To assess associations of protective workplace and home practices to pesticide exposure levels.
Using data from orchard workers in the Yakima Valley, Washington, we examined associations of workplace and home protective practices to (1) urinary metabolite concentrations of dimethylthiophosphate (DMTP) in adults and children aged 2–6; and (2) azinphos-methyl levels in house and vehicle dust.
Data were from 95 orchard workers and 94 children. Contrary to expectation, adult farm workers who wore boots or washed hands using hand sanitizer had higher concentrations of DMTP than those who did not. Children who attended daycare had higher DMTP concentrations than children who did not.
Few workplace or home practices were associated with pesticide exposure levels; workers who used hand sanitizer had higher concentrations of DMTP, as did children who attended daycare.
Pesticides; agriculture; United States Environmental Protection Agency Worker Protection Standard; home practices; workplace practices
To examine barriers and facilitators of biomedical research
participation among Hispanics in a rural community in Washington State.
Questionnaires addressed socio-demographics, health care access, and
barriers and facilitators of participation in biomedical studies. This is a
descriptive analysis of the findings.
Barriers include the need to care for family members (82%),
fear of having to pay for research treatments (74%), cultural
beliefs (65%), lack of time (75%) and trust (71%),
and the degree of hassle (73%). Facilitators include having a
friend/relative with the disease being researched (80%) and monetary
Researchers should be mindful of these facilitators and barriers when
recruiting for biomedical research studies.
biomedical research; Hispanic; research ethics; recruitment
Nearly 67% of Hispanics ages 50 and older report that they have never had a screening colonoscopy. Barriers to screening include cost, lack of health insurance, anticipation of pain, fear, lack of awareness, and embarrassment, significantly more problematic among those Hispanics who are poor and lived in underserved rural and border communities. This study addressed barriers using promotoras and a home-based educational intervention to improve knowledge of and screening for colorectal cancer among Hispanics in Yakima Valley, Washington. Study participants completed pre and post surveys on general cancer knowledge and knowledge specific to colorectal cancer and screening practices and attended a promotora led home-based educational intervention consisting of home-health parties. Results indicated increase in knowledge of and participation in screening for colorectal cancer. Promotora facilitated home-based interventions offer ways to reach Hispanics in rural and other underserved communities to reduce barriers and improve access to cancer screening.
Hispanics; barriers; colorectal cancer; promotora; home-based; education
Breast cancer is the leading cause of cancer-related death among U.S. Hispanic women. Hispanics are less likely than non-Hispanic White women to be diagnosed at an early stage and survive breast cancer.
For this cross-sectional study, we assessed differences in breast cancer knowledge, attitudes, and screening practices between Hispanic women with (FH+) and without (FH−) a family history of breast cancer in three U.S.-Mexico border counties.
Among 137 Hispanic women age 40 and older, FH+ women had levels of knowledge and attitudes about breast cancer similar to those of FH− women. FH+ participants were more likely to have ever performed breast self-examinations, although levels of compliance with screening guidelines did not significantly differ between FH+ and FH− groups.
U.S. Hispanic women with a family history of breast cancer constitute an at-risk group for which adhering to preventive screening guidelines could substantially reduce breast cancer mortality.
Breast cancer; knowledge; detection; Hispanic
For Hispanic women, the Breast Cancer Risk Assessment Tool (BCRAT; “Gail Model”) combines 1990–1996 breast cancer incidence for Hispanic women with relative risks for breast cancer risk factors from non-Hispanic white (NHW) women. BCRAT risk projections have never been comprehensively evaluated for Hispanic women. We compared the relative risks and calibration of BCRAT risk projections for 6,353 Hispanic to 128,976 NHW postmenopausal participants aged 50 and older in the Women’s Health Initiative (WHI). Calibration was assessed by the ratio of the number of breast cancers observed with that expected by the BCRAT (O/E). We re-evaluated calibration for an updated BCRAT that combined BCRAT relative risks with 1993–2007 breast cancer incidence that is contemporaneous with the WHI. Cox regression was used to estimate relative risks. Discriminatory accuracy was assessed using the concordance statistic (AUC). In the WHI Main Study, the BCRAT underestimated the number of breast cancers by 18% in both Hispanics (O/E = 1.18, P = 0.06) and NHWs (O/E = 1.18, P < 0.001). Updating the BCRAT improved calibration for Hispanic women (O/E = 1.08, P = 0.4) and NHW women (O/E = 0.98, P = 0.2). For Hispanic women, relative risks for number of breast biopsies (1.71 vs. 1.27, P = 0.03) and age at first birth (0.97 vs. 1.24, P = 0.02) differed between the WHI and BCRAT. The AUC was higher for Hispanic women than NHW women (0.63 vs. 0.58, P = 0.03). Updating the BCRAT with contemporaneous breast cancer incidence rates improved calibration in the WHI. The modest discriminatory accuracy of the BCRAT for Hispanic women might improve by using risk factor relative risks specific to Hispanic women.
Hispanic; Breast cancer; Risk prediction; Risk assessment; BCRAT
Breast cancer is the most frequently diagnosed malignancy among Chilean women and an increasingly significant public health threat. This study assessed the accuracy of breast cancer risk perception among underserved, Chilean women.
Women aged 50 to 70 years, with no mammogram during the last two years, were randomly selected from a community clinic registry in Santiago, Chile (n=500). Perceived risk was measured using three methods: absolute risk, comparative risk and numerical risk. Risk comprehension was measured by comparing women’s perceived and objective risk estimates. Multivariate logistic regression was used to assess overestimation of perceived risk.
Women at high risk of breast cancer were more likely than average risk women to perceive themselves at high or higher risk, using absolute and comparative risk approaches (p<0.001). The majority of participants (67%) overestimated their breast cancer risk, based on risk comprehension; although, participants achieved higher accuracy with comparative risk (40%) and absolute risk (31.6%) methods. [Age, breast cancer knowledge and Breast Cancer Risk Assessment Tool (BCRAT) 5-year risk were significantly associated (p<0.01) with accuracy of perceived risk].
Chilean women residing in an underserved community may not accurately assess their breast cancer risk, though risk perception and level of accuracy differed between perceived risk measures. Comparative and absolute risk methods may better reflect women’s interpretation and accuracy of risk perception.
Improving our understanding of Chilean women’s perceptions of developing breast cancer may lead to the development of culturally relevant efforts to reduce the breast cancer burden in this population.
Hispanic; Latina; Breast Cancer; Risk perception; Risk comprehension
In the United States, 5-year breast cancer survival is highest among Asian American women, followed by non-Hispanic white, Hispanic, and African American women. Breast cancer treatment disparities may play a role. We examined racial/ethnic differences in adjuvant hormonal therapy use among women aged 18–64 years, diagnosed with hormone receptor-positive breast cancer, using data collected by the Northern California Breast Cancer Family Registry (NC-BCFR), and explored changes in use over time.
Odds ratios (OR) comparing self-reported ever-use by race/ethnicity (African American, Hispanic, non-Hispanic white vs. Asian American) were estimated using multivariable adjusted logistic regression. Analyses were stratified by recruitment phase (phase I, diagnosed January 1995–September 1998, phase II, diagnosed October 1998–April 2003) and genetic susceptibility, as cases with increased genetic susceptibility were oversampled.
Among 1385 women (731 phase I, 654 phase II), no significant racial/ethnic differences in use were observed among phase I or phase II cases. However, among phase I cases with no susceptibility indicators, African American and non-Hispanic white women were less likely than Asian American women to use hormonal therapy (OR 0.20, 95% confidence interval [CI]0.06–0.60; OR 0.40, CI 0.17–0.94, respectively). No racial/ethnic differences in use were observed among women with 1+ susceptibility indicators from either recruitment phase.
Racial/ethnic differences in adjuvant hormonal therapy use were limited to earlier diagnosis years (phase I) and were attenuated over time. Findings should be confirmed in other populations but indicate that in this population, treatment disparities between African American and Asian American women narrowed over time as adjuvant hormonal treatments became more commonly prescribed.
This study aimed to identify intrapersonal, behavioral, and environmental factors associated with engaging in recommended levels of physical activity among rural Latino middle school youth. Data were from an anonymous survey of 773 Latino youth (51% female) about level of and barriers and motivators to physical activity, risk behaviors, and park use. Logistic regression models identified factors correlated with meeting recommended levels of physical activity (5 days or more 360 min/day). Thirty-four percent of girls and 41% of boys reported meeting this physical activity recommendation. Participation in an organized after school activity (p < .001) and in physical education (PE) classes 5 days a week (p < .001) were strongly associated with meeting recommended physical activity level. Making PE available 5 days a week and creating opportunities for organized after school physical activity programs may increase the number of rural Latino middle school youth who meet recommended physical activity level.
To evaluate long-term change in fruit and vegetable intake following a group randomized trial of worksites.
Medium-sized blue-collar businesses in the Seattle metropolitan area were recruited. Intake was assessed using serial cross-sectional samples of current workforce at 3 time points. The multilevel 18-month intervention involved partnership with the companies. Long-term follow-up was at 4.4 years postbaseline. Statistical analysis used general linear models, adjusting for worksite random effects.
Initially, 45 worksites were randomized, with 29 agreeing to participate in a new study. Fruits and vegetable intake increased, with larger sustained changes in the intervention worksites, resulting in a long-term differential change of 0.25 servings per day, 95% confidence interval (0.09 to 0.40).
Intervention sustained small effects at 4 years, including 2 years with no contact. Although effects were not large, this low-intensity intervention approach could provide an important public health model.
Intervention evaluation studies; behavior change persistence; food; fruits and vegetables; long-term effects
Evidence suggests Latinas residing along the United States-Mexico border face higher breast cancer mortality rates compared to Latinas in the interior of either country. The purpose of this study was to investigate breast cancer knowledge, attitudes, and use of breast cancer preventive screening among U.S. Latina and Mexican women residing along the U.S.-Mexico border.
For this binational cross-sectional study, 265 participants completed an interviewer-administered questionnaire that obtained information on sociodemographic characteristics, knowledge, attitudes, family history, and screening practices. Differences between Mexican (n=128) and U.S. Latina (n=137) participants were assessed by Pearson's chi-square, Fischer's exact test, t tests, and multivariate regression analyses.
U.S. Latinas had significantly increased odds of having ever received a mammogram/breast ultrasound (adjusted odds ratio [OR]=2.95) and clinical breast examination (OR=2.67) compared to Mexican participants. A significantly greater proportion of Mexican women had high knowledge levels (54.8%) compared to U.S. Latinas (45.2%, p<0.05). Age, education, and insurance status were significantly associated with breast cancer screening use.
Despite having higher levels of breast cancer knowledge than U.S. Latinas, Mexican women along the U.S.-Mexico border are not receiving the recommended breast cancer screening procedures. Although U.S. border Latinas had higher breast cancer screening levels than their Mexican counterparts, these levels are lower than those seen among the general U.S. Latina population. Our findings underscore the lack of access to breast cancer prevention screening services and emphasize the need to ensure that existing breast cancer screening programs are effective in reaching women along the U.S.-Mexico border.
Residential proximity to pesticide-treated farmland is an important pesticide exposure pathway.
In-person interviews and biological samples were collected from 100 farmworker and 100 non-farmworker adults and children living in Eastern Washington State. We examined the relationship of residential proximity to farmland to urinary metabolite concentrations of dimethylphosphate (DMTP) and levels of pesticide residues in house dust.
DMTP concentrations were higher in farmworkers than non-farmworkers (71 μg/L vs 6 μg/L) and in farmworker children than non-farmworker children (17 μg/L vs 8 μg/L). Compared to non-farmworker households, farmworker households had higher levels of azinphos-methyl (643 ng/g vs 121 ng/g) and phosmet (153 ng/g vs 50 ng/g). Overall, a 20% reduction in DMTP concentration was observed per mile increase in distance from farmland.
Lower OP metabolite concentrations correlated with increasing distance from farmland.
PESTICIDES; DRIFT; RESIDENTIAL PROXIMITY TO FARMLAND
To examine the relationship between age, race, ethnicity, education, insurance coverage, and income and use of cancer screening services.
We used a population-based sample (N = 1863) from a community randomized intervention study that took place in eastern Washington State.
Pap testing was directly associated with having public health insurance, being 40 and older, and having a high income (>$35,000). Having Medicare coverage was predictive of having had a mammogram or sigmoidoscopy / colonoscopy screening, but not an FOBT.
Our findings may reflect age-dependent factors that influence access to health care.
cervical cancer; breast cancer; colorectal cancer; Hispanic; demographic factors
To explore the association of baseline co-worker social support with follow-up measures of health care use and sickness absence.
Data were obtained on 1,240 employees from 33 worksites, through Promoting Activity and Changes in Eating, a group randomized weight maintenance trial. Co-worker social support, health care utilization, and absenteeism were assessed via a self-reported questionnaire. Generalized Estimating Equations were employed using STATA version 10.
Higher baseline co-worker social support was significantly associated with a greater number of doctors’ visits (p = 0.015). Co-worker social support was unrelated to number of hospitalizations, emergency room visits, or absenteeism.
The relationship between co-worker social support and health care utilization and absenteeism is complex and uncertain. Future studies should measure more specific outcomes, incorporate important mediating variables, and distill how social networks influence these outcomes.
Social support may be associated with improved diet and physical activity—determinants of overweight and obesity. Wellness programs increasingly target worksites. The aim was to evaluate the relationship between worksite social support and dietary behaviors, physical activity, and body mass index (BMI).
Baseline data were obtained on 2,878 employees from 2005 to 2007 from 34 worksites through Promoting Activity and Changes in Eating, a group-randomized weight reduction intervention in Greater Seattle. Worksite social support, diet, physical activity, and BMI were assessed via self-reported questionnaire. Principal components analysis was applied to workgroup questions. To adjust for design effects, random effects models were employed.
No associations were found with worksite social support and BMI, or with many obesogenic behaviors. However, individuals with higher worksite social support had 14.3% higher (95% CI: 5.6%-23.7%) mean physical activity score and 4% higher (95% CI: 1%–7%) mean fruit and vegetable intake compared to individuals with one-unit lower support.
Our findings do not support a conclusive relationship between higher worksite social support and obesogenic behaviors, with the exception of physical activity and fruit and vegetable intake. Future studies are needed to confirm these relationships and evaluate how worksite social support impacts trial outcomes.
Mortality after breast cancer diagnosis is known to vary by race/ethnicity even after adjustment for differences in tumor characteristics. As adjuvant hormonal therapy decreases risk of recurrence and increases overall survival among women with hormone receptor-positive tumors, treatment disparities may play a role. We explored racial/ethnic differences in initiation of adjuvant hormonal therapy, defined as 2 or more prescriptions for tamoxifen or aromatase inhibitor filled within the first year after diagnosis of hormone receptor-positive localized or regional stage breast cancer. The sample included women diagnosed with breast cancer enrolled in Kaiser Permanente Northern California (KPNC).
Odds ratios [OR] and 95% confidence intervals [CI] compared initiation by race/ethnicity (Hispanic, African American, Chinese, Japanese, Filipino, and South Asian vs. non-Hispanic White (NHW)) using logistic regression. Covariates included age and year of diagnosis, area-level socioeconomic status, co-morbidities, tumor stage, histology, grade, breast cancer surgery, radiation and chemotherapy use.
Our sample included 13,753 women aged 20–79 years, diagnosed between 1996 and 2007, and 70% initiated adjuvant hormonal therapy. In multivariable analysis, Hispanic and Chinese women were less likely than NHW women to initiate adjuvant hormonal therapy ([OR]=0.82; [CI] 0.71–0.96 and [OR]=0.78; [CI] 0.63–0.98; respectively).
Within an equal access, insured population, lower levels of initiation of adjuvant hormonal therapy were found for Hispanic and Chinese women. Findings need to be confirmed in other populations and the reasons for under-initiation among these groups need to be explored.
breast cancer; adjuvant hormonal therapy; tamoxifen; aromatase inhibitors; racial/ethnic disparities
Less than half of youth engage in sufficient physical activity to achieve health benefits. Key environmental factors of park and recreation spaces may influence youth physical activity. We sought to ascertain youth characteristics and behaviors that attract youth to parks with specific amenities and encourage physical activity while at the parks in a rural, predominantly Latino community. We examined the quality of amenities in the 13 parks and recreation spaces that middle school aged youth have access to in their community using the Environmental Assessment of Parks and Recreation Spaces (EAPRS) tool. Middle school students completed surveys in the school classroom (n = 1,102) regarding park use, physical activity, and intrapersonal characteristics (e.g., motivators). We used logistic regression to identify correlates of any park use, use of higher quality field and court parks, and active and sedentary park use. Younger age, participation in an after school activity, and identification of a team as a motivator were positively associated with any park use. Use of higher quality court and field parks was associated with participation in an after school activity and being Latino. The odds of being active in the parks were greater for boys and Latinos. Older age and alcohol use are correlated with being sedentary at the park, while odds of being sedentary at the park were lower for boys and youth who met physical activity guidelines. Organized team activities may encourage active use of higher quality fields and courts parks by Latino youth; thereby, increasing their level of physical activity.
Physical activity; Parks; Youth; Rural; Latino
In the US, Hispanic women have a higher incidence of, and mortality from, cervical cancer than non-Hispanic white women. The reason for this disparity may be attributable to both low rates of screening and poor adherence to recommended diagnostic follow-up after an abnormal Pap test. The 'Cervical Cancer Screening and Adherence to Follow-up Among Hispanic Women' study is a collaboration between a research institution and community partners made up of members from community based organizations, the Yakima Valley Farm Workers Clinic and the Breast, Cervical, and Colon Health Program of the Yakima District . The study will assess the efficacy of two culturally-appropriate, tailored educational programs designed to increase cervical cancer screening among Hispanic women, based in the Yakima Valley, Washington, US.
A parallel randomized-controlled trial of 600 Hispanic women aged 21–64, who are non-compliant with Papanicolau (Pap) test screening guidelines. Participants will be randomized using block randomization to (1) a control arm (usual care); (2) a low-intensity information program, consisting of a Spanish-language video that educates women on the importance of cervical cancer screening; or (3) a high-intensity program consisting of the video plus a ‘promotora’ or lay-community health educator-led, home based intervention to encourage cervical cancer screening. Participants who attend cervical cancer screening, and receive a diagnosis of an abnormal Pap test will be assigned to a patient navigator who will provide support and information to promote adherence to follow-up tests, and any necessary surgery or treatment. Primary endpoint: Participants will be tracked via medical record review at community-based clinics, to identify women who have had a Pap test within 7 months of baseline assessment. Medical record reviewers will be blinded to randomization arm. Secondary endpoint: An evaluation of the patient navigator program as a method to improve adherence and reduce time to follow-up among participants who receive an abnormal Pap test result. An additional secondary endpoint is the cost-effectiveness of the two different intensity intervention programs.
This culturally sensitive intervention aims to increase compliance and adherence to cervical screening in a Hispanic population. If effective, such interventions may reduce incidence of cervical cancer.
Hispanic women; Pap test; Cervical cancer screening; Cancer disparities
Breast cancer has the highest incidence of all cancers among women in Chile. In 2005, a national health program progressively introduced free mammography screening for women aged 50 and older; however, three years later the rates of compliance with mammographic screening was only 12% in Santiago, the capital city of Chile. This implementation article combines the findings of two previous studies that applied qualitative and quantitative methods to improve mammography screening in an area of Santiago. Socio-cultural and accessibility factors were identified as barriers and facilitators during the qualitative phase of the study and then applied to the design of a quantitative randomized clinical trial. After six months of intervention, 6% of women in the standard care group, 51.8% in the low intensity intervention group, and 70.1% in the high intensity intervention group had undergone a screening mammogram. This review discusses how the utilization of mixed methods research can contribute to the improvement of the implementation of health policies in local communities.
Breast cancer screening; Chile; implementation; mixed models
To evaluate changes in the worksite environment in response to a multilevel intervention over a two year period.
Worksites were recruited in the greater Seattle area, and 34 were randomized to intervention or comparison condition. The intervention was based on the ecological model, with a framework of defined phases of intervention that included worksite wide events implemented in partnership with employee-based advisory boards. The assessment of the worksite environment used a modification of the CHEW. Subscales were developed using baseline data only. The intervention effect on different aspects of the worksite environment was estimated using logistic regression with robust estimating procedures.
Only changes in the physical activity and nutrition information environments were significantly associated with the intervention.
This paper provides one of the first attempts at using environmental assessment in the evaluation of worksite interventions.
Organophosphate pesticides (OPs) are commonly used in the United States, and farm workers are at risk for chronic exposure. Using data from a community randomized trial to interrupt the take-home pathway of pesticide exposure, we examined the association between floor surface type (smooth floor, thin carpet, and thick carpet) and rooms in which dust samples were collected (living room vs. non-living room) and concentrations of azinphos-methyl residues in home environments. We also examined the association between vehicle type (truck, auto, or other) and footwell floor surfaces (carpeted, smooth surface, or no mat) and concentrations of azinphos-methyl in vehicle dust samples. Dust samples were collected from 203 and 179 households and vehicles, respectively. All households had at least one child aged 2–6. Vehicle dust samples were collected from footwells of the vehicle used for commuting to and from work. A total of 183 samples were collected from living rooms, and 20 were collected from other rooms in the home. Forty-two samples were collected from thick carpets, 130 from thin carpets, and 27 from smooth floor surfaces. Thick and thin carpets had a significantly greater dust mass than smooth floor surfaces (6.0 g/m2 for thick carpets, 7.8 g/m2 for thin carpets, and 1.5 g/m2 for smooth surfaces). Of the 179 vehicle samples, 113 were from cars, 34 from trucks, and 32 from other vehicles. Vehicles with no mats had a significantly higher mass of dust (21.3 g) than those with hard mats (9.3 g) but did not differ from vehicles with plush mats (12.0g). Further research is needed to characterize the environment in which children may be exposed to pesticides.
farmworkers; floor surface; house dust; pesticides; take-home pathway; vehicle dust
Trained community health promoters (i.e., promotoras) conducted home-based group educational interventions (home health parties) to educate Hispanic women from the Lower Yakima Valley of Washington state about breast cancer and mammography screening.
Women aged 40–79 participating in the parties completed baseline and follow-up surveys 6 months postintervention (n = 70). Changes in general cancer knowledge, breast cancer screening practices, and intentions to be screened among participants from baseline to follow-up were measured using McNemar's test for marginal homogeneity to evaluate the effectiveness of the parties.
The average age of the sample was 50.0 years (standard deviation [SD] 10.0), 84% reported less than an eighth grade education, and 54% were covered by the state's Basic Health Care Plan. Significant changes between baseline and follow-up were observed with respect to (1) believing that risk of cancer could not be reduced (41% vs. 15%, respectively, p = 0.001), (2) ever having a mammogram (83% vs. 91%, p = 0.014), (3) discussing a mammogram with a doctor (37% vs. 67%, p < 0.001), and (4) intending to have a mammogram within the next few months among women who did not report having a mammogram between baseline and follow-up (61% vs. 81%, p = 0.046).
Participation in home-based group educational interventions delivered by promotoras may be associated with improved breast cancer screening practices among Hispanic women.
To describe the relationship between acculturation and human papillomavirus (HPV) infection among diverse US Latinas, a group at high risk for cervical cancer.
Using survey and medical testing data from the 2003–2004 National Health and Nutrition Examination Survey (NHANES), we examined the relationship between acculturation level and HPV infection among diverse Latinas (n=503) and Mexican American women (n=442). Multivariable logistic regression was performed using infection with any type of HPV and with high-risk oncogenic genotypes as outcome variables.
More acculturated Mexican American women were more likely to be infected with high-risk HPV than less acculturated women. In multivariate analyses, Mexican Americans with higher levels of self-rated English language ability (2.48 OR, 95% CI: 1.42–4.33); with birth in the US (2.07 OR, 95% CI: 1.03–4.16); and with US born parents (2.98 OR, 95% CI: 1.45–3.72) were more likely to be infected with high-risk HPV genotypes. Mexican American women with higher levels of acculturation were more likely to test positive for other sexually transmitted infections.
Higher acculturation levels related to more frequent infection with high-risk HPV genotypes and other STIs among US Mexican American women. This association may in part be due to engagement in sexual behaviors.
To evaluate the effectiveness of a community intervention in promoting adoption of behaviors to reduce the take-home pathway of pesticide exposure in farmworker households.
Using two cross-sectional samples of farmworker households in 11 intervention and 12 comparison communities in Washington State, we examined whether differences over time in reported pesticide safety practices varied by community intervention status.
Pesticide safety practices increased in both intervention and comparison communities over time. Changes were significantly greater in intervention communities for removing work shoes before entering the home (p=0.003) and marginally significantly greater for changing out of work clothes within one hour of arriving home (p=0.05).
The intervention was associated with modest effects in certain behaviors among farmworkers. Further research is needed to identify successful strategies for reducing the take-home pathway of pesticide exposure.
A key tenet of community-based participatory research is that communities be involved in all facets of research, from defining the problem to identifying solutions, to assisting in the research, and to participating in the publication of results. In this study, we instituted a small grants program for community participation. A Request for Applications (RFA) was developed and circulated widely throughout the Valley. The RFA sought proposals to address health disparities in cancer education, prevention, and treatment among Hispanics living in the Valley. Funds available were $2,500.00–3,500.00 for 1 year’s worth of work. To help evaluate the progress of the RFA community projects according to the perspectives of the Community Advisory Board (CAB), an open-ended, semi-structured interview was created and administered by a former staff member to CAB members. In 4 years, ten small grants proposed by community members were funded. Funds allocated totaled approximately $25,000. Interviews with CAB members indicated that the RFA program was perceived positively, but there were concerns about sustainability. Our community grants program resulted in the implementation of several novel cancer prevention programs conducted by a variety of community organizations in the Lower Yakima Valley.
Community based participatory research; Community grants; Cancer education; Community advisory board