New Mexico State University

Border Epidemiology and Environmental Health Center

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Research and Projects

Promotora Outreach for Cervical Cancer Screening

Co-Principal Investigators:
Hugo Vilchis, Director, Border Epidemiology and Environmental Health Center, & Associate Professor – NMSU
Beti Thompson, Full Member, Public Health Sciences - FHCRC
Gloria Coronado, Assistant Member, Public Health Sciences - FHCRC

NIH-NCI U54 pilot project (2007-2010)

Hispanic women in the United States (U.S.) experience nearly double the incidence of invasive cervical cancer experienced by non-Hispanic whites. The problem is especially severe in the border communities of the U.S. and Mexico. Differences in prevalence of Papanicolaou (Pap) tests for early cervical lesion detection are thought, in part, to explain the differences in incidence, however, difference in participation in follow-up care among women with abnormal cervical cytologic findings also may contribute to the disparity. The overall goals of this outreach project are to increase pap testing and follow-up testing for abnormal pap smears among women living in the border communities of New Mexico and Mexico. Specifically, using a promotora program to promote pap testing and follow-up for abnormal tests, we will:

Aim 1: Primarily, increase the number of pap tests that occur in a specific border community clinic compared to two non-intervention clinics.
Aim 2: Secondarily, increase the follow-up rates for abnormal pap smears in the specific Border clinic.

Promotoras who work with the intervention clinic will be trained to provide information to and encourage women to receive pap testing. They also will be trained to work with the clinic to identify the results of the tests and to encourage women with abnormal tests to receive follow-up testing. Finally, they will refer women to usual care if the initial or follow-up tests are negative or refer women to treatment if the woman presents with cervical cancer. A number of agencies exist in the community to treat women with cervical cancer. The main questions of interest, corresponding to our specific aims are: 1) Is there increased pap testing as a result of the intervention? and 2) Is there increased follow-up testing (e.g., repeat pap or colposcopy) as a result of the intervention? A secondary aim is to answer question 3) What is the pattern(s) for treatment of cervical cancer? During the first six months of this three-year project, information will be gathered on existing pap test rates in the three clinics that will participate. The next 24 months will consist of intervention in one clinic to increase pap screening rates and follow-up rates for abnormal tests and to follow treatment patterns. During the final 6 months, we will assess differences in pap screening and abnormal pap follow-up rates.

 

Una Mano Amiga, Patient Navigator Program for Southwest New Mexico

Co-Principal Investigators:
Hugo Vilchis, Director, Border Epidemiology and Environmental Health Center, & Associate Professor – NMSU
Carol Moinpour, Member, Public Health Sciences – FHCRC
Nigel Bush, Associate Member, Public Health Sciences – FHCRC

NIH-NCI U54 pilot project (2008-2011)

The southwest region of New Mexico is characterized by small communities living in extreme rural remoteness, typified by low income, with especially high proportions with no health insurance. This region poses significant challenges to the delivery of health and human services. The cost, time, and trained staff needed to conduct outreach and find creative ways to provide services is daunting: small populations are isolated by large distances, local cultures tend to promote self-dependence and reliance on the family; low literacy levels and language difficulties prevail. To address the serious geographic and economic health disparities in this isolated corner of New Mexico, the investigators, in collaboration with Gila Medical Regional Center/Cancer Treatment Center and the Grant County Health Council, will implement and test a culturally appropriate rural cancer patient navigator program employing health promotoras from within the local communities. This project, will provide services to cancer patients, including their families, in Grant County, one of the most underserved counties of southern New Mexico. The specific aims of this new promotora-based patient navigator program are:

Aim 1: to assess the detailed cancer navigation needs of patients and their families in an underserved target area of rural southwest New Mexico.
Aim 2: to test the feasibility of training local promotoras as patient navigators; and

Aim 3: to evaluate the process and effectiveness of promotora patient navigator activities across the target region.

Graduate Training in Cancer Research and Health Disparities

Co-Principal Investigators:
Mary O'Connell, Professor, Plant and Environmental Sciences - NMSU
Hugo Vilchis, Director, Border Epidemiology and Environmental Health Center, & Associate Professor – NMSU
Maxine Linial, Full Member, Basic Sciences - FHCRC
Steve Schwartz, Full Member, Public Health Sciences - FHCRC

NIH-NCI U54 pilot project (2007-2010)

Without appropriate role models, it is difficult to provide positive messages regarding the importance of cancer research, cancer prevention, and cancer treatment to underrepresented minorities. The rationale for this graduate student-training program is based on the need to increase student and faculty interest at NMSU in cancer research, specifically among minority graduate students and faculty, and to increase the awareness of these issues at Fred Hutchinson Cancer Research Center (FHCRC).

The goal of this project is to enhance training in cancer research for graduate students at both New Mexico State University (NMSU) and the FHCRC [in association with the graduate school at the University of Washington (UW)]. This will be accomplished through three specific aims.

Aim 1: Lab based graduate students at NMSU will spend three quarters at the FHCRC doing research in a lab that will augment research skills related to their dissertation research, and if appropriate, take courses through the Molecular and Cellular Biology Graduate Program at the University of Washington.
Aim 2: Epidemiology and Public Health graduate students at the FHCRC will enhance their education in cancer research through a new course in "Health and Health Services Disparities in Minority Populations." Students from this course may be selected to participate in a two-week practicum at The Border Epidemiology and Environmental Health Center (BEC) of NMSU, where they will be exposed to US-Mexico border health issues and ongoing research under Dr. Vilchis’ mentorship.
Aim 3: Minority MPH students from the Department of Health Sciences will have the opportunity to complete a research practicum with groups a faculty mentor at the FHCRC. Faculty at FHCRC will assist students in future career training, including applying to the Ph.D. program at the UW/FHCRC.

A secondary goal of these aims is to attract underrepresented minority students to the programs at the FHCRC for graduate, postdoctoral, and faculty appointments.

Proposals related to Environmental Health

  • Uranium health effects needs assessment
  • Food Safety and Epidemiology: practical approaches for food protection
  • Atmospheric Aerosols: Bio-Security and Human Health
  • Desarrollo un sistema de tratamiento de agua para consumo humano basado en la inactivación de cryptosporidium y Giardia lambia por medio de luz UV y la remoción de arsénico y flúor por medio de zeolitas modificadas
  • Reduction of Pesticide Exposure Risk in Migrant Agricultural Workers
LEAD
  • Lead poisoning continues to be a problem in New Mexico. From 1994-1999 approximately 2.7 % of children under the age of 6 had elevated lead levels in Doña Ana County, New Mexico. Many of those considered at risk do not know that lead is a danger and are unaware of the availability of free blood-lead level testing. Doña Ana County is at the confluence of several industrial areas known to have been lead pollutants. Additionally, low income housing developments are known to have problems with lead. Lead is harmful in many ways. Expectant mothers can transfer lead to the developing fetus from any environmental exposure she experiences during pregnancy. Fetuses, infants, and children are particularly vulnerable to lead exposure because lead is more easily absorbed into their growing bodies. Additionally, their tissues are more sensitive to the damaging effects of lead. Another problem is that most children do not exhibit signs of lead poisoning and appear to be quite healthy. Lead poisoning can lead to developmental delays, learning disabilities, and in severe cases, even death. There are ways to offset the risk of lead exposure. First is to increase awareness of the dangers of lead through education. Next, conduct blood-lead level screening to establish baseline information on blood-lead levels in the previously mentioned population. Currently there is little to no data available. It is estimated that most individuals who qualify, do not receive the blood-lead level test. Thus only through education and testing can a parent/guardian be made aware of the dangers of lead poisoning and the resources available to them to take action.
Binational Border Health Information System (BBHIS)
  • This system was developed to allow health authorities of New Mexico, Texas and Chihuahua to communicate, share and react in a timely manner to epidemiological alerts. The system, developed by the BEC, was adopted by the US-Mexico Border Governors Conference.
Binational Nuestros Niños Immunization Program
  • Nuestros Niños is a binational immunization initiative started in 1992 in El Paso-Juarez-Las Cruces area. Several posters promoting children vaccination have been designed, replicated, and distributed in the area; and, the media promotional campaign has been expanded to other regional markets. The state wide New Mexico Immunization Coalition, adopted the Nuestros Niños logo and campaign as its platform for use throughout the state of New Mexico. The BEC served as coordination point for the 3 cities until 2006.
Border Information and Education Network! (BIEN!)
  • BIEN! is a community-based network that includes local libraries, health clinics, hospitals, community and health organizations, and centers of higher education. The web-base portal (www.bienhealth.org) provides access to reliable health information in English and Spanish to the public, health providers of clinics and hospitals, researchers, faculty, and students. The BEC maintains the BIEN! Web site.
Border Binational Health Week/Vaccination Week of the Americas
  • The BEC staff was key to the successful outcome of the multitude of events in celebration of 2005 and 2006 National Infant Immunization Week/Vaccination Week of the Americas (NIIW/VWA).
Binational Espejo Project
  • This binational HIV/Sexually Transmitted Disease (STD) health promotion and education project aimed to reduce the incidence of HIV/STD among high–risk populations (women working in cantinas) in Palomas, Chihuahua (1994-2002). The BEC staff worked with the Chihuahua Department of Health to design the Espejo Binational Health Promotion and Education Program in coordination with staff from NMBHO. The intervention activities allowed area clinicians to diagnose and treat STD cases, while health promotion activities educated the high-risk population and promoted healthy behavior changes.

Border Infectious Disease Surveillance (BIDS)

  • The Border Infectious Disease Surveillance (BIDS) is a network of selected clinical sites that conduct surveillance for infectious diseases along the border region. BIDS is designed, implemented and conducted by public health agencies on both sides of the U.S.-Mexico border. The BIDS Project was formed in response to binational consensus among public health officials about the need for a system for surveillance of infectious diseases along the Border. The Centers for Disease Control and Prevention (CDC) in collaboration with Mexican Secretariat of Health and the U.S. and Mexican border state and local health departments established an active sentinel surveillance network to complement and enhance existing passive systems for infectious disease surveillance along the U.S.-Mexico border.
  • The objectives of the BIDS program are:
    1. Establish an active, binational sentinel surveillance network that uses standardized data collection instruments, operational definitions, and laboratory diagnostic tests to enhance infectious disease surveillance at clinical sites located along the U.S.-Mexico border. 
    2. Gather and exchange disease incidence and risk factor information that will assist public health officials with the development of binational control and prevention strategies appropriate for this region. 
    3. Improve local laboratory diagnostic capabilities by supporting and enhancing those local laboratories that provide services for BIDS-affiliated sentinel sites. 
    4. Develop educational and training opportunities for local public health practitioners as part of broader efforts to improve public health infrastructure in the region. 
    5. Improve binational communications and data exchange between public health officials by electronically linking BIDS sentinel sites, laboratories, and local, regional, and state epidemiologists.
  • The clinical facilities participating in this binational surveillance project along the US-Mexico border were organized in eight groups:
     
    Group I: Tijuana and San Diego
    Group II: Ciudad Juarez, El Paso, and Las Cruces
    Group III: Reynosa and McAllen
    Group IV: Matamoros and Brownsville
    Group V: Mexicali and Imperial
    Group VI: Nuevo Laredo and Laredo, and
    Groups VII & VIII: Nogales Sonora, Nogales, and Tucson. 

 

You could learn more about the BIDS project from the "Emerging Infectious Disease" journal, available at http://www.cdc.gov/ncidod/eid/vol9no1/02-0047.htm

Substance Abuse Initiatives
  • The BEC coordinated the development and operation of the Substance Abuse Committee of the New Mexico Border Health Council and the Substance Abuse Commission of the Border Governors' Conference (2002-2006). The ORO/BEC was actively involved in the development of the Substance Abuse Prevention Plan for the Southwestern New Mexico border counties that was developed by the newly integrated Southwest Regional Substance Abuse Collaborative. In addition, the BEC supported the establishment of the Binational Border Alliance of Substance Abuse Coalitions, which served as the Border Governors Health Work Table committee on Substance Abuse.
Binational Tri-state Mosquito Health Education Program
  • The BEC developed, in coordination with El Paso City-County Health and Environment District, NMDOH, and Ciudad Juarez (Mexico) Public Health Jurisdiction, an active mosquito surveillance program and established the regional Binational Vector Control Working Group. The group elaborated a mosquito-borne disease plan and distributed bilingual promotional material. The BEC provided guidance and technical assistance. This intervention, decreased the occurrence of West Nile virus encephalitis in our area and reduced the risk of other deadly diseases like dengue, and malaria.
Vacúname Program
  • The Vacúname program was a immunization initiative in Doña Ana, Sierra, Otero, and Luna Counties. The objective was to improve the on-time vaccination of children less than one year of age by offering good quality photos of their children to mothers attending health clinics.
Healthy Border/Healthy Gente Initiative
  • The Healthy Border/Healthy Gente initiative in the New Mexico border region is a model of strategic management and planning tool developed by NMBHO and the BEC. The process used a modified Healthy People community planning process. Actions related to Healthy Border support a local health promotion and disease prevention agenda that is community-driven, population based and integrated with existing community health improvement processes; support the local and state public health roles of assessment, policy development and assurance; and, support the existing state and local public health strategic planning processes. The BEC provided technical assistance and data-driven support services to local organizations and programs that promoted the Healthy Border/Healthy Gente initiative from 2000 to 2006.