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Richards A, Raymond-Flesch M, Hughes SD, Zhou Y, Koester KA. Lessons Learned with a Triad of Stakeholder Advisory Boards: Working with Adolescents, Mothers, and Clinicians to Design the TRUST Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:483. [PMID: 36980041 PMCID: PMC10047518 DOI: 10.3390/children10030483] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/18/2023] [Accepted: 02/25/2023] [Indexed: 03/05/2023]
Abstract
Optimal care for pediatric and adolescent patients is carried out under a triadic engagement model, whereby the patient, caregiver, and clinician work in collaboration. Seeking input from all triad members in the development and implementation of clinical trials and interventions may improve health outcomes for children and adolescents. Sufficient evidence demonstrating how to effectively engage stakeholders from all branches of this triadic model is lacking. We address this gap by describing the successes and challenges our team has encountered while convening advisory groups with adolescent patients, parent stakeholders, and their clinicians to assist in the development and deployment of a technology-based intervention to promote the utilization of sexual and reproductive health services by increasing adolescent-clinician alone-time. Each stakeholder group contributed in unique and complementary ways. Working with advisors, our team aligned the priorities of each group with the goals of the research team. The results were improvements made in the content, design, and delivery of the TRUST intervention. While we were largely successful in the recruitment and engagement of adolescent patients and clinicians, we had less success with parents. Future research will need to explore additional strategies for recruitment and engagement of parents, particularly in rural, minority, and underserved communities.
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Affiliation(s)
- Alexis Richards
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California San Francisco, San Francisco, CA 94107, USA
| | - Marissa Raymond-Flesch
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA 94107, USA
| | - Shana D. Hughes
- Vitalant Research Institute and Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA 94105, USA
| | - Yinglan Zhou
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA 94158, USA
| | - Kimberly A. Koester
- Department of Medicine, Division of Prevention Science, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA 94158, USA
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Bergin RJ, Short CE, Davis N, Marker J, Dawson MT, Milton S, McNamara M, Druce P, Milley K, Karnchanachari N, Skaczkowski G. The nature and impact of patient and public involvement in cancer prevention, screening and early detection research: A systematic review. Prev Med 2023; 167:107412. [PMID: 36592674 DOI: 10.1016/j.ypmed.2022.107412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/23/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
Patient and public involvement can produce high-quality, relevant research that better addresses the needs of patients and their families. This systematic review investigated the nature and impact of patient and public involvement in cancer prevention, screening and early detection research. Two patient representatives were involved as members of the review team. Databases (Medline, EMBASE, Emcare, Involve Evidence Library) were searched for English-language studies published 1995-March 2022. Titles/abstracts were screened by two reviewers independently. For eligible studies, data were extracted on study characteristics, patient and public involvement (who, when, how, and impact on research outcomes), and reporting quality using the Guidance for Reporting Involvement of Patients and the Public 2-Short Form. Of 4095 articles screened, 58 were eligible. Most research was from the United States (81%) and examined cancer screening or prevention (82%). Community members/organisations/public were the most involved (71%); fewer studies involved patients and/or carers (14%). Over half reported a high-level of involvement (i.e. partner and/or expert involvement), although this declined in later stages of the research cycle, e.g. data analysis. Common positive impacts included improved study design, research methods and recruitment, although most papers (62%) did not describe methods to determine impact. Reporting quality was sub-optimal, largely due to failure to consider challenges. This review found that high-level involvement of patients and the public in cancer prevention, screening and early detection research is feasible and has several advantages. However, improvements are needed to encourage involvement across the research cycle, and in evaluating and reporting its impact.
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Affiliation(s)
- Rebecca J Bergin
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia; Department of General Practice/Centre for Cancer Research, University of Melbourne, Melbourne, Australia.
| | - Camille E Short
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences and Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia
| | - Nikki Davis
- Patient representative, Primary Care Collaborative Cancer Clinical Trials Group (PC4) Community Advisory Group, Melbourne, Australia
| | - Julie Marker
- Patient representative, Primary Care Collaborative Cancer Clinical Trials Group (PC4) Community Advisory Group, Melbourne, Australia; Patient representative, Cancer Voices South Australia, Adelaide, Australia
| | | | - Shakira Milton
- Department of General Practice/Centre for Cancer Research, University of Melbourne, Melbourne, Australia
| | - Mairead McNamara
- Department of General Practice/Centre for Cancer Research, University of Melbourne, Melbourne, Australia
| | - Paige Druce
- Department of General Practice/Centre for Cancer Research, University of Melbourne, Melbourne, Australia; Central Clinical School, Monash University, Melbourne, Australia
| | - Kristi Milley
- Department of General Practice/Centre for Cancer Research, University of Melbourne, Melbourne, Australia
| | - Napin Karnchanachari
- Department of General Practice/Centre for Cancer Research, University of Melbourne, Melbourne, Australia
| | - Gemma Skaczkowski
- Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia; School of Psychology & Public Health, La Trobe University, Melbourne, Australia
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Matthews AK, Murray M, Ben Levi J, Odell D, Jeremiah R, Moore L, Oyaluade D, Chappel A, Burke L, Watson K. Preliminary Evaluation of a Citizen Scientist Educational Curriculum Aimed at Engaging Black Men in Lung Cancer Early Detection Screening. Am J Mens Health 2022; 16:15579883221099417. [PMID: 35694882 PMCID: PMC9201322 DOI: 10.1177/15579883221099417] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 03/03/2022] [Accepted: 04/07/2022] [Indexed: 11/29/2022] Open
Abstract
This article describes an educational program to engage African American men as citizen scientists (CSs) and future research partners in a lung cancer screening project. We provide an overview of the curriculum used, the structure and format of the educational sessions, and associated educational outcomes. Furthermore, we describe lessons learned in the engagement of African American men as CS in community-based lung-health equity research. The CS educational program included five group-based sessions delivered through zoom. The educational curriculum was adapted from the University of Florida Citizen Scientist program and tailored to address lung health and the contextual experiences of African American men. Each session lasted 90 minutes. Pre- and post-test measures were collected to examine changes in knowledge, comfort, health literacy, research interests, and medical mistrust. Eight African American men completed the CS educational program. Attendance rates were high for each session (100%). Seven participants completed additional human subject research certification. Improvements were observed from pre- to post-test in participants' level of knowledge, comfort, and health literacy but not medical mistrust. CS reported the most interest in participating in research aimed to identify important community strengths and problems. Study findings suggest that it was feasible to deliver an online citizen scientist educational program designed to prepare participants to serve as partners in a lung cancer screening intervention for African American men. Results suggest the educational program has the potential to improve key outcomes including completion of regulatory training and increased research-related knowledge, comfort, and health literacy.
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Affiliation(s)
- Alicia K. Matthews
- College of Nursing, The University of
Illinois at Chicago, Chicago, IL, USA
| | | | - Josef Ben Levi
- College of Education, Northeastern
Illinois University, Chicago, IL, USA
| | - David Odell
- Feinberg School of Medicine,
Northwestern University, Chicago, IL, USA
| | - Rohan Jeremiah
- College of Nursing, The University of
Illinois at Chicago, Chicago, IL, USA
| | | | - Damilola Oyaluade
- Cancer Center, The University of
Illinois at Chicago, Chicago, IL, USA
| | - Alexis Chappel
- College of Education, Northeastern
Illinois University, Chicago, IL, USA
| | - Larisa Burke
- College of Nursing, The University of
Illinois at Chicago, Chicago, IL, USA
| | - Karriem Watson
- School of Public Health, The University
of Illinois at Chicago, Chicago, IL, USA
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Almeida R, Lopez-Macha A, Dugatkin T, Joseph G, Duron Y, Hurtado de Mendoza A, D. Graves K, Fejerman L. Community research collaboration to develop a promotores-based hereditary breast cancer education program for Spanish-speaking Latinas. HEALTH EDUCATION RESEARCH 2021; 36:319-336. [PMID: 34113985 PMCID: PMC9115327 DOI: 10.1093/her/cyab011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Indexed: 06/12/2023]
Abstract
Breast cancer (BC) is the most common cancer in Latinas and the leading cause of cancer death. Latinas tend to be diagnosed at later stages, receive poorer quality care and have a higher risk of mortality than non-Latina White (NLW) women. Among women with a genetic predisposition to hereditary BC, genetic counseling can be beneficial. Latinas participate in genetic counseling at lower rates than NLW women. The goal of this study was to develop comprehensive, culturally appropriate materials for community health educators (promotores)-led hereditary BC education program for Spanish-speaking Latinas. We developed the curriculum through feedback from 7 focus groups, with a total of 68 participants (35 promotores and 33 community members). We used a mixed-methods approach that relied on quantitative analysis of survey questions and qualitative content analysis of the focus groups transcripts. Pre and post promotores' training survey responses suggested improvement in the promotores' cancer-related knowledge. Themes that emerged from the qualitative analyses were (i) barriers to health education and/or care; (ii) importance of educating the Latino community about BC and genetics and (iii) role of the promotores. Future research will further evaluate the impact of the program in promotores' knowledge and community members' screening behaviors.
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Affiliation(s)
| | | | | | - Galen Joseph
- University of California, San Francisco, CA, USA
| | | | | | | | - Laura Fejerman
- University of California, San Francisco, CA, USA
- University of California, Davis, San Francisco, CA, USA
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5
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Chebli P, Lemus J, Avila C, Peña K, Mariscal B, Merlos S, Guitelman J, Molina Y. Multilevel determinants of financial toxicity in breast cancer care: perspectives of healthcare professionals and Latina survivors. Support Care Cancer 2020; 28:3179-3188. [PMID: 31712953 PMCID: PMC7214214 DOI: 10.1007/s00520-019-05119-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 10/02/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE Financial toxicity is a multidimensional side effect of cancer treatment. Yet, most relevant research has focused on individual-level determinants of financial toxicity and characterized only patient perspectives. This study examined the multilevel determinants of financial toxicity from the perspectives of Latina breast cancer survivors and healthcare professionals. METHODS We analyzed qualitative data from focus groups with 19 Latina breast cancer survivors and interviews with 10 healthcare professionals recruited through community partners and venues in Chicago. RESULTS At the individual-level, the lack of knowledge and prioritization regarding financial aspects of care (e.g., costs of treatment, insurance coverage) was identified as important determinants of financial toxicity. However, healthcare professionals emphasized the need for early financial planning, while survivors prioritized survival over financial concerns immediately after diagnosis. At the interpersonal-level, social networks were identified as important platforms for disseminating information on financial resources. At the community-level, community norms and dynamics were identified as important barriers to seeking financial assistance. Access to culturally astute community-based organizations was considered one potential solution to eliminate these barriers. At the organizational/healthcare policy-level, financial assistance programs' restrictive eligibility criteria, lack of coverage post-treatment, limited availability, and instability were identified as major determinants of financial toxicity. CONCLUSION Our findings suggest that multilevel interventions at the individual-, interpersonal-, community-, and organizational/healthcare policy-levels are needed to adequately address financial toxicity among Latina and other survivors from disadvantaged communities.
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Affiliation(s)
- Perla Chebli
- School of Public Health, University of Illinois at Chicago, 649 SPHPI MC923, Chicago, IL, USA
| | - Jocelyne Lemus
- School of Public Health, University of Illinois at Chicago, 649 SPHPI MC923, Chicago, IL, USA
| | - Corazón Avila
- School of Public Health, University of Illinois at Chicago, 649 SPHPI MC923, Chicago, IL, USA
| | - Kryztal Peña
- School of Public Health, University of Illinois at Chicago, 649 SPHPI MC923, Chicago, IL, USA
| | | | | | | | - Yamilé Molina
- School of Public Health, University of Illinois at Chicago, 649 SPHPI MC923, Chicago, IL, USA.
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