Papers by Sherrie Wallington
Journal of Community Health, Mar 7, 2019
Objective: To conduct an integrative review to identify and synthesize studies exploring human pa... more Objective: To conduct an integrative review to identify and synthesize studies exploring human papillomavirus (HPV) knowledge, awareness, beliefs, attitudes, and acceptability of the HPV vaccine among Latino fathers living in the United States. The review methodology was informed by those developed by Whittemore and Knafl, which allow for the inclusion of qualitative, quantitative, and mixed methods studies. Using the Preferred Reporting Items for Systematic Reviews Meta-Analyses (PRISMA) guidelines, five electronic databases (PubMed, Medline, PsycINFO, CINAHL, Science Direct) were searched for peer-reviewed, full-text studies published in English with samples that included Latino fathers and examined knowledge, awareness, beliefs, attitudes about the HPV and the HPV vaccines. Studies that did not provide information on the inclusion of fathers in the sample were excluded. Identified eligible studies were analyzed and synthesized using the matrix method. Results: Eleven eligible studies were identified. Most (n=10) included mothers and fathers. One study included only fathers, and this study determined that although fathers held positive attitudes toward the HPV vaccine, a notable number of participants were unsure of or had not formed an opinion about the HPV vaccine. Fathers felt that a recommendation from their child's physician would impact whether they vaccinated their child. Moreover, of the 10 studies including both parents, only two specifically compared fathers' and mothers' knowledge and awareness about the HPV and vaccine acceptability. These two studies determined that fathers were less aware of the HPV and had lower HPV vaccine-related knowledge than mothers. Nevertheless, all of the 11 examined studies, found moderate to high acceptability of the HPV vaccine among Latino parents despite uncertainty about possible vaccine risks and costs. Only 11 studies were identified that included Latino fathers. Of these studies, only one was conducted exclusively with Latino fathers and two compared fathers and mothers. Additional research focusing on Latino fathers is needed given the central role of the family in the Latino culture and the shared role fathers and mothers have in decision-making related to their children's health.
Journal of Cancer Education, 2016
Washington, DC, has one of the highest incidence and mortality rates for breast cancer in the USA... more Washington, DC, has one of the highest incidence and mortality rates for breast cancer in the USA. Patient navigation coupled with informational and community resources are important strategies that assist patients' access and help them understand the complex world of cancer care. The Georgetown Lombardi Comprehensive Cancer Center's Capital Breast Care Center (CBCC) is a safety net mammography screening center that utilizes a community-based navigation program. In addition to providing assistance with coordination of clinical services, navigators at CBCC are integral in establishing intra-community partnerships to educate members of the community about breast cancer screening. The aim of this study was to detail die role of patient navigation at the CBCC, with an emphasis on community engagement and community-based partnerships. We describe tire process by which CBCC established partnerships with multiple community organizations between 2004 and 2015 and analyzed data of women screened in relationship to die evolution of the patient navigation services. Application of the CBCC navigation model that integrates individual patient outreach with community engagement has yielded viable and lasting community partnerships that have resulted in an increase in mammography uptake, especially among medically under-served minority women.
American Society of Clinical Oncology Educational Book
The population of older adults with cancer in the United States is rapidly increasing, which will... more The population of older adults with cancer in the United States is rapidly increasing, which will have a substantial impact on the oncology and public health workforces across the cancer continuum, from prevention to end of life. Unfortunately, inequities in existing social structures that cause increased psychosocial stressors have led to disparities in the incidence of cancer and the morbidity and mortality of cancer for individuals from marginalized backgrounds. It is imperative that older adults, especially those from historically marginalized backgrounds, be adequately represented in all stages of cancer research to address health inequities. Continued efforts and progress toward achieving social justice and health equity require a deeper commitment to and better understanding of the impact of social determinants of health within the cancer domain. Undoubtedly, a more holistic and integrated view that extends beyond the biologic and genetic factors of health must be adopted for...
Journal of Adolescent Health, 2013
Purpose-To identify the association between mother's recent receipt of a Pap test and daughter's ... more Purpose-To identify the association between mother's recent receipt of a Pap test and daughter's uptake and completion of the three-shot human papillomavirus (HPV) vaccination series. Methods-We used cross-sectional data from the 2008 to 2010 Behavioral Risk Factor Surveillance System from 9 U.S. states and Puerto Rico and logistic regression models to examine the association between mother's receipt of a Pap test in the past 3 years and daughter's uptake and completion of the three-shot HPV vaccination series among adolescent girls aged 9-17 years (N = 4,776). Results-Approximately one-quarter of adolescent girls began the HPV vaccination series, and 13.6% completed the three-shot series. Uptake and completion were more likely among girls whose mothers had obtained a Pap test within the past 3 years-for HPV uptake, odds ratio: 1.342, 95% confidence interval: 1.073-1.692; for HPV completion, odds ratio: 1.904; 95% confidence interval: 1.372-2.721-but the relationship between mother's recent Pap test and vaccine uptake was explained by the mother's use of a personal doctor and obtaining a routine physical examination in the past year. Conclusions-HPV vaccination uptake and completion were more likely among adolescent girls whose mothers obtained a recent Pap test. Interventions designed to educate mothers on the importance of HPV vaccination and to facilitate relationships between physicians and mothers may prove successful at increasing HPV vaccination among adolescent girls.
Cancer Prevention Research, 2013
Environmental factors play an important and explanatory role in health disparities. Research sugg... more Environmental factors play an important and explanatory role in health disparities. Research suggests that a community should be an integral part of the process of solving community problems. Consequently, there has been a shift from traditional academic research to more community participatory approaches. To our knowledge none of these approaches have examined the role of academic co-locations (multiple site locations) as part of a community-level cancer prevention and disparities approach. Our co-location strategy involves exporting faculty and staff, clinical trials, interventions, outreach, education, and research from Georgetown University's main campus to a newly established office site located in Southeast, DC, a medically underserved area. Using the environmental focus group study as a case example of the impact of our co-location strategy, we seek to put forward an academic co-location definition and framework for implementation. Our findings show that co-location is a ...
Public health nutrition, Feb 10, 2017
Increasing evidence documents fathers' influential role in their children's eating, physi... more Increasing evidence documents fathers' influential role in their children's eating, physical activity (PA) and sedentary behaviours (SB). We aimed to expand limited existing research examining fathers' influence in these areas by exploring Latino fathers' beliefs, attitudes and practices related to eating, PA and SB of their young children. Seven focus group discussions were conducted in Spanish with Latino fathers (n 28) of children aged 2-8 years. Audio recordings were transcribed and translated verbatim without identifiers. Data were analysed using thematic analysis to identify key concepts and themes using NVivo 11 software. Fathers expressed positive beliefs and attitudes about the importance of healthy eating for their young children, themselves and their families. Nevertheless, the majority reported familial practices including eating out, getting take-out, etc. that have been linked to increased obesity risk among Latino children. Fathers were more involved a...
Maternal and Child Health Journal, 2015
Objectives-This study is among the first to examine metropolitan status differences in human papi... more Objectives-This study is among the first to examine metropolitan status differences in human papillomavirus (HPV) vaccine initiation and completion among United States adolescent girls and is unique in its focus on how maternal socioeconomic status and health care access moderate metropolitan status differences in HPV vaccination. Methods-Using cross-sectional data from 3573 girls aged 12-17 in the U.S. from the 2008-2010 Behavioral Risk Factor Surveillance System, we estimate main and interaction effects from binary logistic regression models to identify subgroups of girls for which there are metropolitan versus non-metropolitan differences in HPV vaccination. Results-Overall 34 % of girls initiated vaccination, and 19 % completed all three shots. On average, there were no metropolitan status differences in vaccination odds. However, there were important subgroup differences. Among low-income girls and girls whose mothers did not complete high school, those in non-metropolitan areas had significantly higher probability of vaccine initiation than those in metropolitan areas. Among high-income girls and girls whose mothers completed college, those in metropolitan areas had significantly higher odds of vaccine initiation than those in non-metropolitan areas. Moreover, among girls whose mothers experienced a medical cost barrier, non-metropolitan girls were less likely to initiate vaccination compared to metropolitan girls. Conclusions-Mothers remain essential targets for public health efforts to increase HPV vaccination and combat cervical cancer. Public health experts who study barriers to HPV vaccination and physicians who come into contact with mothers should be aware of group-specific barriers to vaccination and employ more tailored efforts to increase vaccination.
Translational Behavioral Medicine, 2016
Given the increasing interest in expanding obesity prevention efforts to cover community-based pr... more Given the increasing interest in expanding obesity prevention efforts to cover community-based programs, we examined whether individuals would access a YMCA for physical activity promotion. We provided a no-cost 12-month YMCA membership to socioeconomically disadvantaged black women who were randomized to the intervention arm of a weight gain prevention trial (n = 91). Analyses examined associations of membership activation and use with baseline psychosocial, contextual, health-related, and sociodemographic factors. Many participants (70.3 %) activated their memberships; however, use was low (42.2 % had no subsequent visits, 46.9 % had one to ten visits). There were no predictors of membership activation, but individuals living below/borderline the federal poverty line were more likely to use the center (1+ visits), as were those who met physical activity guidelines at baseline. More comprehensive and intensive interventions may be necessary to promote use of community resources-even when provided free-among high-risk populations of women with obesity that live in rural areas of the USA.
The Routledge Handbook of Language and Health Communication, 2010
Journal of Dual Diagnosis
There is increasing literature supporting the adverse effects of disasters on substance use and p... more There is increasing literature supporting the adverse effects of disasters on substance use and psychiatric disorders. The co-occurrence of psychiatric disorders with substance use intensifies the challenge of treatment delivery. Thus the aim of this study was to examine the prevalence of substance use, treatment characteristics, and demographics of discharges from substance abuse treatment in New Orleans, post-Hurricane Katrina. Trends associated with discharges that have a co-occurring psychiatric and substance use disorder (COD) were also assessed. The secondary aim of this study was to examine the association of successful substance abuse treatment completion among those with a COD post-Hurricane Katrina. Substance abuse treatment discharge data (N = 16,507) from New Orleans, Louisiana, for years 2006 through 2011 were obtained from the Treatment Episode Data Set-Discharge. Multiple logistic regression analysis was employed to examine the association of discharges with a COD and completion of substance abuse treatment. Demographic, psychiatric, and treatment characteristics of discharges in 2006 were compared to characteristics in 2011. Trends of characteristics were also assessed through the study period. Roughly a third (35.2%) of all discharges in New Orleans from 2006 to 2011 had a COD. After controlling for race, employment, treatment service setting at discharge, primary substance problem, and the discharge's principal source of referral, discharges with a COD were 29% less likely to complete treatment as compared to those with no COD (AOR = 0.71, 95% CI [0.56, 0.90], p = .004). Treatment completion among discharges with a COD has significantly declined from 36.8% in 2006 to 18.7% in 2011 (p < .0001). Notable significant trends in homelessness, criminality, and heroin use were identified among discharges with a COD. Substance abuse treatment undergoes various changes in the event of a natural disaster. These changes may increase challenges for successful treatment completion for vulnerable populations such as those with a COD. Results of this study demonstrate that discharges with a COD are less likely to complete treatment as compared to those with no COD disorder. Unmet treatment needs may also increase odds of criminalization and homelessness.
Journal for specialists in pediatric nursing : JSPN, Jan 13, 2017
Promoting physical activity (PA) is a key component of preventing and controlling childhood obesi... more Promoting physical activity (PA) is a key component of preventing and controlling childhood obesity. Despite well-documented benefits of PA, globally, rates of PA among young children have declined over the past decades, and most children are not accruing sufficient PA daily. Helping children develop the foundation for PA habits early in life is critical for the promotion of health in childhood and prevention of chronic diseases later in life, and will ultimately promote longer and healthier lives for individuals and the general population. The purpose of this review is to provide a synthesis of current evidence on influences on PA and sedentary behaviors of preschool-age children in high-income countries. A systematic review of three databases was performed. Studies conducted in high-income countries and published from 2000 onward that addressed influences on PA and sedentary behaviors of preschool-age children were identified and reviewed. Additionally, reference lists of identifi...
Substance Use & Misuse, 2016
Substance abuse treatment following a natural disaster is often met with challenges. If treatment... more Substance abuse treatment following a natural disaster is often met with challenges. If treatment is available, facilities may be unequipped to service an influx of patients or provide specialized care for unique populations. This paper seeks to evaluate trends in substance abuse treatment over time and assess changes pre- and post-Hurricane Katrina. Substance abuse treatment admission data (N = 42,678) from New Orleans, Louisiana, for years 2000 through 2012 were obtained from the Treatment Episode Data Set. Admissions were examined to evaluate demographic, socioeconomic, psychiatric, and criminality trends in substance abuse treatment and assess changes following Hurricane Katrina. Treatment admissions have decreased from 2000 to 2012. About one in five admissions had a psychiatric illness in addition to a substance abuse problem. A staggering 76% of admissions with a psychiatric illness were referred by the criminal justice system post-Katrina as compared to pre-Katrina. Rates of alcohol and marijuana admissions have remained stable from 2000 to 2012. Cocaine/crack admissions have declined and admissions who abused heroin have increased over time. Treatment admissions stabilized following Hurricane Katrina; however, since 2009, they have begun to decline. Targeted exploration of factors affecting admission to treatment in New Orleans with populations such as the homeless, those with a psychiatric illness in addition to a substance abuse problem, and those referred by the criminal justice system is essential. The results of this study assist in identifying variations in substance abuse treatment characteristics for those admitted to treatment in New Orleans.
ABSTRACT Background: Understanding and measuring how people receive and perceive tobacco-related ... more ABSTRACT Background: Understanding and measuring how people receive and perceive tobacco-related messages, both pro- and anti-tobacco, is essential to effective tobacco control. The changing media environment, the changing ethnic and racial landscape of the nation, and the continuing disparities in tobacco use warrant a precise measure of exposure to tobacco messages. Methods: In 2006-07, a multi-site collaborative of three Community Network Programs (CNPs), the Tobacco Research Network on Disparities (TReND), the National Cancer Institute and the American Legacy Foundation, conducted 11 focus groups among African Americans, American Indians, and Latinos to examine how different groups receive and perceive tobacco-related messages. Nvivo was used to organize the qualitative data and content analysis to identify emerging themes. Themes were extracted by multiple coders and verified for inter-rater reliability. Results: Themes emerged across seven categories: Messages that Discourage Tobacco Use, Messages that Encourage Tobacco Use, Attention Paid to Tobacco Messages, Awareness of Safe Cigarettes, Seeing or Hearing of Tobacco Messages, Tobacco Warning Strategies, and Perceptions of Warning Labels. Details from each category will be discussed along with next steps in developing and testing the TeRMM index for reliability and validity. Conclusions: This was the first phase of a project that will develop and validate an index to measure tobacco-related messages and media exposure that is sensitive to media consumption patterns of various racial/ethnic and socioeconomic groups. The TeRMM index will provide a tool to understand media exposure among specific groups, thus informing the development of effective interventions for low socioeconomic and minority racial/ethnic groups.
American Journal of Preventive Medicine, 2015
Research suggests that community involvement is integral to solving public health problems, inclu... more Research suggests that community involvement is integral to solving public health problems, including involvement in clinical trials-a gold standard. Significant racial/ethnic disparities exist in the accrual of participants for clinical trials. Location and cultural aspects of clinical trials influence recruitment and accrual to clinical trials. It is increasingly necessary to be aware of defining characteristics, such as location and culture of the populations from which research participants are enrolled. Little research has examined the effect of location and cultural competency in adapting clinical trial research for minority and underserved communities on accrual for clinical trials. Utilizing embedded community academic sites, the authors applied cultural competency frameworks to adapt clinical trial research in order to increase minority participation in nontherapeutic cancer clinical trials. This strategy resulted in successful accrual of participants to new clinical research trials, specifically targeting participation from minority and underserved communities in metropolitan Washington, DC. From 2012 to 2014, a total of 559 participants enrolled across six nontherapeutic clinical trials, representing a 62% increase in the enrollment of blacks in clinical research. Embedding cancer prevention programs and research in the community was shown to be yet another important strategy in the arsenal of approaches that can potentially enhance clinical research enrollment and capacity. The analyses showed that the capacity to acquire cultural knowledge about patients-their physical locales, cultural values, and environments in which they live-is essential to recruiting culturally and ethnically diverse population samples.
Communication research suggests that as more health information flows to the general public, unde... more Communication research suggests that as more health information flows to the general public, underserved racial/ethnic minority women may benefit less compared to women who are better off because of differential access to and ability to utilize information. This finding has significant implications for preventing human papilloma virus (HPV) among the underserved. For example, a recent study reported that a prior HPV diagnosis was strongly associated with awareness of HPV after controlling for socio-demographic characteristics. While African American women (83%) were more likely than White (80%) or Latina (75%) women to report having had a Pap smear in the past 3 years, Black (33%) and Latina (28%) women were still significantly less likely than white women (44%) to have heard of HPV, despite being at least as likely to be diagnosed with disease. Such differential awareness could be the result of poor provider-patient communication or lower access to, and trust in information on HPV ...
In March 2007, The Advisory Committee on Immunization Practices (ACIP) recommended female adolesc... more In March 2007, The Advisory Committee on Immunization Practices (ACIP) recommended female adolescents receive the Human Papillomavirus vaccine. Males received recommendation approximately 2 years later. Subsequently, over 25 states introduced legislation to encourage HPV vaccination initiation for all adolescents. Objective: Estimate state legislation’s effect on HPV vaccine initiation and patient care provider (PCP) recommendations by gender. HPV vaccine legislation acquired from the National Conference on State Legislatures was classified into four groups based on status: none, introduced or active in committee (Active), passed either or both Houses (Passed), died in committee (Died). Gender differences in PCP recommendations and HPV vaccine initiation among adolescents were estimated using NIS – Teen 2010 to 2012 data. Multivariable logistic modeling in progress explores the effect of legislation status on these estimates. Over half the respondents represent states that produced ...
Journal of Immigrant and Minority Health, 2012
We report on information channels associated with awareness about human papillomavirus (HPV) amon... more We report on information channels associated with awareness about human papillomavirus (HPV) among immigrant Central and South American Latinos. We conducted a survey of 1,334 Latino C 21 years attending safety-net clinics in 2007-2008. Logistic regression analyses evaluated associations with HPV awareness. Fortyeight percent were aware of HPV infection and 40% were aware of the vaccine. Spanish television (38%) and providers (23%) were the primary HPV information sources. Infection awareness was associated with internet use (OR 1.47; 95% CI 1.10-1.96) and self-efficacy to find health information (OR 1.19; 95% CI 1.08-1.30). Vaccine awareness was associated with media use for health information (OR 1.27; 95% CI 1.09-1.49) and internet use (OR 1.59; 95% CI 1.18-2.13). Although Spanish television has reached this low HPV awareness group, there may be missed opportunities for education by providers. Television and the internet may also be effective channels for future interventions.
Contemporary Clinical Trials Communications, 2016
Background: Clinical trials test new ways to prevent, detect, diagnose, or treat diseases. Resear... more Background: Clinical trials test new ways to prevent, detect, diagnose, or treat diseases. Researchers have found that minority patients are willing to participate in clinical trials, yet these patients have barriers which hinder their access to trials. Methods: To explore African American women's participation in breast cancer clinical trials, eight focus groups were conducted with breast cancer patients, family members/care givers, religious leaders, and healthcare providers to gather information on the perspectives and opinions on the topic. The focus group conversations were transcribed, and transcripts were imported into QSR International's NVivo 10 software. The transcripts were organized into folders based on four categories. The content analysis performed was based on recordings and notes. Results: The following themes were generated as a result of conducting these focus groups and gathering information on the perspectives and opinions about participating in clinical trials, based on the groups who participated: Promoting participation in research; Personal experience with cancer; Support and support services; Awareness, knowledge, and experience with clinical trials; Providers' roles in clinical trials. Conclusion: The data collected in this study present several actionable themes that, if addressed by individual researchers and the medical community at large, could increase participation in clinical trials by African American patients. They also provide a deeper and more nuanced understanding of the factors influencing African American patients' decisions around participating in clinical trials.
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, Sep 14, 2016
Population-level research on the implications of retail pharmacy policies to end the sale of toba... more Population-level research on the implications of retail pharmacy policies to end the sale of tobacco products is scant, and the impact of such policies on racial/ethnic and socioeconomic disparities across neighborhoods in access to tobacco products remains unexplored. We investigated the association between neighborhood sociodemographic characteristics and tobacco retail density in Rhode Island (RI) (N=240 census tracts). We also investigated whether the CVS Health (N=60) policy to end the sale of tobacco products reduces the disparity in the density of tobacco retail across neighborhoods, and we conducted a prospective policy analysis to determine if a similar policy change in all pharmacies in RI (N=135) would reduce the disparity in tobacco retail density. The results revealed statistically significant associations between neighborhood sociodemographic characteristics and tobacco retail outlet density across RI neighborhoods. The results when excluding the CVS Health locations, ...
Human vaccines & immunotherapeutics, Jun 6, 2016
To determine the effectiveness of existing school entry and education mandates on HPV vaccination... more To determine the effectiveness of existing school entry and education mandates on HPV vaccination coverage, we compared coverage among girls residing in states and jurisdictions with and without education and school-entry mandates. Virginia and the District of Columbia enacted school entry mandates, though both laws included liberal opt-out provisions. Ten additional states had mandates requiring distribution of education to parents or provision of education within school curricula. Using data from the National Immunization Survey-Teen from 2009-2013, we estimated multilevel logistic regression models to compare coverage with HPV vaccines for girls ages 13-17 residing in states and jurisdictions with and without school entry and education mandates, adjusting for demographic factors, healthcare access, and provider recommendation. Girls residing in states and jurisdictions with HPV vaccine school entry mandates (DC and VA) and education mandates (LA, MI, CO, IN, IA, IL, NJ, NC, TX, a...
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Papers by Sherrie Wallington