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Bade BC, Makhnevich A, Dauber-Decker KL, Solomon J, Cohn E, Chusid J, Raoof S, Silvestri G, Cohen SL. Qualitative interviews for hospitalists addressing lung cancer screening. Curr Probl Diagn Radiol 2024:S0363-0188(24)00157-9. [PMID: 39164184 DOI: 10.1067/j.cpradiol.2024.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 08/13/2024] [Indexed: 08/22/2024]
Abstract
Novel strategies are needed to improve low rates of lung cancer screening (LCS) in the US. Seeking to determine hospitalists' perspectives on leveraging hospitalizations to identify patients eligible for LCS, we performed qualitative interviews with eight hospitalists from two hospitals within a large integrated healthcare system. The interviews used semi-structured questions to assess (1) knowledge and practice of general screening and LCS guidelines from the United States Preventive Services Task Force (USPSTF), (2) identification of smoking history, and (3) hospitalists' views on how data obtained during hospitalization may be utilized to improve general screening and LCS post hospitalization. We ultimately reached the conclusion that hospitalists would support a dedicated program to identify hospitalized patients eligible for LCS and facilitate testing after discharge. Efforts to identify patients and arrange subsequent screening should be performed by team members outside the inpatient team.
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Affiliation(s)
- Brett C Bade
- Northwell, New Hyde Park, NY, USA; Institute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Alex Makhnevich
- Northwell, New Hyde Park, NY, USA; Institute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Katherine L Dauber-Decker
- Northwell, New Hyde Park, NY, USA; Institute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Jeffrey Solomon
- Northwell, New Hyde Park, NY, USA; Institute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Elizabeth Cohn
- Northwell, New Hyde Park, NY, USA; Institute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Jesse Chusid
- Northwell, New Hyde Park, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Suhail Raoof
- Northwell, New Hyde Park, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | | | - Stuart L Cohen
- Northwell, New Hyde Park, NY, USA; Institute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
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Abstract
BACKGROUND Among Chinese immigrants, osteoporosis is undertreated, misdiagnosed, and a leading cause of fragility fractures. In orthopaedic surgery departments, prevention education and health behavior change programs are necessary to improve their bone health. PURPOSE The purpose of this study was to examine the effectiveness of an osteoporosis prevention education program on participants' self-efficacy with regard to exercise and nutrition when provided by an orthopaedic surgery team during an annual Chinese Health Fair in Santa Clara County, CA. METHODS This pilot study used a single-group pretest and posttest design. Chinese immigrants at risk of osteoporosis were recruited during a 1-day health fair. The Bone Health Intervention (BHI) included orthopaedic surgeon consultation, visual aids including osteoporosis images and bone models, a video that included a discussion on calcium and vitamin D in the Chinese diet and culturally-acceptable exercise, and osteoporosis educational handouts. The Osteoporosis Self-Efficacy Scale (OSES) was utilized to measure participants' confidence in the ability to participate in self-care behaviors related to physical activity and calcium intake before and after the intervention. Paired t tests were used to compare participants' OSES scores pre- and postintervention. RESULTS There was a significant increase in mean OSES scores postintervention, indicating that the intervention could be an effective method of increasing participants' self-efficacy regarding calcium intake and time spent in exercising. CONCLUSION These results indicate that a culturally meaningful education program can potentially reduce fragility fracture risk. Orthopaedic health providers are ideal candidates to deliver preventive care education to improve outcomes for Chinese immigrants.
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Wong CP, Lok MK, Wun YT, Pang SM. Chinese men's knowledge and risk factors of osteoporosis: compared with women's. Am J Mens Health 2013; 8:159-66. [PMID: 24027205 DOI: 10.1177/1557988313503981] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Male osteoporosis is underappreciated. Little is known about men's knowledge of osteoporosis and how much men are at risk. This study surveyed men's knowledge of osteoporosis and their risk factors with reference to women in the primary care setting in Macau, China. A convenience sample of 302 men and 635 women aged 18 to 90 years completed questionnaires comprising the Osteoporosis Knowledge Assessment Tool and the One-Minute Osteoporosis Risk Test. Their risks of osteoporosis were assessed with the Osteoporosis Self-Assessment Screening Test. Men and women, who were aged 55 years or below, had similarly limited knowledge of osteoporosis. People aged above 55 years had significantly less knowledge; men had less knowledge than women only in this age-group. If questions specific to women or menopause were excluded, men had similar knowledge as women. A higher proportion of men than women had risk factors as more men consumed alcohol or smoked tobacco. Similar proportions of men and women reported a loss of 1 inch in body height after age 40. After age 55, 29.2% men were at medium to high risk of osteoporosis. This study concludes that health education and primary prevention of osteoporosis should be promoted to men starting in middle-age.
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Affiliation(s)
- Chi Peng Wong
- 1Health Bureau, Macau Special Administrative Region, Macau, China
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Poor health, but not fracture and fall risk, is associated with nonattendance at bone mineral density screening. South Med J 2012; 105:325-8. [PMID: 22766656 DOI: 10.1097/smj.0b013e318258ffca] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Bone mineral density screening identifies women at risk for fracture. Nonattendance at screening is associated with subsequent hip fracture. Determining reasons for nonattendance may help in the designing of methods to improve screening. METHODS We hypothesize that nonattenders may report poorer health and have a higher risk of fracture and fall. Women were randomly chosen from a list of people scheduled for a screening dual x-ray absorptiometry (DXA) scan. We used a validated telephone survey to calculate osteoporosis, fracture, and fall risk scores. Women answered questions about their health and medical conditions. RESULTS Of 263 women contacted, 226 (86%) women agreed to participate; 145 participants completed a dual-energy x-ray absorptiometry scan and 81 women failed to attend. Women who did not attend screening were more likely to report a serious medical condition (59.3% vs 46.9%; P = 0.09). Nonattenders were more likely to report their health as fair or poor (51.9% vs 33.8%; P = 0.01). There were no differences for osteoporosis, fall, and fracture risks. CONCLUSIONS Failure to attend osteoporosis screening is associated with significant health problems and poor self-rated health. Improving point of care access may increase the amount of osteoporosis screening among women with multiple comorbidities.
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