Otero, Jessica

Abstract INTRODUCTION In the past decade, Jacksonville, Florida has seen an increase in African immigrants. However, little is known about their health needs and perspectives related to community health and clinical trials. The Mayo Clinic Comprehensive Cancer Center (MCCCC) Community Outreach and Engagement (COE) Office and Programs partnered with multiple community-based organizations as part of the FL Community Engagement Alliance Against COVID-19 to hold a series of focus groups with African immigrants to better understand their perspectives surroudning these determinants. METHODS This was a qualitative study with African immigrants residing in Jacksonville, Florida. Data was collected by community partner, Jocelyn Turner Consulting, who has led multiple community-based studies in Florida. Recruitment was in partnership with African businesses and churches. Using a guide developed by MCCCC COE, three focus groups were held to explore African immigrants’ 1) general experiences, 2) access to social services, 3) perspective of community health and diseases, 4) access and use of healthcare services, 5) knowledge and participation in clinical trials, and 6) appropriate strategies for providing community education and enhancing participation in research studies. RESULTS 24 participants participated in the focus groups. 83% had recently immigrated from Africa (Democratic of the Congo, Benin, Ghana, Sudan, Mali, Nigeria, Ethiopia, and Nigeria). The remaining 17% recently immigrated from Haiti or came to the US as a baby. Participants reported suprise to the proliferation of chronic diseases, such as increased cancer diagnoses of those who immigrated to the United States. Most participants associated this with the Western sedentary lifestyle, dietary habits, and lack of access to fresh food. Participants connected to refugee organizations reported knowledge of the ability to access health education resources and mental/physical care services, but those not connected with similar organizations expressed limited knowledge about access. Similarly, participants with no connection to refugee organizations reported not knowing where to access healthcare services and not seeking services until home remedies had failed. Only 33% of participants reported knowledge of clinical trials and all reported mistrust of research. Many of the participants expressed a need for health-related information upon arrival in the United States. CONCLUSION There is currently little infrastructure in place to support African immigrants in Jacksonville, Florida, which can contribute to cancer health disparities in this population. Strong community engagement is needed to partner with African immigrant communities to address culturally specific needs identified of this underrepresented population. The needs expressed by participants include information on physical activity, nutrition, and healthcare/clinical trials. A strong partnership with African immigrant communities has the potential to address cancer disparities and increase both trust and participation in clinical trials. Citation Format: Jocelyn Turner, Laureen Husband, Jessica Otero, Opeyemi Bolajoko, Parisa Fathi, Jennifer Crook, Folakemi Odedina. Perspectives of African immigrants on community health needs and clinical trials [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A052.

Abstract BACKGROUND Black populations are disproportionately affected by prostate cancer globally. The leading countries in prostate cancer mortality are found in Africa and the Caribbean. This data is being presented as part of the Prostate Cancer Transatlantic Consortium (CaPTC) Prostate Cancer Familial Cohort Study of African Ancestry study with the purpose of identifying the various factors that influence prostate cancer risk factors. Access to care, a known cancer risk factor, not only affects a person’s ability to receive treatment but to receive accurate health information, preventative care, diagnoses, and more. Researching exactly how different social determinants, such as this one, affect cancer risk factors for specific populations is imperative to reducing their cancer burden. METHODS: This ten-year prospective study started in 2017 and has been conducted in Nigeria, Cameroon, and the United States. Participants have been recruited in clinics and different community settings. Upon consent, participants were asked to complete a validated survey with a unique identifier on epidemiological, behavioral, clinical, and anthropometric variables. They were then asked to provide a saliva sample that was also given a unique identifier. Associations of characteristics from the survey were evaluated using logistic regression models. Others were tested for statistical significance using a Chi-Squared test. RESULTS: A total of 803 responses are included in this dataset. Of these participants, 9.6% were from Cameroon, 82.6% from Nigeria, and 7.3% from the United States. More than half of the participants (54.9%) shared they did not have healthcare coverage. In addition, a chi-squared test showed 10.2% in the United States, 13.9% in Nigeria and 35.1% in Cameroon were unable to see a physician due to cost with a p-value of less than .001 indicating statistical significance. While participants in the United States did not report any cancer diagnoses, logistical regression found a significant inverse relationship between health literacy and increased risk of a cancer diagnosis. CONCLUSION Research shows a relationship between health access factors and cancer risk factors, but little research is done for specific populations. Further research should be done to measure the exact impact access to care has on cancer diagnoses for specific communities. It is very important that health equity researchers assess exactly how these factors affect the specific populations they work with to tailor evidence-based interventions to their needs. Citation Format: Jessica Otero, Emeka Iweala, Ademola Popoola, Paul Jibrin, Mohammed Faruk, Anthonia Sowumi, Omolara Fatiregun, Nkegoum Blaise, Catherine Oladoyinbo, Ifeoma Okoye, Abdulkadir Ayo Salako, Abidemi Omonisi, Iya Eze Bassey, Kayode Adenji, Nggada Haruna Asura, Ernest Kaninjing, Oluwole Kukoyi, Parisa Fathi, Ruth Enuka, Oluwaseyi Toye, Jennifer Crook, Folakemi Odedina. Influence of access to care on cancer diagnoses in the CaPTC Prostate Cancer Familial Cohort Study of African Ancestry in Nigeria, Cameroon, and the United States [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 B072.

Abstract INTRODUCTION The Prostate Cancer Transatlantic Consortium (CaPTC) has the goal of better understanding the burden of prostate cancer among Black men of West African descent. While prostate cancer disproportionately affects Blacks around the world, little research is done to understand what mental health and social support play a role in prostate cancer risk factors. The purpose of this 10-year longitudinal study is to establish a cohort of U.S.-born Black men, West African-born Black men who reside in the U.S, and West African Black men in Africa who would be prospectively and longitudinally followed to better understand the cause of prostate cancer and how different factors might influence it. METHODS Study staff partnered with community-based organizations, events, and stakeholders to engage with the priority population. Snowball sampling was also used for recruitment. All participants were made aware of the longitudinal nature of the study and that they would be contacted every two years for follow-up. Informed consent was done in community settings electronically and on paper. Once consent was received, participants completed the survey with a unique identifier and filled out a Cohort Contact sheet. They were given the option to complete this on their own or with the help of the study staff. Study Staff would then measure participants’ weight, height, and waistline, to be recorded on the survey form. After this, participant saliva was collected and tracked with the unique identifier. All collected data was stored on RedCap and a Chi-squared test was utilized to identify statistical significance. RESULTS 803 participants are included in this data with 77 in Cameroon, 663 in Nigeria, and 59 in the United States. When asked about emotional support, 13.6% (US) 11.8% (Nigeria), and 14.3% (Cameroon) indicated never or rarely having emotional support. 5.8% of those in the United States, 5.6% of those in Nigeria, and 7.8% of those in Cameroon felt dissatisfied or very dissatisfied with their lives. The p-value for both was found to be <0.001, therefore, suggesting statistical significance. On the other hand, participants described having an average of 6.53 (US), 9.4 (Nigeria), and 8.26% (Cameroon) days where their mental health was not good. However, this was statistically insignificant with a p-value of .95. CONCLUSION Mental health issues have been on the rise since the COVID-19 pandemic. While many people of color have stigmatized needing mental health help, it is important to find ways to overcome this barrier in assessing mental health and social support needs. Future research should continue to ask mental health and social support questions in order to assess their role in prostate cancer risk factors. Citation Format: Jessica Otero, Emeka Iweala, Ademola Popoola, Paul Jibrin, Mohammed Faruk, Anthonia Sowumi, Omolara Fatiregun, Nkegoum Blaise, Catherine Oladoyinbo, Ifeoma Okoye, Abdulkadir Ayo Salako, Abidemi Omonisi, Iya Eze Bassey, Kayode Adenji, Nggada Haruna Asura, Ernest Kaninjing, Oluwole Kukoyi, Parisa Fathi, Ruth Enuka, Oluwaseyi Toye, Jennifer Crook, Folakemi Odedina. Quality of life indicators including mental health factors in CaPTC prostate cancer familial cohort study of men of African Ancestry in Nigeria, Cameroon, and United States [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 B073.

Abstract INTRODUCTION The Cancer Research Education and Engagement (CaRE2) Health Equity Center seeks to eliminate cancer disparities within Black and Latinx communities through research, training, education, and community engagement. The goal of this presentation is to share the unique model of community engagement that was implemented by the CaRE2 Center's Community Outreach Core (COC) during the COVID-19 pandemic. METHODS During the COVID-19 pandemic, the COC hosted community outreach events to address prostate and pancreatic cancer disparities. We overcame the challenges of COVID-19 by hosting these programs over Zoom, Facebook, and Twitter and allowing participants to interact and ask questions. The use of these platforms allowed us to develop and implement the innovative “bed to bedside” model, which allowed participants to gain a well-rounded understanding of the cancer process from cancer survivors, physicians, and researchers of color. The goal of these events were to 1) increase awareness of the importance of prostate and pancreatic cancer screening, 2) educate patients and community members about potential prostate and pancreatic cancer treatments, 3) raise awareness on prostate and pancreatic cancer research, and 4) address the causes and solutions to prostate and pancreatic cancer disparities in the Black and Latinx community. RESULT A total of 4 events were conducted between September and November of 2021, reaching a total of 30 persons directly and about 30 more through social media. At each event, evidence-based prostate cancer and pancreatic cancer education was disseminated. Of the attendees, 48% identified as Black or African American and 14% as Latino(x). Attendees were given the option to provide feedback and 90% of attendees agreed or strongly agreed that the presentations met their expectations. One benefit of conducting outreach activities via these platforms was the ability for more individuals to attend and the elimination of transportation barriers. Participants reported that attending virtually was easy to navigate and provided a suitable environment given the ongoing pandemic. Participants also reported that they enjoyed the “bed to bedside” model and shared that hearing from a survivor of color led to them feeling more comfortable in considering cancer screening. CONCLUSION The Care2 COC, in partnership with the community, is addressing disparities in the Black and Latinx population. One of the barriers that we had to overcome was continuing community outreach during the COVID-19 pandemic. The decision to provide health education outreach over social platforms, was essential to maintain our reach and impact. This allowed for the implementation of the “bed to bedside” model that included the different perspectives of care. We concluded that this model was effective and helped normalize the treatment process. We also concluded that outreach to the community should continue to provide cancer information via virtual formats especially as the COVID-19 related incidence and mortality begins to increase. Citation Format: Jessica Otero, Fern Webb, Folakemi Odedina, Nissa Askins, Linda Behar-Horenstein, Lourdes Baez-Conde, Mariana Stern, Sandra Suther, Renee Reams. Multifaceted approaches to engaging Black and Latinx populations: From bed to bedside [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-059.