Preventing Cancer in Latinos, One Text Message at a Time
The nation’s Latino population has been one of its fastest growing in recent decades, accounting for more than half of total U.S. population growth from 2000 to 2014. This group is expected to reach 106 million in 2050, double what it is today, according to U.S. Census Bureau population projections.
Despite population size, Latinos are an underserved group, experiencing significant disparities in health care including higher rates of particular cancers, lower cancer screening rates and cancer diagnoses at more advanced stages than non-Latinos. Now, consider this: the growth rate in U.S. Latino cancer cases is projected to hit an astounding 142 percent by 2030.
Paula Cupertino, Ph.D., director of the University of Kansas Medical Center’s Juntos Center for Advancing Latino Health, and her bilingual team, which includes researchers from The University of Kansas Cancer Center and Children’s Mercy, are working to reduce this looming health crisis through cancer prevention, and they are doing it in a unique way. Cupertino’s team is connecting Latinos with tobacco cessation treatment (both medication and behavioral support) via text messaging.
Why text messaging? Latinos are the fastest users and adopters of cell phones and respond more to the text message market than any other group. Since 2009, Latinos have closed the gap between whites for cell phone ownership – about 86 percent of Latinos own cellphones compared with 84 percent of whites. Eighty-seven percent of Latinos use their phones for texting, whereas only 79 percent of whites text.
“Given Latinos preferences towards smartphones, mobile health care is key. Latinos are a critically underserved group that falls outside of the traditional health care system. Access to standard face-to-face care can be an issue, but anyone with a cellphone can text and simply access cessation resources,” Cupertino said.
“It’s encouraging to see how engaged Latinos are with this program. When participants communicate with their counselor via text, they are enjoying a real back-and-forth conversation. These interactions average about 30 texts per day. With other ethnicities, the average is eight text messages."
Over the last several years, text message programs have been implemented to promote and encourage healthy behaviors. However, when it comes to existing Spanish language tobacco cessation text message programs in the United States, Cupertino’s research team found that these programs are not adapted or tailored to Latinos. To address this need, Cupertino and Edward Ellerbeck, M.D., MPH, co-leader of the cancer control & population health research program, worked with mobile health engagement company Agile Health to create a program that would “speak” to this population.
Prior to the study, Agile Health had rolled out a similar text messaging program to its clients – which includes companies such as Walmart – but the program was not gaining traction with the Latino community. Latinos have unique smoking habits, tending to be social smokers who smoke fewer cigarettes than other population groups, and the program needed to be tailored to their usage habits.
The team applied for and was awarded a Small Business Technology Transfer (STTR) grant from the National Institutes of Health (NIH), which funds small business and nonprofit research institutions and serves to bridge the gap between basic science and commercialization of the resulting innovations.
Now 600 participants in the United States are enrolled in a trial evaluating the effectiveness of a smoking cessation text messaging program. What’s more, it has sparked international collaborations in two other countries: Mexico, where a smoking cessation program of this kind has never before existed; and Brazil, where more than 20,000 smokers have already adopted this pre-paid program.
For the U.S. program, Juntos researcher Mariana Ramirez reports a 33 percent quit rate. By comparison, 2010 data from the National Health Interview Survey shows that only 6.2 percent of all smokers (of all races) quit in a given year. One-hundred percent of the study’s reported quitters have been biologically tested, confirming there is no tobacco in the participant’s system. Participant feedback has been overwhelmingly positive. One commented that if it weren’t for the program, he would have continued smoking.
Ramirez attributes its success to Latinos higher-than-average engagement with their cellphones.
“It’s encouraging to see how engaged Latinos are with this program. When participants communicate with their counselor via text, they are enjoying a real back-and-forth conversation. These interactions average about 30 texts per day. With other ethnicities, the average is eight text messages,” Ramirez said.
Cupertino notes that, given its effectiveness, in terms of both quit-rate and cost, the program has potential for an even greater global reach.
“My entire Juntos team is made up of Latino immigrants from countries all over the world – Brazil, Ecuador, Spain, Colombia, Mexico, to name a few,” Cupertino said. “We are passionate about helping Latinos everywhere quit smoking tobacco, one text message at a time.”
- Ready to quit? KanQuit!, a free program for Kansas residents, can help you create a Quitting Plan.