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Quintiliani LM, Dedier J, Amezquita M, Sierra-Ruiz M, Romero D, Murillo J, Mahar S, Goodman M, Kane JB, Cummings D, Woolley TG, Spinola I, Crouter SE. Community Walks: a cluster randomized controlled trial of a multilevel physical activity intervention for low income public housing residents. BMC Public Health 2023; 23:1676. [PMID: 37653386 PMCID: PMC10470135 DOI: 10.1186/s12889-023-16574-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Physical activity behavioral interventions to change individual-level drivers of activity, like motivation, attitudes, and self-efficacy, are often not sustained beyond the intervention period. Interventions at both environmental and individual levels might facilitate durable change. This community-based study seeks to test a multilevel, multicomponent intervention to increase moderate intensity physical activity among people with low incomes living in U.S. public housing developments, over a 2 year period. METHODS The study design is a prospective, cluster randomized controlled trial, with housing developments (n=12) as the units of randomization. In a four-group, factorial trial, we will compare an environmental intervention (E) alone (3 developments), an individual intervention (I) alone (3 developments), an environmental plus individual (E+I) intervention (3 developments), against an assessment only control group (3 developments). The environmental only intervention consists of community health workers leading walking groups and indoor activities, a walking advocacy program for residents, and provision of walking maps/signage. The individual only intervention consists of a 12-week automated telephone program to increase physical activity motivation and self-efficacy. All residents are invited to participate in the intervention activities being delivered at their development. The primary outcome is change in moderate intensity physical activity measured via an accelerometer-based device among an evaluation cohort (n=50 individuals at each of the 12 developments) from baseline to 24-month follow up. Mediation (e.g., neighborhood walkability, motivation) and moderation (e.g., neighborhood stress) of our interventions will be assessed. Lastly, we will interview key informants to assess factors from the Consolidated Framework for Implementation Research domains to inform future implementation. DISCUSSION We hypothesize participants living in developments in any of the three intervention groups (E only, I only, and E+I combined) will increase minutes of moderate intensity physical activity more than participants in control group developments. We expect delivery of an intervention package targeting environmental and social factors to become active, combined with the individual level intervention, will improve overall physical activity levels to recommended guidelines at the development level. If effective, this trial has the potential for implementation through other federal and state housing authorities. TRIAL REGISTRATION Clinical Trails.gov PRS Protocol Registration and Results System, NCT05147298 . Registered 28 November 2021.
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Affiliation(s)
- Lisa M Quintiliani
- Boston University, Chobanian and Avedisian School of Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA.
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA.
| | - Julien Dedier
- Boston University, Chobanian and Avedisian School of Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA
| | - Marislena Amezquita
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA
| | - Melibea Sierra-Ruiz
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA
| | - Dariela Romero
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA
| | - Jennifer Murillo
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA
| | - Sarah Mahar
- School of Public Health, Boston University, 715 Albany St, Boston, MA, 02118, USA
| | - Melody Goodman
- Department of Biostatistics, School of Public Health, New York University, 708 Broadway, New York, NY, 10003, USA
| | - John B Kane
- Grants and Strategic Partnerships, Boston Housing Authority, 52 Chauncy St, Boston, MA, 02111, USA
| | - Doreen Cummings
- Trinity Management Company, LLC, 75 Federal St. Floor 4, Boston, MA, 02110, USA
| | | | - Iolando Spinola
- WalkMassachusetts, 50 Milk St. 16th Floor, Boston, MA, 021109, USA
| | - Scott E Crouter
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee Knoxville, 1914 Andy Holt Avenue, Knoxville, TN, 37996, USA
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Villalobos A, Chambers DA. Advancing the science of integrating multiple interventions by blending and bundling. JNCI Cancer Spectr 2023; 7:pkad070. [PMID: 37707597 PMCID: PMC10587993 DOI: 10.1093/jncics/pkad070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/05/2023] [Accepted: 09/10/2023] [Indexed: 09/15/2023] Open
Abstract
Cancer prevention and control research has produced a variety of effective interventions over the years, though most are single disease focused. To meet the Cancer Moonshot goal to reduce the cancer death rate by 50% by 2047, it may be necessary to overcome the limitations of siloed interventions that do not meet people's multiple needs and limitations in system capacity to deliver the increasing number of interventions in parallel. In this article, we propose integrating multiple evidence-based interventions as a potential solution. We define 2 types of integrated interventions, blended and bundled, and provide examples to illustrate each. We then offer a schematic and outline considerations for how to assemble blended or bundled interventions including looking at the intervention need or opportunity along the cancer continuum as well as co-occurring behaviors or motivations. We also discuss delivery workflow integration considerations including social-ecological level(s), context or setting, implementer, and intended beneficiary. Finally, in assembling integrated interventions, we encourage consideration of practice-based expertise and community and/or patient input. After assembly, we share thoughts related to implementation and evaluation of blended or bundled interventions. To conclude the article, we present multiple research opportunities in this space. With swift progress on these research directions, cancer prevention and control interventionists and implementation scientists can contribute to achieving the promise of the reignited Cancer Moonshot.
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Affiliation(s)
- Aubrey Villalobos
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - David A Chambers
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
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Casale M, Somefun O, Haupt Ronnie G, Desmond C, Sherr L, Cluver L. A conceptual framework and exploratory model for health and social intervention acceptability among African adolescents and youth. Soc Sci Med 2023; 326:115899. [PMID: 37087974 DOI: 10.1016/j.socscimed.2023.115899] [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: 08/03/2022] [Revised: 04/05/2023] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Abstract
Intervention acceptability has become an increasingly key consideration in the development, evaluation and implementation of health and social interventions. However, to date this area of investigation has been constrained by the absence of a consistent definition of acceptability, comprehensive conceptual frameworks disaggregating its components, and few reliable assessment measures. This paper aims to contribute to this gap, by proposing a conceptual framework and exploratory model for acceptability with a specific priority population for health and developmental interventions: adolescents and youth in Africa. We document our multi-staged approach to model development, comprising both inductive and deductive components, and both systematic and interpretative review methods. This included thematic analyses of respective acceptability definitions and findings, from 55 studies assessing acceptability of 60 interventions conducted with young people aged 10-24 in (mainly Southern and Eastern) Africa over a decade; a consideration of these findings in relation to Sekhon et al.'s Theoretical Framework of Acceptability (TFA); a cross-disciplinary review of acceptability definitions and models; a review of key health behavioural change models; and expert consultation with interdisciplinary researchers. Our proposed framework incorporates nine component constructs: affective attitude, intervention understanding, perceived positive effects, relevance, perceived social acceptability, burden, ethicality, perceived negative effects and self-efficacy. We discuss the rationale for the inclusion and definition of each component, highlighting key behavioural models that adopt similar constructs. We then extend this framework to develop an exploratory model for acceptability with young people, that links the framework components to each other and to intervention engagement. Acceptability is represented as an emergent property of a complex, adaptive system of interacting components, which can influence user engagement directly and indirectly, and in turn be influenced by user engagement. We discuss opportunities for applying and further refining or developing these models, and their value as a point of reference for the development of acceptability assessment tools.
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Affiliation(s)
- Marisa Casale
- School of Public Health, University of the Western Cape, Cape Town, South Africa; Department of Social Policy and Intervention, University of Oxford, Barnett House, Oxford, United Kingdom.
| | - Oluwaseyi Somefun
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | | | - Chris Desmond
- Centre for Rural Health, University of KwaZulu-Natal, South Africa
| | | | - Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, Barnett House, Oxford, United Kingdom; Dept of Psychiatry and Mental Health, University of Cape Town, South Africa
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Ngwenya S, Mashau NS, Mhlongo ES, Traoré AN, Mudau AG. Health risk management framework for heavy metals and cyanide in Kwekwe city of Zimbabwe: a mixed-method study protocol. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:26. [PMID: 37013628 PMCID: PMC10069024 DOI: 10.1186/s41043-023-00367-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/22/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND According to WHO, in 2015, over 35% of ischaemic heart disease, the leading cause of death and disability worldwide, and about 42% of strokes, the second largest contributor to global mortality, could have been prevented by reducing or removing exposure to chemical pollutants. Heavy metal and cyanide pollution are prevalent in developing countries, especially in sub-Saharan Africa where the effects of industrial pollutants are more severe, partly due to poor regulation. In Zimbabwe, the mining industry alone contributed to 25% of occupational conditions and injuries in 2020. Therefore, to mitigate these problems, this study seeks to develop a health risk management framework for heavy metals and cyanide pollution in the industrial city of Kwekwe. METHODS The convergent parallel mixed-method study design will be utilised. Qualitative and quantitative data will be collected, analysed, and merged in order to inform the development of the risk framework. An analytical cross-sectional survey would be used to determine levels of heavy metals in surface water, soil, and vegetables. Free cyanide will be determined in surface water samples only. The phenomenological qualitative inquiry will be used to investigate health events and risks associated with potentially toxic pollutants (heavy metals and cyanide) to describe or interpret participants' lived experiences. The qualitative and quantitative results will be used to develop and validate the framework to manage identified health risks. For data analysis, statistical analysis will be used in the quantitative study, while thematic analysis will be used in the qualitative study. The study was approved by the University of Venda Ethics Committee (Registration Number FHS/22/PH/05/2306) and the Medical Research Council of Zimbabwe (Approval Number MRCZ/A/2944). All ethical principles will be adhered to throughout the study in accordance with the Helsinki Declaration. DISCUSSION While existing risk management frameworks have significantly contributed to human and environmental health protection, novel and comprehensive frameworks need to be developed to counter the ever-dynamic and evolving risks associated with chemical pollutants. If the management framework is successfully developed, it could offer an opportunity for the prevention and control of potentially toxic elements.
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Affiliation(s)
- Sheunesu Ngwenya
- Department of Public Health, School of Health Sciences, University of Venda, P Bag X5050, Thohoyandou, South Africa.
| | - Ntsieni S Mashau
- Department of Public Health, School of Health Sciences, University of Venda, P Bag X5050, Thohoyandou, South Africa
| | - Emmanuel S Mhlongo
- Department of Earth Sciences, University of Venda, Thohoyandou, South Africa
| | - Afsatou N Traoré
- Department of Biochemistry and Microbiology, University of Venda, Thohoyandou, South Africa
| | - Azwinndini G Mudau
- Department of Public Health, School of Health Sciences, University of Venda, P Bag X5050, Thohoyandou, South Africa
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Moss JL, Stoltzfus KC, Popalis ML, Calo WA, Kraschnewski JL. Assessing the use of constructs from the consolidated framework for implementation research in U.S. rural cancer screening promotion programs: a systematic search and scoping review. BMC Health Serv Res 2023; 23:48. [PMID: 36653800 PMCID: PMC9846667 DOI: 10.1186/s12913-022-08976-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/16/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Cancer screening is suboptimal in rural areas, and interventions are needed to improve uptake. The Consolidated Framework for Implementation Research (CFIR) is a widely-used implementation science framework to optimize planning and delivery of evidence-based interventions, which may be particularly useful for screening promotion in rural areas. We examined the discussion of CFIR-defined domains and constructs in programs to improve cancer screening in rural areas. METHODS We conducted a systematic search of research databases (e.g., Medline, CINAHL) to identify studies (published through November 2022) of cancer screening promotion programs delivered in rural areas in the United States. We identified 166 records, and 15 studies were included. Next, two reviewers used a standardized abstraction tool to conduct a critical scoping review of CFIR constructs in rural cancer screening promotion programs. RESULTS Each study reported at least some CFIR domains and constructs, but studies varied in how they were reported. Broadly, constructs from the domains of Process, Intervention, and Outer setting were commonly reported, but constructs from the domains of Inner setting and Individuals were less commonly reported. The most common constructs were planning (100% of studies reporting), followed by adaptability, cosmopolitanism, and reflecting and evaluating (86.7% for each). No studies reported tension for change, self-efficacy, or opinion leader. CONCLUSIONS Leveraging CFIR in the planning and delivery of cancer screening promotion programs in rural areas can improve program implementation. Additional studies are needed to evaluate the impact of underutilized CFIR domains, i.e., Inner setting and Individuals, on cancer screening programs.
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Affiliation(s)
- Jennifer L Moss
- Penn State College of Medicine, Hershey, PA, USA.
- Department of Family and Community Medicine, Department of Public Health Sciences, Penn State College of Medicine, The Pennsylvania State University, 90 Hope Drive, #2120E, MC A172, P.O. Box 855, Hershey, PA, 17033, USA.
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Oh AY, Rising CJ, Gaysynsky A, Tsakraklides S, Huang GC, Chou WYS, Blake KD, Vanderpool RC. Advancing multi-level health communication research: A Delphi study on barriers and opportunities. Transl Behav Med 2022; 12:1133-1145. [PMID: 36378100 PMCID: PMC9802573 DOI: 10.1093/tbm/ibac068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Adopting a multi-level perspective that considers the many interrelated contexts influencing health could make health communication interventions more effective and equitable. However, despite increasing interest in the use of multi-level approaches, multi-level health communication (MLHC) interventions are infrequently utilized. We therefore sought to conduct a modified Delphi study to better understand how researchers conceptualize MLHC interventions and identify opportunities for advancing MLHC work. Communication and health behavior experts were invited to complete two rounds of surveys about the characteristics, benefits, pitfalls, best practices, barriers, and facilitators of MLHC interventions; the role of technology in facilitating MLHC interventions; and ways to advance MLHC intervention research (46 experts completed the first survey, 44 completed both surveys). Survey data were analyzed using a mixed-methods approach. Panelists reached consensus on two components of the proposed definition of MLHC interventions and also put forward a set of best practices for these interventions. Panelists felt that most health intervention research could benefit from a multi-level approach, and generally agreed that MLHC approaches offered certain advantages over single-level approaches. However, they also expressed concern related to the time, cost, and complexity of MLHC interventions. Although panelists felt that technology could potentially support MLHC interventions, they also recognized the potential for technology to exacerbate disparities. Finally, panelists prioritized a set of methodological advances and practical supports that would be needed to facilitate future MLHC intervention research. The results of this study point to several future directions for the field, including advancing how interactions between levels are assessed, increasing the empirical evidence base demonstrating the advantages of MLHC interventions, and identifying best practices for the use of technology. The findings also suggest that researchers may need additional support to overcome the perceived practical challenges of conducting MLHC interventions.
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Affiliation(s)
- April Y Oh
- Implementation Science Team, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Camella J Rising
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Anna Gaysynsky
- Health Communication and Informatics Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
- ICF Next, ICF, Rockville, MD, USA
| | | | - Grace C Huang
- Public Health and Epidemiology, Westat, Rockville, MD, USA
| | - Wen-Ying Sylvia Chou
- Health Communication and Informatics Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Kelly D Blake
- Health Communication and Informatics Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Robin C Vanderpool
- Health Communication and Informatics Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
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Moss JL, Leach K, Stoltzfus KC, Granzow M, Reiter PL, Onega T, Klesges LM, Ruffin MT. Multilevel Associations with Cancer Screening Among Women in Rural, Segregated Communities Within the Northeastern USA: a Mixed-Methods Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1982-1992. [PMID: 34263433 PMCID: PMC8279881 DOI: 10.1007/s13187-021-02069-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/05/2021] [Indexed: 06/13/2023]
Abstract
We recruited women (primarily non-Hispanic White) from 14 rural, segregated counties in a Northeastern US state for an explanatory sequential study: 100 women (ages 50-65 years) completed a survey, and 16 women participated in focus groups. We sought to identify personal (e.g., healthcare mistrust) and environmental (e.g., travel time to healthcare providers) factors related to colorectal and cervical cancer screening. Quantitatively, 89% of participants were up-to-date for cervical screening, and 65% for colorectal screening. Factors interacted such that compounding barriers were associated with lower odds of screening (e.g., insurance status and healthcare mistrust: interaction p = .02 for cervical; interaction p = .05 for colorectal). Qualitatively, three themes emerged regarding barriers to screening: privacy concerns, logistical barriers, and lack of trust in adequacy of healthcare services. While cancer screening was common in rural, segregated counties, women who reported both environmental and personal barriers to screening had lower uptake. Future interventions to promote screening can target these barriers.
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Affiliation(s)
- Jennifer L Moss
- Department of Family and Community Medicine, Department of Public Health Sciences, Penn State College of Medicine, The Pennsylvania State University, 134 Sipe Ave., #205, MC HS72, P.O. Box 850, Hershey, PA, 17033, USA.
| | - Kelsey Leach
- Department of Family and Community Medicine, Department of Public Health Sciences, Penn State College of Medicine, The Pennsylvania State University, 134 Sipe Ave., #205, MC HS72, P.O. Box 850, Hershey, PA, 17033, USA
| | - Kelsey C Stoltzfus
- Department of Family and Community Medicine, Department of Public Health Sciences, Penn State College of Medicine, The Pennsylvania State University, 134 Sipe Ave., #205, MC HS72, P.O. Box 850, Hershey, PA, 17033, USA
| | - Marni Granzow
- Department of Family and Community Medicine, Department of Public Health Sciences, Penn State College of Medicine, The Pennsylvania State University, 134 Sipe Ave., #205, MC HS72, P.O. Box 850, Hershey, PA, 17033, USA
| | - Paul L Reiter
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Tracy Onega
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- University of Utah, Salt Lake City, UT, USA
| | - Lisa M Klesges
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Mack T Ruffin
- Department of Family and Community Medicine, Department of Public Health Sciences, Penn State College of Medicine, The Pennsylvania State University, 134 Sipe Ave., #205, MC HS72, P.O. Box 850, Hershey, PA, 17033, USA
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Ortega A, Bejarano CM, Cushing CC, Staggs VS, Papa AE, Steel C, Shook RP, Conway TL, Saelens BE, Glanz K, Cain KL, Frank LD, Kerr J, Schipperijn J, Sallis JF, Carlson JA. Location-specific psychosocial and environmental correlates of physical activity and sedentary time in young adolescents: preliminary evidence for location-specific approaches from a cross-sectional observational study. Int J Behav Nutr Phys Act 2022; 19:108. [PMID: 36028885 PMCID: PMC9419353 DOI: 10.1186/s12966-022-01336-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A better understanding of the extent to which psychosocial and environmental correlates of physical activity are specific to locations would inform intervention optimization. PURPOSE To investigate cross-sectional associations of location-general and location-specific variables with physical activity and sedentary time in three common locations adolescents spend time. METHODS Adolescents (N = 472,Mage = 14.1,SD = 1.5) wore an accelerometer and global positioning systems (GPS) tracker and self-reported on psychosocial (e.g., self-efficacy) and environmental (e.g., equipment) factors relevant to physical activity and sedentary time. We categorized each survey item based on whether it was specific to a location to generate psychosocial and environmental indices that were location-general or specific to either school, non-school, or home location. Physical activity (MVPA) and sedentary time were based on time/location match to home, school, or all "other" locations. Mixed-effects models investigated the relation of each index with location-specific activity. RESULTS The location-general and non-school physical activity psychosocial indices were related to greater MVPA at school and "other" locations. The school physical activity environment index was related to greater MVPA and less sedentary time at school. The home activity environment index was related to greater MVPA at home. The non-school sedentary psychosocial index was related to less sedentary time at home. Interactions among indices revealed adolescents with low support on one index benefited (i.e., exhibited more optimal behavior) from high support on another index (e.g., higher scores on the location-general PA psychosocial index moderated lower scores on the home PA environment index). Concurrent high support on two indices did not provide additional benefit. CONCLUSIONS No psychosocial or environment indices, including location-general indices, were related to activity in all locations. Most of the location-specific indices were associated with activity in the matching location(s). These findings provide preliminary evidence that psychosocial and environmental correlates of activity are location specific. Future studies should further develop location-specific measures and evaluate these constructs and whether interventions may be optimized by targeting location-specific psychosocial and environmental variables across multiple locations.
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Affiliation(s)
- Adrian Ortega
- Clinical Child Psychology Program, University of Kansas, 2005 Dole Human Development Center, 1000 Sunnyside Ave, Lawrence, Kansas, USA.
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy, Kansas, MO, USA.
| | - Carolina M Bejarano
- Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine & Clinical Psychology, Cincinnati, USA
| | - Christopher C Cushing
- Clinical Child Psychology Program, University of Kansas, 2005 Dole Human Development Center, 1000 Sunnyside Ave, Lawrence, Kansas, USA
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy, Kansas, MO, USA
- Schiefelbusch Institute for Lifespan Studies, University of Kansas, Lawrence, Kansas, USA
| | - Vincent S Staggs
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy, Kansas, MO, USA
- Biostatistics & Epidemiology, Health Services & Outcomes Research, Children's Mercy, Kansas, MO, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Amy E Papa
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy, Kansas, MO, USA
| | - Chelsea Steel
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy, Kansas, MO, USA
| | - Robin P Shook
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy, Kansas, MO, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Terry L Conway
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, La Jolla, San Diego, California, USA
| | - Brian E Saelens
- Department of Pediatrics, University of Washington & Seattle Children's Research Institute, Seattle, Washington, USA
| | - Karen Glanz
- Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Kelli L Cain
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, La Jolla, San Diego, California, USA
| | - Lawrence D Frank
- School of Community and Regional Planning, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jacqueline Kerr
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, La Jolla, San Diego, California, USA
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, La Jolla, San Diego, California, USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Jordan A Carlson
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy, Kansas, MO, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
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A multilevel approach for advancing organizational interventions. INDUSTRIAL AND ORGANIZATIONAL PSYCHOLOGY-PERSPECTIVES ON SCIENCE AND PRACTICE 2022. [DOI: 10.1017/iop.2021.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Oh A, Gaysynsky A, Winer RL, Lee HY, Brewer NT, White A. Considerations and opportunities for multilevel HPV vaccine communication interventions. Transl Behav Med 2022; 12:343-349. [PMID: 35171276 PMCID: PMC9012999 DOI: 10.1093/tbm/ibab129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
From 2016 to 2019, the National Cancer Institute and the Centers for Disease Control and Prevention funded three Special Interest Projects focused on developing and testing multilevel HPV vaccination communication interventions. In this commentary, we highlight lessons learned from the funded projects, including the importance of engaging community members in the early stages of the research process, the challenges of evaluating multilevel interventions, and the need to consider stakeholder implementation preferences.
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Affiliation(s)
- April Oh
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Anna Gaysynsky
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
- ICF Next Government, ICF, Rockville, MD, USA
| | - Rachel L Winer
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | - Hee Y Lee
- School of Social Work, University of Alabama, Tuscaloosa, AL, USA
| | - Noel T Brewer
- Department Of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Arica White
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Nishimi K, Glickman E, Smith K, Ben-Joseph E, Carson S, Vranceanu AM, Dunn EC. Master-planned communities in the United States as novel contexts for individual and population-level research. Prev Med 2022; 154:106864. [PMID: 34740677 DOI: 10.1016/j.ypmed.2021.106864] [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: 03/01/2021] [Revised: 10/13/2021] [Accepted: 10/30/2021] [Indexed: 11/25/2022]
Abstract
It has long been known that social and physical environments can shape individual and population health, for better or worse. Master-planned communities (MPCs) in the US are custom-designed residential neighborhoods with defined boundaries planned and developed under a single, private owner or entity from their inception. Across the US, these vary greatly in scale ranging from 100 to over 50,000 homes, but broadly all provide residents with housing, infrastructure, landscaping, and purpose-built facilities to support socialization. Current research in the urban planning literature suggests that MPCs can influence the health of their residents. However, few studies have examined the use of MPCs as settings to conduct individual or population health research. In this paper, we examine the potential of MPCs as context for observational or intervention studies aimed at understanding individual and population-level health and well-being. We first summarize links between built and social environment and individual and population health research. Next, we describe the history of planned communities in the US. Then, we review specific features of MPCs related to governance, development, design, and social structure. We end by exploring how those specific features may lead to potential opportunities and challenges when using MPCs in health research. Through this discussion, we highlight MPCs as overlooked settings that may offer potential for collaborative, innovative, and socially engaged health research.
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Affiliation(s)
- Kristen Nishimi
- Mental Health Service, San Francisco Veterans Affairs Healthcare System, 4150 Clement St, San Francisco, CA 94121, USA; Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA.
| | - Emma Glickman
- Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge Street, Simches Research Building, Boston, MA 02114, USA
| | - Kathryn Smith
- Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge Street, Simches Research Building, Boston, MA 02114, USA
| | - Eran Ben-Joseph
- Department of Urban Studies and Planning, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02142, USA
| | - Shelley Carson
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA 02138, USA
| | - Ana-Maria Vranceanu
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USA; Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, One Bowdoin Square, Boston, MA 02114, USA
| | - Erin C Dunn
- Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge Street, Simches Research Building, Boston, MA 02114, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USA; Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, 75 Ames Street, Cambridge, MA 02142, USA.
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12
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Oh A, Vinson CA, Chambers DA. Future directions for implementation science at the National Cancer Institute: Implementation Science Centers in Cancer Control. Transl Behav Med 2021; 11:669-675. [PMID: 32145023 DOI: 10.1093/tbm/ibaa018] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The National Cancer Institute (NCI) Cancer Moonshot initiative seeks to accelerate cancer research for the USA. One of the scientific priorities identified by the Moonshot's Blue Ribbon Panel (BRP) of scientific experts was the implementation of evidence-based approaches. In September 2019, the NCI launched the Implementation Science Centers in Cancer Control (ISC3 or "Centers") initiative to advance this Moonshot priority. The vision of the ISC3 is to promote the development of research centers to build capacity and research in high-priority areas of cancer control implementation science (e.g., scale-up and spread, sustainability and adaptation, and precision implementation), build implementation laboratories within community and clinical settings, improve the state of measurement and methods, and improve the adoption, implementation, and sustainment of evidence-based cancer control interventions. This paper highlights the research agenda, vision, and strategic direction for these Centers and encourages transdisciplinary scientists to learn more about opportunities to collaborate with these Centers.
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Affiliation(s)
- April Oh
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Cynthia A Vinson
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - David A Chambers
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
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13
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Communication research at the National Cancer Institute, 2013-2019: a grant portfolio analysis. Cancer Causes Control 2021; 32:1333-1345. [PMID: 34313875 DOI: 10.1007/s10552-021-01481-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To analyze communication-focused grants funded by the National Cancer Institute (NCI) between fiscal years 2013 and 2019 to provide insight into the characteristics of funded projects and identify promising areas for future research. METHODS iSearch, a portfolio analysis tool, was queried to identify communication-related grants funded by NCI. Abstracts and specific aims were coded for key study characteristics. 344 unique competing grants with a substantial communication component were included in the final analysis. SAS version 9.4 was used to calculate code frequencies. RESULTS Most communication grants focused on cancer prevention (n = 197), with fewer targeting diagnosis, treatment, survivorship, or end-of-life. Tobacco product use was the most frequently addressed topic (n = 128). Most grants targeted or measured outcomes at the individual (n = 332) or interpersonal level (n = 127). Cancer patients/survivors (n = 101) and healthcare providers (n = 63) were often the population of focus, while caregivers or those at increased risk for cancer received less attention. Studies were often based in healthcare settings (n = 125); few studies were based in schools or worksites. Many grants employed randomized controlled trials (n = 168), but more novel methods, like optimization trials, were uncommon. CONCLUSION NCI's support of health communication research covers a diverse array of topics, populations, and methods. However, the current analysis also points to several promising opportunities for future research, including efforts focused on communication at later stages of the cancer control continuum and at multiple levels of influence, as well as studies that take advantage of a greater diversity of settings and leverage novel methodological approaches.
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Klein WMP, O'Connell ME, Bloch MH, Czajkowski SM, Green PA, Han PKJ, Moser RP, Nebeling LC, Vanderpool RC. Behavioral Research in Cancer Prevention and Control: Emerging Challenges and Opportunities. J Natl Cancer Inst 2021; 114:179-186. [PMID: 34240206 PMCID: PMC8344826 DOI: 10.1093/jnci/djab139] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/25/2021] [Accepted: 07/02/2021] [Indexed: 12/24/2022] Open
Abstract
It is estimated that behaviors such as poor diet, alcohol consumption, tobacco use, sedentary behavior, and excessive ultraviolet exposure account for nearly one-half of all cancer morbidity and mortality. Accordingly, the behavioral, social, and communication sciences have been important contributors to cancer prevention and control research, with methodological advances and implementation science helping to produce optimally effective interventions. To sustain these contributions, it is vital to adapt to the contemporary context. Efforts must consider ancillary effects of the 2019 coronavirus disease pandemic, profound changes in the information environment and public understanding of and trust in science, renewed attention to structural racism and social determinants of health, and the rapidly increasing population of cancer survivors. Within this context, it is essential to accelerate reductions in tobacco use across all population subgroups; consider new models of energy balance (diet, physical activity, sedentary behavior); increase awareness of alcohol as a risk factor for cancer; and identify better communication practices in the context of cancer-related decisions such as screening and genetic testing. Successful integration of behavioral research and cancer prevention depends on working globally and seamlessly across disciplines, taking a multilevel approach where possible. Methodological and analytic approaches should be emphasized in research training programs and should use new and underused data sources and technologies. As the leadership core of the National Cancer Institute’s Behavioral Research Program, we reflect on these challenges and opportunities and consider implications for the next phase of behavioral research in cancer prevention and control.
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Affiliation(s)
- William M P Klein
- Associate Director, Behavioral Research Program, National Cancer Institute
| | - Mary E O'Connell
- Scientific Program Manager, Behavioral Research Program, National Cancer Institute
| | - Michele H Bloch
- Chief, Tobacco Control Research Branch, National Cancer Institute
| | | | - Paige A Green
- Chief, Basic Biobehavioral/Psychological Sciences Research Branch, National Cancer Institute
| | - Paul K J Han
- Senior Scientist, Behavioral Research Program, National Cancer Institute
| | - Richard P Moser
- Training Director and Research Methods Coordinator, Division of Cancer Control and Population Sciences, National Cancer Institute
| | - Linda C Nebeling
- Deputy Associate Director, Behavioral Research Program, National Cancer Institute
| | - Robin C Vanderpool
- Chief, Health Communication and Informatics Research Branch, National Cancer Institute
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Abstract
BACKGROUND Preventing and managing chronic illness necessitates multilevel, theory-based interventions targeting behaviors, environmental factors, and personal determinants that increase risk for illness onset, greater burden, and poorer outcomes. OBJECTIVES The purpose of this article is to provide the basis for multilevel interventions, describe community-engaged intervention mapping as an approach to designing theory-based interventions, and discuss potential benefits of applying community-engaged intervention mapping in preparing nurse scientists to build programs of interdisciplinary research in preventing and managing chronic illness. METHODS Community-engaged intervention mapping integrates two methodological approaches: intervention mapping and community-engaged research. RESULTS The six-step intervention mapping approach provides a logical structure for preparing nurse scientists in designing, adapting, and implementing multilevel, theory-based interventions. Community-engaged research approaches offer principles and direction for engaging patients, clinicians, community members, and other stakeholders throughout the research process. Integrating these methods retains the theoretical integrity of interventions; improves the relevance and timely completion of the research and its products; and enhances intended beneficiaries and the community's understanding, trust, and use of the results. DISCUSSION Potential benefits of preparation in community-engaged intervention mapping to nurse scientists and nursing science include explicit consideration of multilevel factors influencing health. Additional benefits include guidance for linking relevant constructs from behavior- and environment-oriented theories with evidence-based methods for affecting desired changes in care and quality of life outcomes. Moreover, enhancement of the theoretical fidelity of the intervention, explication of the mechanisms influencing change in the primary outcome, and improved relevance and feasibility of interventions for intended beneficiaries and potential adopters are other benefits.
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Quintiliani LM, Whiteley JA, Murillo J, Lara R, Jean C, Quinn EK, Kane J, Crouter SE, Heeren TC, Bowen DJ. Community health worker-delivered weight management intervention among public housing residents: A feasibility study. Prev Med Rep 2021; 22:101360. [PMID: 33816090 PMCID: PMC8008178 DOI: 10.1016/j.pmedr.2021.101360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 02/27/2021] [Accepted: 03/04/2021] [Indexed: 01/22/2023] Open
Abstract
Community health worker-led interventions may be an optimal approach to promote behavior change among populations with low incomes due to the community health workers’ unique insights into participants’ social and environmental contexts and potential ability to deliver interventions widely. The objective was to determine the feasibility (implementation, acceptability, preliminary efficacy) of a weight management intervention for adults living in public housing developments. In 2016–2018, in Boston Massachusetts, we conducted a 3-month, two-group randomized trial comparing participants who received a tailored feedback report (control group) to participants who received the same report plus behavioral counseling. Community health workers provided up to 12 motivational interviewing-based counseling sessions in English or Spanish for diet and physical activity behaviors using a website designed to guide standardized content delivery. 102 participants enrolled; 8 (7.8%) were lost at 3-month follow up. Mean age was 46.5 (SD = 11.9) years; the majority were women (88%), Hispanic (67%), with ≤ high school degree (62%). For implementation, among intervention group participants (n = 50), 5 completed 0 sessions and 45 completed a mean of 4.6 (SD = 3.1) sessions. For acceptability, most indicated they would be very likely (79%) to participate again. For preliminary efficacy, adjusted linear regression models showed mean changes in weight (-0.94 kg, p = 0.31), moderate-to-vigorous physical activity (+11.7 min/day, p = 0.14), and fruit/vegetable intake (+2.30 servings/day, p < 0.0001) in the intervention vs. control group. Findings indicate a low-income public housing population was reached through a community health worker-led intervention with sufficient implementation and acceptability and promising beneficial changes in weight, nutrition, and physical activity outcomes.
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Affiliation(s)
- Lisa M Quintiliani
- Boston University, Department of Medicine, Section of General Internal Medicine, Boston Medical Center, United States
| | - Jessica A Whiteley
- University of Massachusetts Boston, College of Nursing and Health Sciences, Department of Exercise and Health Sciences, United States
| | - Jennifer Murillo
- Section of General Internal Medicine, Boston Medical Center, United States
| | - Ramona Lara
- Section of General Internal Medicine, Boston Medical Center, United States
| | - Cheryl Jean
- Section of General Internal Medicine, Boston Medical Center, United States
| | - Emily K Quinn
- Boston University, School of Public Health, Biostatics and Epidemiology Data Analytics Center, United States
| | - John Kane
- Boston Housing Authority, United States
| | - Scott E Crouter
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, United States
| | - Timothy C Heeren
- Department of Biostatistics, Boston University, School of Public Health, United States
| | - Deborah J Bowen
- Department of Bioethics and Humanities, University of Washington, United States
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17
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Elmore LW, Greer SF, Daniels EC, Saxe CC, Melner MH, Krawiec GM, Cance WG, Phelps WC. Blueprint for cancer research: Critical gaps and opportunities. CA Cancer J Clin 2021; 71:107-139. [PMID: 33326126 DOI: 10.3322/caac.21652] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/15/2020] [Accepted: 10/15/2020] [Indexed: 12/12/2022] Open
Abstract
We are experiencing a revolution in cancer. Advances in screening, targeted and immune therapies, big data, computational methodologies, and significant new knowledge of cancer biology are transforming the ways in which we prevent, detect, diagnose, treat, and survive cancer. These advances are enabling durable progress in the goal to achieve personalized cancer care. Despite these gains, more work is needed to develop better tools and strategies to limit cancer as a major health concern. One persistent gap is the inconsistent coordination among researchers and caregivers to implement evidence-based programs that rely on a fuller understanding of the molecular, cellular, and systems biology mechanisms underpinning different types of cancer. Here, the authors integrate conversations with over 90 leading cancer experts to highlight current challenges, encourage a robust and diverse national research portfolio, and capture timely opportunities to advance evidence-based approaches for all patients with cancer and for all communities.
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Affiliation(s)
- Lynne W Elmore
- Office of the Chief Medical and Scientific Officer, American Cancer Society, Atlanta, Georgia
| | - Susanna F Greer
- Office of the Chief Medical and Scientific Officer, American Cancer Society, Atlanta, Georgia
| | - Elvan C Daniels
- Office of the Chief Medical and Scientific Officer, American Cancer Society, Atlanta, Georgia
| | - Charles C Saxe
- Office of the Chief Medical and Scientific Officer, American Cancer Society, Atlanta, Georgia
| | - Michael H Melner
- Office of the Chief Medical and Scientific Officer, American Cancer Society, Atlanta, Georgia
| | - Ginger M Krawiec
- Office of the Chief Medical and Scientific Officer, American Cancer Society, Atlanta, Georgia
| | - William G Cance
- Office of the Chief Medical and Scientific Officer, American Cancer Society, Atlanta, Georgia
| | - William C Phelps
- Office of the Chief Medical and Scientific Officer, American Cancer Society, Atlanta, Georgia
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Lo Moro G, Soneson E, Jones PB, Galante J. Establishing a Theory-Based Multi-Level Approach for Primary Prevention of Mental Disorders in Young People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9445. [PMID: 33339317 PMCID: PMC7766147 DOI: 10.3390/ijerph17249445] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/06/2020] [Accepted: 12/12/2020] [Indexed: 12/14/2022]
Abstract
The increasing prevalence of mental health disorders and psychosocial distress among young people exceeds the capacity of mental health services. Social and systemic factors determine mental health as much as individual factors. To determine how best to address multi-level risk factors, we must first understand the distribution of risk. Previously, we have used psychometric methods applied to two epidemiologically-principled samples of people aged 14-24 to establish a robust, latent common mental distress (CMD) factor of depression and anxiety normally distributed across the population. This was linearly associated with suicidal thoughts and non-suicidal self-harm such that effective interventions to reduce CMD across the whole population could have a greater total benefit than those that focus on the minority with the most severe scores. In a randomised trial of mindfulness interventions in university students (the Mindful Student Study), we demonstrated a population-shift effect whereby the intervention group appeared resilient to a universal stressor. Given these findings, and in light of the COVID-19 pandemic, we argue that population-based interventions to reduce CMD are urgently required. To target all types of mental health determinants, these interventions must be multi-level. Careful design and evaluation, interdisciplinary work, and extensive local stakeholder involvement are crucial for these interventions to be effective.
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Affiliation(s)
- Giuseppina Lo Moro
- Department of Public Health Sciences, University of Turin, 10126 Torino, Italy;
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK;
| | - Emma Soneson
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK;
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK;
- National Institute for Health Research Applied Research Collaboration East of England, Cambridge CB2 8AH, UK
| | - Julieta Galante
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK;
- National Institute for Health Research Applied Research Collaboration East of England, Cambridge CB2 8AH, UK
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Hall KL. Forging Forward Together: Transforming Scientific Practice to Accelerate Scientific Progress. Ann Behav Med 2020; 54:968-977. [PMID: 33416841 DOI: 10.1093/abm/kaaa092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Rapidly advancing solutions requires our community to continuously re-examine successes of yesterday to inspire new approaches for today while collaboratively envisioning what’s needed for tomorrow.
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Affiliation(s)
- Kara L Hall
- National Cancer Institute, Division of Cancer Control and Population Sciences, Rockville, Maryland, USA
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20
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Alcaraz KI, Wiedt TL, Daniels EC, Yabroff KR, Guerra CE, Wender RC. Understanding and addressing social determinants to advance cancer health equity in the United States: A blueprint for practice, research, and policy. CA Cancer J Clin 2020; 70:31-46. [PMID: 31661164 DOI: 10.3322/caac.21586] [Citation(s) in RCA: 243] [Impact Index Per Article: 60.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/12/2019] [Accepted: 09/25/2019] [Indexed: 12/21/2022] Open
Abstract
Although cancer mortality rates declined in the United States in recent decades, some populations experienced little benefit from advances in cancer prevention, early detection, treatment, and survivorship care. In fact, some cancer disparities between populations of low and high socioeconomic status widened during this period. Many potentially preventable cancer deaths continue to occur, and disadvantaged populations bear a disproportionate burden. Reducing the burden of cancer and eliminating cancer-related disparities will require more focused and coordinated action across multiple sectors and in partnership with communities. This article, part of the American Cancer Society's Cancer Control Blueprint series, introduces a framework for understanding and addressing social determinants to advance cancer health equity and presents actionable recommendations for practice, research, and policy. The article aims to accelerate progress toward eliminating disparities in cancer and achieving health equity.
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Affiliation(s)
- Kassandra I Alcaraz
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia
| | - Tracy L Wiedt
- Cancer Control Department, American Cancer Society, Atlanta, Georgia
| | - Elvan C Daniels
- Extramural Research, American Cancer Society, Atlanta, Georgia
| | - K Robin Yabroff
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Carmen E Guerra
- Perelman School of Medicine and Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Richard C Wender
- Cancer Control Department, American Cancer Society, Atlanta, Georgia
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21
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Tribby CP, Perez LG, Berrigan D. Book Review: Social Ecology in the Digital Age: Solving Complex Problems in a Globalized World. FRONTIERS IN SOCIOLOGY 2019; 4:27. [PMCID: PMC8022751 DOI: 10.3389/fsoc.2019.00027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 03/25/2019] [Indexed: 06/28/2023]
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