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Disparity of Non-communicable Diseases among Pacific Islanders

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: 31 December 2024 | Viewed by 7178

Special Issue Editor

Office of Research & Sponsored Programs, University of Guam, Mangilao, GU 96923, USA
Interests: cancer health disparities; child obesity prevention; non-communicable disease prevention

Special Issue Information

Dear Colleagues,

Non-Communicable Diseases (NCDs), also known as chronic diseases, include cancer, cardiovascular diseases such as heart attacks and stroke, respiratory diseases such as chronic obstructive pulmonary disease and asthma, and diabetes. Each year, NCDs kill 41 million people worldwide, with 77% of these NCD deaths occurring in low- and middle-income countries. Unfortunately, Pacific Islanders experience some of the highest mortality rates resulting from NCDs worldwide. The reason for the disparity of NCDs among Pacific Islanders is likely a combination of metabolic risk factors, such as obesity, high blood pressure, hyperglycemia, and hyperlipidemia, and modifiable behavioral risk factors such as tobacco use, physical inactivity, alcohol consumption, and unhealthy dietary choices. Poverty, food insecurity, inadequate health insurance coverage, and a lack of education also negatively impact NCD. Prevention is a key component in the reduction of NCDs among Pacific Islanders. This Special Issue is aimed at providing selected contributions on the current state of disparity of NCDs among Pacific Islanders. Potential topics include, but are not limited to:

  • The impact of food insecurity on NCDs among various Pacific Islander populations;
  • The prevention and control of NCDs among various Pacific Islander populations;
  • Cancer prevention among various Pacific Islander populations;
  • Metabolic risk factors among children from various Pacific Islander populations;
  • Metabolic risk factors among adults from various Pacific Islander populations;
  • Predictors of obesity among Pacific Islander children and adolescents;
  • Tobacco and areca nut use among Pacific Islander adolescents.

Dr. Rachael Leon Guerrero
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Non-Communicable Disease (NCD)
  • pacific islander
  • disparity
  • risk factors

Published Papers (5 papers)

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Research

8 pages, 948 KiB  
Article
Disparities in Colorectal Cancer Incidence among Asian and Pacific Islander Populations in Guam, Hawai’i, and the United States
Int. J. Environ. Res. Public Health 2024, 21(2), 170; https://doi.org/10.3390/ijerph21020170 - 01 Feb 2024
Viewed by 1053
Abstract
Colorectal cancer (CRC) ranks among the three most common cancers in Guam (GU), Hawai’i (HI), and the mainland United States (US). CRC prevalence in these areas is high among Filipinos, and indigenous CHamorus and Native Hawaiians; however, data on these populations are frequently [...] Read more.
Colorectal cancer (CRC) ranks among the three most common cancers in Guam (GU), Hawai’i (HI), and the mainland United States (US). CRC prevalence in these areas is high among Filipinos, and indigenous CHamorus and Native Hawaiians; however, data on these populations are frequently aggregated in epidemiological studies, which can mask true CRC disparities. We examined CRC cumulative incidence rates (CIRs) among CHamorus in GU, Filipinos in GU, HI, and the US, and Native Hawaiians in HI and the US. CRC CIRs were calculated for two age groups (20–49 years; early onset, and 50–79 years; senior) and four time periods (2000–2004, 2005–2009, 2010–2014, and 2015–2019), stratified by ethnicity, sex, and location. Data analyzed included all invasive CRC cases reported to the Surveillance, Epidemiology, and End Results 9-Registry (n = 166,666), the Hawai’i Tumor Registry (n = 10,760), and the Guam Cancer Registry (n = 698) between 2000 and 2019. Senior CIRs were highest in HI and lowest in GU throughout all time periods, with a downward trend observed for senior CIRs in the US and HI, but not GU. This downward trend held true for all ethnic groups, except for CHamorus in GU, females in GU, and females of CHamoru ethnicity in GU. In contrast, early onset CIRs increased across all locations, sexes, and ethnic groups, except for Filipinos in HI and males of Filipino ethnicity in HI. Our findings provide crucial insights for future research and policy development aimed at reducing the burden of CRC among indigenous populations. Full article
(This article belongs to the Special Issue Disparity of Non-communicable Diseases among Pacific Islanders)
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12 pages, 321 KiB  
Article
Types of Offers of Combustible Cigarettes, E-Cigarettes, and Betel Nut Experienced by Guam Youths
Int. J. Environ. Res. Public Health 2023, 20(19), 6832; https://doi.org/10.3390/ijerph20196832 - 26 Sep 2023
Viewed by 1193
Abstract
The present study examined types of scenarios in which Guam youths are offered tobacco—namely, combustible cigarettes and e-cigarettes—and betel (areca) nut. We conducted 10 focus groups with public middle school students (n = 34) from Guam. Results suggested that the types of [...] Read more.
The present study examined types of scenarios in which Guam youths are offered tobacco—namely, combustible cigarettes and e-cigarettes—and betel (areca) nut. We conducted 10 focus groups with public middle school students (n = 34) from Guam. Results suggested that the types of offer scenarios of combustible cigarettes, e-cigarettes, and betel nut referenced by the students fall into two categories—direct-relational offers and indirect-contextual offers. The results also suggested that both categories of offer scenarios were more likely to occur in school rather than in other locations such as the home. Family members were more likely to make offers than other types of people. Indirect-contextual offers were more easily avoidable depending on the substance offered, the location where the offer took place, and the person making the offer. Based on the findings, we provide brief suggestions on developing a school-based prevention curriculum focused on training young adolescents from Guam on ways to resist offers of cigarettes, e-cigarettes, and betel nut. Full article
(This article belongs to the Special Issue Disparity of Non-communicable Diseases among Pacific Islanders)
10 pages, 683 KiB  
Article
The Betel Nut Intervention Trial (BENIT)—A Randomized Clinical Trial for Areca Nut and Betel Quid Cessation: Primary Outcomes
Int. J. Environ. Res. Public Health 2023, 20(16), 6622; https://doi.org/10.3390/ijerph20166622 - 21 Aug 2023
Cited by 2 | Viewed by 1214
Abstract
Background: Areca nut and betel quid (ANBQ) chewing is a widespread carcinogenic habit. The BENIT (ClinicalTrials—NCT02942745) is the first known randomized trial designed for ANBQ chewers. Methods: We compared the intensive behavioral treatment intervention condition (IC) with the control condition (CC) in the [...] Read more.
Background: Areca nut and betel quid (ANBQ) chewing is a widespread carcinogenic habit. The BENIT (ClinicalTrials—NCT02942745) is the first known randomized trial designed for ANBQ chewers. Methods: We compared the intensive behavioral treatment intervention condition (IC) with the control condition (CC) in the BENIT and included a 5-stage early stopping rule. We report the primary analysis at stage 3. English-literate adults in Guam and Saipan who self-identified as ANBQ chewers with tobacco were enrolled between August 2016 and August 2020. IC participants (n = 88) received five in-person sessions over 22 days and a brochure containing quitting advice. CC participants (n = 88) received only the brochure. Participants were assessed at baseline and on day 22 of follow-up. Self-reported chewing status at day 22 was determined by a composite of two survey items with disparate wording and response options for cross-verification. Results: Cessation rates were 38.6% (IC) and 9.1% (CC). Proportional hazards regression revealed a p = 0.0058, which met the Stage 3 criteria for significance, and an estimated reduction in ANBQ chewing for IC compared to the CC of 71% (95% CI: 41%–88%). Conclusions: Robust self-reported intervention effects at day 22 suggest that intensive cessation programs such as BENIT should be further developed and implemented on a larger scale. Full article
(This article belongs to the Special Issue Disparity of Non-communicable Diseases among Pacific Islanders)
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13 pages, 495 KiB  
Article
Barriers, Facilitators, and Strategies for Developing a Culturally Informed Lifestyle Intervention for Native Hawaiian, CHamoru, and Filipino Breast Cancer Survivors: Mixed-Methods Findings from Focus Group Participants
Int. J. Environ. Res. Public Health 2023, 20(12), 6075; https://doi.org/10.3390/ijerph20126075 - 07 Jun 2023
Viewed by 1442
Abstract
Breast cancer disproportionately impacts Native Hawaiian, CHamoru, and Filipino women. Few culturally informed interventions addressing breast cancer survivors exist and none have been developed or tested specifically for Native Hawaiian, CHamoru, and Filipino women. This study aimed to conduct focus groups with Native [...] Read more.
Breast cancer disproportionately impacts Native Hawaiian, CHamoru, and Filipino women. Few culturally informed interventions addressing breast cancer survivors exist and none have been developed or tested specifically for Native Hawaiian, CHamoru, and Filipino women. This study aimed to conduct focus groups with Native Hawaiian, CHamoru, and Filipino women previously diagnosed with breast cancer to inform future research in Guam and Hawai’i. Convenience sampling and grounded theory approaches were used. Focus group sessions were conducted during summer 2023 and included questions to understand the barriers, motivators, and implementation recommendations for lifestyle interventions aimed at reducing the risk for breast cancer recurrence among the target population. Data saturation was reached after a total of seven focus groups (an average of four survivors/group per site) were conducted (three in Hawai’i and four in Guam), which represented 28 breast cancer survivors. Themes from the focus groups emerged around developing support systems with other survivors, providing physical activity and nutrition intervention activities and materials in multiple formats, and incorporating activities and foods that accommodate the side effects of breast cancer treatments and are culturally relevant. The average desired intervention length was eight weeks. These findings will inform the development and feasibility testing of a culturally informed lifestyle intervention for breast cancer survivors in Guam and Hawai’i. Full article
(This article belongs to the Special Issue Disparity of Non-communicable Diseases among Pacific Islanders)
13 pages, 624 KiB  
Article
Knowledge and Attitudes of Guam Residents towards Cancer Clinical Trial Participation
Int. J. Environ. Res. Public Health 2022, 19(23), 15917; https://doi.org/10.3390/ijerph192315917 - 29 Nov 2022
Cited by 1 | Viewed by 1083
Abstract
(1) Background: Currently there are no cancer clinical trials in Guam, where CHamoru people suffer the highest rates of cancer mortality, and interest to do so is growing. This study investigated the knowledge and attitudes of Guam residents towards cancer clinical trial participation [...] Read more.
(1) Background: Currently there are no cancer clinical trials in Guam, where CHamoru people suffer the highest rates of cancer mortality, and interest to do so is growing. This study investigated the knowledge and attitudes of Guam residents towards cancer clinical trial participation prior to implementation. (2) Methods: A telephone survey was developed, tested, and conducted among Guam resident adults, 18 years of age and older. Survey questions were summarized by descriptive statistics. Logistic regression models were used to investigate the associations between Guam residents’ demographics and their clinical trial knowledge and attitudes. Adjusted odds ratios (aOR) and associated 95% confidence intervals (CI) were calculated. (3) Results: One hundred fifty-two people participated in the survey, most of whom were CHamoru (47.0%). Fifty-three percent had heard the term ‘clinical trial’; 73.7% would take part in a trial if they had cancer; and 59.9% believed they would receive good quality treatment from a trial offered in Guam. CHamoru were more likely than Whites to associate out-of-pocket expenses with clinical trial participation (aOR = 5.34, 95% CI = 1.68–17.00). Physician ethnicity was important to 30% of non-Whites and significantly associated with those who spoke a language other than English (aOR = 3.40, 95% CI = 1.29–8.95). Most people (65.0%) did not believe clinical trials participants were ‘guinea pigs’. (4) Conclusion: Though knowledge about cancer clinical trials is limited, attitudes were primarily positive towards participating in cancer clinical trials offered in Guam. Future delivery of cancer clinical trials will benefit from identifying potential barriers to recruitment and adopting an approach suited to Guam’s population. Full article
(This article belongs to the Special Issue Disparity of Non-communicable Diseases among Pacific Islanders)
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