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Telephone genetic counseling (TGC) is accepted as standard clinical care for people seeking hereditary cancer risk assessment. TGC has been shown to be non-inferior to in-person genetic counseling, but trials have been conducted with a predominantly highly educated, non-Hispanic White population. This article describes the process of culturally adapting a TGC protocol and visual aid booklet for Spanish-preferring Latina breast cancer survivors at risk for hereditary breast and ovarian cancers. The adaptation process included two phases. Phase 1 involved a review of the literature and recommendations from an expert team including community partners. Phase 2 included interviews and a pilot with the target population (n = 14) to collect feedback about the adapted protocol and booklet following steps from the Learner Verification and Revision Framework. We describe the adaptation process and report the main adaptations following the Framework for Reporting Adaptations and Modifications to Evidence-based Interventions (FRAME). Adaptations in Phase 1 were responsive to the target population needs and characteristics (e.g., delivered in Spanish at an appropriate health literacy level, addressing knowledge gaps, targeting cultural values). Phase 2 interviews were crucial to refine details (e.g., selecting words) and to add components to address GCT barriers (e.g., saliva sample video). Cultural adaptations to evidence-based TGC protocols can increase the fit and quality of care for historically underserved populations. As TGC visits become routine in clinical care, it is crucial to consider the needs of diverse communities to adequately promote equity and justice in cancer care.

Objective : To describe the experience of a Latino transgender man during his attempt to quit smoking using a text messaging intervention. Methods : A Latino transgender man enrolled in a smoking cessation randomized controlled trial for Latino smokers. The participant was randomized to Decidetexto, a smoking cessation mobile intervention. The participant received a 24-week text messaging intervention. We assessed text messaging interactivity with the program, satisfaction, and self-reported abstinence at Week 12 and Month 6. Results : During the 24-week intervention period, the participant sent a total of 287 text messages to the program. When analyzing the content of the text messages sent by the participants, four important themes were identified: 1) gender identity, 2) low social support, 3) stressors (e.g., gender dysphoria), and 4) gender affirmation surgery as a reason to quit smoking. At both Week 12 and Month 6, the participant reported being extremely satisfied with the intervention and self-reported cigarette use. Conclusion : A smoking cessation mobile intervention generated high satisfaction and frequent interactivity among a Latino transgender man. This case report provides important insights into the experience of one Latino transgender man during his attempt to quit smoking. There is an urgent need to develop or adapt existing smoking cessation interventions to better meet the needs of transgender people.

Resumen Objetivo Evaluar las practicas clinicas, barreras y facilitadores para dejar de fumar en clinicas de primer nivel de atencion en la Ciudad de Mexico. Material y metodos Diseno de metodos mixtos. Se realizaron encuestas (n = 70) y entrevistas semiestructuradas (n = 9) a personal de salud involucrado en el servicio de las clinicas para dejar de fumar. Resultados Datos cuantitativos muestran que el personal medico realizo mas que el de enfermeria las siguientes practicas: preguntar a pacientes si fumaban (57,9% vs. 34,5%, p = 0,057), si tenian interes en dejar de fumar (65,7% vs. 26,9%, p = 0,003), brindar asesoria (54,3% vs. 29,2%, p = 0,056) y necesidad de farmacoterapia (21,9% vs. 10%, p = 0,285). El personal de enfermeria informo mas que el personal medico la falta de recursos, farmacoterapia y necesidad de capacitacion para asesoria. Los resultados cualitativos muestran como barreras: percepcion de falta de motivacion para dejar de fumar entre pacientes, falta de tiempo en consulta, largos tiempos de espera para citas y falta de capacitacion; y como facilitadores: contar con servicio para dejar de fumar, farmacoterapia sin costo, y equipo multidisciplinario. Conclusiones Las intervenciones para dejar de fumar se implementan parcialmente. Es necesaria una reestructuracion de los servicios, donde el personal de enfermeria tenga un mayor rol.

Smoking and sedentary lifestyle frequently co-occur among Latinos. Evidence suggests that moderate to vigorous physical activity (MVPA) may enhance smoking cessation rates. However, this synergistic phenomenon has not been studied among Latinos, the largest minority group in the United States. This qualitative study consisted of semi-structured interviews in English or Spanish with Latino adults who smoke (n = 20) to understand their perspectives on physical activity. Participants were recruited using community-based recruitment strategies. The Health Belief Model was used as a framework for qualitative theoretical analysis. Multiple perceived benefits (e.g., mood management, strategy to quit smoking), susceptibility (e.g., risk of cardiovascular diseases, physical impairment), and barriers (e.g., lack of social support, low financial resources) of being physically active were identified. Moreover, multiple cues to action to do physical activity (e.g., being a role model, spending time with family and friends) were identified. These factors provide concrete operational strategies to address smoking cessation and physical activity among Latinos. Further research is needed on how best to integrate these perspectives into smoking cessation interventions.

The purpose of this pilot study was to assess the immediate impact of vaping prevention graphic messages on the susceptibility to future vaping among Black and Latino adolescents (ages 12 to 17). Graphic messages (available in English and Spanish) were developed using participatory research procedures with Black and Latino adolescents. Recruitment was conducted by a team of diverse, bilingual (English and Spanish), trained recruiters. Participants (n = 362) were randomized in a 1:1:1:1 schema to receive one of four graphic messages (health rewards, financial rewards, autonomy, and social norms). Overall, all graphic messages but one showed a slight decrease in the number of participants susceptible to future vaping, though none of these differences was statistically significant. The graphic message on health rewards decreased the number of participants susceptible to future vaping the most (55.7% vs. 50%, at pre- vs. post-viewing, p = 0.125), followed by the graphic messages on social norms and autonomy (55.1% vs. 52.8%, p = 0.687; 55.4% vs. 52.2%, p = 0.435; respectively). The graphic message on financial rewards increased the number of participants susceptible to future vaping slightly (52.7% vs. 53.8%, p = 1.00). Future research is needed to evaluate susceptibility to future vaping before and after exposure to different and/or repeated vaping prevention graphic messages.

INTRODUCTION. Stress and depressive symptoms have been linked to a reduced likelihood of sustaining smoking cessation. Because stress and depressive symptoms may negatively affect motivation to quit, stress and depression may also be important for whether or not smokers make a quit attempt. OBJECTIVE. To examine the relationship between perceived stress and depressive symptoms and initiating a quit attempt in a smoking cessation induction trial. METHODS. We conducted a secondary analysis of existing data from a randomized clinical trial (N=255) comparing motivational interviewing to health education and brief advice for smoking cessation induction in smokers with low motivation to quit. RESULTS. We observed positive associations between baseline predictors and quit attempts at week 12 (r=0.192, p

Introduction: Smoking and sedentarism frequently co-occur among Latinos. Evidence suggests that moderate to vigorous physical activity (MVPA) may enhance smoking cessation rates. However, this synergistic phenomenon has not been studied among Latinos, the largest minority group in the U.S. Objective: To understand the perspectives of Latino smokers on physical activity. Methods: Participants were recruited using community-based recruitment strategies. Semi-structured interviews were conducted in English and Spanish with Latino smokers. The Health Belief Model was used as a framework for qualitative theoretical analysis. Results: At baseline, participants’ mean age was 54.9 years old (SD 12.1), 50% of the participants were female, and 85% self-identified as heterosexual or straight. Eight participants (40%) indicated their language of preference as “Only Spanish” and 50% were born in Cuba and the Dominican Republic (25% for each country). Most participants (70%) were light smokers (1-10 cigarettes per day), 35% smoked their first cigarettes within five minutes after waking up, and 50% used menthol cigarettes. We identified perceived benefits (e.g., mood management, weight loss, strategy to quit smoking), susceptibility (e.g., risk of cardiovascular diseases and physical impairment, susceptibility to weight gain), and barriers (e.g., lack of social support, health constraints, and low financial resources) of being physically active. Moreover, we identified cues to action to do physical activity (e.g., being a role model: “⋯I’m going to do it [physical activity] so she [the daughter] can do it too⋯”; spending time with family and friends: “Well, since I have some little nephews and some little nieces... I go with them to the playground⋯”; being outdoors: “⋯go to the parks a lot or go nature walking⋯ being out in the woods⋯ taking all of nature⋯ I would go down to [local towns in New York] on my bicycle⋯”). Conclusion: Multiple perceived factors of being physically active were identified among Latino smokers. These factors provide concrete operational strategies to address smoking cessation and physical activity among Latinos. Further research is needed on how best to integrate these perspectives into smoking cessation interventions. Citation Format: Francisco Cartujano-Barrera, Edgar Alaniz-Cantu, Maria Valeria Bautista Rojas, Ruthmarie Hernández-Torres, Scott McIntosh, Deborah J. Ossip, Ana Paula Cupertino. Understanding the perspectives of Latino smokers on physical activity: A qualitative study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1971.

PURPOSE Cervical cancer screening is not well implemented in many low- and middle-income countries (LMICs). Mobile health (mHealth) refers to utilization of mobile technologies in health promotion and disease management. We aimed to qualitatively synthesize published articles reporting the impact of mHealth on cervical cancer screening–related health behaviors. METHODS Three reviewers independently reviewed articles with the following criteria: the exposure or intervention of interest was mHealth, including messages or educational information sent via mobile telephone or e-mail; the comparison was people not using mHealth technology to receive screening-related information, and studies comparing multiple different mHealth interventional strategies were also eligible; the primary outcome was cervical cancer screening uptake, and secondary outcomes included awareness, intention, and knowledge of screening; appropriate research designs included randomized controlled trials and quasi-experimental or observational research; and the study was conducted in an LMIC. RESULTS Of the 8 selected studies, 5 treated mobile telephone or message reminders as the exposure or intervention, and 3 compared the effects of different messages on screening uptake. The outcomes were diverse, including screening uptake (n = 4); health beliefs regarding the Papanicolaou (Pap) test (n = 1); knowledge of, attitude toward, and adherence to colpocytologic examination (n = 1); interest in receiving messages about Pap test results or appointment (n = 1); and return for Pap test reports (n = 1). CONCLUSION Overall, our systematic review suggests that mobile technologies, particularly telephone reminders or messages, lead to increased Pap test uptake; additional work is needed to unequivocally verify whether mhealth interventions can improve knowledge regarding cervical cancer. Our study will inform mHealth-based interventions for cervical cancer screening promotion in LMICs.

Tobacco-related health disparities (TRHDs) have a significant impact on population health in the USA. Effectively preventing and controlling TRHDs among young adult populations require multiple prevention and cessation points, including within college/university contexts. This commentary addresses current campus tobacco control policies and cessation interventions for U.S. college students, with an emphasis on TRHDs and opportunities for research and research translation to reduce these disparities. This commentary is informed by literature published between 2010 and 2020 regarding (a) prevalence and impact of campus tobacco control policies; and/or (b) behavioral outcomes from cessation interventions for young adults attending colleges. Despite a doubling of college campuses adopting tobacco-free policies from 2012 to 2017, roughly two-thirds continue to operate without such policies. Few policies address alternative tobacco products (e.g., e-cigarettes, cigars/cigarillos, and hookah), and communication about and enforcement of existing policies is extremely limited. A broad range of cessation intervention strategies have targeted individuals in this age group, but with little focus on TRHDs and limited intervention dissemination. Importantly, college students representing populations at risk for TRHDs (e.g., racial/ethnic/sexual/gender minorities, low socioeconomic status) are less likely to be exposed to strong tobacco control policies or supports for cessation. There are untapped opportunities for behavioral medicine approaches to reduce TRHDs in college settings. Research findings regarding multilevel (policy, community-level, and individual-level) interventions must be translated to policy/practice in order to address tobacco use, particularly among vulnerable college student populations.

Background: Puerto Ricans report the highest smoking rate (28.5%) among women and men compared to other Latino subgroups. Puerto Rican smokers are less likely to use smoking resources and quit smoking. Objective: To assess smoking behaviors and sociodemographic characteristics related to smoking cessation outcomes among Puerto Ricans in the United States. Methods: The study is a secondary analysis of the Decídetexto text message smoking cessation clinical trial, including 457 Latino smokers with access to nicotine replacement therapy (NRT). The study included 111 Puerto Rican smokers (Decídetexto: 49; control: 62). Pearson Chi-squares were used for categorical dependent variables and point biserial correlation for continuous dependent associations with smoking cessation outcomes assessed at 6mo (quit attempts, number of cigarettes per day, quit attempts, and self-reported cessation). Results: Participants were largely middle-aged (49.6 years), women (52.3%), and more than half (69.4%) preferred the Spanish language. The mean number of cigarettes per day was 11.55 (SD=6.85), and they reported an average of 2.49 (SD=5.088) quit attempts in the last year. The majority of reported using menthol cigarettes (73.9%) and previously using medication (58.6%) and e-cigarettes (55%). A six-month, 7-day self-reported smoking abstinence was 24.3% (32.7% for Decídetexto and 17.7% for control). Previous quit attempts and education were significantly associated with the self-reported 7-day abstinence at six months year (rpb = .252, n = 111, p = .008; Χ2(4) = 10.772, p= .029 ). Age, gender, language preference, employment status, cigarettes per day, menthol cigarettes, and e-cigarette use were not related to 7-day self-reported smoking cessation. Conclusion: Decídetexto mobile smoking cessation is likely to facilitate smoking cessation among Puerto Ricans living in the US. Results from the present study will inform future randomized clinical trials for the understudied Puerto Rican Latino population with the highest smoking rate. Citation Format: Ruthmarie Hernández-Torres, Francisco Cartujano-Barrera, Arlette Chavez-Iñiguez, Deborah Ossip, M. Patricia Rivera, Eida M. Castro-Figueroa, Ana Paula Cupertino. Decídetexto: A mobile smoking cessation intervention among Puerto Ricans in the US [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 B004.

Objective: The objective of this study is to describe weight change among Latinos participating in a randomized, culturally appropriate mobile smoking cessation intervention. Background: More than 60% of cancer-related deaths in the U.S. are attributed to tobacco use, poor nutrition, and physical inactivity. Weight gain is one of the possible barriers to smoking cessation success. The obesity rate among Latinos (44.8%) is the second-highest rate among all racial and ethnic groups. Furthermore, Latino adults have the highest rate of inactivity and 75% of Latinos do not meet the recommended levels of fruit/vegetable consumption. Therefore, the relationship between smoking cessation and weight gain among Latinos is an important aspect to consider in smoking cessation treatment for these underrepresented communities. Methods: The present study describes the weight change of participants in a culturally-tailored mobile smoking cessation program (Decídetexto) over six months. Participants were randomized to one of two conditions: 1) Decídetexto, or 2) standard care (printed materials, referral to quitline). Baseline and 6-month follow-up assessments were performed. The cessation outcome was cotinine-verified 7-day point prevalence abstinence. Weight and BMI were compared from baseline to 6-month to verify the impact of smoking cessation on weight. These changes were also compared from baseline to 6-month among intervention participants vs standard treatment participants to assess any impact of the intervention on weight. Results: Subjects (n=348) had complete weight information to be included in this analysis. Most participants were in the overweight and obese BMI categories at baseline (n=259, 74.4%). At 6 months, there was no significant change in BMI status among all participants. Weight change among those who quit at 6 months compared to those who did not quit smoking was also not statistically significant (p=.70). Quitters had an overall higher amount of absolute weight gain by one pound compared to non-quitters at 6 months (5.04±5.02 lbs vs 4.31±4.09 lbs, respectively) which was not statistically significant (p=0.33). In both the intervention and control groups, more subjects did gain weight overall (n=60,36.2% vs n=69,37.9%, respectively). More subjects lost weight in the control group compared to the intervention group (n=55,30.22% vs n=48,28.9%, respectively). Approximately one-third of both the intervention and control groups did not change their weight (n=58,34.9%, vs n=58,37.9%). There was no statistically significant difference between groups in any weight change direction (p=0.95). Conclusion: Participants in a culturally-tailored mobile smoking cessation program for Latino smokers did not experience significant changes in weight compared to standard treatment. Importantly, those who quit smoking also did not experience significant changes in weight. This is an outcome that could inform future counseling of participants in smoking cessation programs, as fear of weight gain is a significant barrier to quit success. Citation Format: Katherine K.S. Rieth, Evelyn Arana, Francisco Cartujano-Barrera, Scott McIntosh, Ana Paula Cupertino. Decídetexto: Assessment of weight change after smoking cessation treatment in Latino smokers [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 B005.

BACKGROUND Latinos remain disproportionately underrepresented in clinical trials, comprising only 2%-3% of research participants. In order to address health disparities, it is critically important to increase enrollment of Latino smokers in smoking cessation trials. There is limited research examining effective recruitment strategies for this population. OBJECTIVE The purpose of this study was to compare the effectiveness of direct versus mass and high- versus low-effort recruitment strategies on recruitment and retention of Latino smokers to a randomized smoking cessation trial. We also examine how the type of recruitment might have influenced the characteristics of enrolled participants. METHODS Latino smokers were enrolled into Decídetexto from 4 states—New Jersey, Kansas, Missouri, and New York. Participants were recruited from August 2018 until March 2021. Mass recruitment strategies included English and Spanish advertisements to the Latino community via flyers, Facebook ads, newspapers, television, radio, church bulletins, and our Decídetexto website. Direct, high-effort strategies included referrals from clinics or community-based organizations with whom we partnered, in-person community outreach, and patient registry calls. Direct, low-effort strategies included texting or emailing pre-existing lists of patients who smoked. A team of trained bilingual (English and Spanish) recruiters from 9 different Spanish-speaking countries of origin conducted recruitment, assessed eligibility, and enrolled participants into the trial. RESULTS Of 1112 individuals who were screened, 895 (80.5%) met eligibility criteria, and 457 (457/895, 51.1%) enrolled in the trial. Within the pool of screened individuals, those recruited by low-effort recruitment strategies (both mass and direct) were significantly more likely to be eligible (odds ratio [OR] 1.67, 95% CI 1.01-2.76 and OR 1.70, 95% CI 0.98-2.96, respectively) and enrolled in the trial (OR 2.60, 95% CI 1.81-3.73 and OR 3.02, 95% CI 2.03-4.51, respectively) compared with those enrolled by direct, high-effort strategies. Among participants enrolled, the retention rates at 3 months and 6 months among participants recruited via low-effort strategies (both mass and direct) were similar to participants recruited via direct, high-effort methods. Compared with enrolled participants recruited via direct (high- and low-effort) strategies, participants recruited via mass strategies were less likely to have health insurance (44.0% vs 71.2% and 71.7%, respectively; PPP=.007), more likely to primarily speak Spanish (89.3% vs 65.8% and 66.3%, respectively), and more likely to be at high risk for alcohol abuse (5.8 mean score vs 3.8 mean score and 3.9 mean score, respectively; P CONCLUSIONS Although most participants were recruited via direct, high-effort strategies, direct low-effort recruitment strategies yielded a screening pool more likely to be eligible for the trial. Mass recruitment strategies were associated with fewer acculturated enrollees with lower access to health services—groups who might benefit a great deal from the intervention. CLINICALTRIAL ClinicalTrials.gov identifier: NCT03586596; https://clinicaltrials.gov/ct2/show/NCT03586596 INTERNATIONAL REGISTERED REPORT RR2-DOI: 10.1016/j.cct.2020.106188

There is an underrepresentation of Latinos in smoking cessation clinical trials. This study describes the feasibility and effectiveness of recruiting Latino smokers in the U.S. from an emergency department (ED) patient registry into a randomized smoking cessation clinical trial. Recruitment occurred from the Hackensack University Medical Center ED. Potential participants were contacted from a patient registry. The primary outcome was whether the participant responded to a call or text. Secondary outcomes included the best day of the week, week of the month, and time of day to obtain a response. Of the 1680 potential participants, 1132 were called (67.5%), while 548 (32.5%) were texted. For calls, response rate was higher compared to text (26.4% vs 6.4%, p &lt, 0.001). More participants were interested in the study when contacted by calls compared to text (11.4% vs. 1.8%) and more participants were enrolled in the study when contacted by calls compared to text (1.1% vs. 0.2%). Regression models showed that ethnicity, age, time of day, and week of the month were not significantly associated with response rates. Recruitment of Latinos from an ED patient registry into a smoking cessation clinical trial is feasible using call and text, although enrollment may be low.

There is an underrepresentation of Latinos in smoking cessation clinical trials. This study describes the feasibility and effectiveness of recruiting Latino smokers in the U.S. from an emergency department (ED) patient registry into a randomized smoking cessation clinical trial. Recruitment occurred from the Hackensack University Medical Center ED. Potential participants were contacted from a patient registry. The primary outcome was whether the participant responded to a call or text. Secondary outcomes included the best day of the week, week of the month, and time of day to obtain a response. Of the 1680 potential participants, 1132 were called (67.5%), while 548 (32.5%) were texted. For calls, response rate was higher compared to text (26.4% vs 6.4%; p < 0.001). More participants were interested in the study when contacted by calls compared to text (11.4% vs. 1.8%) and more participants were enrolled in the study when contacted by calls compared to text (1.1% vs. 0.2%). Regression models showed that ethnicity, age, time of day, and week of the month were not significantly associated with response rates. Recruitment of Latinos from an ED patient registry into a smoking cessation clinical trial is feasible using call and text, although enrollment may be low.

Objective: To systematically review published articles reporting the use of smoking cessation mobile health (mHealth) interventions in Latin America. Methods: Five different databases were searched from database inception to 2020. Criteria: (1) the research was a smoking cessation randomized controlled trial (RCT), quasi-experimental research, or single-arm study; (2) the intervention used at least one type of mHealth intervention; (3) the research was conducted in Latin American; and (4) the research reported the cessation rate. Results: Of the seven selected studies, four were conducted in Brazil, two in Mexico, and one in Peru. Only one study was an adequately powered RCT. Interventions relied on text messages ( n = 3), web-based tools ( n = 2), and telephone calls ( n = 3). Some studies ( n = 4) provided pharmacotherapy support. Smoking cessation outcomes included self-reported ( n = 5) and biochemically verified ( n = 2) abstinence. Follow-ups were conducted at Month 6 ( n = 2), Week 12 ( n = 4), and Day 30 ( n = 1). Cessation rates varied from 9.4% at Week 12 to 55.5% at Day 30. Conclusion: Despite the promising cessation rates of mHealth interventions in Brazil, Mexico, and Peru, there is a need to rigorously evaluate these interventions in different Latin American countries with RCTs that are long-term, adequately powered, and use biochemical verification of cessation.

The 12-item Smoking Self-Efficacy Questionnaire (SEQ-12) is a valid and reliable instrument to assess confidence in one’s ability to refrain from smoking in a variety of different situations. This study evaluated the psychometric properties of the Spanish version of the 12-item Smoking Self-Efficacy Questionnaire (SEQ-12) among a sample of Spanish-speaking Latino smokers engaged in a smoking cessation research study. A forward-backward translation procedure guided the translation of the SEQ-12 into Spanish. The Spanish version of the SEQ-12 showed promising internal consistency reliability and construct validity among Latino smokers, with potential applications in both research and clinical settings.

Introduction Over the last few decades, Latino migration to the U.S.has re-shaped the ethnic composition of the country, and influencedthe meaning of “ethnic” and “racial” identity. The purpose of thisqualitative study was to explore the definition and meaning of beingLatino and how this may guide the development of interventions topromote their health. Methods Twenty-six Latino immigrants living in Kansas completeda socio-demographic survey and semi-structured interviews to assessand explore personal immigration experiences and perspectives onthe meaning of being Latino in the U.S. Results Participant reports were grouped into eight themes on Latinoidentity that were organized by geographic origin, family roots/ties,and acculturation. Immigration experiences were described as bothpositive and negative with most participants experiencing discriminationand loneliness, but also reports of improved quality of life.Further, most participants reported a strong sense of Latinidad; thatLatino immigrant communities in the U.S. are interdependent andsupportive of each other. Conclusions The experience of being a member of a minority groupmight contribute to the development of a cohesive sense of Latinoidentity as participants acculturate to the U.S. while preserving asense of attachment to their culture of origin. Future interventionsshould be sensitive to migration experiences as they might influencechanges in health behaviors.

Introduction Mobile health interventions are a promising mode to address tobacco-related disparities among Latinos, the largest minority group and the highest users of text messaging technology. The purpose of this pilot study was to assess engagement in a smoking cessation intervention delivered via text message (Kick Buts) among Latino smokers. Methods We relied on a community-based recruitment strategy to enroll 20 Latino smokers in Kick Buts. Outcome measures included biochemically verified abstinence at 12 weeks, participant text messaging interactivity with the program, and satisfaction. Results Participants' mean age was 40.7 years old (SD=14.6). Most of the participants were male (70%), did not have health insurance (75%), and reported low nicotine-dependence (60%). The majority of participants (75%) sent at least one text message to the program. On average, participants who interacted with the program sent 31.8 (SD=39.7) text messages. Eight themes were identified in participants' messages (eg, well-being, self-efficacy, strategies to quit, extra-treatment social support, etc). At 12 weeks, 30% of the participants were biochemically verified as abstinent. Conclusion A smoking cessation text message intervention generated high engagement among Latinos and resulted in noteworthy cessation rates. Future studies should assess the relationship of text messaging interactions with psychological effects (eg, intra-treatment social support, therapeutic alliance, and perceived autonomy support).

IntroductionDisparities exist among Latino smokers with respect to knowledge and access to smoking cessation resources. This study tested the feasibility of using case management (CM) to increase access to pharmacotherapy and quitlines among Latino smokers.MethodsLatino smokers were randomized to CM (n = 40) or standard care (SC, n = 40). All participants received educational materials describing how to utilize pharmacy assistance for cessation pharmacotherapy and connect with quitlines. CM participants received four phone calls from staff to encourage pharmacotherapy and quitline use. At 6-months follow-up, we assessed the utilization of pharmacotherapy and quitline. Additional outcomes included self-reported smoking status and approval for pharmacotherapy assistance.ResultsUsing intention-to-treat analysis, CM produced higher utilization than SC of both pharmacotherapy (15.0% versus 2.5%; P = 0.108) and quitlines (12.5% versus 5.0%; P = 0.432), although differences were not statistically significant. Approval for pharmacotherapy assistance programs (20.0% versus 0.0%; P = 0.0005) was significantly higher for CM than SC participants. Self-reported point-prevalence smoking abstinence at 6-months were 20.0% and 17.5% for CM and SC, respectively (P = 0.775).ConclusionsCM holds promise as an effective intervention to connect Latino smokers to evidence-based cessation treatment.

Previous studies have identified variants in genes encoding proteins associated with the degree of addiction, smoking onset, and cessation. We aimed to describe thirty-one single nucleotide polymorphisms (SNPs) in seven candidate genomic regions spanning six genes associated with tobacco-smoking in a cross-sectional study from two different interventions for quitting smoking: (1) thirty-eight smokers were recruited via multimedia to participate in e-Decídete! program (e-Dec) and (2) ninety-four attended an institutional smoking cessation program on-site. SNPs genotyping was done by real-time PCR using TaqMan probes. The analysis of alleles and genotypes was carried out using the EpiInfo v7. on-site subjects had more years smoking and tobacco index than e-Dec smokers (p &lt, 0.05, both), in CYP2A6 we found differences in the rs28399433 (p &lt, 0.01), the e-Dec group had a higher frequency of TT genotype (0.78 vs. 0.35), and TG genotype frequency was higher in the on-site group (0.63 vs. 0.18), same as GG genotype (0.03 vs. 0.02). Moreover, three SNPs in NRXN1, two in CHRNA3, and two in CHRNA5 had differences in genotype frequencies (p &lt, 0.01). Cigarettes per day were different (p &lt, 0.05) in the metabolizer classification by CYP2A6 alleles. In conclusion, subjects attending a mobile smoking cessation intervention smoked fewer cigarettes per day, by fewer years, and by fewer cumulative pack-years. There were differences in the genotype frequencies of SNPs in genes related to nicotine metabolism and nicotine dependence. Slow metabolizers smoked more cigarettes per day than intermediate and normal metabolizers.

Background Guatemala lacks cancer prevention strategies and has low screening rates. Objective To assess the history of chronic conditions, risk factors, and cancer screening uptake among three Indigenous populations of Southwestern Guatemala. Methods We conducted a health needs assessment. Results The assessment was completed by 247 adults. Median age was 40 years old (IR: 28-59). Most participants were female (94.3%), of Mayan descent (95.8%), and did not have a primary health care provider (84.2%). Most have never been screened for colorectal (men=100.0%; women=98.8%), prostate (75.0%), breast (90.9%), or cervical (76.9%) cancer, and all have severe tooth decay. However, most participants reported healthy behaviors including being physically active (women=59.7%; men=92.9%), being nonsmokers (women=99.6%; men=78.6%), and not consuming alcohol (women=82.3%; men=46.7%). Conclusions Although most participants reported healthy behaviors, there is a remarkable lack of access to cancer screening. An increase in cancer incidence is expected unless cancer prevention efforts are undertaken.

Background: The killing of George Floyd triggered the Black Lives Matter protests against police brutality and social injustices in the midst of the COVID-19 pandemic. No research to date has assessed the COVID-19 prevention practices and beliefs of protesters. The purpose of this study was to assess COVID-19 prevention practices and beliefs of Black Lives Matter protesters in the USA. Methods: A pilot mixed methods study was employed. Participants completed a survey collecting data on their frequency in following COVID-19 recommended guidelines and answered open-ended interview questions to elucidate the results from the survey. Results: Twenty participants completed the study. Participants’ average age was 29 and most participants were female (80%) and black (75%). Most always or almost always properly wore their masks (50% and 25%, respectively) and washed their hands during a protest 2-3 times or more than 3 times (35% and 50%, respectively). Although all believed that COVID-19 testing is important (90%), most had never been tested (85%) and most did not self-quarantine for 14 days after protesting (95%). Moreover, most participants reported never or rarely following social distancing guidelines at a protest (25% and 30%, respectively) and most reported being Not at all or Slightly concerned about COVID-19 while at a protest (25% and 30%, respectively). Qualitative data highlighted the following themes: 1) Fighting for social justice, 2) Protesting being more important than COVID-19, 3) Unable to keep 6 ft distance, 4) Masks worn most of the time, 5) Protests sparked global movement, and 6) Increasing awareness of injustices. Conclusion: Although protesters believe that both the fight for social justice and taking precautions during the COVID-19 pandemic are important, they believe the fight for social justice is more important than the COVID-19 pandemic. However, they understand the importance of COVID-19 and try to practice the recommended guidelines to prevent its spread while protesting. These results make an important contribution for policies for controlling the spread of the disease, and also understanding human behavior of protesting for social justice during a pandemic.

6538 Background: Data are sparse regarding the prevalence of cancer and cancer risk factors among transgender people. Transgender people experience structural stigma and extreme rates of violence that may contribute to cancer through multiple mechanisms. The purpose of this study was to assess cancer risk factors and cancer in transgender people in a single institutional electronic health record (EHR) and compare the rates to those among cisgender, or non-transgender, people. Methods: Using a combination of structured gender identity data, diagnosis codes, and keyword searches, we identified a cohort of transgender people seen at our institution, a large tertiary care center. We next identified a cohort of cisgender people matched by age, year of first encounter in our EHR, and years of follow-up. Among these cohorts, we searched for cancer, premalignant lesions, human immunodeficiency virus (HIV), human papilloma virus (HPV), and hepatitis and assessed body mass index (BMI) and smoking status through structured EHR fields. Lastly, we compared the prevalence of cancer, premalignant lesions, and cancer risk factors between the two cohorts using chi-square tests. If expected cell sizes were

6516 Background: Cancer risk factors for transgender people are largely unexplored. Extreme rates of interpersonal violence experienced by transgender people may increase the risk of cancer. The associations between exposure to interpersonal violence and cancer risk factors have not been investigated. Methods: We searched for experiences of violence in cohorts of 923 transgender and 1846 cisgender people matched by age, follow-up time, and year of the first encounter and measured the association between these experiences and smoking as well as BMI ≥ 40. We then estimated the prevalence ratios for these risk factors using robust Poisson regression models including gender identity, violence, and their interaction, adjusted for age and follow-up time. Results: Transgender people experienced more violence than cisgender people. Among transgender people, there were significantly higher rates of smoking among those who had experienced any type of violence (50% vs 35%, p

Background Adult cancer survivors (ACS) are at increased risk for developing various comorbid conditions and having poor health-related quality of life (HRQOL) when compared to adults with no history of cancer. The effect of social and emotional support on HRQOL among ACS is not fully elucidated. The purpose of this study was to understand the role of social and emotional support on HRQOL in ACS and to examine if the association between social and emotional support and HRQOL is modified by gender, time since cancer diagnosis, or marital status. Methods Data for this study were obtained from the 2009 Behavioral Risk Factor Surveillance System. Statistical analysis was based on ACS with complete data (n = 23,939) on all variables considered. Multivariable logistic regression models were used to model the association between social and emotional support and indicators of HRQOL (i.e., general health, physical health, mental health, and activity limitation). To examine if gender, marital status, or the number of years since cancer diagnosis modify the association, separate stratified analyses were conducted. Results When compared to ACS who reported that they Rarely/Never received social and emotional support, those who reported that they Always received were 32 % less likely to report Fair/Poor General health, 23 % less likely to report frequent unhealthy days of Physical health, 73 % less likely to report frequent unhealthy days of Mental health and 38 % less likely to report frequent unhealthy days of Activity limitation. Social and emotional support was positively associated with all four domains of HRQOL among ACS who were female, unmarried, or greater than 5 years since cancer diagnosis, while this positive association was evident only with one or two domains of HRQOL among their corresponding counterparts (i.e., male, married, less than 5 years since diagnosis). Conclusions Social and emotional support is an important factor directly related to a better HRQOL, but it is modified by gender, marital status, and time since diagnosis. Findings from this study should inform health care providers about the importance of a support system for ACS in improving their overall quality of life.

The purpose of this pilot study was to assess the feasibility and acceptability of a mobile smoking cessation intervention in Puerto Rico. This was a single-arm pilot study with 26 smokers in Puerto Rico who were enrolled in Decídetexto, a mobile smoking cessation intervention. Decídetexto 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. Outcome measures included self-reported 7-day point prevalence abstinence at Months 3 and 6, pharmacotherapy adherence, satisfaction with the intervention, and changes in self-efficacy. The average age of the participants was 46.8 years (SD 12.7), half of them (53.8%) were female. Most participants (92.3%) smoked daily and half of them (53.8%) used menthol cigarettes. All participants requested nicotine patches at baseline. However, only 13.0% of participants used the patch &gt, 75% of days. At Month 3, 10 participants (38.4%) self-reported 7-day point prevalence abstinence (88.5% follow-up rate). At Month 6, 16 participants (61.5%) self-reported 7-day point prevalence abstinence (76.9% follow-up rate). Most participants (90%, 18/20) reported being satisfied/extremely satisfied with the intervention at Month 6. Self-efficacy mean scores significantly increased from 40.4 (SD 12.1) at baseline to 57.9 (SD 11.3) at Month 3 (p &lt, 0.01). The study suggests that Decídetexto holds promise for further testing among Puerto Rican smokers.