Introduction: Zika virus is primarily transmitted through mosquito bites. Because Zika virus infec-tion during pregnancy can cause serious birth defects, reproductive-aged women need protection from Zika virus infection. This report describes Zika virus prevention behaviors among women aged 18-49 years and assesses whether pregnancy status and healthcare provider counseling increases Zika virus prevention behaviors. Methods: A population-based cell phone survey of women aged 18-49 years living in Puerto Rico was conducted in July-November 2016. Data were analyzed in 2018-2019. Prevalence estimates and 95% CIs were calculated for Zika virus prevention behaviors. Adjusted prevalence ratios were estimated to examine the association of pregnancy status with healthcare provider counseling on Zika virus prevention behaviors, controlling for age, education, and health insurance status. Results: Most women reported using screens on open doors/windows (87.7%) and eliminating stand-ing water in/around their homes (92.3%). Other Zika virus prevention behaviors were less common (<33%). In adjusted analysis, pregnant women were more likely than women not at risk for unintended pregnancy to report using mosquito repellent every/most days (adjusted prevalence ratio=1.44, 95% CI=1.13, 1.85). Healthcare provider counseling was associated with receiving professional spraying/larvi-cide treatment (adjusted prevalence ratio=1.42, 95% CI=1.17, 1.74), sleeping under a bed net (adjusted prevalence ratio=2.37, 95% CI=1.33, 4.24), using mosquito repellent (adjusted prevalence ratio=1.57, 95% CI=1.40, 1.77), and wearing long sleeves/pants (adjusted prevalence ratio=1.32, 95% CI=1.12, 1.55). Conclusions: Receipt of healthcare provider counseling was more consistently associated with Zika virus prevention behaviors than pregnancy status. Healthcare provider counseling is an important strat-egy for increasing the uptake of Zika virus prevention behaviors among women aged 18-49 years. Published by Elsevier Inc. on behalf of American Journal of Preventive Medi-cine.

INTRODUCTION:Genetic testing remains low among racial/ethnic minority populations in the United States. We aimed to determine the prevalence and correlates of awareness of direct-to-consumer (DTC) genetic tests and the prevalence of genetic test use in a population-based sample of adults in Puerto Rico.METHODS:We analyzed data from adults aged 18 years or older who completed information on genetic test awareness (n = 611; 96% of study population) from the Health Information National Trends Survey conducted in Puerto Rico in 2009. Odds ratios with 95% confidence intervals were estimated by using logistic regression models to identify factors associated with awareness of DTC genetic tests.RESULTS:The majority of respondents (56%) were aware of direct-to-consumer genetic tests, and approximately 4% had ever undergone any genetic test. Respondents who had never been married were less likely to be aware of DTC tests, as were current smokers. Respondents who ever sought cancer information were more likely to be aware of these tests.CONCLUSION:We provide the first published data on the awareness of DTC genetic tests and on use of genetic testing in Puerto Rico. Forty-four percent of our sample of Puerto Rican adults were unaware of direct-to-consumer genetic tests. Given the lack of clear benefits of DTC genetic tests to the general population, educational interventions should be developed to increase awareness and specific knowledge regarding the appropriate use of DTC genetic tests among people who are already aware of their existence.

Abstract Background: Effective development and dissemination of cancer control messages to the public requires a firm understanding of individuals’ information-seeking practices and preferences, and cancer-relevant risk behaviors, attitudes, and knowledge. The Health Information National Trends Survey (HINTS) was developed by the U.S. National Cancer Institute (NCI) as a mechanism for collecting such data to inform effective health communication strategies across populations. It provides surveillance of the nation's investment in cancer communication tracking the effects of the changing communication environment on cancer-related knowledge, attitudes and behaviors. The University of Puerto Rico Comprehensive Cancer Center, the Puerto Rico Behavioral Risk Factors Surveillance System, and the NCI, implemented HINTS in Puerto Rico in 2009. HINTS Puerto Rico provides an opportunity to better understand the cancer information and education needs of the population and informed cancer control planning for Puerto Rico. In this study, we describe health and cancer information-seeking behaviors, sources of information and trust in information sources among the population in Puerto Rico. Methods: For HINTS-Puerto Rico, the Spanish version of HINTS 2007 telephone survey was carefully reviewed and edited for language appropriateness for the island population by the HINTS Puerto Rico team. Data was collected between April and June, 2009. Variables of interest for this analysis include: health and cancer information seeking and sources; trust in health information sources, use of the Internet for health, and sociodemographic characteristics (age, sex, education, and ethnic group, place of birth, annual household income, marital status, and employment status). We used multivariate logistic regression models for each of the outcomes of interest (health information seeking, cancer information seeking, and health-related use of the Internet) to estimate the odds ratios (ORs) and their 95% CIs for the association between sociodemographic characteristics and these behaviors. Results: A total of 639 (603 complete and 36 partially complete) interviews were conducted. Nearly one-third of respondents had ever looked for information about health (32.9%) or about cancer (28.1 %). The Internet was the most frequently reported source of information (56.4% of information seekers). The majority of respondents were generally positive in their characterization of their information-seeking experiences, and the most highly trusted sources of information were healthcare providers and government health agencies. College educated (OR=7.6,95% CI 3.0-19.3) and females (OR = 2.8,95% CI 1.6-5.0) were more likely to seek health information. Similarly, college educated (OR=5.4,95% CI 1.8-14.1) and females (OR=2.0,95% CI 1.2-3.3) were more likely to seek cancer information. Only 32.7% of respondents had ever accessed the Internet and college educated were more likely to use it (OR=12.2). Conclusion: Results provide insights into the health and cancer information-seeking behaviors and experiences of the population in Puerto Rico and contribute to the evidence base for cancer control planning on the island. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A17.

Effective communication around cancer control requires understanding of population information seeking practices and their cancer-relevant risk behaviors, attitudes, and knowledge. The Health Information National Trends Survey (HINTS) developed by the U.S. National Cancer Institute (NCI) provides surveillance of the nation's investment in cancer communication tracking the effects of the changing communication environment on cancer-related knowledge, attitudes, and behaviors. The University of Puerto Rico Comprehensive Cancer Center (UPRCCC), the Puerto Rico Behavioral Risk Factors Surveillance System (PRBRFSS), and the NCI implemented HINTS in Puerto Rico in 2009. In this article we describe the health and cancer information seeking behaviors, sources of information, trust in information sources, and experiences seeking information among the population of Puerto Rico. A total of 639 (603 complete and 36 partially complete) interviews were conducted. Nearly one-third of respondents had ever looked for information about health (32.9%) or about cancer (28.1%). The Internet was the most frequently reported source of information. College educated (odds ratio [OR]=7.6) and females (OR=2.8) were more likely to seek health information. Similarly, college educated (OR=5.4) and females (OR=2.0) were more likely to seek cancer information. Only 32.7% of respondents had ever accessed the Internet, and college educated were more likely to use it (OR=12.2). Results provide insights into the health and cancer information seeking behaviors and experiences of the population in Puerto Rico and contribute to the evidence base for cancer control planning on the island.

Abstract Introduction: Identifying individuals at highest risk for cancer may improve prevention and early detection efforts in these populations. Nonetheless, awareness and use of genetic testing remains low, particularly among ethnic minorities in the United States. Given the lack of information on the subject particularly for Puerto Ricans, this study aimed to determine the prevalence and correlates of genetic testing awareness and use in a population-based sample of adults in Puerto Rico. Methods: We analyzed data from adults aged (18+ years) participating in the 2009 Health Information National Trends Survey (HINTS) conducted in Puerto Rico (n=639), with complete information regarding age, sex, genetic test awareness, and use (n=611,95.6%). Using the Spanish version of the HINTS 2007-2008 survey, the HINTS Puerto Rico data collection was conducted from April to June 2009 through the PR-Behavioral Risk Factors Surveillance System (PR-BRFSS) telephone research center. The 2009 PR-HINTS utilized a cross-sectional, complex sample survey design, data weighting, and jackknife variance estimation. Prevalence odds ratios were estimated with 95% confidence intervals using logistic regression models in order to identify factors associated with genetic testing awareness and use in Puerto Rico. Awareness about genetic tests was measured by the following item: “Genetic tests that analyze your DNA, diet, and lifestyle for potential health risks are currently being marketed by companies directly to consumers. Have you heard or read about these genetic tests.” Results: Mean age of study participants was 45.9 years; 52.9% of participants were women and 47.1 % were men. Overall, 55.8% (95% CI=48.4%-63.2%) of the study population had heard or read about genetic tests, while only 4.3% (95% CI=1.6%-7.0%) had ever had any of these tests performed. In multivariate analysis, no differences in awareness of genetic tests were observed by age, sex, or educational attainment (p>0.05); whereas, marital status was associated with genetic test awareness. Those married/living together and those divorced/separated/widowed were more likely to be aware of genetic tests compared to those never married (p<0.05). Current smokers were less likely than never smokers (OR=0.52,95% CI: 0.31-0.88) to be aware of genetic tests, whereas no differences were observed between former and never smokers (p>0.05). Those who ever sought cancer information were two times as likely to had heard or read about genetic testing of their existence (OR=2.01,95% CI=1.05-3.82); however health information was not associated with awareness of genetic tests in multivariate analyses, those who had sought information on cancer were twice. Neither personal nor family history of cancer were associated with genetic testing awareness (p > 0.05). Conclusions: This study provides the first published data on the awareness and use of genetic tests in Puerto Rico. Although our results for test awareness and use are higher than those reported in the U.S. in the 2006 Health Styles national survey (14% and 0.6%, respectively), 40% of the population remains unaware of their existence. This information is relevant for determining the need for population-based outreach and education efforts in this area. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A36.

Objective. Childhood asthma is highly prevalent in some areas of Puerto Rico. The objective of this study was to estimate the prevalence of asthma in two municipalities of Northern Puerto Rico. Methods. Children 6 to 7 and 13 to 14 years of age participated in the school-based cross-sectional study. Results. A total of 1,467 elementary school students and 1,334 junior-high school students were included in the survey. A high prevalence of asthma was observed; 46% in elementary schools and 24% in junior-high schools. In elementary schools, family history of asthma (FHA) was associated with ever wheezed (PR = 2.00, 95%CI 1.59, 2.52), wheeze during last year (PR = 2.02, 95%CI 1.54, 2.62), and asthma (PR = 2.33, 95%CI 1.86, 2.92). For junior-high schools FHA was associated with ever wheezed (PR = 2.01, 95%CI 1.56, 2.57), wheeze during previous year (PR = 2.00, 95%CI 1.47, 2.73), and asthma (PR = 2.72, 95%CI 2.06, 3.60). Conclusions. This study showed a high prevalence of asthma and related symptoms in Northern Puerto Rico. FHA was strongly associated with asthma and its symptoms. Further research is recommended to look at genetics, sensitivity levels, indoor and outdoor pollution, and gene-environment interactions.