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Objective: Assess the feasibility and acceptability of a culturally- and linguistically-adapted smoking cessation text messaging intervention for Latino smokers. Methods: Using a community-based strategy, 50 Latino smokers were recruited to participate in a smoking cessation pilot study. Participants received a 12-week text messaging intervention and were offered Nicotine Replacement Therapy (NRT) at no cost. We assessed biochemically verified abstinence at 12 weeks, text messaging interactivity with the program, NRT utilization, self-efficacy, therapeutic alliance, and satisfaction. Results: Participants were 44.8 years old on average (SD 9.80), and they were primarily male (66%) and had no health insurance (78%). Most of the participants were born in Mexico (82%) and were light smokers (1–10 CPD) (68%). All participants requested the first order of NRT, and 66% requested a refill. Participants sent an average of 39.7 text messages during the 12-week intervention (SD 82.70). At 12 weeks, 30% of participants were biochemically verified abstinent (88% follow-up rate) and working alliance mean value was 79.2 (SD 9.04). Self-efficacy mean score increased from 33.98 (SD 10.36) at baseline to 40.05 (SD 17.65) at follow-up (p = 0.04). The majority of participants (90.9%, 40/44) reported being very or extremely satisfied with the program. Conclusion: A culturally- and linguistically-adapted smoking cessation text messaging intervention for Latinos offers a promising strategy to increase the use of NRT, generated high satisfaction and frequent interactivity, significantly increased self-efficacy, produced high therapeutic alliance, and resulted in noteworthy cessation rates at the end of treatment. Additional testing as a formal randomized clinical trial is warranted.

Introduction Latinos, the largest minority group in the U.S., experience tobacco-related disparities, including limited access to cessation resources. Evidence supports the efficacy of mobile interventions for smoking cessation, which may be greater among Latinos, the highest users of text messaging. Objectives To describe the methodology of a randomized clinical trial to evaluate the impact of Decidetexto, a culturally appropriate mobile smoking cessation intervention versus standard care on smoking abstinence (cotinine-verified 7-day point prevalence abstinence) at Month 6 among Latino smokers. Methods Latino smokers (N = 618) will be randomized to one of two conditions: 1) Decidetexto or 2) standard of care. Decidetexto is a mobile smoking cessation intervention (available in English and Spanish) that incorporates three integrated components: 1) a tablet-based software that collects smoking-related information to develop an individualized quit plan, 2) a 24-week text messaging counseling program with interactive capabilities, and 3) pharmacotherapy support. Decidetexto follows the Social Cognitive Theory as theoretical framework. Standard of care consists of printed smoking cessation materials along with referral to telephone quitline. Participants in both groups are given access to free pharmacotherapy (nicotine patches or gum) by calling study phone number. Promotores de Salud will rely on community-based approaches and clinical settings to recruit smokers into the study. All participants will complete follow-up assessments at Week 12 and Month 6. Discussion If successful, Decidetexto will be ready to be implemented in different community- and clinic-based settings to reduce tobacco-related disparities.

Background As an important transition stage in human development, adolescence is a critical window for vaping prevention. There is a substantial gap in communication research on vaping prevention among racial and ethnic minority groups. Their representation is essential to develop, implement, and disseminate innovative and effective interventions for vaping prevention. Objective The aim of this study is to describe the participatory research (PR) procedures used with Black and Latino adolescents to develop culturally and linguistically appropriate graphic messages for vaping prevention. Methods This PR study used a qualitative, user-centered design method. We conducted a series of focus groups with 16 Black and Latino adolescents to develop culturally and linguistically appropriate graphic messages for vaping prevention. The biobehavioral model of nicotine addiction provided a framework for the development of the graphic messages. Participants met 4 times to provide iterative feedback on the graphic messages until they reached a consensus on overall quality and content. Results At baseline, the participants’ mean age was 15.4 years (SD 1.4). Of the participants, 50% (8/16) were female, 88% (14/16) were heterosexual, 56% (9/16) were Black/African American, and 44% (7/16) were Hispanic/Latino. A total of 12 of the 16 participants (75%) chose to participate in the English sessions. Participants decided to create four types of graphic messages: (1) financial reward, (2) health reward, (3) social norms, and (4) self-efficacy. Meeting 4 times with the 4 groups provided sufficient opportunities for iterative feedback on the graphic messages to reach a consensus on overall quality and content. Conclusions It is feasible and practical to build PR among Black and Latino adolescents focused on vaping prevention. Adolescents added innovation and creativity to the development of culturally and linguistically appropriate graphic messages for vaping prevention. Appropriate staffing, funding, and approaches are key for successful PR efforts among Black and Latino adolescents. Future research is needed to evaluate the impact of the graphic messages on vaping prevention.

BACKGROUND: Nutrition is important for preventing and treating chronic diseases highly prevalent among Latinos, yet no tool exists for measuring nutrition literacy among Spanish speakers. This study aimed to adapt the validated Nutrition Literacy Assessment Instrument for Spanish-speaking Latinos. METHODS: This study was developed in two phases: adaptation and validity testing. Adaptation included translation, expert item content review, and interviews with Spanish speakers. For validity testing, 51 participants completed the Short Assessment of Health Literacy-Spanish (SAHL-S), the Nutrition Literacy Assessment Instrument in Spanish (NLit-S), and socio-demographic questionnaire. Validity and reliability statistics were analyzed. RESULTS: Content validity was confirmed with a Scale Content Validity Index of 0.96. Validity testing demonstrated NLit-S scores were strongly correlated with SAHL-S scores (r= .52, p< .001). Entire reliability was substantial at 0.994 (CI 0.992–0.996) and internal consistency was excellent (Cronbach’s α= .92). DISCUSSION: The NLit-S demonstrates validity and reliability for measuring nutrition literacy among Spanish-speakers.

Latina women at risk of hereditary breast and ovarian cancer (HBOC) have lower awareness, knowledge, and use of genetic counseling and testing services (GCT) than non-Latina Whites. Few interventions have been developed to reduce these disparities among at-risk Latinas. This pilot study assessed the impact of a culturally targeted narrative video developed by our team. The study included 40 Latina immigrants living in the United States who were at risk of HBOC, including affected and unaffected women. We assessed pre-post differences in psychosocial outcomes. Participants were 47.35 years old on average (SD = 9.48). Most (70%) were unaffected with cancer, had an annual income of $40,000 or less (65%), an education of High School or less (62.5%), and were uninsured (77.5%). The video significantly enhanced knowledge (p &lt, 0.001), positive attitudes (p &lt, 0.05), anticipatory positive emotions (p &lt, 0.05), and intentions to participate in counseling (p &lt, 0.001). Importantly, the video also significantly reduced negative attitudes (p &lt, 0.05), and attitudinal ambivalence (p &lt, 0.001). The culturally targeted video shows preliminary evidence in improving psychosocial outcomes related to GCT uptake in Latinas at risk for HBOC. This intervention is a promising easily-disseminable strategy to address disparities in GCT utilization.

Introduction: While smoking remains one of the leading causes of death in Mexico, uptake of evidence-based cessation therapy remains low. Widespread use of mobile devices and internet in Mexico has created new avenues for providing access to cessation treatment. Methods: We assessed the feasibility and acceptability of “Vive Sin Tabaco… ¡Decídete!” (English: Live without Tobacco…. Decide!), a web-based, informed decision-making tool designed to help Mexican smokers develop a quit plan and take advantage of cessation resources. We invited 164 smokers in two primary care clinics. Measures included physical, situational, and psychological nicotine dependence, interest in using pharmacotherapy and counseling, smoking status at 3 months, and satisfaction with the program. Results: Most participants were light smokers and reported low-to-moderate nicotine dependence. Immediately after using ¡Vive Sin Tabaco… ¡Decídete!, the majority were interested in quitting, set a quit date, and reported interest in using pharmacotherapy and cessation counseling. Follow-up rate at 3 months was 81.5%; seven-day point prevalence abstinence was 19.1% using intention-to-treat analysis. Conclusion: Integration of e-Health tools in primary healthcare settings has the potential to improve knowledge about cessation treatments among smokers and integrate smoking cessation into routine of care.

The purpose of this study was to identify the perspectives from key leaders of community-based organizations (CBOs) and clinics serving people living with HIV on barriers and facilitators of smoking cessation among Latino smokers living with HIV. Semi-structured interviews were conducted in English and Spanish with 10 key leaders. Using a social ecological model, qualitative theoretical analysis was used to analyze the results. Participants identified barriers at the individual (e.g., low education level, HIV, and financial stress), interpersonal (e.g., language barriers, low social support), organizational (e.g., lack of smoking cessation resources and targeted interventions), community (e.g., HIV and mental health stigma), and policy (e.g., paperwork for insurance) level. Participants identified facilitators at the individual (e.g., high participation in trials, good medication adherence), interpersonal (e.g., no smoking in social circles), organizational (e.g., bilingual staff, culturally competent care), community (e.g., providing transportation, the coronavirus disease 2019 as an opportunity for smoking cessation), and policy level (e.g., existence of funding, comprehensive insurance programs). These results provide operational strategies to address smoking disparities among Latino smokers living with HIV. Further research is needed on how to integrate these perspectives into effective smoking cessation interventions.

PURPOSE Guatemala, a low- and middle-income country, has some of the poorest worldwide health indicators, including a high cancer incidence. We explored general cancer knowledge and breast and cervical cancer screening practices among Indigenous women in Lake Atitlán, Guatemala. METHODS We conducted 14 in-person, semistructured interviews and one focus group with 5 traditional midwives (comadronas). All participants were Mayan women from a rural community in Lake Atitlán (median age, 43.5 years; range, 18-72 years). The interviews and focus group were conducted in the participant’s preferred language, Spanish or Kaqchikel. Three coders analyzed the data using a process of inductive thematic analysis. RESULTS Participants had little knowledge and awareness about cancer in general, including screening and prevention. They associated the term cancer with death. Most had more knowledge about cervical cancer risk factors and screening compared with breast cancer. Participants voiced misinformation that breast cancer is caused by bad breast milk and that screenings for cervical cancer involve a hysterectomy. The terms uterine, ovarian, and cervical cancer were used interchangeably. None of the participants had ever been screened for breast cancer and all participants reported not knowing anyone who had been screened in the community. Some participants reported having received pap smears in the past. Major barriers reported include the cost and travel to health institutions and fear that the procedures may hurt. There was a strong preference for female doctors to conduct screenings given stigma. Participants reported experiencing discrimination and language barriers when attending hospitals. Participants mostly relied on family members and natural traditional medicine when they felt sick. Community and family support seemed to be key for health-seeking behaviors. CONCLUSION Findings highlight the lack of knowledge, limited screening practices, and numerous barriers among Mayan women in Guatemala. Efforts should focus on health promotion through educational workshops and increased accessibility to health services.

ObjectiveTo assess the feasibility of Pare de fumar conosco, a web-based smoking cessation decision-making tool, among patients with chronic conditions in Brazil.MethodsWe recruited 85 Brazilian smokers in two clinical centres for chronic conditions to complete Pare de fumar conosco. Outcome measures included interest in using smoking cessation resources and self-reported 7-day point prevalence abstinence 12 weeks following the intervention.ResultsThe average age of participants was 54.2 years old (SD=10.5) and 77.9% had not completed high school. All participants were daily smokers and the majority smoked ≥11 cigarettes per day (63.5%). Pre–post intervention interest in using pharmacotherapy and group counselling significantly increased (82.4% vs 22.4%, p≤0.0001; and 85.9% vs 21.2%, p≤0.0001, respectively). At 12 weeks, eight participants (9.4%) reported 7-day point prevalence abstinence using intention-to-treat analysis (35.2% follow-up rate).ConclusionThe Pare de fumar conosco smoking cessation web-based tool significantly increased interest in pharmacotherapy and behavioural counselling. Additional testing as a formal randomised clinical trial appears warranted.

Disparities for genetic cancer risk assessment (GCRA) for hereditary breast and ovarian cancer (HBOC) persist between Latina and non-Hispanic Whites. There are few tested culturally targeted interventions. We developed a culturally targeted video to enhance GCRA uptake in at-risk Latinas. Interviews with healthcare providers (n = 20) and at-risk Latinas (n = 20) were conducted as formative research to inform the development of the video. Findings from the formative research, health behavior conceptual models, and evidence-based risk communication strategies informed the messages for the script. Then, we conducted a focus group with at-risk Latinas (n = 7) to obtain feedback for final refinement of the script. The final video was piloted for acceptability and potential dissemination in a sample of Latino community health workers (CHWs) (n = 31). Providers and at-risk Latinas suggested using simple language and visual aids to facilitate comprehension. Participants in the focus group identified areas for further clarification (e.g., cost). The result was an 18-min video that illustrates “Rosa’s” story. Rosa learns about HBOC risk factors and overcomes barriers to attend genetic counseling. CHWs reported high overall satisfaction with the video (M = 9.61, SD = .88, range 1–10). A culturally targeted video has the potential to reach underserved populations with low literacy and English proficiency.

BACKGROUND Of the 14.3 million Mexicans who smoke, only a minority take advantage of evidence-based approaches to smoking cessation. Mobile health interventions have the potential to increase the reach of effective cessation interventions in Mexico. OBJECTIVE This study aimed to assess the feasibility and acceptability of an innovative, personalized, and interactive smoking cessation mobile intervention developed for Mexican smokers. METHODS We recruited 40 Mexican smokers to participate in Vive sin Tabaco... ¡Decídete!, a smoking cessation program that uses a tablet-based decision support software to drive a 12-week text messaging smoking cessation program and pharmacotherapy support. Outcome measures included participant text messaging interactivity with the program, participant satisfaction, and 12-week verified abstinence using urinary cotinine testing or exhaled carbon monoxide. RESULTS Average age of the participants was 36 years (SD 10.7), and they were primarily male (65%, 26/40) with at least an undergraduate degree (62%, 25/40). Most participants (95%, 38/40) smoked daily and were interested in quitting in the next 7 days. As an indicator of participant interactivity, participants sent an average of 21 text messages during the 12-week intervention (SD 17.62). Of the 843 messages that participants sent to the program, only 96 messages (11.3%, 96/843) used keywords. At 12 weeks, 40% (16/40) of participants were biochemically verified (87%, 35/40, follow-up rate). The majority of participants (85%, 30/35) reported being very satisfied or extremely satisfied with the program. CONCLUSIONS The Vive sin Tabaco... ¡Decídete! smoking cessation mobile intervention was accepted by participants, generated high satisfaction and high text messaging interactivity, and resulted in a noteworthy cessation rate at the end of treatment. This intervention is a promising strategy for smoking cessation in Mexico. Additional testing as a formal randomized clinical trial appears warranted.

BackgroundOf the 14.3 million Mexicans who smoke, only a minority take advantage of evidence-based approaches to smoking cessation. Mobile health interventions have the potential to increase the reach of effective cessation interventions in Mexico. ObjectiveThis study aimed to assess the feasibility and acceptability of an innovative, personalized, and interactive smoking cessation mobile intervention developed for Mexican smokers. MethodsWe recruited 40 Mexican smokers to participate in Vive sin Tabaco... ¡Decídete!, a smoking cessation program that uses a tablet-based decision support software to drive a 12-week text messaging smoking cessation program and pharmacotherapy support. Outcome measures included participant text messaging interactivity with the program, participant satisfaction, and 12-week verified abstinence using urinary cotinine testing or exhaled carbon monoxide. ResultsAverage age of the participants was 36 years (SD 10.7), and they were primarily male (65%, 26/40) with at least an undergraduate degree (62%, 25/40). Most participants (95%, 38/40) smoked daily and were interested in quitting in the next 7 days. As an indicator of participant interactivity, participants sent an average of 21 text messages during the 12-week intervention (SD 17.62). Of the 843 messages that participants sent to the program, only 96 messages (11.3%, 96/843) used keywords. At 12 weeks, 40% (16/40) of participants were biochemically verified (87%, 35/40, follow-up rate). The majority of participants (85%, 30/35) reported being very satisfied or extremely satisfied with the program. ConclusionsThe Vive sin Tabaco... ¡Decídete! smoking cessation mobile intervention was accepted by participants, generated high satisfaction and high text messaging interactivity, and resulted in a noteworthy cessation rate at the end of treatment. This intervention is a promising strategy for smoking cessation in Mexico. Additional testing as a formal randomized clinical trial appears warranted.

Aim: To identify depressive symptoms and biological psychosocial risk factors associated among patients with multiple chronic conditions (MCC). Methods: The study was conducted in a center for the treatment of hypertension, diabetes, and chronic kidney disease in Brazil. During three months a structured interview was conducted among patients waiting for routine visits. In the univariate analysis, descriptive statistics were performed to characterize the sample and in the bivariate analysis were used the chi-square. The risk of depression was calculated in a Prevalence Ratio with 95% confidence interval, as association measure. Variables with p

Although motivational interviewing (MI) has been shown to be effective in changing health behaviors, its effects on smoking cessation have been mixed. The purpose of the present study is to assess factors of motivation and self-efficacy as they mediate the relationship between MI and smoking cessation. This is a secondary analysis of an MI based smoking cessation randomized trial. MI counseling was associated with change in smoking behaviors during a 12 months intervention but was not related to autonomous motivation, controlled motivation, or self-efficacy at baseline and 6 months, the hypothesized mediators. This study confirmed the pathway to quit smoking through increase in self-efficacy.

To describe community-based participatory processes used to develop promotore training on cancer research, and to assess the feasibility of training promotores from rural communities to disseminate cancer research information.Prospective, cohort design.Rural communities in the state of Kansas.34 Spanish-speaking promotores attended an information session; 27 enrolled and 22 completed training.With input from a community advisory board, the authors developed a leadership and cancer curriculum and trained Spanish-speaking promotores to disseminate information on cancer research. Promotores completed pretraining and post-training surveys in Spanish to assess demographic characteristics and changes in knowledge of cancer, cancer treatment and cancer research studies, and intent to participate in cancer research.Cancer knowledge, awareness of cancer clinical trials, interest in participating in cancer clinical research studies.Compared to pretraining, after training, promotores were more likely to correctly define cancer, identify biopsies, describe cancer stages, and report ever having heard of cancer research studies.Completion rates of the training and willingness to participate in cancer research were high, supporting the feasibility of training promotores to deliver community-based education to promote cancer research participation.Nursing professionals and researchers can collaborate with promotores to disseminate cancer education and research among underserved rural Latino communities in Kansas and elsewhere. Members of these communities appear willing and interested in improving their knowledge of cancer and cancer clinical trials.

The study objective was to determine the prevalence of diabetes and prediabetes among rural and urban populations in Kansas.This study utilized 2009 BRFSS data and included 18,912 respondents. Participants were identified through a stratified random sample of adult Kansans, living in a non-institutionalized setting, and with access to a land-based telephone line. Analyses were conducted using SAS to provide descriptive statistics for groups based on diabetes status. A logistic regression was conducted to explore significant variables associated with the likelihood of diabetes.Diabetes prevalence was lower among urban (11.8%) populations than rural (12.7%) areas of Kansas, but the inverse was true for pre-diabetes (3.7% urban, 3.1% in rural). Lower income and lower levels of educational attainment were associated with increased rates of diabetes and pre-diabetes, with the highest prevalence levels overall found among rural Latinos (19.3%) and urban African Americans (22.9%). Multivariate regression suggests that age, income, ethnicity, education, sex, rural vs urban status, and race all served as significant predicators of diabetes, net of other factors.Rural residents were more likely than urban residents to report having diabetes, whereas urban residents were more likely than rural residents to report having pre-diabetes. Although rural vs urban status played a significant role in the model's predicative ability for diabetes and pre-diabetes diagnosis, increased age was by far the most significant factor in diabetes and pre-diabetes diagnosis.

Increasing workforce diversity is essential to improving the health outcomes for minority populations, particularly Latinos. This paper describes an innovative 6-week health disparities internship program for underrepresented precollege and college students aimed at empowering students to become health science researchers focused on issues that continue to affect minority communities. Our program embraces the educational philosophy developed by Paulo Freire, which supports the development of critical awareness, critical thinking, and reflection. In this manner, this internship program shifts the paradigm away from traditional approaches focused solely on knowledge remediation. Program participants became conscious of their realities while they grew to envision themselves as agents of change capable of transforming their communities.