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Perez GK, Rabin JT, Tandon M, Strauss NM, Irwin K, Philpotts L, Ostroff J, Park ER. Do Tobacco Treatment Trials Address Disparities in Smoking Outcomes Among Black and Hispanic Cancer Patients? A Systematic Review of Smoking Cessation Interventions for Black and Hispanic Patients Diagnosed with Cancer. J Racial Ethn Health Disparities 2024; 11:2390-2406. [PMID: 37468742 PMCID: PMC11236890 DOI: 10.1007/s40615-023-01705-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 05/30/2023] [Accepted: 06/27/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To characterize the representation of Black and Hispanic cancer patients in tobacco treatment trials, and to offer recommendations for future research. METHODS We conducted two systematic searches of the literature (2018, 2021) using 5 databases (MEDLINE via EBSCO, Pubmed, PsycInfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (EMBASE)) to examine the prevalence of tobacco trials that included Black or Hispanic cancer patients. Two coders independently screened all articles at title, abstract, and full-text to identify eligible trials. Information about the proportion of Black and Hispanic patients included, trial design features, and whether the authors analyzed outcomes for Black and Hispanic patients were documented. RESULTS Of 4682 identified studies, only 10 published trials included and reported on the rates of Black or Hispanic cancer patients enrolled in their tobacco trial. The proportion of enrolled Black cancer patients ranged from 2 to 55.6%. Only our studies documented enrollment rates for Hispanics, and rates were less than 6%. None of the studies offered strategies to promote or the accrual of Black or Hispanic patients. DISCUSSION There remains a large gap in the literature regarding the reach and efficacy of tobacco treatment for Black and Hispanic cancer patients. Black and Hispanic cancer patients remain largely under-represented in tobacco cessation trials, limiting the applicability of existing, evidence-based treatments. To optimize intervention generalizability, future studies should emphasize the targeted recruitment and engagement of these patients in tobacco trials.
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Affiliation(s)
- Giselle K Perez
- Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA.
- Health Promotion and Resilience Intervention Research Program, 100 Cambridge Street, 16th floor, Boston, MA, 02114, USA.
| | - Julia T Rabin
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | | | | | - Kelly Irwin
- Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA
- Health Promotion and Resilience Intervention Research Program, 100 Cambridge Street, 16th floor, Boston, MA, 02114, USA
| | - Lisa Philpotts
- Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA
| | - Jamie Ostroff
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Elyse R Park
- Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA
- Health Promotion and Resilience Intervention Research Program, 100 Cambridge Street, 16th floor, Boston, MA, 02114, USA
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Trejo E, Velazquez AI, Castillo E, Couey P, Cicerelli B, McBride R, Burke NJ, Dixit N. Acceptability and Feasibility of Survivorship Group Medical Visits for Breast Cancer Survivors in a Safety Net Hospital. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:445-454. [PMID: 38724720 PMCID: PMC11219419 DOI: 10.1007/s13187-024-02429-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/23/2024] [Indexed: 07/03/2024]
Abstract
Providing cost-effective, comprehensive survivorship care remains a significant challenge. Breast cancer survivors (BCS) who have limited income and are from marginalized racial and ethnic groups experience a worse quality of life and report higher distress. Thus, innovative care models are required to address the needs of BCS in low resource settings. Group medical visits (GMV), utilized in chronic disease management, are an excellent model for education and building skills. This single-arm intervention study was conducted at a public hospital in California. GMVs consisted of five 2-h weekly sessions focused on survivorship care planning, side effects of treatment and prevention, emotional health, sexual health, physical activity, and diet. The patient navigators recruited three consecutive GMV groups of six English-speaking BCS (N = 17). A multidisciplinary team delivered GMVs, and a patient navigator facilitated all the sessions. We used attendance rates, pre- and post-surveys, and debriefing interviews to assess the feasibility and acceptability of the intervention. We enrolled 18 BCS. One participant dropped out before the intervention started, 17 BCS consistently attended and actively participated in the GMV, and 76% (13) attended all planned sessions. Participants rated GMVs in the post-survey and shared their support for GMVs in debriefing interviews. The BCS who completed the post-survey reported that GMVs increased their awareness, confidence, and knowledge of survivorship care. GMVs were explicitly designed to address unmet needs for services necessary for survivorship care but not readily available in safety net settings. Our pilot data suggest that patient-navigator-facilitated GMVs are a feasible and acceptable model for integrating survivorship care in public hospitals.
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Affiliation(s)
- Evelin Trejo
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA, USA
| | - Ana I Velazquez
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Elizabeth Castillo
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA, USA
| | - Paul Couey
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA, USA
| | - Barbara Cicerelli
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA, USA
| | - Robin McBride
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA, USA
| | - Nancy J Burke
- Department of Public Health, University of California Merced, Merced, CA, USA
| | - Niharika Dixit
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA, USA.
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA.
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Scholten PR, Stalpers LJA, Bronsema I, van Os RM, Westerveld H, van Lonkhuijzen LRCW. The effectiveness of smoking cessation interventions after cancer diagnosis: A systematic review and meta-analysis. J Cancer Policy 2024; 39:100463. [PMID: 38065242 DOI: 10.1016/j.jcpo.2023.100463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/11/2023] [Accepted: 12/03/2023] [Indexed: 03/08/2024]
Abstract
OBJECTIVES patients with cancer who smoke have more side effects during and after treatment, and a lower survival rate than patients with cancer who quit smoking. Supporting patients with cancer to quit smoking should be standard care. The aim of this systematic review was to determine the most effective smoking cessation method for patients diagnosed with cancer. METHODS PubMed, Embase, Web of Science and Google Scholar were systematically searched. Included were randomized controlled trials and observational studies published after January 2000 with any smoking cessation intervention in patients with any type of cancer. Result of these studies were evaluated in a meta-analysis. RESULTS A total of 18,780 papers were retrieved. After duplicate removal and exclusion based on title and abstract, 72 publications were left. After full text screening, 19 (randomized) controlled trials and 20 observational studies were included. The overall methodological quality of the included studies, rated by GRADE criteria, was very low. Two out of 21 combined intervention trials showed a statistical significant effect. Meta-analysis of 18 RCTs and 3 observational studies showed a significant benefit of combined modality interventions (OR 1.67, 95% C.I.: 1.24-2.26, p = 0.0008) and behavioural interventions (OR 1.33, 95% C.I.: 1.02 - 1.74, p = 0.03), but not for single modality pharmacological interventions (OR 1.11; 95% C.I.: 0.69-1.78, p = 0.66). CONCLUSION A combination of pharmacological and behavioural interventions may be the most effective intervention for smoking cessation in patients with cancer.
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Affiliation(s)
- Peter R Scholten
- Center for Gynaecologic Oncology Amsterdam, Amsterdam UMC, University of Amsterdam, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiotherapy, Amsterdam UMC, University of Amsterdam, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Lukas J A Stalpers
- Department of Radiotherapy, Amsterdam UMC, University of Amsterdam, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Iris Bronsema
- Center for Gynaecologic Oncology Amsterdam, Amsterdam UMC, University of Amsterdam, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiotherapy, Amsterdam UMC, University of Amsterdam, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Rob M van Os
- Department of Radiotherapy, Amsterdam UMC, University of Amsterdam, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Henrike Westerveld
- Department of Radiotherapy, Amsterdam UMC, University of Amsterdam, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Luc R C W van Lonkhuijzen
- Center for Gynaecologic Oncology Amsterdam, Amsterdam UMC, University of Amsterdam, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
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Loy MH, Prisco L, Parikh C. Implementation of Virtual Integrative Oncology Shared Medical Appointment Series (VIOSMAS) Within Mixed Diagnosis Population. Integr Cancer Ther 2024; 23:15347354231223969. [PMID: 38243739 PMCID: PMC10799580 DOI: 10.1177/15347354231223969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 11/09/2023] [Accepted: 12/15/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Integrative oncology [IO] is sought-after by patients, endorsed by clinical guidelines, and valued within National Cancer Institute Centers. Shared Medical Appointments [SMA] leverage health education and social connection to deliver enhanced patient experience, population health, cost-reduction, and clinician well-being. Integrative Oncology Shared Medical Appointments increase access to integrative medicine but delivering these services via telehealth have not been evaluated. OBJECTIVE We created, and pilot tested a Virtual Integrative Oncology Shared Medical Appointment Series (VIOSMAS) to assess its feasibility, acceptability, and efficacy at an urban academic teaching hospital. METHODS The 7-session hour-long Living Well with and after Cancer series included didactics, multi-disciplinary experiential sessions, and group discussion. Topics included (1) Introduction, (2) Herbs/Botanicals/Fungi, (3) Mindful Movement, (4) Acupuncture, (5) Narratives and Nature, (6) Diet and Culinary Medicine, and (7) Vitamins/Supplements. Virtual visits via telehealth were offered to enhance patient participation during the pandemic. Outcome measures included recruitment, retention, pre/post-series patient survey and qualitative clinician feedback. RESULTS Between 9/2021 and 4/2023, 72 unique patients were recruited to 5 cohorts and had a total of 332 VIOSMAS visits. A total of 50 patients (69%) attended 4 or more of the 7-session series; 60 (83% were women); patients ranged in age from 28 to 93 years (median 66); 36 (50%) lived outside the city center; the most common cancer diagnoses were breast, lymphoma, and lung cancer. Patients were from diverse demographics. Pre-program, patients reported desiring assistance in addressing diverse symptoms including fatigue, insomnia, pain, gastrointestinal (GI) symptoms, anxiety, and depression. Post-series, patients reported that the VIOSMAS addressed their goals and symptoms; they also reported incorporating recommended lifestyle changes in diet, exercise, sleep, and stress management; they were satisfied with the number of sessions and telehealth format. The participating clinicians reported high levels of satisfaction with VIOSMAS. Revenue to the institution from VIOSMAS exceeded the revenue potential of equivalent time spent for individual visits while supporting extended physician-patient contact. CONCLUSION VIOSMAS is feasible for patients and clinicians, addresses patients' symptoms and questions about lifestyle and complementary therapies, and generates more revenue than individual visits. Larger implementation trials with appropriate comparison groups are recommended.
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Affiliation(s)
- Michelle H. Loy
- Cornell University, New York, NY, USA
- Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
| | | | - Chiti Parikh
- Cornell University, New York, NY, USA
- Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
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Frazer K, Bhardwaj N, Fox P, Stokes D, Niranjan V, Quinn S, Kelleher CC, Fitzpatrick P. Systematic Review of Smoking Cessation Interventions for Smokers Diagnosed with Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192417010. [PMID: 36554894 PMCID: PMC9779002 DOI: 10.3390/ijerph192417010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 05/11/2023]
Abstract
The detrimental impact of smoking on health and wellbeing are irrefutable. Additionally, smoking is associated with the development of cancer, a reduction treatment outcomes and poorer health outcomes. Nevertheless, a significant number of people continue to smoke following a cancer diagnosis. Little is understood of the smoking cessation services provided to smokers with cancer or their engagement with them. This systematic review aimed to identify existing smoking cessation interventions for this cohort diagnosed with breast, head and neck, lung and cervical cancers (linked to risk). Systematic searches of Pubmed, Embase, Psych Info and CINAHL from 1 January 2015 to 15 December 2020 were conducted. Included studies examined the characteristics of smoking cessation interventions and impact on referrals and quit attempts. The impact on healthcare professionals was included if reported. Included studies were restricted to adults with a cancer diagnosis and published in English. No restriction was placed on study designs, and narrative data synthesis was conducted due to heterogeneity. A review protocol was registered on PROSPERO CRD 42020214204, and reporting adheres to PRISMA reporting guidelines. Data were screened, extracted in duplicate and an assessment of the quality of evidence undertaken using Mixed Methods Assessment Tool. 23 studies met the inclusion criteria, representing USA, Canada, England, Lebanon, Australia and including randomized controlled trials (9), observational studies (10), quality improvement (3), and one qualitative study. Hospital and cancer clinics [including a dental clinic] were the settings for all studies. 43% (10/23) of studies reported interventions for smokers diagnosed with head and neck cancer, 13% (3/23) for smokers diagnosed with lung cancer, one study provides evidence for breast cancer, and the remaining nine studies (39%) report on multiple cancers including the ones specified in this review. Methodological quality was variable. There were limited data to identify one optimal intervention for this cohort. Key elements included the timing and frequency of quit conversations, use of electronic records, pharmacotherapy including extended use of varenicline, increased counselling sessions and a service embedded in oncology departments. More studies are required to ensure tailored smoking cessation pathways are co-developed for smokers with a diagnosis of cancer to support this population.
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Shani P, Walter E. Acceptability and Use of Mind-Body Interventions Among African American Cancer Survivors: An Integrative Review. Integr Cancer Ther 2022; 21:15347354221103275. [PMID: 35786041 PMCID: PMC9251965 DOI: 10.1177/15347354221103275] [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: 11/22/2022] Open
Abstract
Mind-body interventions have been shown to improve physical and mental health outcomes among cancer survivors, and African Americans have one of the highest cancer mortality rates of all racial/ethnic groups, while often facing considerable barriers to quality healthcare. African American cancer survivors report difficulty accessing mind-body practices, and few studies have focused exclusively on African American populations. This integrative review aims to explore the acceptability and use of mind-body interventions among African American cancer survivors. This review seeks to determine if current research indicates that mind-body interventions may be helpful in improving outcomes for African American cancer survivors. The literature search resulted in 284 studies, of which 14 met the inclusion criteria. Inclusion criteria were articles published in or after 2016, written in the English language, addressing mind-body modalities, and including a study population of ≥50% African American cancer survivors. Other reviews, meta-analyses, or studies without results were excluded. Results indicate that African American cancer survivors have expressed receptiveness to interventions incorporating mindfulness, meditation, yoga, Tai Chi, and other mind-body or complimentary/alternative medicine interventions. Still, few studies have offered such interventions exclusively to African American cancer survivors. This review indicated that African American cancer survivors across demographic backgrounds are interested in and view mind-body practices as an acceptable way to improve quality of life, pain interference, fatigue, anxiety, depression, and physical health; however, the interventions should be culturally appropriate and accessible. In conclusion, despite a growing interest in mind-body interventions, African American communities are often unaware of opportunities to engage in these practices in their communities, and mind-body practices are inaccessible due to cost or geographical location. Additional research that offers such interventions specific to African American cancer survivors is warranted.
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Affiliation(s)
- Pinky Shani
- University of Houston College of Nursing, Sugar Land, TX, USA
| | - Eli Walter
- University of Houston College of Nursing, Sugar Land, TX, USA
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Hirschey R, Nyrop KA, Mayer DK. Healthy Behaviors: Prevalence of Uptake Among Cancer Survivors. Clin J Oncol Nurs 2020; 24:19-29. [PMID: 32945809 DOI: 10.1188/20.cjon.s2.19-29] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although most cancer survivors adhere to recommendations to refrain from tobacco and minimize alcohol use, survivors of certain cancers are not meeting these recommendations. In addition, most cancer survivors do not achieve optimal recommendations for diet and physical activity, further decreasing survivor health and quality of life. Sun protective and sleep behaviors also tend to be suboptimal among survivors. Uptake of age-appropriate vaccinations is variable among survivors. OBJECTIVES The purpose of this article is to review the prevalence of healthy behavior uptake among cancer survivors and provide nurses with an overview of effective interventions, strategies, and resources to help patients improve these behaviors. METHODS An expert panel was convened to conduct an integrative review and synthesis on the state of the science of healthy behavior uptake among cancer survivors. FINDINGS Not meeting recommendations for healthy lifestyle behaviors increases the risk of second cancers and mortality and decreases overall health and quality of life. Healthy lifestyle behaviors can contribute to improved function, quality of life, and overall survival for cancer survivors. Nurses can help survivors to understand and improve their behaviors.
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Roth I, Thompson-Lastad A, Thomas AU. The Quadruple Aim as a Framework for Integrative Group Medical Visits. J Altern Complement Med 2020; 26:261-264. [PMID: 31971813 PMCID: PMC7153643 DOI: 10.1089/acm.2019.0425] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Isabel Roth
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - Ariana Thompson-Lastad
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA
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