Yessenia Castro, Ph.D., is a postdoctoral fellow in the Department of Health Disparities Research at the University of Texas M.D. Anderson Cancer Center (MDACC). She is seeking five years of funding through the National Cancer Institute's Mentored Research Scientist Development Award to Promote Diversity (K01). Dr. Castro conducts research examining social, interpersonal, intrapersonal, and cultural determinants of smoking cessation in minority and underserved populations under the mentorship of Dr. David Wetter. MDACC provides an unusually rich training environment that includes an extraordinary number of workshops, seminars, and courses;outstanding opportunities for developing skills in grant writing, publication, and project management;and superb resources for assisting young investigators. Dr. Castro's long term career goals are to serve as an independent, research-oriented faculty member in a university environment, and to develop a program of research focused on understanding culturally relevant influences of cancer risk behaviors, with a particular focus on smoking among Latinos. Such a program could improve smoking cessation interventions tailored for or targeted at Latinos, and ultimately aid in eliminating health disparities among this population. In the current proposal, Dr. Castro delineates four short term goals to be achieved throughout the award period that are intended to serve as the foundation for an independent research career. These are: 1) accumulate a strong knowledge base in the social, cognitive, and affective mechanisms and processes involved in tobacco dependence and cessation among underserved adult populations;2)extend her current knowledge of research on gender and race/ethnicity into the area of cancer prevention;particularly, smoking cessation among Latinos;3) gain knowledge and experience in culturally competent community level research from a public health perspective, and;4) learn the appropriate statistical methods and modeling techniques for evaluating complex longitudinal data. These goals will be achieved through a combination of: 1) rigorous formal coursework and directed readings;2) numerous professional development experiences;3) numerous project implementation, data analysis, and manuscript writing/publication experiences, and;4) intensive mentoring by a team of highly successful scientists with diverse expertise, such that each mentor can provide invaluable guidance in achieving a specific short term goal, but most can advise about more than one goal. The proposed research plan seeks to address the paucity of existing research addressing the mechanisms underlying smoking cessation among Latinos. Research in addictions and health behavior has identified a number of individual-level factors that are key determinants of smoking cessation including social/environmental, inter-/intrapersonal, and cognitive/affective factors. Emerging research suggests that many of the known determinants of smoking cessation may be of equal importance to minority smokers, but more research is needed in this area, as noted by several prominent publications including the Surgeon General's Report and the Treating Tobacco Use and Dependence Clinical Practice Guideline. Further, with the exception of data addressing the influence of acculturation on smoking prevalence, almost nothing is known about the effect of acculturation and other culturally relevant variables (e.g., acculturative stress, perceived discrimination) on the process of smoking cessation. Thus, the proposed project will utilize data from three longitudinal studies of Latino smokers to examine the impact of culturally relevant factors on mechanisms of smoking cessation. The ultimate goal of this project is to develop and evaluate a comprehensive conceptual model linking cultural factors to mechanisms of smoking cessation that is informed by previous work addressing the impact of culture on mental and physical health, socioeconomic status influences on health, and theories of addictive behaviors. Additionally, the project will evaluate specific, fine-grained hypotheses using data collected with state-of-the-science ecological momentary assessment techniques.
Although Latinos are less likely to smoke, they exhibit more difficulty quitting, are less likely to seek or receive help with quitting, and are at high risk of developing tobacco related chronic illnesses. Further, very little is known about the determinants of smoking cessation among Latinos, or how factors specific to minority status influence determinants of cessation. Advancing knowledge in these areas would help to identify treatment targets, improve current smoking cessation interventions, and ultimately aid in eliminating health disparities among Latinos.
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