Winkleby Lab In the Prevention Research Center

IMPACTO II:  The Monterey County Hispanic Behavioral Risk Factor Survey Study

            In the last decade, California has experienced the largest wave of immigration in its history, with this new immigration being predominantly from Latin America. Currently 25 percent of the State’s population was born outside of the U.S. and soon Hispanics will comprise the major ethnic group in California. This proposal brings a community coalition together with the Monterey County Health Department and survey research scientists at Stanford University and the Public Health Institute’s CATI Unit to study cancer-related issues in Hispanic women and men, many of whom are medically underserved and socioeconomically disadvantaged.

            The specific aims of the research are to: (1) complete an epidemiologic cross-sectional survey (the Monterey County Hispanic Behavioral Risk Factor Survey) with approximately 1,000 Hispanic women and men in Monterey County to learn more about cancer-related risk factors and screening practices, and how these factors vary across population subgroups; and (2) disseminate the findings of the survey to the Hispanic population in Monterey County and use a community development model to offer tailored programs to Hispanic women and men. These programs will encourage the adoption of healthy lifestyle behaviors and promote early detection and screening of prevalent cancers.

            The survey will include a random-digit dial, telephone survey of over 800 Hispanic women and men, 18-65 years of age, in Monterey County. So that the lowest income residents are represented, the survey will also include approximately 100 residents without telephones and 100 residents of agricultural labor camps. The survey will use a similar design and methodology as a survey that was completed 10 years ago with 1,000 Hispanic women and men in Monterey County (IMPACTO I). The new survey (IMPACTO II) will repeat questions from the first survey and focus on four cancer-related risk factors: high dietary fat intake, physical inactivity, excess body weight, and high alcohol intake. The survey will also assess health care access and screening practices related to the diagnosis and treatment of prevalent cancers (cervical, colorectal and breast). In addition, the survey will incorporate new questions (e.g., workplace physical activity, alcohol intake by type of alcohol, level of acculturation, generational status, impact of discrimination on health) based on a scientific literature review, focus groups, and interviews with key community leaders, completed during the CIRCA Pilot Award. Data from IMPACTO I and II will allow the collaborative team to: (1) determine the prevalence and ten year differences in the four cancer-related risk factors and in health care access and screening practices related to the diagnosis and treatment of cervical, colorectal and breast cancers; and (2) determine the extent to which cancer-related risk factors, medical access and screening practices differ by various socio-demographic characteristics, such as gender, age, primary language, educational attainment, and generational status.

             The findings of the survey will be tailored to meet the language, literacy, and cultural needs of Hispanics and will be disseminated to the Hispanic population in Monterey County and the broader scientific community. In addition, the collaborative team will promote and implement tailored programs using a community development model that empowers the Hispanic community to address cancer control issues at the individual, family, and community levels. The results of this collaborative work will provide significant momentum to future epidemiological studies and primary prevention programs that focus on cancer-related issues that enhance the health of the Hispanic population in California.


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