EXPOSURE TO EXTREME HEAT EVENTS AND CHRONIC RESPIRATORY DISEASES AMONG A NATIONALLY REPRESENTATIVE SAMPLE OF THE UNITED STATES POPULATION

Previous studies have shown that extreme weather events are on the rise in response to our changing climate. Such events are projected to become more frequent, more intense, and longer lasting. A consistent exposure metric for measuring these extreme events as well as information regarding how these events lead to ill health are needed to inform meaningful adaptation strategies that are specific to the needs of local communities. Using federal meteorological data corresponding to 17 years (1997-2013) of the National Health Interview Survey, this research: 1) developed a location-specific exposure metric that captures individuals’ “exposure” at a spatial scale that is consistent with publicly available county-level health outcome data; 2) characterized the United States’ population in counties that have experienced higher numbers of extreme heat events and thus identified population groups likely to experience future events; and 3) developed an empirical model describing the association between exposure to extreme heat events and hay fever. This research confirmed that the natural modes of forcing (e.g., El Niño-Southern Oscillation), seasonality, urban-rural classification, and division of country have an impact on the number extreme heat events recorded. Also, many of the areas affected by extreme heat events are shown to have a variety of vulnerable populations including women of childbearing age, people who are poor, and older adults. Lastly, this research showed that adults in the highest quartile of exposure to extreme heat events had a 7% increased odds of hay fever compared to those in the lowest quartile, suggesting that exposure to extreme heat events increases risk of hay fever among US adults.

CERVIXCHECK: A SPIRITUALLY-BASED SMS TEXT MESSAGING PILOT INTERVENTION TO INCREASE CERVICAL CANCER AWARENESS AND PAP TEST SCREENING INTENTION AMONG AFRICAN AMERICAN WOMEN

African American women account for a disproportionate burden of cervical cancer incidence and mortality rate when compared to non-Hispanic White women. Cervical cancer is one of the most preventable types of cancer, and women can be screened for it with a routine Pap test. Given that religion occupies an essential place in African American lives, framing health messages with important spiritual themes and delivering them through a popular communication delivery channel may allow for a more culturally-relevant and accessible technology-based approach to promoting cervical cancer educational content to African American women. Using community-engaged research as a framework, the purpose of this multiple methods study was to develop, pilot test, and evaluate the feasibility, acceptability, and initial efficacy of a spiritually-based SMS text messaging intervention to increase cervical cancer awareness and Pap test screening intention among African American women. The study recruited church-attending African American women ages 21-65 and was conducted in three phases. Phases 1 and 2 consisted of a series of focus group discussions (n=15), cognitive response interviews (n=8), and initial usability testing that were conducted to inform the intervention development and modifications. Phase 3 utilized a non-experimental one-group pretest-posttest design to pilot test the 16-day text messaging intervention (n=52). Of the individuals enrolled, forty-six completed the posttest (retention rate=88%). Findings provided evidence for the early feasibility, high acceptability, and some initial efficacy of the CervixCheck intervention. There were significant pre-post increases observed for knowledge about cervical cancer and the Pap test (p = .001) and subjective norms (p = .006). Additionally, results post-intervention revealed that 83% of participants reported being either “satisfied” or “very satisfied” with the program and 85% found the text messages either “useful” or “very useful”. 85% of the participants also indicated that they would “likely” or “very likely” share the information they learned from the intervention with the women around them, with 39% indicating that they had already shared some of the information they received with others they knew. A spiritually-based SMS text messaging intervention could be a culturally appropriate and cost-effective method of promoting cervical cancer early detection information to African American women.