Abbenyi, Adeline

Abstract Background: Digital access, health literacy, and confidence in obtaining cancer information are well-known factors that influence cancer beliefs and behaviors. However, less is understood about whether these information-related factors vary across regions within a cancer center's catchment area and how they collectively relate to cancer beliefs in large community samples. This study investigated regional differences in digital access, health literacy, and confidence in seeking information, and examined the connections between these factors and cancer risk perceptions, fatalistic beliefs, prevention confusion, and willingness to participate in cancer clinical trials. Methods: Data (N=2,334) from the 2023 Mayo Clinic Comprehensive Cancer Center’s Cancer-Focused Needs Assessment, conducted across catchment areas in Arizona, Florida, and the Midwest (Minnesota, Wisconsin, Iowa). Regional differences in digital access (Internet use and device ownership), health literacy, and confidence in obtaining cancer information were analyzed using multivariable ANCOVAs and logistic regressions, adjusting for sociodemographic covariates. Follow-up models examined whether these information precursors are associated with perceived cancer risk, fatalistic beliefs, confusion about recommendations, and willingness to participate in cancer clinical trials, adjusting for the same covariates. Results: Regions showed minimal differences in digital access and health literacy. Health literacy was instead associated with ethnicity, age, gender, and education (all p<.001). Confidence in obtaining cancer information followed similar trends, with significant influences of ethnicity and gender (p<.01). Internet use was strongly associated with sociodemographic factors (all p<.01). Additionally, the information precursors consistently correlated with cancer beliefs across the full sample: Higher health literacy and greater confidence in obtaining cancer information were associated with increased perceived cancer risk, reduced cancer fatalism, and less confusion regarding prevention guidelines (ps < .001). Internet use and device access were significantly related to a greater willingness to participate in clinical trials (ps < .01). These relationships persisted even after controlling for sociodemographic covariates. Conclusions: Regional differences in digital access and health literacy were minimal, indicating a consistent information environment. Within this context, individual sociodemographic and information-related factors played a larger role, strongly shaping cancer beliefs. These findings underscore technology access and information empowerment as key targets for enhancing cancer prevention knowledge and research engagement, and indicate that the effects of information empowerment are primarily driven at the individual rather than the geographic level. Citation Format: Tingyu Zou, Monica L. Albertie, Emelina Asto-Flores, Manisha Salinas, Farhia Omar, Adeline Abbenyi, Noreen Stephenson, Nuwanthi Heendeniya, James R. Cerhan, Kathleen J. Yost, Folakemi T. Odedina. Digital access, health literacy, and cancer beliefs: Findings from a multi-region community survey [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 7553.

The COVID-19 pandemic caused unprecedented disruption of social networks and negatively impacted social determinants of health (SDoH, e.g., economic stability, mental health, health care access) among African Americans. The FAITH! (Fostering African-American Improvement in Total Health!) Program, an academic-community partnership with African American churches, pivoted to pandemic-related impacts on health behaviors of African Americans. This exploratory, cross-sectional study examined associations between multilevel factors influencing difficulty maintaining a healthy lifestyle during the early pandemic phase, including mental/emotional health and COVID-19 hardships (e.g., job/food/housing insecurity, paying utilities). An online survey was distributed via FAITH!-affiliated churches and social media. Logistic regression (odds ratios [ORs], adjusted for age/gender) and associated 95% confidence intervals [CIs]) examined associations between difficulty maintaining a healthy lifestyle and multilevel factors. Greater than half of respondents reported difficulty maintaining a healthy lifestyle (N = 169, 54% [91/169]). Adjusted odds of having difficulty maintaining a healthy lifestyle were greater for those reporting mental/emotional health issues (high-stress OR 4.0; 95% CI [1.9,8.9], p < .001); occasional symptoms of depression (OR 3.7; 95% CI [01.9,7.7]; p < .001); anger (OR 2.5; 95% CI [1.2,5.4]; p = .044), and anxiety (OR 2.8; 95% CI [1.4,6.0]; p = .008)). COVID-19 hardships of job insecurity (OR 1.4.; 95% CI [0.7, 2,8]; p = .015), difficulty paying rent (OR 4.4; 95% CI [2.1,9.9]; p < .001) or difficulty paying for food/utilities (OR 5.4; 95% CI [2.6,11.7]; p < .001) were associated with difficulty maintaining a healthy lifestyle. Our study revealed the negative impact of mental/emotional health and COVID-19 hardships on maintaining a healthy lifestyle among African Americans. This could inform SDoH-focused lifestyle interventions during future public health crises.

Abstract Introduction. Understanding the unique social and environmental contexts of communities is essential for designing effective, locally tailored cancer intervention strategies. This study aimed to identify key findings from a comprehensive, multifaceted, cancer-focused needs assessment conducted across three U.S. regions, offering insights into the social, behavioral, and structural barriers that hinder cancer prevention and control, and informing regionally tailored interventions. Methods. This study focused on adult residents within the Mayo Clinic Comprehensive Cancer Center catchment areas, covering 75 counties across Arizona, Florida, and the Midwest (Minnesota, Wisconsin, and Iowa). Data was collected through collaborations with the University of Florida and Mayo Clinic Survey Research Centers, and the “Boots on the Ground" approach involving community health workers. Methods included phone calls, online submissions, and community outreach for an anonymous survey. Validated measures assessed healthcare access, lifestyle, social networks, neighborhood conditions, and discrimination. Descriptive analyses were conducted using valid responses. Non-responses and selections of “Prefer not to answer” were excluded from percentage calculations to ensure interpretive accuracy. Results. Involving 2,681 respondents, the data reveal consistent yet regionally nuanced barriers to cancer prevention. Health insurance coverage was relatively high across all regions—77.6% in Arizona, 85.5% in Florida, and 89.2% in the Midwest. Despite this, access to care remained limited. In Arizona, 22% of respondents could not afford to see a regular doctor, and 41.3% reported delays due to work or transportation. In Florida, 26.6% reported financial barriers to primary care, and nearly half (49.7%) experienced delays in receiving care. The Midwest showed fewer neighborhood safety concerns but still faced high rates of care delays (46.7%) and housing-related issues (42.6%). Neighborhood-level challenges were common. Housing-related problems were reported by 42.9% of respondents in Arizona, 54% in Florida, and 42.6% in the Midwest. Concerns about drug use were highest in Arizona (40%) but present across all regions. Health behavior risks were also widespread: 72–79% of respondents reported sleep difficulties, and many reported low physical activity, suboptimal sun protection, and routine alcohol use. Psychosocial stressors were prominent, with 51–65% of respondents reporting experiences of disrespect and 42–66% feeling unheard by healthcare providers. Conclusions. Despite relatively high rates of insurance coverage, communities across all regions face persistent challenges in accessing timely, affordable, and respectful healthcare. Coupled with neighborhood instability, adverse health behaviors, and psychosocial stressors, these barriers highlight the urgent need for regionally tailored strategies that strengthen both cancer prevention and care. Addressing these interconnected challenges at the community level is essential for promoting more equitable cancer outcomes. Citation Format: Tingyu Zou, Monica L. Albertie, Emelina Asto-Flores, Manisha Salinas, Farhia Omar, Adeline Abbenyi, Noreen Stephenson-Hubert, Nuwanthi Heendeniya, Kathleen Yost, Folakemi T. Odedina. Place, people, and prevention: Contextual drivers of cancer health equity in three US Regions [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B031.

Abstract Introduction: Understanding how communities access and engage with health information is essential for effective health communication. Health literacy—the ability to read, understand, and use healthcare information—plays a crucial role in making informed health decisions. With the rise of digital technologies, internet access and online engagement have become key tools for obtaining health information. However, variations in health literacy and digital engagement can limit some populations' ability to fully access these resources. This study examined health literacy, cancer information-seeking behaviors, internet access, and digital engagement among adults in the Mayo Clinic Comprehensive Cancer Center catchment areas to inform more effective and region-specific health communication strategies. Methods: This study focused on adult residents within the Mayo Clinic Comprehensive Cancer Center catchment areas, covering 75 counties across Arizona, Florida, and the Midwest (Minnesota, Wisconsin, and Iowa). Data were collected through partnerships with the University of Florida and Mayo Clinic Survey Research Centers, and the "Boots on the Ground" approach involving community health workers. Methods included phone calls, online submissions, and community outreach for an anonymous survey. Validated measures assessed health literacy, information access, and digital engagement. Descriptive analyses were performed using valid responses, excluding non-responses and "Prefer not to answer" options to ensure interpretive accuracy. Results: Data from 2,681 respondents highlighted consistent barriers to cancer prevention with regional differences. In Arizona, 42.6% of respondents need help reading medical materials, but only 3.1% reported lacking confidence in obtaining cancer-related information. In contrast, 63.1% felt very or completely confident in accessing cancer advice. The primary sources of health information were doctors (17.6%), internet searches (11.4%), and family (9.8%). In Florida, 38.4% need assistance, but only 2.7% lack confidence, and 68.2% feel very or completely confident. Doctors (18%) and internet searches (13.1%) were top sources. In the Midwest, 38.5% struggle with medical documents, and 3.1% reported lacking confidence, while 66.4% felt very or completely confident. Internet access is widespread across all regions, with smartphones being the dominant device. Daily internet use for communication, browsing, and engagement with health apps and social networks remains high. Conclusion: Although many respondents face challenges with reading health-related materials, most report high confidence in obtaining cancer information, suggesting a gap between functional health literacy and perceived ability to access information. The widespread use of mobile devices and near-universal internet access offers a valuable opportunity to enhance health communication through digital tools. These findings emphasize the importance of tailored digital outreach to bridge literacy gaps and ensure underserved populations can access reliable health information. Citation Format: Tingyu Zou, Monica L. Albertie, Emelina Asto-Flores, Manisha Salinas, Farhia Omar, Adeline Abbenyi, Noreen Stephenson-Hubert, Nuwanthi Heendeniya, Kathleen Yost, Folakemi T. Odedina. Health literacy and digital engagement across US Regions: Insights from the mayo clinic catchment areas [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B030.

Abstract Purpose: The Mayo Clinic Comprehensive Cancer Center (MCCCC) serves its communities through every pillar of the cancer continuum from prevention to survivorship. To effectively educate our communities along this continuum, MCCCC partnered with a trusted community partner, leveraged the stories of survivors, and addressed stigma in a safe space for community members to ask vulnerable questions. Methods: The MCCCC partnered with Pamoja Women on the Friend-to-Friend initiative. Pamoja Women is a trusted community partner supporting East African women and their families, some of whom are refugees. They provided the space to hold each event, an environment where the women were comfortable with support from their community. The program highlighted cancer education, screening, and risk reduction through culturally appropriate discussions between friends. Topics were identified based on community interest and the cancer incidence in the community. Survivors shared their personal stories and medical experts discussed prevention, risk reduction, screening, addressed myths, answered questions, and showcased discoveries in research and treatment methods. Results: We have held 3 events covering breast, cervical, and HPV vaccination. Each event saw an increase in participation with almost 50 participants attending the series. Furthermore, there was an increase in awareness of screening methods, prevention, and risk reduction. Pamoja Women provided navigation to screening through transportation to and advocacy during appointments. This continuity from education to screening led to heading the call to action for screening. Due to its success, the four-part series has been expanded to include the topics of endometrial, prostate cancer, and breast cancer for a second time. Conclusion: Partnering with trusted community organizations has led to safe spaces for cancer education with friends. This approach has led to successful education and navigation to screening in communities that do not always have access to this essential information. Citation Format: Adeline Abbenyi, Manal Abbadi, Khadija Ali, Fatuma Ahmed. Friend-to-friend: Culturally tailored health education for East African communities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B103.

Background: COVID-19 vaccine hesitancy in the United States is high, with at least 63 million unvaccinated individuals to date. Socioeconomically disadvantaged populations experience lower COVID-19 vaccination rates despite facing a disproportionate COVID-19 burden. Objective: To assess the factors associated with COVID-19 vaccine acceptance among under-resourced, adult patients. Methods: Participants were patients receiving care at a Federally Qualified Health Center (FQHC) in St. Paul, Minnesota. Data were collected via multiple modes over 2 phases in 2020 (self-administered electronic survey) and 2021 (study team-administered survey by telephone, self-administered written survey) to promote diversity and inclusion for study participation. The primary outcome was COVID-19 vaccine acceptance. Using logistic regression analysis, associations between vaccine acceptance and factors including risk perception, concerns about the COVID-19 vaccine, social determinants of health (SDOH), co-morbidities, pandemic-induced hardships, and stress were assessed by adjusted odds ratios (AORs) and 95% confidence intervals (CI). Results: One hundred sixty-eight patients (62.5% female; mean age [SD]: 49.9 [17.4] years; 32% <$20 000 annual household income; 69% <college education) were included in the study. Sixty-one percent of the patients received or were willing to receive the vaccine. Risk perception was positively associated with vaccine acceptance (AOR: 5.3; 95% CI: 2.5, 11.5, P < .001), while concerns about the vaccine (eg, safety, side effects, rapid development of the vaccine, etc.) were negatively associated with vaccine acceptance (all P < .001). SDOH, co-morbidities, pandemic-induced hardships were not associated with vaccine acceptance. Conclusions: Our study in a socioeconomically disadvantaged population suggests that risk perception is associated with an increased likelihood of vaccine acceptance, while concerns about the COVID-19 vaccine are associated with a lower likelihood of vaccine acceptance. As these factors could impact vaccine uptake, consistent, innovative, and context-specific risk communication strategies may improve vaccine coverage in this population.

Objectives: This study was conducted to assess an intervention that was created by a community–academic partnership to address COVID-19 health inequities. We evaluated a community-engaged bidirectional pandemic crisis and emergency risk communication (CERC) framework with immigrant and refugee populations during the COVID-19 pandemic. Methods: A 17-year community-engaged research partnership adopted a CERC framework in March 2020 to address COVID-19 prevention, testing, and socioeconomic impacts with immigrant and refugee groups in southeast Minnesota. The partnership used bidirectional communication between communication leaders and their social networks to refine messages, leverage resources, and advise policy makers. We conducted a mixed-methods evaluation for intervention acceptability, feasibility, reach, adaptation, and sustainability through multisource data, including email communications, work group notes, semistructured interviews, and focus groups. Results: The intervention reached at least 39 000 people in 9 months. It was implemented as intended and perceived efficacy was high. Frequent communication between community and academic partners allowed the team to respond rapidly to concerns and facilitated connection of community members to resources. Framework implementation also led to systems and policy changes to meet the needs of immigrant and refugee populations. Conclusions: Community-engaged CERC is feasible and sustainable and can reduce COVID-19 disparities through shared creation and dissemination of public health messages, enhanced connection to existing resources, and incorporation of community perspectives in regional pandemic mitigation policies.

The COVID-19 pandemic has disproportionately affected underserved and minority populations in the United States. This is partially attributable to limited access to diagnostic testing from deeply rooted structural inequities precipitating higher infection and mortality rates. We describe the process of establishing a drive-through collection site by leveraging an academic–community partnership between a medical institution and a federally qualified health center in Minnesota. Over 10 weeks, 2006 COVID-19 tests were provided to a socioeconomically disadvantaged population of racial/ethnic minorities and low-income essential workers.

Purpose: To evaluate a healthy eating and physical activity intervention for immigrant families, derived through community-based participatory research. Design: The Healthy Immigrant Families study was a randomized controlled trial with delayed intervention control group, with families as the randomization unit. Setting: US Midwest city. Participants: Participants were recruited by community partners from Hispanic, Somali, and Sudanese immigrant communities. Intervention: Family health promoters from participating communities delivered 6 healthy eating modules, 4 physical activity modules, and 2 modules synthesizing information in 12 home visits (60-90 minutes) within the first 6 months. Up to 12 follow-up phone calls to each participant occurred within the second 6 months. Measures: Primary measures were dietary quality measured with weekday 24-hour recall and reported as Healthy Eating Index score (0-100) and physical activity measured with accelerometers (14 wear days) at baseline, 6, 12, and 24 months. Results: In total, 151 persons (81 adolescents and 70 adults; 44 families) were randomly assigned. At 12 months, significant improvement occurred in Healthy Eating Index scores for adults in the intervention group compared with controls (change, +8.6 vs −4.4; P < .01) and persisted at 24 months (+7.4 from baseline; P < .01). No differences were observed for adolescents and no significant differences occurred between groups for physical activity. Conclusion: This intervention produced sustained dietary quality improvement among adults but not among adolescents. Program outcomes are relevant to communities working to decrease cardiovascular risk among immigrant populations.