TOCA at Banner Health

Mental health care is vital to refugee integration, yet current frameworks often lack the cultural sensitivity needed to address distinct subgroup needs. This limits the understanding of how cultural and experiential factors shape refugees' mental health and responses to care. Research that predominantly treats refugees as a homogeneous group overlooks these differences, hindering the development of effective, nuanced interventions. Although social connectedness is widely recognized as protective for mental health, prior research often has simplified this to general social support measures, overlooking the unique structure and function of refugees' social networks. To address these gaps, this pilot study used a community-based participatory approach and egocentric network data to examine social support, social network characteristics, and mental health across six refugee groups-Bhutanese, Burmese, Congolese, Iraqi, Somali, and Syrian-resettled in Arizona, a key U.S. resettlement location. Our sample (N = 150) was 53.0% male and 47.0% female with an average age of 41.4 years; 31.3% reported no formal education and 44.7% were unemployed. Univariate analyses revealed significant differences in sociodemographic characteristics, social support levels, social network characteristics, and mental health statuses (psychological distress and suicidal thoughts) among refugee subgroups. These findings underscore the need for culturally responsive interventions that encourage cross-cultural engagement, expand community support, and foster diverse networks to support refugee mental health and integration. This study is the first to employ egocentric network data to compare social networks and mental health indicators among Arizona's refugee subgroups.

Abstract Introduction: Understanding how communities access and engage with health information is essential for effective health communication. Health literacy—the ability to read, understand, and use healthcare information—plays a crucial role in making informed health decisions. With the rise of digital technologies, internet access and online engagement have become key tools for obtaining health information. However, variations in health literacy and digital engagement can limit some populations' ability to fully access these resources. This study examined health literacy, cancer information-seeking behaviors, internet access, and digital engagement among adults in the Mayo Clinic Comprehensive Cancer Center catchment areas to inform more effective and region-specific health communication strategies. Methods: This study focused on adult residents within the Mayo Clinic Comprehensive Cancer Center catchment areas, covering 75 counties across Arizona, Florida, and the Midwest (Minnesota, Wisconsin, and Iowa). Data were collected through partnerships with the University of Florida and Mayo Clinic Survey Research Centers, and the "Boots on the Ground" approach involving community health workers. Methods included phone calls, online submissions, and community outreach for an anonymous survey. Validated measures assessed health literacy, information access, and digital engagement. Descriptive analyses were performed using valid responses, excluding non-responses and "Prefer not to answer" options to ensure interpretive accuracy. Results: Data from 2,681 respondents highlighted consistent barriers to cancer prevention with regional differences. In Arizona, 42.6% of respondents need help reading medical materials, but only 3.1% reported lacking confidence in obtaining cancer-related information. In contrast, 63.1% felt very or completely confident in accessing cancer advice. The primary sources of health information were doctors (17.6%), internet searches (11.4%), and family (9.8%). In Florida, 38.4% need assistance, but only 2.7% lack confidence, and 68.2% feel very or completely confident. Doctors (18%) and internet searches (13.1%) were top sources. In the Midwest, 38.5% struggle with medical documents, and 3.1% reported lacking confidence, while 66.4% felt very or completely confident. Internet access is widespread across all regions, with smartphones being the dominant device. Daily internet use for communication, browsing, and engagement with health apps and social networks remains high. Conclusion: Although many respondents face challenges with reading health-related materials, most report high confidence in obtaining cancer information, suggesting a gap between functional health literacy and perceived ability to access information. The widespread use of mobile devices and near-universal internet access offers a valuable opportunity to enhance health communication through digital tools. These findings emphasize the importance of tailored digital outreach to bridge literacy gaps and ensure underserved populations can access reliable health information. Citation Format: Tingyu Zou, Monica L. Albertie, Emelina Asto-Flores, Manisha Salinas, Farhia Omar, Adeline Abbenyi, Noreen Stephenson-Hubert, Nuwanthi Heendeniya, Kathleen Yost, Folakemi T. Odedina. Health literacy and digital engagement across US Regions: Insights from the mayo clinic catchment areas [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B030.