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Introduction Breast cancer survivorship is a life‐long process involving challenges to health‐care communities and individuals, especially Latinas. Patient Navigation has shown some success in meeting these challenges. The purpose of this study was to compare the effects of an enhanced Patient Navigation program (Intervention; PN+) vs Control (PN) over time on general cancer and breast cancer‐specific quality of life (QoL) in Latina breast cancer survivors (BCS). Methods We conducted a 2‐year, two‐arm randomized controlled trial of the “Staying Healthy” program among Latina BCS. The design compared PN+ vs PN over time. We recruited 60 patients into each study arm and randomized them by sequential numerical assignment. PN+ participants received culturally tailored educational materials and active, personalized Patient Navigation services, including phone calls, transportation, and care coordination. PN participants were navigated only upon request. Primary outcomes included general cancer (Functional Assessments of Cancer Therapy [FACTS]‐G) and breast cancer‐specific (FACT‐B) QoL. Results PN+ participants had significantly improved QoL measures compared to PN at 6‐month follow‐up on all subscales (P‐values .007‐.04) except physical well‐being (PWB; P = .11). Intervention effect size coefficient (standard error) for FACT‐G overall was 7.9 (3.1); P = .01. For FACT‐B, it was 10.9 (3.9); P = .006. Again, all subscales showed significant effects [range 1.7‐3.1 (0.8‐1.2); P‐values .006‐.04], except for PWB [1.5 (1.0); P = .16] and social/family well‐being (SWB) [2.1 (1.1); P = .06]. There were no differences between groups at baseline. Discussion Multiple cultural, psychosocial, and socioeconomic variables contributing to these intervention effects will be addressed in future studies. As the national BCS population continues to increase, more Patient Navigation‐focused partnerships among patients, health‐care professionals, research groups, and community organizations are needed to improve BCS experiences. The Staying Healthy program has the potential to serve as a national survivorship care model for improving Latina BCS QoL., We evaluated the effect of a two‐year, two‐arm randomized controlled trial (the “Staying Healthy” program) on quality of life (QoL) among Latina breast cancer survivors (BCS). The design compared enhanced Patient Navigation (Intervention; PN+) versus usual (Control; PN) over time. PN+ participants had significantly improved quality of life measures compared to PN at 6‐month follow‐up.

BACKGROUND The objective of the current study was to examine how modifiable factors such as satisfaction with cancer care and self-efficacy impact health-related quality of life (HRQOL) among Latino cancer survivors. METHODS Latinos previously diagnosed with breast, prostate, or colorectal cancer (N = 288) completed questionnaires (Patient Satisfaction with Cancer Care Scale, Stanford Chronic Disease Self-Management Measures, Functional Assessment of Cancer Therapy-General, and Short Acculturation Scale for Hispanics) within 2 years after receiving primary cancer treatment. RESULTS Path model analyses demonstrated that satisfaction with cancer care was associated with greater HRQOL and that this relationship was explained by several facets of self-efficacy (ie, confidence in managing psychological distress [z = 3.81; P

BACKGROUND: The interaction of clinical and patient-level challenges following a breast cancer diagnosis can be a significant source of health care disparities. Failure to address specific cultural features that create or exacerbate barriers can lead to less-than optimal navigation results, specifically in Hispanic/Latino women. METHODS: To address these disparities, the study leaders in San Antonio, Texas, and 5 other regional partners of the federally-funded Redes En Accion: The National Latino Cancer Research Network developed a culturally-tailored patient navigation intervention model for Latinas with breast cancer. RESULTS: Compared with control patients, a higher percentage of navigated subjects initiated treatment within 30 days (69.0% versus 46.3%, P = .029) and 60 days (97.6% versus 73.1%, P = .001) following their cancer diagnosis. Time from cancer diagnosis to first treatment was lower in the navigated group (mean, 22.22 days; median, 23.00 days) than controls (mean, 48.30 days; median, 33.00 days). These results were independent of cancer stage at diagnosis and numerous characteristics of cancer clinics and individual participants. CONCLUSIONS: Successful application of patient navigation increased the percentage of Latinas initiating breast cancer treatment within 30 and 60 days of diagnosis. This was achieved through navigator provision of services such as accompaniment to appointments, transportation arrangements, patient telephone support, patient-family telephone support, Spanish-English language translation, and assistance with insurance paperwork.

BACKGROUND. Breast cancer is the leading cause of cancer-related deaths in Latinas, chiefly because of later diagnosis. The time from screening to diagnosis is critical to optimizing cancer care, yet the efficacy of navigation in reducing it is insufficiently documented. Here, the authors evaluate a culturally sensitive patient navigation program to reduce the time to diagnosis and increase the proportions of women diagnosed within 30 days and 60 days. METHODS. The authors analyzed 425 Latinas who had Breast Imaging Reporting and Data System (BI-RADS) radiologic abnormalities categorized as BI-RADS-3, BI-RADS-4, or BI-RADS-5 from July 2008 to January 2011. There were 217 women in the navigated group and 208 women in the control group. Women were navigated by locally trained navigators or were not navigated (data for this group were abstracted from charts). The Kaplan-Meier method, Cox proportional hazards regression, and logistic regression were used to determine differences between groups. RESULTS. The time to diagnosis was shorter in the navigated group (mean, 32.5 days vs 44.6 days in the control group; hazard ratio, 1.32; P = .007). Stratified analysis revealed that navigation significantly shortened the time to diagnosis among women who had BI-RADS-3 radiologic abnormalities (mean, 21.3 days vs 63.0 days; hazard ratio, 2.42; P < .001) but not among those who had BI-RADS-4 or BI-RADS-5 radiologic abnormalities (mean, 37.6 days vs 36.9 days; hazard ratio, 0.98; P = .989). Timely diagnosis occurred more frequently among navigated Latinas (within 30 days: 67.3% vs 57.7%; P = .045; within 60 days: 86.2% vs 78.4%; P = .023). This was driven by the BI-RADS-3 strata (within 30 days: 83.6% vs 50%; P < .001; within 60 days: 94.5% vs 67.2%; P < .001). A lack of missed appointments was associated with timely diagnosis. CONCLUSIONS. Patient-centered navigation to assist Latina women with abnormal screening mammograms appeared to reduced the time to diagnosis and increase rates of timely diagnosis overall. However, in stratified analyses, only navigated Latinas with an initial BI-RADS-3 screen benefited, probably because of a reduction in missed diagnostic appointments. Cancer 2013. © 2012 American Cancer Society.

Objective—The study evaluated the association of religiosity/spirituality (R/S) and health-related quality of life (HRQOL) among Latina breast cancer survivors (BCS) in order to determine whether R/S would be positively correlated with HRQOL and whether R/S would significantly influence HRQOL. Methods—The cross-sectional study utilized self-report data from 117 Latina BCS survivors. R/ S was measured with the Systems of Belief Inventory - 15 Revised (SBI-15R) and HRQOL was measured with the Functional Assessment of Cancer Therapy – General (FACT-G). Analyses included calculation of descriptive statistics, t-tests, bivariate correlations, and multivariate analyses. Results—Latina BCS had very high levels of R/S and generally good HRQOL. The SBI-15R total score was positively correlated with FACT-G social well-being (r=0.266, p=0.005), relationship with doctor (r=0.219, p=0.020), and functional well-being (r=0.216, p=0.022). Multivariate analyses revealed that SBI-15R was a significant predictor of FACT-G functional well-being (p=0.041) and satisfaction with the relationship with the doctor (p=0.050), where higher levels of R/S predicted higher levels of well-being. Conclusions—Latina BCS had very high levels of R/S, which were significantly, positively correlated with dimensions of HRQOL (social well-being, functional well-being, relationship with doctor). Further, these high levels of R/S predicted better functional well-being and satisfaction with the patient-doctor relationship while controlling for potentially confounding variables. Implications are discussed.

BACKGROUND There are analogies between the development of therapeutic drugs for cancer and the development of interventions for reducing cancer health disparities. In both cases, it can take between 12 and 15 years for the benefits to become apparent. METHODS The initial preclinical phase of drug development is analogous to the development of community partnerships and helping the community learn about cancer. The preclinical phase of in vitro and in vivo testing is analogous to identifying the disparities in the community. Then clinical testing begins with phase 1, toxicity, and dose-establishing studies. Analogously, community-based participatory research is used to develop disparities–reducing interventions (DRIs) within the community. RESULTS The phase 2 clinical studies to determine whether the drug has activity are analogous to the DRI being implemented in the community to determine whether it can cause behavioral changes that will reduce cancer health disparities. If a drug passes phase 1 and 2 studies, phase 3 clinical trials are initiated. These are controlled studies to examine the efficacy of the drug. The similar activity for disparities research is to determine whether the DRI is better than the current standard/usual practice in controlled trials. If the drug is beneficial, the final phase is the dissemination and adoption of the drug. Analogously in disparities, if the DRI is beneficial, it is disseminated and is culturally adapted to other racial/ethnic groups and finally adopted as standard practice. CONCLUSIONS The process of creating an effective DRI can be envisioned to have 4 stages, which can be used to aid in measuring the progress being made in reducing cancer health disparities. Cancer 2008. Published 2008 by the American Cancer Society.

Aim This study investigated the reliability and validity of the Brief Sensation Seeking Scale (BSSS-8) in both English and Spanish with Latinos, the fastest-growing minority group in the United States, and the correlation between sensation seeking and tobacco and alcohol use. Design Cross-sectional survey, computer-assisted telephone interviews (CATI). Setting Dallas and Houston, Texas. Participants A total of 789 Latinos participated in this study. Participants were currently in the work-force, not enrolled in college, and between the ages of 18 and 30 years. Measurements Participants completed a self-report questionnaire (in either English or Spanish) consisting of items measuring tobacco and alcohol use as well as the eight-item Brief Sensation Seeking Scale. Findings and conclusions For English-speaking Latino participants, the BSSS factor structure was second-order unidimensional and correlated positively with life-time cigarette use, intention to smoke in the future and amount and frequency of alcohol consumption. For Spanish-speaking Latino participants, a four-subfactor solution for the BSSS provided the best fit to the data although correlations between the four subscales and cigarette use were small.

BACKGROUND The American Cancer Society, Centers for Disease Control and Prevention, National Cancer Institute, and North American Association of Central Cancer Registries collaborate annually to provide U.S. cancer information, this year featuring the first comprehensive compilation of cancer information for U.S. Latinos. METHODS Cancer incidence was obtained from 90% of the Hispanic/Latino and 82% of the U.S. populations. Cancer deaths were obtained for the entire U.S. population. Cancer screening, risk factor, incidence, and mortality data were compiled for Latino and non-Latino adults and children (incidence only). Long-term (1975–2003) and fixed-interval (1995–2003) trends and comparative analyses by disease stage, urbanicity, and area poverty were evaluated. RESULTS The long-term trend in overall cancer death rates, declining since the early 1990s, continued through 2003 for all races and both sexes combined. However, female lung cancer incidence rates increased from 1975 to 2003, decelerating since 1991 and breast cancer incidence rates stabilized from 2001 to 2003. Latinos had lower incidence rates in 1999–2003 for most cancers, but higher rates for stomach, liver, cervix, and myeloma (females) than did non-Latino white populations. Latino children have higher incidence of leukemia, retinoblastoma, osteosarcoma, and germ-cell tumors than do non-Latino white children. For several common cancers, Latinos were less likely than non-Latinos to be diagnosed at localized stages. CONCLUSIONS The lower cancer rates observed in Latino immigrants could be sustained by maintenance of healthy behaviors. Some infection-related cancers in Latinos could be controlled by evidence-based interventions. Affordable, culturally sensitive, linguistically appropriate, and timely access to cancer information, prevention, screening, and treatment are important in Latino outreach and community networks. Cancer 2006. Published 2006 by the American Cancer Society.

The National Hispanic Leadership Initiative: En Accion is a multisite program of research and action for prevention and control among diverse U.S. Hispanic populations. The work includes surveys that display wide differences in screening and smoking rates in different regions and cultures. Education and advocacy is carried out within six communities through mass media and community organization. Our common approach to research and action has proven itself to be adaptable among diverse Hispanic populations.

Among minorities and the medically underserved, the relationship between life style factors involving diet, nutrition, and fitness and the risks for cancer is complex, significant, and controversial. The issue must be viewed in the context of various influences, including socioeconomic disparities and cultural relevance, with consideration given to relevant factors, such as inherent difficulties of data collection and interpretation. The authors examined wide-ranging aspects of this issue, as presented by leading scientists and authorities at a symposium exploring the role of diet, nutrition, and fitness in cancer. Culture and socioeconomic status strongly influence both individual and societal attitudes and behaviors regarding food, fitness, and weight status. These factors are significant not only as they relate to cancer development but as considerations in developing programs to modify risk behaviors. There is a substantial need for more cancer research focusing on both the preventive and therapeutic impact of diet and fitness, with specific attention given to the role of these life style factors in cancer among culturally diverse groups. In addition, a population-based, culturally sensitive approach to behavior modification programs provides the only practical strategy for achieving risk reduction among minority groups.