indicate they agree condoms are effective in preventing STI transmission, there was a low perceived susceptibility of contracting an STI. Conclusion: Findings suggest implementing Proud Teens of Philly may be beneficial in reducing STIs and HPV related cancers among at-risk youth by promoting healthy sexual behaviors. Citation Format: Ra'Ann Merceir, Aisha Bhimla, Adebola Duro-Aina, Yin Tan, Sabrina Liao, Min Qi Wang, Renee Jackson, Grace X. Ma. Evidence-based sexual health education program among at-risk youth baseline findings [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-054.

Background: Asian Americans have the highest incidence and mortality rates of hepatocellular carcinoma among all U.S. racial/ethnic groups. Inadequate hepatitis B (HBV) monitoring and treatment contribute to poorer outcomes and increased healthcare costs. We conducted a Patient Navigator-led Intervention (PNMI) through a randomized controlled trial to improve monitoring and treatment adherence among Asian Americans with chronic HBV infection. Methods: From 2015 to 2017, we enrolled 532 eligible Asian American adults living with chronic HBV (CHB) in greater Philadelphia area, New Jersey, and New York City. They were non-compliant with HBV follow up care, and randomly assigned to either intervention or control group. Generalized linear mixed-effects models (GLMM) were used to estimate the odds ratio (OR) for the rates of doctor’s visit for CHB and having ALT test. Results: Our findings indicated that intervention group had higher rate of doctors’ visits than that of control group at both 6-month (77.22% v. 45.75%) and 12 months assessments (90.73% v. 60.61%). More intervention group participants received ALT test than control group did at 6-month (52.90% v. 25.10% at 6 months) and 12-month (75.40% v. 46.75%). Results of the GLMM showed that those in the intervention group were more likely than those in the control group to have doctor’s visit and ALT test at 6- and 12-month follow-ups. Conclusions: The findings from this culturally and linguistically appropriate PNMI intervention demonstrated strong effects on adherence to hepatitis B virus (HBV) follow-up care among non-adherent Asian American patients living with chronic HBV infection. These findings suggest opportunities for implementation the evidence-based best practice that could lead to reducing disparities in chronic liver disease and liver cancer among high-risk, underserved populations. Citation Format: Grace X. Ma, Lin Zhu, Shumenghui Zhai, Yin Tan, Xiaoli Ma, Olorunseun O. Ogunwobi, Michelle Naidoo, Tsunyou Ting, Min Qi Wang. Improving monitoring and treatment adherence among underserved Asian Americans with chronic hepatitis B through a patient navigator-led intervention [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PR02.

Background: HPV vaccination is recommended for female and male adolescents in the U.S. to prevent HPV-related cancer, yet the uptake remains suboptimal nationwide. Compared with other racial/ethnic groups, Asian American adolescents have the lowest HPV vaccination rates. Successful HPV vaccine depends heavily on parents' attitudes, perceptions, and willingness to have their adolescents vaccinated. Objective: This pilot study aimed to examine the intervention effect on the primary outcome of a provider-based, culturally tailored, multilevel intervention to promote HPV vaccination. Method: A total of 180 parents (110 for intervention group and 70 for control group) with 290 adolescents aged 11 to 18 (170 for intervention group, 120 for control group) were recruited from primary care community health centers in Philadelphia and NYC from 2015 to 2017. Specifically, we compared the uptake of first shot of HPV vaccination at the 6-month post-intervention assessment and completion rate of three shots. Results: The uptake of at least 1 shot of HPV vaccine was significantly higher among the intervention group (76.36%) than the control (10.00%). The difference between intervention and control group remained statistically significant (odds ratio = .38.47, 95% 13.99 - 105.80) even when we controlled for demographics and health-related covariates, lending support to the significant and strong effects of our intervention on vaccination uptake. Conclusion: Our finding indicates that provider-based, culturally tailored, multilevel intervention showed promising effect of HPV vaccination uptake among Asian American adolescents. Greater effort and measures are needed for broader implementation of such intervention. Future research is also necessary to explore the application to ethnic minority populations to prevent cancer and reduce health disparities. Acknowledgement: This project was supported by National Outreach Network (NON) - Community Health Educator (CHE) supplement grant funded by Center for Reduce Cancer Health Disparities (CRCHD)-National Cancer Institute (NCI) (Grant Number: U54CA153513; PI: Grace X. Ma, PhD). The authors wish to thank clinical collaborator Chinatown Medical Services (CMS) and their staff for their support and collaboration. Citation Format: Grace X. Ma, Shumenghui Zhai, Lin Zhu, Philip Siu, Yin Tan, Sarah Lai, Ivette Astudillo, Safa S. Ibrahim, Ming-Chin Yeh, Min Qi Wang. Promising effects of a culturally tailored multilevel pilot intervention to increase HPV vaccination uptake among Asian American female and male adolescents [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A029.

Background: HPV vaccination is recommended for female and male adolescents in the U.S. to prevent HPV-related cancer, yet the uptake remains suboptimal nationwide. Asian American female adolescents have the lowest HPV vaccine rates. Successful HPV vaccine depends heavily on parents' attitudes, perceptions, and willingness to have their adolescents vaccinated. Objective: This study was designed to test the feasibility and outcomes of a provider-based culturally tailored intervention among Asian American parents and their eligible adolescents. Methods: Asian American parents (n=120) who had adolescent girls and boys aged 11 to 18 (n=170) were recruited from a primary-care community health center. The primary outcome was first and second shots of HPV vaccination uptake 6 months following the intervention. Secondary outcomes included third shot of HPV vaccine at 6 months after the intervention for adolescents over the age of 12, increase in knowledge and belief in HPV vaccine, and engagement of adolescents in decision-making at post intervention. Results: Among 170 adolescents, 68% of them received first and second shots of HPV vaccine (73% for girls vs 63% for boys). Among 81 adolescents over the age of 12, 63% of them received third shot (63% for girls vs 76% for boys). Parents' (n=120) knowledge and belief in HPV vaccine and engagement of adolescents in decision-making have significantly increased from baseline to post intervention (p Conclusion: A culturally tailored pilot intervention in a clinical setting demonstrated promising effects, which can potentially yield significant increase in HPV vaccine uptake among Asian American and other underserved ethnic minority female and male adolescents to prevent cancer. Citation Format: Grace X. Ma, Yin Tan, Shumenghui Zhai, Philip Siu, Sarah Lai, Lin Zhu, Adeodat Ilboudo, Min Qi Wang. Promising effects of a culturally tailored pilot intervention to increase HPV vaccination uptake among female and male adolescents [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B14.

Objectives: Given the substantial disparity in hepatitis B virus (HBV) infection among Vietnamese Americans, it is important to understand what intervention components facilitate behavioral change. In this study, we evaluated the influence of psychosocial factors on HBV screening. Methods: The study sample consists of 1,716 Vietnamese participants in our HBV intervention trial, recruited from 36 community-based organizations in Pennsylvania, New Jersey, and New York City between 2009 and 2014. Using Health Belief Model and Social Cognitive Theory, we measured self-efficacy, knowledge, perceived barriers, perceived benefits, perceived severity, and risk susceptibility. Analysis of covariance (ANCOVA) was used to compare pre- and post-intervention changes of psychosocial variables. Structural equation modeling (SEM) was used to explore the direct and indirect effects of the psychosocial variables on HBV screening. Results: Knowledge, self-efficacy, perceived benefits, and perceived barriers were directly associated with HBV screening, with knowledge having the strongest effect. Perceived severity and risk susceptibility had indirect association with HBV screening through other variables. Indirect paths among the 6 psychosocial variables were also identified. Conclusions: To promote HBV screening among Vietnamese Americans, intervention efforts should focus on increasing knowledge, self-efficacy, and perceived benefits; decreasing perceived barriers; and account for the dynamic cognitive processing. Citation Format: Minsun Lee, Lin Zhu, Min Qi Wang, Zhengyu Wei, Yin Tan, Minhhuyen Nguyen, Olorunseun O. Ogunwobi, Grace X. Ma. The role of psychosocial predictors in HBV screening behavior among Vietnamese Americans [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C60.