Arab Community Center for Economic and Social Services

Abstract Purpose: Much research is needed to advance our knowledge of LGBTQ cancer disparities, but research is hindered by inconsistency in collection of data on sexual orientation and gender identity (SOGI) across clinical and research settings. Nationally, there have been increased efforts to standardize SOGI data collection. The purpose of this study was to identify potential patient-level barriers and facilitators to SOGI data collection within the catchment area of a midwestern cancer center. Methods: Investigators conducted 4 focus groups in partnership with community-based organizations and stakeholder groups that reflected the catchment area’s diverse populations. Using a semi-structured approach, participants were asked about their experiences with SOGI data collection, barriers and facilitators to this collection, and how they viewed the practice of collecting SOGI data. Focus groups were audio recorded and transcribed. Data was coded and interpreted using applied thematic analysis. Results: Four focus groups were conducted with 32 participants in total. There were 2 LGBTQ groups (one mixed race/ethnicity, one African American), and 2 predominantly non-LGBTQ groups (one African American and one Middle Eastern/North African or MENA). Across all participants, 53% were African American (n=17), 25% identified as MENA (n=8), 28% were White (n=9), 44% of the participants identified as women (n=19), one individual identified as a transgender woman & 2 individuals as non-binary, and 53% reported their sexual orientation as gay/lesbian/same-loving. In all groups, participants emphasized a need to educate both patients and providers about the importance of SOGI data collection, why it is collected, and its relevance to improving medical care. Participants further discussed the quality and depth of the patient-provider relationship as a critical factor in a patient’s comfort and willingness to share SOGI data. Participants also underscored the importance of privacy ownership (i.e., the ownership of one’s own private information) and control in relation to SOGI status, and the desire to minimize potential privacy turbulence of an unexpected and unwelcome disclosure breach. All groups discussed how the potential for harm resulting from SOGI disclosure could deter patients from sharing SOGI information. Those who identified as LGBTQ, recounted both personal experiences and the experiences of others in which disclosure of SOGI information directly led to poor treatment by a healthcare professional. It is this potential for harm and discrimination that led many participants to stress the need for privacy control until a safe environment is established. Conclusions: Findings highlight a number of potential patient barriers to SOGI data collection from community members’ perspectives, including the need for widespread education on this topic and clinical environments in which patients are safe disclosing SOGI status. Future research and practice should consider specific methods to normalize the practice of SOGI data collection in the cancer care context. Citation Format: Ariel Washington, Ali Fakih, Lindsey Toman, Riham Ayoub, Emma Noble, Susan Musto, Brittany Dowe, Scott Ellis, Andrea Sakleh, Hayley S. Thompson, Latonya Riddle-Jones. ‘We’ve got to go to the doctor and we’re scared to death’: Community members perspectives on sexual orientation and gender identity data collection in healthcare settings [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B092.

Among Arab-American women in Michigan, rates of cervical cancer screening are lower than those in non-Hispanic White and Black women in the state. A deep understanding of the Arab community’s perspective on cervical cancer screening is needed to address the disparity in rates across populations in Michigan. Arab and Chaldean women across Michigan were invited to participate in Zoom-based focus groups to understand the attitudes, acceptability, and barriers of cervical cancer screening among this population. Four focus groups with a total of 19 women aged 30 to 61 were conducted. The focus groups were conducted in English, Arabic, or both languages. The guided discussion was focused on knowledge of cervical cancer and Human papillomavirus (HPV) and its transmission, attitudes towards HPV vaccination, and attitudes towards cervical cancer screening. HPV self-sampling as an alternative to traditional provider-based screening was specifically discussed as this has been proposed as a way to increase screening in hard-to-reach populations. The conversations revealed insights related to barriers at the individual and community levels for screening and vaccination, attitudes towards preventive health care including screening, a need for accessible women’s health literature, and health education. The women also discussed vaccine hesitancy related to HPV and COVID-19, suggesting a need for targeted community interventions.

Mangrove forests in the Gulf Cooperation Council (GCC) countries are facing multiple threats from natural and anthropogenic-driven land use change stressors, contributing to altered ecosystem conditions. Remote sensing tools can be used to monitor mangroves, measure mangrove forest-and-tree-level attributes and vegetation indices at different spatial and temporal scales that allow a detailed and comprehensive understanding of these important ecosystems. Using a systematic literature approach, we reviewed 58 remote sensing-based mangrove assessment articles published from 2010 through 2022. The main objectives of the study were to examine the extent of mangrove distribution and cover, and the remotely sensed data sources used to assess mangrove forest/tree attributes. The key importance of and threats to mangroves that were specific to the region were also examined. Mangrove distribution and cover were mainly estimated from satellite images (75.2%), using NDVI (Normalized Difference Vegetation Index) derived from Landsat (73.3%), IKONOS (15%), Sentinel (11.7%), WorldView (10%), QuickBird (8.3%), SPOT-5 (6.7%), MODIS (5%) and others (5%) such as PlanetScope. Remotely sensed data from aerial photographs/images (6.7%), LiDAR (Light Detection and Ranging) (5%) and UAV (Unmanned Aerial Vehicles)/Drones (3.3%) were the least used. Mangrove cover decreased in Saudi Arabia, Oman, Bahrain, and Kuwait between 1996 and 2020. However, mangrove cover increased appreciably in Qatar and remained relatively stable for the United Arab Emirates (UAE) over the same period, which was attributed to government conservation initiatives toward expanding mangrove afforestation and restoration through direct seeding and seedling planting. The reported country-level mangrove distribution and cover change results varied between studies due to the lack of a standardized methodology, differences in satellite imagery resolution and classification approaches used. There is a need for UAV-LiDAR ground truthing to validate country-and-local-level satellite data. Urban development-driven coastal land reclamation and pollution, climate change-driven temperature and sea level rise, drought and hypersalinity from extreme evaporation are serious threats to mangrove ecosystems. Thus, we encourage the prioritization of mangrove conservation and restoration schemes to support the achievement of related UN Sustainable Development Goals (13 climate action, 14 life below water, and 15 life on land) in the GCC countries.

Abstract Cervical cancer screening rates among Arab-American women have been consistently shown to be lower than that of non-Hispanic White and Black women in the state of Michigan. Addressing the low cervical cancer screening rates among Arab American women in Michigan requires a deep understanding of the community’s perspective about cervical cancer screening. Thus, we conducted a series of focus groups in Southeastern Michigan to understand the attitudes, acceptability, and barriers of cervical cancer screening among this population. Four focus groups with a total of 19 women were conducted via Zoom. Participants were recruited through social media channels and community organizations. All focus groups were conducted with self-identifying Arab, Arab American, or Chaldean women aged 30 to 61. The focus groups were conducted in either English, Arabic, or a mixture of both languages. Women completed a brief anchoring survey with demographic questions and a self-assessment of their HPV knowledge (see Table 1). The guided discussion centered around knowledge of cervical cancer, broadly, knowledge of Human papillomavirus (HPV) and its transmission, attitudes towards the HPV vaccination, and attitudes towards cervical cancer screening, which included HPV self-sampling methods. The recorded sessions were transcribed and are being coded using Dedoose Version 8.0.35, a qualitative analysis software. During the focus group, the discussion centered around barriers at the individual and community levels for screening and vaccination, attitudes towards preventive health care including screening, a need for accessible women’s health literature, and health education. The women also discussed vaccine hesitancy related to HPV and COVID19. This suggests the need for targeted community interventions. General characteristics of participants (N*=19) N Mean Age (N=17) 37.9 8.7 (SD) Married (N=18) 11 61.1% Survey Language Arabic 6 31.6% English 13 68.4% How well would you say the financial needs are met in your household? Just sufficient 9 50% More than sufficiently met 3 16.7% Barely making it 3 16.7% Not met at all 3 16.7% How well informed do you think you are about cervical cancer? Not informed at all 1 5.6% Not well informed 10 55.6% Moderately informed 5 27.8% Well informed 1 5.6% Very well informed 1 5.6% Have you had vaginal sex (intercourse) before? Yes 15 83.3% No 3 16.7% Have you had oral sex before? Yes 8 47.1% No 9 52.9% Do you have any children? Yes 15 83.3% No 3 16.7% *Complete data available for 17 participants, partially complete data for 2 participants, and missing data for 1 participant Citation Format: Lilah Khoja, Heidi G. Torres, Mariam Ayyash, Madiha Tariq, Alison M. Mondul, Rafael Meza, Celeste L. Pearce. Cervical cancer screening and vaccination acceptability and attitudes amongst Arab American women in southeastern Michigan [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2211.

SummaryBackgroundArab American women have preferred women physicians of their own culture in the past. The primary aim of this study is to determine the current influence of religion/culture among MENA women and their preferences for physicians of same sex, culture, and religion on the avoidance and uncomfortableness of routine and women’s health exams.MethodsA cross sectional community survey including religiosity and the importance of physician matched sex, culture, and religion was completed. Outcome measures were avoidance of a routine physical exam, or a women’s health exam because of religious/cultural issues; and the uncomfortableness of the women’s health exam. Linear regression modeling was used to evaluate the association between outcomes and potential predictors, with significance assessed using a bootstrap method.FindingsThe responses of 97 MENA women 30–65 years old showed that MENA women agreed that they would avoid routine health exams because of religious/cultural issues if their physician was of the same religion or culture as they were (p < 0.001, p < 0.05, respectively) or they had less education (p < 0.05). MENA women also avoided women’s health exams due to religious/cultural issues if her physician was of the same religion as she (p < 0.01).InterpretationMENA women 30–65 years old may no longer be bound to a female physician of their same religion/culture for their health exams.

Introduction:The association between HIV status and hypertension is not well described within sub-Saharan Africa. We examined prevalence and risk factors for hypertension among HIV positive and negative individuals living in a rural district of Uganda.Methods:We conducted a cross-sectional analysis in two concurrent cohorts of 600 HIV negative and 721 HIV seropositive individuals aged ≥35 years.Results:Of the 721 HIV positive participants, 59.8% were women and the median age was 44.3 years, while for HIV negative individuals, 55% were women and the median age was 47.8 years. Over 90% of HIV positive individuals were on antiretroviral treatment. The prevalence of hypertension (≥140/≥90 mmHg) was 33.5% in HIV negative individuals and 23.9% in HIV positive individuals. Age (adjusted OR = 1.05, 95% CI 1.03 to 1.06) and BMI (adjusted OR = 1.08, 95% CI 1.05 to 1.12) were associated with higher odds of hypertension. Having HIV was associated with lower odds of hypertension (adjusted OR = 0.66, 95% CI 0.50 to 0.88), lower systolic blood pressure (–5.1 mmHg, 95% CI: –7.4 to –2.4) and lower diastolic blood pressure (–4.0 mmHg, 95% CI: –5.6 to –2.5). We did not observe differences in the odds of hypertension by CD4 count, viral load or ART among HIV positive individuals in this sample.Conclusions:Hypertension was prevalent in one third of HIV negative individuals and in one fourth of HIV positive patients. While access to health information among individuals attending HIV clinics may explain observed differences, more research is needed to understand plausible biological and social mechanisms that could explain lower blood pressure among people living with HIV in Uganda.

To report the clinical characteristics, surgical management, and medium-term outcomes of total hip replacement (THR) performed in dogs with previous contralateral pelvic limb amputation. Thirteen client-owned dogs. Multi-institutional retrospective clinical study. Data recorded from medical records included signalment, indication for amputation and THR, and surgical complications. Implant positioning and complications were assessed on radiographs. Clinical outcomes were evaluated during follow-up examinations by one of the authors and through a mobility- and lifestyle-based questionnaire completed by owners. All 13 dogs had satisfactory clinical results at follow-up a median of 3 months (range, 2-36) after THR. No postoperative luxation was recorded. Four dogs had minor complications that did not require additional treatment. The only major complication was one failure of osseointegration of a cementless acetabular cup, and it was successfully revised. Total hip replacement resulted in satisfactory clinical results and acceptable morbidity in this population. Total hip replacement should be considered in dogs with severe coxofemoral joint disease and contralateral pelvic limb amputation.

Abstract Background Arab-Americans constitute ~ 5% of Michigan’s population. Estimates of obesity in Arab-Americans are not up-to-date. Here we describe the distribution of, and factors associated with obesity in an Arab-American population.Methods Arab-American patients, ages 18–98 years, from Arab Community Center for Economic and Social Services (ACCESS) clinic located in Dearborn, Michigan were identified from medical records. Retrospective chart review abstracted age, sex, marital status, employment, body mass index (BMI), hypertension (HTN), diabetes mellitus (DM), hyperlipidemia (HLD), employment status, tobacco use and alcohol consumption. This cohort was compared to Michigan’s Behavioral Risk Factor Surveillance System (BRFSS) data from 2018 and to a cohort seeking care between 2013–2019 from a free clinic in Ferndale, Michigan.Results Of the 2,363 Arab-American patients from the ACCESS clinic, 67% (n = 1591) were female and 33% (n = 772) were male. Among Arab-Americans, patients who were older or with HTN, DM or HLD had a higher prevalence of obesity than patients who were younger or without these comorbidities (all p-value &lt; 0.001). Patients with HTN were 3 times as likely to be obese than those without HTN (95% 95% CI: 2.41–3.93; p &lt; 0.001). Similarly, the odds of being obese were 2.5 times higher if the patient was diabetic (95% CI: 1.92–3.16; p &lt; 0.001) and 2.2 times higher if the patient had HLD (95% CI: 1.75–2.83; p &lt; 0.001). 9,589 individuals from Michigan’s BRFSS data were included in the study and no significant difference in obesity rates between Arab-Americans (31%) and the BRFSS population (32.6%) was noted. Compared to Arab-Americans, patients seen at the free clinic (n = 1,033) had a higher obesity rate (52.6%; p &lt; 0.001) as well as significantly higher rates of HTN, DM and HLD (all p &lt; 0.001). In Arab-Americans, a trend was observed in which obesity increased with age upto 44 years and declined thereafter. This was not the case in BRFSS and FCFC patients, where consistent increase in obesity was seen with increasing age.Conclusion Obesity rates in Arab-Americans were comparable to their BRFSS counterparts, and lower than their FCFC counterparts. Further studies are required to understand the impact of obesity and the association of comorbidities in Arab-Americans residing in the US.

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