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Jaramillo Y, DeVito EE, Silva MA, Rojas Perez OF, Benitez B, Frankforter T, Leon K, Paris M. Enrollment of Spanish-speaking Latinx adults in clinical trials: Five lessons learned from a randomized study in substance use treatment. Drug Alcohol Depend 2023; 253:111016. [PMID: 37952354 PMCID: PMC10842233 DOI: 10.1016/j.drugalcdep.2023.111016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 06/12/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023]
Abstract
Latinx individuals are the largest ethnic minoritized group in the United States (US) at 19% of the population. However, they remain underrepresented in clinical research, accounting for less than 8% of clinical trial participants. Consideration of cultural values could help overcome barriers to inclusion in clinical trials and result in better recruitment and retention of Latinx individuals. In this commentary, we describe general guidance on culturally responsive modifications to facilitate the successful recruitment and retention of Spanish-speaking Latinx participants in Randomized Clinical Trials (RCTs) for substance use. We identify five culturally responsive strategies to help enroll participants in RCTs: 1. Create an ethnically diverse research team, 2. Assess available community partners, 3. Familiarize oneself with the target community, 4. Establish confianza (trust) with participants, and 5. Remain visible to participants and staff from recruitment sites. Representation of Latinx individuals in clinical trials is essential to ensure treatments are responsive to their needs and equitydriven. Some of these strategies can further research in helping to promote the participation of Latinx individuals experiencing substance use concerns, including outreach to those not seeking treatment.
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Affiliation(s)
| | - Elise E DeVito
- Yale University School of Medicine, New Haven, CT, United States
| | - Michelle A Silva
- Yale University School of Medicine, New Haven, CT, United States
| | | | - Bryan Benitez
- Yale University School of Medicine, New Haven, CT, United States
| | - Tami Frankforter
- Yale University School of Medicine, New Haven, CT, United States
| | - Kathleen Leon
- Yale New Haven Hospital, New Haven, CT, United States
| | - Manuel Paris
- Yale University School of Medicine, New Haven, CT, United States
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2
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Werts SJ, Lavelle SA, Crane TE, Thomson CA. Recruitment and Retention Strategies Used in Dietary Randomized Controlled Interventions with Cancer Survivors: A Systematic Review. Cancers (Basel) 2023; 15:4366. [PMID: 37686640 PMCID: PMC10486591 DOI: 10.3390/cancers15174366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND The purpose of this review was to systematically evaluate the quality of reporting of recruitment and retention methods in diet-related intervention trials among cancer survivors. METHODS A systematic search of five databases in Spring 2023 identified dietary intervention randomized controlled trials with a minimum of 50 cancer survivors, an intervention of at least eight weeks, and at least six months of study duration. Outcomes investigated include methodologic description and reporting of recruitment and retention rates. RESULTS Seventeen trials met inclusion criteria. Recruitment methods included cancer registry and clinician referral, hospital records, flyers, and media campaigns, and were reported in 88.2% of studies. Eleven of 17 studies (64.7%) met a priori recruitment goals. Eleven studies identified an a priori retention goal and seven met the goal. Retention goals were met more often for studies of less than one year (71.4%) versus greater than one year (50%), and for studies with remote or hybrid delivery (66.7%) versus only in-person delivery (50%). CONCLUSIONS Recruitment goals and methods are frequently reported; reporting of retention methods and goals is limited. Efforts are needed to improve reporting of retention methods and rates to inform best practices and enhance the rigor of future dietary intervention trials.
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Affiliation(s)
- Samantha J. Werts
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ 85724, USA
| | - Sarah A. Lavelle
- College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ 85721, USA;
| | - Tracy E. Crane
- Miller School of Medicine, University of Miami, Miami, FL 33136, USA;
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, USA
| | - Cynthia A. Thomson
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ 85724, USA
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Cavallo M, Morgana G, Dozzani I, Gatti A, Vandoni M, Pippi R, Pucci G, Vaudo G, Fanelli CG. Unraveling Barriers to a Healthy Lifestyle: Understanding Barriers to Diet and Physical Activity in Patients with Chronic Non-Communicable Diseases. Nutrients 2023; 15:3473. [PMID: 37571410 PMCID: PMC10421422 DOI: 10.3390/nu15153473] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
Although the important contribution of nutrition and physical activity to people's health is known, it is equally well known that there are many barriers to adherence to healthy habits (i.e., of an organizational, economic, and/or psychological nature) experienced by the general population, as well as by people with non-communicable diseases. Knowledge of these barriers seems essential to the implementation of the activities and strategies needed to overcome them. Here, we aim to highlight the most frequent barriers to nutrition and exercise improvement that patients with chronic-degenerative diseases experience. Drawing from the Pubmed database, our analysis includes quantitative or mixed descriptive studies published within the last 10 years, involving adult participants with non-communicable diseases. Barriers of an organizational nature, as well as those of an environmental, economic, or psychological nature, are reported. The study of patients' barriers enables healthcare and non-health professionals, stakeholders, and policymakers to propose truly effective solutions that can help both the general population and those with chronic pathologies to adhere to a healthy lifestyle.
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Affiliation(s)
- Massimiliano Cavallo
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100 Terni, Italy; (M.C.); (G.P.); (G.V.)
| | - Giovanni Morgana
- Post-Graduate School of Sports Medicine, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy;
| | - Ivan Dozzani
- Post-Graduate School of Clinical Nutrition and Dietetics, Department of Medicine and Surgery, University of Perugia, Piazzale Gambuli 1, 06132 Perugia, Italy;
| | - Alessandro Gatti
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (A.G.); (M.V.)
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (A.G.); (M.V.)
| | - Roberto Pippi
- Healthy Lifestyle Institute, C.U.R.I.A.Mo. (Centro Universitario Ricerca Interdipartimentale Attività Motoria), Department of Medicine and Surgery, University of Perugia, 06126 Perugia, Italy;
| | - Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100 Terni, Italy; (M.C.); (G.P.); (G.V.)
| | - Gaetano Vaudo
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100 Terni, Italy; (M.C.); (G.P.); (G.V.)
| | - Carmine Giuseppe Fanelli
- Healthy Lifestyle Institute, C.U.R.I.A.Mo. (Centro Universitario Ricerca Interdipartimentale Attività Motoria), Department of Medicine and Surgery, University of Perugia, 06126 Perugia, Italy;
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Contento I, Paul R, Marin-Chollom AM, Ogden Gaffney A, Sepulveda J, Dominguez N, Gray H, Haase AM, Hershman DL, Koch P, Greenlee H. Developing a Diet and Physical Activity Intervention for Hispanic/Latina Breast Cancer Survivors. Cancer Control 2022; 29:10732748221133987. [PMID: 36254717 PMCID: PMC9583197 DOI: 10.1177/10732748221133987] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objectives There is limited guidance on how to effectively educate cancer survivors to adopt and maintain specific diet and physical activity recommendations, especially among underserved and under-resourced populations. Here, the objective is to present the development of a behavioral and theoretically-based multi-modal diet and physical activity intervention program for Hispanic/Latina breast cancer survivors, Mi Vida Saludable (My Healthy Life). Methods The development process was based on the 6 steps of the Nutrition Education DESIGN Procedure: (1). Decide behaviors; (2). Explore determinants; (3). Select theory-based model; (4). Indicate objectives; (5). Generate plans; and (6). Nail down evaluation. The theoretical framework for the intervention is Social Cognitive Theory. Results The resulting behavioral intervention consists of 2 components. The first component is in-person group education consisting of 4 lessons over 1 month. Each 4-hour group lesson includes a hands-on cooking component, a physical activity component, and facilitator-led nutrition education and discussion, with 2 field trips to a local grocery store and farmers’ market. The second component is an e-Health program that includes weekly text messages, biweekly emailed newsletters, and ongoing website access. Conclusion The systematic DESIGN Procedure provided practical guidance for developing a behaviorally-focused, theory-based, and culturally sensitive program that addresses both dietary and physical activity behaviors for delivery both in-person education and through eHealth. The Procedure may be useful for developing other behaviorally focused and theory-based interventions.
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Affiliation(s)
- Isobel Contento
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA
| | - Rachel Paul
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA
| | - Amanda M. Marin-Chollom
- Department of Psychological Sciences, Central Connecticut State University, New Britain, CT, USA
| | | | | | | | - Heewon Gray
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Anne M. Haase
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Dawn L. Hershman
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Pamela Koch
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA
| | - Heather Greenlee
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA,Heather Greenlee, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., M4-B402, Seattle, WA 98109-1024, USA.
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Ridley-Merriweather KE, Head KJ, Younker SM, Evans MD, Moore CM, Lindsey DS, Wu CY, Wiehe SE. Identifying effective communication for recruitment of minority women to a breast cancer prevention study: A novel focus group approach. Contemp Clin Trials Commun 2022; 27:100910. [PMID: 35369402 PMCID: PMC8968002 DOI: 10.1016/j.conctc.2022.100910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/21/2022] [Accepted: 03/15/2022] [Indexed: 11/26/2022] Open
Abstract
Ensuring that racial and ethnic minority women are involved in breast cancer research is important to address well-documented current disparities in cancer incidence, stages of diagnosis, and mortality rates. This study used a novel interactive focus group method to identify innovative communication strategies for recruiting women from two minority groups—Latinas and Asian Americans—into the Komen Tissue Bank, a specific breast cancer biobank clinical trial. Through activities that employed visual interactive tools to facilitate group discussion and self-reflection, the authors examined perspectives and motivations for Asian American women (N = 17) and Latinas (N = 14) toward donating their healthy breast tissue. Findings included three themes that, while common to both groups, were unique in how they were expressed: lack of knowledge concerning breast cancer risks and participation in clinical research, cultural influences in BC risk thinking, and how altruism relates to perceived personal connection to breast cancer. More significantly, this study illuminated the importance of using innovative methods to encourage deeper, more enlightened participation among underrepresented populations that may not arise in a traditional focus group format. The findings from this study will inform future health communication efforts to recruit women from these groups into clinical research projects like the Komen Tissue Bank.
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Joo JY, Liu MF. Culturally tailored interventions for ethnic minorities: A scoping review. Nurs Open 2021; 8:2078-2090. [PMID: 34388862 PMCID: PMC8363345 DOI: 10.1002/nop2.733] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/20/2020] [Accepted: 11/10/2020] [Indexed: 01/22/2023] Open
Abstract
AIM This scoping review identifies strengths and weakness of culturally tailored interventions for ethnic minorities' care in the United States. It reviews recently published studies to improve understanding of these interventions for future research and practice. DESIGN Scoping review. METHODS By searching five electronic databases-CINAHL, PubMed, Ovid, Scopus and Web of Science, this review located 58 empirical studies published between 2015-2019. This review was guided by the PRISMA statements. RESULTS The review identified four weaknesses and five strengths of culturally tailored interventions. Weaknesses included unclear guidelines, low attention and retention rates, failure to measure processes and inadequate training for healthcare providers. The intervention strengths were culturally respectful and patient-centred care, healthy lifestyle promotion, increased family and community supports, technology use for efficient and timely care and increased knowledge of disease by participants.
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Affiliation(s)
| | - Megan F. Liu
- School of Gerontology Health ManagementCollege of NursingTaipei Medical UniversityTaipeiTaiwan
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Savioni L, Triberti S, Durosini I, Sebri V, Pravettoni G. Cancer patients' participation and commitment to psychological interventions: a scoping review. Psychol Health 2021; 37:1022-1055. [PMID: 33966548 DOI: 10.1080/08870446.2021.1916494] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Some psychological interventions have been developed to improve cancer patients' and survivors' quality of life, well-being, and health engagement. However, studies are usually focused on effectiveness and less on factors influencing survivors' decision to participate, both subjective (e.g., needs) and contingent (e.g., factors related to participation/non participation). This scoping review identifies factors influencing participation, decline to participate, attrition and adherence in psychological interventions. METHODS 3 electronic databases were searched for published studies on psychological interventions. Retrieved publications were scanned by authors against inclusion criteria and forty-two articles were selected. Relevant information were summarized narratively. RESULTS More information is available on attrition and factors related to participation/non participation, so that future psychological interventions may employ ad-hoc tools to take into consideration patients' reasons to adhere to psychological interventions. Secondarily, non-participation/dropout is often linked to factors related to intervention' commitment and its interference with daily life. On the contrary, patients' reasons to participate often identify with the value they find in the intervention according to their personal needs and experience of illness. CONCLUSION We suggest that future research should analyze patients' representation of psychological interventions and take them into account to tailor the interventions on participants' lived experience, to improve participation.
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Affiliation(s)
- Lucrezia Savioni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Stefano Triberti
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Ilaria Durosini
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Valeria Sebri
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
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8
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Unger JM, Hershman DL, Till C, Minasian LM, Osarogiagbon RU, Fleury ME, Vaidya R. "When Offered to Participate": A Systematic Review and Meta-Analysis of Patient Agreement to Participate in Cancer Clinical Trials. J Natl Cancer Inst 2021; 113:244-257. [PMID: 33022716 PMCID: PMC7936064 DOI: 10.1093/jnci/djaa155] [Citation(s) in RCA: 110] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/26/2020] [Accepted: 09/21/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Patient participation in clinical trials is vital for knowledge advancement and outcomes improvement. Few adult cancer patients participate in trials. Although patient. decision-making about trial participation has been frequently examined, the participation rate for patients actually offered a trial is unknown. METHODS A systematic review and meta-analysis using 3 major search engines was undertaken. We identified studies from January 1, 2000, to January 1, 2020, that examined clinical trial participation in the United States. Studies must have specified the numbers of patients offered a trial and the number enrolled. A random effects model of proportions was used. All statistical tests were 2-sided. RESULTS We identified 35 studies (30 about treatment trials and 5 about cancer control trials) among which 9759 patients were offered trial participation. Overall, 55.0% (95% confidence interval [CI] = 49.4% to 60.5%) of patients agreed to enroll. Participation rates did not differ between treatment (55.0%, 95% CI = 48.9% to 60.9%) and cancer control trials (55.3%, 95% CI = 38.9% to 71.1%; P = .98). Black patients participated at similar rates (58.4%, 95% CI = 46.8% to 69.7%) compared with White patients (55.1%, 95% CI = 44.3% to 65.6%; P = .88). The main reasons for nonparticipation were treatment choice or lack of interest. CONCLUSIONS More than half of all cancer patients offered a clinical trial do participate. These findings upend several conventional beliefs about cancer clinical trial participation, including that Black patients are less likely to agree to participate and that patient decision-making is the primary barrier to participation. Policies and interventions to improve clinical trial participation should focus more on modifiable systemic structural and clinical barriers, such as improving access to available trials and broadening eligibility criteria.
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Affiliation(s)
- Joseph M Unger
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- SWOG Statistics and Data Management Center, Seattle, WA, USA
| | | | - Cathee Till
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- SWOG Statistics and Data Management Center, Seattle, WA, USA
| | - Lori M Minasian
- National Cancer Institute, Division of Cancer Prevention, Rockville, MD, USA
| | | | - Mark E Fleury
- American Cancer Society Cancer Action Network Inc, Washington, DC, USA
| | - Riha Vaidya
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- SWOG Statistics and Data Management Center, Seattle, WA, USA
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9
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Durosini I, Savioni L, Triberti S, Guiddi P, Pravettoni G. The Motivation Journey: A Grounded Theory Study on Female Cancer Survivors' Experience of a Psychological Intervention for Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:950. [PMID: 33499109 PMCID: PMC7908434 DOI: 10.3390/ijerph18030950] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 01/13/2021] [Accepted: 01/20/2021] [Indexed: 12/25/2022]
Abstract
Psychological interventions are proposed to cancer survivors to support their quality of life against the emotional trauma of cancer and the side effects of treatment. Psychological interventions often require patient engagement and commitment to activities that could be more or less demanding in terms of lifestyle change (e.g., psychotherapy, sports). Analyzing participant motivations (personal aims, expectations, needs) prior to participation is useful to predict their adherence to the intervention as well as final outcomes. Yet, participant motivations may evolve during the intervention because the intervention experience turns out to be meaningful and positively challenging. The present study aimed to obtain a preliminary understanding of the process of motivation change in female cancer survivors who participated in a sport-based intervention to promote quality of life by employing a grounded theory approach. Data analysis took place alongside data collection and according to the procedure of grounded theory ("open coding", "axial coding", and "selective coding") in order to describe the process of motivation change during women's participation in psychological intervention for quality of life. On 14 women interviewed, 13 reported changing their motivation to participate during the first months of involvement, mostly changing from individualistic to group-related motivations (i.e., from self-care to friendship with other participants and enriching group membership), and from physical to psychological growth (i.e., pursuing not only physical health but also self-fulfillment). The discussion explains the preliminary aspects of the motivation change process and highlights the importance to monitor motivation dynamics within psychological interventions.
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Affiliation(s)
- Ilaria Durosini
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.S.); (S.T.); (P.G.); (G.P.)
| | - Lucrezia Savioni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.S.); (S.T.); (P.G.); (G.P.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
| | - Stefano Triberti
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.S.); (S.T.); (P.G.); (G.P.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
| | - Paolo Guiddi
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.S.); (S.T.); (P.G.); (G.P.)
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.S.); (S.T.); (P.G.); (G.P.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
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10
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Crane TE, Badger TA, O’Connor P, Segrin C, Alvarez A, Freylersythe SJ, Penaloza I, Pace TWW, Sikorskii A. Lifestyle intervention for Latina cancer survivors and caregivers: the Nuestra Salud randomized pilot trial. J Cancer Surviv 2020; 15:607-619. [DOI: 10.1007/s11764-020-00954-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 10/10/2020] [Indexed: 12/19/2022]
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Savioni L, Triberti S. Cognitive Biases in Chronic Illness and Their Impact on Patients' Commitment. Front Psychol 2020; 11:579455. [PMID: 33192894 PMCID: PMC7655771 DOI: 10.3389/fpsyg.2020.579455] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/22/2020] [Indexed: 12/21/2022] Open
Affiliation(s)
- Lucrezia Savioni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Stefano Triberti
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
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12
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Siembida EJ, Loomans-Kropp HA, Trivedi N, O’Mara A, Sung L, Tami-Maury I, Freyer DR, Roth M. Systematic review of barriers and facilitators to clinical trial enrollment among adolescents and young adults with cancer: Identifying opportunities for intervention. Cancer 2020; 126:949-957. [PMID: 31869454 PMCID: PMC7029803 DOI: 10.1002/cncr.32675] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/28/2019] [Accepted: 11/23/2019] [Indexed: 01/01/2023]
Abstract
Adolescents and young adults (AYAs) are underrepresented in cancer clinical trials (CCTs). Limited trial enrollment slows progress in improving survival rates and prevents the collection of valuable biospecimens. A systematic literature review was conducted to assess barriers and facilitators to AYA enrollment in CCTs and to identify opportunities to improve enrollment. The PubMed MEDLINE, Web of Science, Scopus, and PsycINFO databases were searched to identify studies relevant to AYA CCT enrollment. Eligibility criteria included the qualitative and/or quantitative evaluation of barriers and facilitators to AYA enrollment. One hundred fifty-five unique publications were identified; 13 were included in the final analysis. Barriers to AYA enrollment in CCTs included a lack of existing trials applicable to the patient population, limited access to available CCTs, and a lack of physician awareness of relevant trials. Facilitators of enrollment included optimizing the research infrastructure, improving the awareness of available CCTs among providers, and enhancing communication about CCTs between providers and patients. In conclusion, the limited available research reports institution- and patient-level barriers and facilitators to AYA CCT enrollment. Because of persistent disparities in AYA enrollment, there is an urgent need to further identify the barriers and facilitators to AYA CCT enrollment to determine actionable areas for intervention.
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Affiliation(s)
- Elizabeth J. Siembida
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA
- Outcomes Research Branch, Division of Cancer Control and Population Sciences. National Cancer Institute, Rockville, MD, USA
| | - Holli A. Loomans-Kropp
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA
- Gastrointestinal and Other Cancers Branch, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA
| | - Neha Trivedi
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
- Health Communication and Informatics Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | | | - Lillian Sung
- Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Irene Tami-Maury
- Department of Behavioral Science, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David R. Freyer
- Children’s Center for Cancer and Blood Diseases, Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Departments of Pediatrics and Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Children’s Hospital Los Angeles and USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Michael Roth
- Department of Pediatrics, Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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13
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Ortiz AP, Machin M, Soto-Salgado M, Centeno-Girona H, Rivera-Collazo D, González D, Chen MS, Colón-López V. Effect of an Educational Video to Increase Calls and Screening into an Anal Cancer Clinical Trial Among HIV+ Hispanics in PR: Results from a Randomized Controlled Behavioral Trial. AIDS Behav 2019; 23:1135-1146. [PMID: 30467711 PMCID: PMC10650566 DOI: 10.1007/s10461-018-2330-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Anal cancer incidence is higher in persons living with HIV/AIDS (PLWHA) than in the general population. Participation of PLWHA in anal cancer clinical trials (CTs) is essential; Hispanic PLWHA are underrepresented in CTs. We conducted a behavioral CT among 305 PLWHA in Puerto Rico to measure the efficacy of an educational video in increasing calls and screening into an anal cancer CT. Participants received printed educational materials on anal cancer and CTs; the intervention group also received an educational video. Outcome assessment based on follow-up interviews showed that printed materials increased awareness about CTs and high-resolution anoscopy (HRA), and willingness to participate in an anal cancer CT in both groups. However, the addition of the video increased the likelihood of participants to call the CT for orientation (RRadjusted = 1.66, 95% CI 1.00-2.76; p = 0.05) and pre-screening evaluation (RRadjusted = 1.70, 95% CI 0.95-3.03; p = 0.07). This intervention could help increase participation of Hispanics into anal cancer-related CTs.
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Affiliation(s)
- Ana P Ortiz
- Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico.
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
| | - Mark Machin
- Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | | | | | - Darilyn Rivera-Collazo
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Daisy González
- University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Moon S Chen
- Cancer Control/Cancer Health Disparities, Division of Hematology and Oncology, University of California, Davis Comprehensive Cancer Center, Sacramento, CA, USA
| | - Vivian Colón-López
- Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
- Department of Health Services Administration, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
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14
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Shi Z, Richardson JM, Aycinena AC, Gray HL, Paul R, Koch P, Contento I, Gaffney AO, Greenlee H. Psychosocial mediators of dietary change among Hispanic/Latina breast cancer survivors in a culturally tailored dietary intervention. Psychooncology 2018; 27:2220-2228. [PMID: 29904989 DOI: 10.1002/pon.4799] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 05/31/2018] [Accepted: 06/08/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To examine psychosocial mediators of the effect of a culturally tailored dietary intervention on dietary change among Hispanic/Latina breast cancer survivors. METHODS Hispanic/Latina breast cancer survivors (n = 70) were randomized to receive either a 12-week theory-based and culturally tailored dietary change program (intervention group, n = 34), or standard-of-care printed recommendations (control group, n = 36) (ClinicalTrials.gov NCT01414062). Fruit/vegetable intake (F/V), % calories from fat, and hypothesized psychosocial mediators were assessed at baseline, 6 and 12 months. Analysis of covariance assessed intervention effects on psychosocial mediators at 6 and 12 months. Mediation analysis using the bootstrap method evaluated the indirect intervention effects on dietary intake at 6 and 12 months through changes in psychosocial mediators at 6 and 12 months. RESULTS Compared with controls, at 6 and 12 months, the intervention group reported greater improvements in stages of change (P < .001, P < .001, respectively), self-efficacy (P = .009, P = .002, respectively), snack preference for F/snack preference for F/V (P = .045, P = .002, respectively); at 12 months, the intervention group reported a decrease in chance-oriented external locus of control (P = .02). At 6 months, mediation analysis showed that the intervention effect was associated with an increase of 1.0 (95% CI, -0.1-2.4) serving/day of F/V, compared with the control group, although no indirect effect through the hypothesized psychosocial mediators was observed. At 12 months, the intervention was associated with an increase in 0.5 serving/day F/V through improved taste/snack preference for F/V at 6 and 12 months (95% CIs, 0.1-1.3, 0.0-1.4, respectively). CONCLUSIONS Future programs can target improving taste/snack preference for F/V to promote dietary change in Hispanic/Latina breast cancer survivors.
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Affiliation(s)
- Zaixing Shi
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.,Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - John M Richardson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ana Corina Aycinena
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.,Department of Health and Behavior Studies, Teachers College Columbia University, New York, NY, USA
| | - Heewon L Gray
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Rachel Paul
- Department of Health and Behavior Studies, Teachers College Columbia University, New York, NY, USA
| | - Pam Koch
- The Laurie M. Tisch Center for Food, Education & Policy; Department of Health and Behavior Studies, Teachers College Columbia University, New York, NY, USA
| | - Isobel Contento
- Department of Health and Behavior Studies, Teachers College Columbia University, New York, NY, USA
| | | | - Heather Greenlee
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.,Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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15
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Coughlin SS, Williams V, Moore N, Bowen D, Anglin J, Mansur N, Leo GD. The Augusta, Georgia Breast Cancer Survivor Study. JOURNAL OF CANCER TREATMENT & DIAGNOSIS 2018; 2:10-15. [PMID: 30320304 PMCID: PMC6183059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Several studies have provided important information about health conditions and other challenges faced by women diagnosed with breast cancer and how they can improve their quality of life and reduce their risk of cancer recurrence. Although African American and Hispanic breast cancer patients have a poorer survival than their white counterparts, few studies have compared the experiences of African American, Hispanic, and non-Hispanic white breast cancer survivors. OBJECTIVES To facilitate collaborative studies on breast cancer survivorship in a multicultural population, including future intervention research on nutrition, and physical activity, and clinical substudies. METHODS This cohort study consists of a postal survey of up to 1,000 women with a history of a breast cancer diagnosis who reside in Augusta-Richmond County, Georgia, USA, and a repeat survey in 4 to 5 years to obtain longitudinal data. The follow-up survey in 4 to 5 years will allow for longitudinal changes in health to be assessed. CONCLUSION The survey will provide a comprehensive picture of the health of breast cancer survivors, across the lifespan, in a large Southern city. A broad range of health issues will be addressed including physical activity, diet, nutrition, personal and family history of cancer, quality-of-life, psychosocial concerns, and beliefs about cancer recurrence risk reduction through lifestyle changes. Through its longitudinal design, the study will also provide important information about changes in physical and mental health as breast cancer survivors advance in age.
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Affiliation(s)
- Steven S Coughlin
- Department of Clinical and Digital Health Sciences, Augusta University, Augusta, GA
- Research Service, Charlie Norwood Veterans Administration Medical Center, Augusta, GA
| | | | - Nicole Moore
- Department of Clinical and Digital Health Sciences, Augusta University, Augusta, GA
| | - Deborah Bowen
- University of Washington School of Medicine, Seattle, WA
| | - Judith Anglin
- Department of Clinical and Digital Health Sciences, Augusta University, Augusta, GA
| | - Nadine Mansur
- Department of Clinical and Digital Health Sciences, Augusta University, Augusta, GA
| | - Gianluca De Leo
- Department of Clinical and Digital Health Sciences, Augusta University, Augusta, GA
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16
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Napoles A, Cook E, Ginossar T, Knight KD, Ford ME. Applying a Conceptual Framework to Maximize the Participation of Diverse Populations in Cancer Clinical Trials. Adv Cancer Res 2016; 133:77-94. [PMID: 28052822 PMCID: PMC5542779 DOI: 10.1016/bs.acr.2016.08.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The underrepresentation of ethnically diverse populations in cancer clinical trials results in the inequitable distribution of the risks and benefits of this research. Using a case study approach, we apply a conceptual framework of factors associated with the participation of diverse population groups in cancer clinical trials developed by Dr. Jean Ford and colleagues to increase understanding of the specific strategies, and barriers and promoters addressed by these strategies, that resulted in marked success in accrual of racially and ethnically diverse populations in cancer clinical research. Results indicate that the studies presented were able to successfully engage minority participants due to the creation and implementation of multilevel, multifaceted strategies that included: culturally and linguistically appropriate outreach, education, and research studies that were accessible in local communities; infrastructure to support engagement of key stakeholders, clinicians, and organizations serving minority communities; testimonials by ethnically diverse cancer survivors; availability of medical interpretation services; and providing infrastructure that facilitated the engagement in clinical research of clinicians who care for minority patient populations. These strategic efforts were effective in addressing limited awareness of trials, lack of opportunities to participate, and acceptance of engagement in cancer clinical trials. Careful attention to the context and population characteristics in which cancer clinical trials are conducted will be necessary to address disparities in research participation and cancer outcomes. These studies illustrate that progress on minority accrual into clinical research requires intentional efforts to overcome barriers at all three stages of the accrual process: awareness, opportunity, and acceptance of participation.
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Affiliation(s)
- A Napoles
- University of California, San Francisco, CA, United States
| | - E Cook
- University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - T Ginossar
- University of New Mexico, Albuquerque, NM, United States
| | - K D Knight
- Medical University of South Carolina, Charleston, SC, United States
| | - M E Ford
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States.
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17
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Greenlee H, Ogden Gaffney A, Aycinena AC, Koch P, Contento I, Karmally W, Richardson JM, Shi Z, Lim E, Tsai WY, Santella RM, Blaner WS, Clugston RD, Cremers S, Pollak S, Sirosh I, Crew KD, Maurer M, Kalinsky K, Hershman DL. Long-term Diet and Biomarker Changes after a Short-term Intervention among Hispanic Breast Cancer Survivors: The ¡Cocinar Para Su Salud! Randomized Controlled Trial. Cancer Epidemiol Biomarkers Prev 2016; 25:1491-1502. [PMID: 27461049 DOI: 10.1158/1055-9965.epi-15-1334] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 06/29/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Among Hispanic breast cancer survivors, we examined the long-term effects of a short-term culturally based dietary intervention on increasing fruits/vegetables (F/V), decreasing fat, and changing biomarkers associated with breast cancer recurrence risk. METHODS Spanish-speaking women (n = 70) with a history of stage 0-III breast cancer who completed treatment were randomized to ¡Cocinar Para Su Salud! (n = 34), a culturally based 9-session program (24 hours over 12 weeks, including nutrition education, cooking classes, and food-shopping field trips), or a control group (n = 36, written dietary recommendations for breast cancer survivors). Diet recalls, fasting blood, and anthropometric measures were collected at baseline, 6, and 12 months. We report changes between groups at 12 months in dietary intake and biomarkers using 2-sample Wilcoxon t tests and generalized estimating equation (GEE) models. RESULTS At 12 months, the intervention group compared with the control group reported higher increases in mean daily F/V servings (total: +2.0 vs. -0.4; P < 0.01), and nonsignificant decreases in the percentage of calories from fat (-2.2% vs. -1.1%; P = 0.69) and weight (-2.6 kg vs. -1.5 kg; P = 0.56). Compared with controls, participants in the intervention group had higher increases in plasma lutein (+20.4% vs. -11.5%; P < 0.01), and borderline significant increases in global DNA methylation (+0.8% vs. -0.5%; P = 0.06). CONCLUSIONS The short-term ¡Cocinar Para Su Salud! program was effective at increasing long-term F/V intake in Hispanic breast cancer survivors and changed biomarkers associated with breast cancer recurrence risk. IMPACT It is possible for short-term behavioral interventions to have long-term effects on behaviors and biomarkers in minority cancer patient populations. Results can inform future study designs. Cancer Epidemiol Biomarkers Prev; 25(11); 1491-502. ©2016 AACR.
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Affiliation(s)
- Heather Greenlee
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York. .,Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York
| | | | - A Corina Aycinena
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York.,Department of Health and Behavior Studies, Teachers College, Columbia University, New York, New York
| | - Pam Koch
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, New York
| | - Isobel Contento
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, New York
| | - Wahida Karmally
- Irving Institute for Clinical and Translational Research, Columbia University, New York, New York
| | - John M Richardson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Zaixing Shi
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Emerson Lim
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Wei-Yann Tsai
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York.,Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
| | - Regina M Santella
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York.,Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - William S Blaner
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Robin D Clugston
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Serge Cremers
- Irving Institute for Clinical and Translational Research, Columbia University, New York, New York
| | - Susan Pollak
- Irving Institute for Clinical and Translational Research, Columbia University, New York, New York
| | - Iryna Sirosh
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Katherine D Crew
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.,Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York.,Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Matthew Maurer
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York.,Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Kevin Kalinsky
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York.,Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Dawn L Hershman
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.,Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York.,Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
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