Redes En Acción

National network to reduce Latino Cancer.

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Training and internships to increase Latino doctors and cancer researchers.

Salud America!

National network to inspire healthy community change for Latino and all families.

 

National Hispanic Leadership Initiative on Cancer (NHLIC): En Acción

Grant: U01 CA 59379
1992-99

SUMMARY

The NHLIC: En Acción sought to initiate the first comprehensive assessment of cancer risk factors among the major populations of Hispanic/Latino men and women and develop state-of-the-art cancer prevention and control strategies tailored to those diverse populations, including Mexican Americans, Puerto Ricans, Cuban Americans, and Central and South Americans. The project aimed to secure baseline survey data of participants at six national sites; implement intervention strategies; and promote cancer screening, access to care, nutritional improvements, smoking cessation, skin protection and reduced cancer risks. The project evaluation process would lead to program training and replication (i.e., if the intervention model can be successfully applied to diverse Hispanic populations and settings around the U.S. to improve screening rates and other cancer risk-reduction behaviors), scientific publications and follow-up survey results.

PRINCIPAL INVESTIGATOR

  • Amelie G. Ramirez, DrPH
    IHPR, The University of Texas Health Science Center at San Antonio (at Baylor College of Medicine for this project)

CO-PRINCIPAL INVESTIGATORS

  • Jose R. Martí, MD
    Brookdale Hospital Medical Center in Brooklyn, New York
  • Eliseo J. Pérez-Stable, MD
    Chief of the Division of General Internal Medicine at U. of California, San Francisco
  • Gregory A. Talavera, MD, MPH
    Faculty at School of Public Health, Division of Health Promotion at San Diego State University
  • Edward J. Trapido, ScD
    Associate Director of the University of Miami Sylvester Comprehensive Cancer Center
  • Roberto Villarreal, MD
    University of Texas Health Science Center at San Antonio, San Antonio, Texas
  • Lucina Suarez, PhD
    Texas Department of Health, Austin, Texas

COLLABORATORS

  • National Cancer Institute
  • Brookdale Hospital Medical Center, Brooklyn
  • University of California at San Francisco
  • San Diego State University
  • The University of Miami
  • University of Texas Health Science Center at San Antonio
  • Texas Department of Health

LOCATION/SERVICE AREA

Baylor College of Medicine served as the coordinating center, with these six heavily Hispanic U.S. regions: Puerto Ricans in New York City; Cuban Americans in Miami; Central and South Americans in San Francisco; and Mexican Americans in San Diego, San Antonio, and Brownsville, Texas.

CONCLUSIONS

Research compared cancer rates and behavioral risks before and after intervention, and formative research was used to develop local newsletters and test role model portrayals. The program focused on implementing a theory-based behavioral journalism (using community role models to relate personal examples of behavior modification) and community peer networkers at each site. Combining national and regional health expertise with grassroots community leadership, the innovative outreach program integrated the latest advances in cancer research into health policy and practice among a substantial segment of this nation’s Hispanic population. In four intervention years, the six sites recruited 955 community networkers, 399 role models and distributed 768,000 monthly newsletters a year. The project developed more than 750 community partnerships and had 900 stories appear in about 40 different media outlets, including TV, radio and newspaper. The NHLIC: En Acción also initiated the first comprehensive assessment of cancer risk factors in diverse populations and obtained preliminary research results. As a result, the program ended up empowering Hispanic communities with the knowledge and the resources needed to prevent and control cancer. For more information, visit the project’s Web site, www.nhlic-enaccion.org.

PUBLICATIONS

  • Ramirez, AG, Vélez, LF, Chalela, P, Gallion, K, & McAlister, AL. 2008 (expected release date). Diffusion Acceleration: A model for behavior change and social mobilization. Update of the book, Promoting Health in Multicultural Populations: A Handbook for Practitioners. In print by SAGE publications.
  • Vélez, LF, Chalela, P, & Ramirez, AG. 2008 (expected release date). Health of Latinos in the United States: An overview. Update of the book, Promoting Health in Multicultural Populations: A Handbook for Practitioners. In print by SAGE publications.
  • Ramirez, AG, Suarez, L, Chalela, P, Talavera, GA, Marti, J, Trapido, EJ, Villarreal, R, & Pérez-Stable, EJ. 2004. Cancer risk factors among men of diverse Hispanic or Latino origins. Preventive Medicine, 39, 2, 263-269.
  • Fernández-Esquer, ME, Espinoza, P, Ramirez, AG, & McAlister, AL. 2003. Repeated Pap smear screenfing among Mexican-American women. Health Education Research, 18, 4, 477-487.
  • Fernández-Esquer, ME, Espinoza, P, Torres, I, Ramirez, AG, & McAlister, AL. 2003. A Su Salud: A quasi-experimental study among Mexican-American women. American Journal of Health Behavior, 27, 5, 536-545.
  • Aparicio-Ting, F, & Ramirez, AG. 2003. Breast and cervical cancer knowledge, attitudes, and screening practices of Hispanic women diagnosed with cervical cancer. Journal of Cancer Education, 18, 4, 230-236.
  • Talavera, GA, Ramirez, AG, Suarez, L, Villarreal, R, Marti, J, Trapido, E, & Perez-Stable, EJ. 2002. Predictors of Digital Rectal Examination in U.S. Latinos. American Journal of Preventive Medicine, 22, 1, 36-41.
  • Perez-Stable, EJ, Ramirez, AG, Villarreal, R, Talavera, GA, Trapido, E, Suarez, L, Marti, J, & McAlister, A. 2001. Cigarette smoking behavior among US Latino men and women from different countries of origin. American Journal of Public Health, 91, 9, 1424-1430.
  • Ramirez, AG, & Suarez, L. 2001. The impact of cancer on Latino populations. In M. Aguirre-Molina & C. W. Molina & R. E. Zambrana (Eds.), Health Issues in the Latino Community (pp. 211-244). San Francisco: Jossey-Bass.
  • Ramirez, AG, & Suarez, L. 2001. Hispanic cultures. In L. Breslow (Ed.), Encyclopedia of Public Health (Vol. 2, pp. 565-567). New York, NY: Macmillan Reference USA – Gale Group.
  • Ramirez, AG, Suarez, L, Laufman, L, Barroso, C, & Chalela, P. 2000. Hispanic women’s breast and cervical cancer knowledge, attitudes, and screening behaviors. American Journal of Health Promotion, 14, 5, 292-300.
  • Ramirez, AG, Suarez, L, McAlister, A, Villarreal, R, Trapido, E, Talavera, GA, Perez-Stable, EJ, & Marti, J. 2000. Cervical cancer screening in regional Hispanic populations. American Journal of Health Behavior, 24, 3, 181-192.
  • Ramirez, AG, Talavera, GA, Villarreal, R, Suarez, L, McAlister, A, Trapido, E, Perez-Stable, E, & Marti, J. 2000. Breast cancer screening in regional Hispanic populations. Health Education Research, 15, 5, 559-568.
  • Suarez, L, Ramirez, AG, Villarreal, R, Marti, J, McAlister, A, Talavera, GA, Trapido, E, & Perez-Stable, EJ. 2000. Social networks and cancer screening in four U.S. Hispanic groups. American Journal of Preventive Medicine, 19, 1, 47-52.
  • Ramirez AG, Villarreal R, McAlister A, Gallion K, Suarez L, Gomez P. 1999. Advancing the Role of Participatory Communication in the Diffusion of Cancer Screening among Hispanics. Journal of Health Communication, 4(1):31-36.
  • Iammarino NK, Laufman L, Ramirez AG, Phillips JL. 1999. Mentoring in the Sciences and the Health Professions. Cancer Research Therapy and Control, 8:193-200.
  • Ramirez, AG, Suarez, L, West, DW, Chalela, P, & Presswood, D. 1999. Hispanics: Are we being counted accurately? Challenges and recommendations. Journal of Registry Management, 26, 4.
  • Suarez, L, & Ramirez, AG. 1999. Hispanic/Latino health and disease: an overview. RM Huff & MV Kline & et al (Eds.), Promoting health in multicultural populations: a handbook for practitioners (Vol. xvii, pp. 115-136). Thousand Oaks, CA: Sage Publications, Inc.
  • Ramirez AG, McAlister A, Villarreal R, Suarez L, Talavera GA, Pérez-Stable EJ, Marti J, Trapido EJ. 1998. Prevention and control in diverse Hispanic populations: A national initiative for research and action. Cancer, 83, Suppl, 1825-1829.
  • Fulgoni VL, Ramirez AG. 1998. Cancer: The Role of Diet, Nutrition and Fitness. Cancer Supplement, 83(8):1775-1783.
  • Kaplan, RM, Navarro, AM, Castro, FG, Elder, JP, Mishra, SI, Hubbel, A, Chrvala, C, Flores, E, Ramirez, A, Fernandez-Esquer, ME, & Ruiz, E. 1996. Increased use of mammography among Hispanic women: Baseline results from the NCI Cooperative Group on cancer prevention in Hispanic communities. American Journal of Preventive Medicine, 12, 467-471.
  • Ramirez AG, McAlister AL, Gallion KJ, Ramirez V, Garza IR, Stamm K, de la Torre J, Chalela P. 1995. Community level cancer control in a Texas barrio: Part I, Theoretical basis, implementation and process evaluation. Monograph, Journal of National Cancer Institute, 18: 117-122.
  • Ramirez AG, Villarreal R, Suarez L, Flores E. 1995. The Emerging Hispanic Population: A Foundation for Cancer Prevention and Control. Monograph, Journal of National Cancer Institute, 18: 1-9.
  • McAlister AL, Fernandez-Esquire ME, Ramirez AG, Gallion KJ, Trevino F, Villarreal R. 1995. Community level cancer control in a Texas barrio: Part II, Baseline and preliminary outcome findings. Monograph, Journal of National Cancer Institute, 18: 123-126.
  • Ramirez, AG, McAlister, A, Gallion, KJ, & Villarreal, R. 1995. Targeting Hispanic populations: future research and prevention strategies. Environmental Health Perspectives, 103, Suppl 8, 287-290.