Laura C. Wyatt

Applying Social Marketing Principles for Community-Based Cancer Screening Programs: Two Case Studies

Minoritized communities often experience worse health outcomes on the cancer continuum. Mainstream strategies may have limited reach and utility to populations experiencing inequities in real-world settings. Through the combined use of community-based participatory research (CBPR) and social marketing strategies, which highlight community-centered and culturally adapted processes, we provide an approach to inform future intervention research across various health topics that has been successful in engaging minoritized and understudied communities. We present two case studies that used participatory social marketing principles to culturally adapt evidence-based cancer screening programs for two communities in New York City. The first program is a campaign to increase screening and vaccination for hepatitis B among Korean and Chinese American immigrants. The second is a culturally adapted program to increase breast and cervical cancer screening among a multiracial and ethnic population of Muslim women. These case studies illustrate the benefits of integrating social marketing and CBPR approaches as a key strategy when developing public health campaigns to effectively reach and influence health behaviors in partnership with communities that have been socially marginalized and historically underserved.

A Culturally Adapted Breast and Cervical Cancer Screening Intervention Among Muslim Women in New York City: Results from the MARHABA Trial

We examine the efficacy of MARHABA, a social marketing-informed, lay health worker (LHW) intervention with patient navigation (PN), to increase breast and cervical cancer screening among Muslim women in New York City. Muslim women were eligible if they were overdue for a mammogram and/or a Pap test. All participants attended a 1-h educational seminar with distribution of small media health education materials, after which randomization occurred. Women in the Education + Media + PN arm received planned follow-ups from a LHW. Women in the Education + Media arm received no further contact. A total of 428 women were randomized into the intervention (214 into each arm). Between baseline and 4-month follow-up, mammogram screening increased from 16.0 to 49.0% in the Education + Media + PN arm (p < 0.001), and from 14.7 to 44.6% in the Education + Media arm (p < 0.001). Pap test screening increased from 16.9 to 42.3% in the Education + Media + PN arm (p < 0.001) and from 17.3 to 37.1% in the Education + Media arm (p < 0.001). Cancer screening knowledge increased in both groups. Between group differences were not statistically significant for screening and knowledge outcomes. A longer follow-up period may have resulted in a greater proportion of up-to-date screenings, given that many women had not yet received their scheduled screenings. Findings suggest that the educational session and small media materials were perhaps sufficient to increase breast and cervical cancer screening among Muslim American women. ClinicalTrials.gov NCT03081507.

Prevalence of breast, cervical, and colorectal cancer screenings among select New York City populations

Abstract Background Prior studies have found racial and ethnic disparities in cancer screenings, yet smaller minority ethnic groups are often aggregated. Methods Data from the 2021–2022 Community Health Resources and Needs Assessment (Cancer CHRNA) and the 2017–2020 NYC Community Health Survey (CHS) examined the prevalence of breast, cervical, and colorectal cancer screenings among Eastern European, Afro-Caribbean, Latine, Chinese, Korean, South Asian, and Southwest Asian and North African (SWANA) groups in New York City. Multivariable logistic regression models estimated adjusted relative risks of cancer screening outcomes by group. Results Up-to-date mammogram screening was low (&lt; 70%) among all groups except Afro-Caribbean in the Cancer CHRNA; and among South Asian, Chinese, and Eastern European groups in the CHS. In logistic regression, South Asian and SWANA groups were less likely to have received an up-to-date mammogram compared to the Afro-Caribbean group in the Cancer CHRNA; no group differences were found in the CHS. Up-to-date Pap screening was low (&lt; 70%) among all groups except Latina in the Cancer CHRNA; and among South Asian and Chinese groups in the CHS. In logistic regression, all other groups were less likely to have received an up-to-date Pap test compared to the Latina group in the Cancer CHRNA; and Chinese and South Asian groups were less likely to have received an up-to-date Pap test compared to the Latina group in the CHS. Up-to-date colonoscopy screening was low (&lt; 70%) among all groups in the Cancer CHRNA; and among SWANA, South Asian, Chinese, and Eastern European groups in the CHS. In logistic regression, all groups except Chinese were less likely to have received an up-to-date colonoscopy compared to the Eastern European group in the Cancer CHRNA; and the Chinese and SWANA groups were less likely to have received an up-to-date colonoscopy compared to the Afro-Caribbean group in the CHS. Conclusions Disparities in cancer screenings differed by screening type and survey, with larger disparities found among groups in the Cancer CHRNA. System level efforts are needed to monitor cancer screening disparities by disaggregating diverse groups; culturally tailored strategies should be used to raise awareness to increase screening. Clinical trial information Not applicable.

Muslim Americans Reaching for Health and Building Alliances (MARHABA): Patient Navigation Intervention to Increase Breast and Cervical Cancer Screening Among Muslim Women in New York City

Studies have reported Muslims in the US and NYC face numerous language and healthcare access barriers. This is a randomized randomized controlled design will be used to test the efficacy of a Patient Navigation (PN) intervention to increase participation in breast and/or cervical cancer screening among Muslim women age 40 - 75 years living in NYC. Study participants will be randomized to an Lay Health Workers (LHW) led small media intervention arm (SM-LHW) or a LHW-led patient navigation plus small media intervention arm (PN-LHW). A specific aim of the study is to develop, implement and evaluate the efficacy of a two-arm, randomized control trial designed to increase receipt of breast and/or cervical cancer screening among Muslim women aged 40 -75 years in New York City (NYC).