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Wolfenden L, Hall A, Bauman A, Milat A, Hodder R, Webb E, Mooney K, Yoong S, Sutherland R, McCrabb S. Research outcomes informing the selection of public health interventions and strategies to implement them: A cross-sectional survey of Australian policy-maker and practitioner preferences. Health Res Policy Syst 2024; 22:58. [PMID: 38745326 PMCID: PMC11095011 DOI: 10.1186/s12961-024-01144-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 04/19/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND A key role of public health policy-makers and practitioners is to ensure beneficial interventions are implemented effectively enough to yield improvements in public health. The use of evidence to guide public health decision-making to achieve this is recommended. However, few studies have examined the relative value, as reported by policy-makers and practitioners, of different broad research outcomes (that is, measures of cost, acceptability, and effectiveness). To guide the conduct of research and better inform public health policy and practice, this study aimed at describing the research outcomes that Australian policy-makers and practitioners consider important for their decision-making when selecting: (a) public health interventions; (b) strategies to support their implementation; and (c) to assess the differences in research outcome preferences between policy-makers and practitioners. METHOD An online value-weighting survey was conducted with Australian public health policy-makers and practitioners working in the field of non-communicable disease prevention. Participants were presented with a list of research outcomes and were asked to select up to five they considered most critical to their decision-making. They then allocated 100 points across these - allocating more points to outcomes perceived as more important. Outcome lists were derived from a review and consolidation of evaluation and outcome frameworks in the fields of public health knowledge translation and implementation. We used descriptive statistics to report relative preferences overall and for policy-makers and practitioners separately. RESULTS Of the 186 participants; 90 primarily identified as policy-makers and 96 as public health prevention practitioners. Overall, research outcomes of effectiveness, equity, feasibility, and sustainability were identified as the four most important outcomes when considering either interventions or strategies to implement them. Scores were similar for most outcomes between policy-makers and practitioners. CONCLUSION For Australian policy-makers and practitioners working in the field of non-communicable disease prevention, outcomes related to effectiveness, equity, feasibility, and sustainability appear particularly important to their decisions about the interventions they select and the strategies they employ to implement them. The findings suggest researchers should seek to meet these information needs and prioritize the inclusion of such outcomes in their research and dissemination activities. The extent to which these outcomes are critical to informing the decision of policy-makers and practitioners working in other jurisdictions or contexts warrants further investigation.
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Affiliation(s)
- Luke Wolfenden
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia.
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia.
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia.
| | - Alix Hall
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia
| | - Adrian Bauman
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia
- Prevention Research Collaboration, Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- The Australian Prevention Partnership Centre, Sydney, NSW, Australia
| | - Andrew Milat
- School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Epidemiology and Evidence, NSW Ministry of Health, Sydney, Australia
| | - Rebecca Hodder
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia
| | - Emily Webb
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia
| | - Kaitlin Mooney
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia
| | - Serene Yoong
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia
- School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, 3122, Australia
- Global Nutrition and Preventive Health, Institute of Health Transformation, School of Health and Social Development, Deakin University, Burwood, VIC, Australia
| | - Rachel Sutherland
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia
| | - Sam McCrabb
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia
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McCrabb S, Hall A, Milat A, Bauman A, Hodder R, Mooney K, Webb E, Barnes C, Yoong S, Sutherland R, Wolfenden L. Disseminating health research to public health policy-makers and practitioners: a survey of source, message content and delivery modality preferences. Health Res Policy Syst 2023; 21:121. [PMID: 38012773 PMCID: PMC10680334 DOI: 10.1186/s12961-023-01066-7] [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: 01/15/2023] [Accepted: 10/29/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Understanding the views of policy-makers and practitioners regarding how best to communicate research evidence is important to support research use in their decision-making. AIM To quantify and describe public health policy-makers and practitioners' views regarding the source, content and form of messages describing public health research findings to inform their decision-making. We also sought to examine differences in preferences between public health policy-makers and practitioners. METHODS A cross sectional, value-weighting survey of policy-makers and practitioners was conducted. Participants were asked to allocate a proportion of 100 points across different (i) sources of research evidence, (ii) message content and (iii) the form in which evidence is presented. Points were allocated based on their rating of influence, usefulness and preference when making decisions about health policy or practice. RESULTS A total of 186 survey responses were received from 90 policy-makers and 96 practitioners. Researchers and government department agencies were the most influential source of research evidence based on mean allocation of points, followed by knowledge brokers, professional peers and associations. Mean point allocation for perceived usefulness of message content was highest for simple summary of key findings and implications, and then evidence-based recommendations and data and statistical summaries. Finally, based on mean scores, policy-makers and practitioners preferred to receive research evidence in the form of peer-reviewed publications, reports, evidence briefs and plain language summaries. There were few differences in scores between policy-makers and practitioners across source, message content or form assessments or those with experience in different behavioural areas. CONCLUSIONS The findings should provide a basis for the future development and optimization of dissemination strategies to this important stakeholder group.
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Affiliation(s)
- Sam McCrabb
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia.
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia.
| | - Alix Hall
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
| | - Andrew Milat
- School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Epidemiology and Evidence, NSW Ministry of Health, Sydney, Australia
| | - Adrian Bauman
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Prevention Research Collaboration, Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- The Australian Prevention Partnership Centre, Sydney, NSW, Australia
| | - Rebecca Hodder
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
| | - Kaitlin Mooney
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Emily Webb
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Courtney Barnes
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
| | - Serene Yoong
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
- School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, 3122, Australia
- Global Nutrition and Preventive Health, Institute of Health Transformation, School of Health and Social Development, Deakin University, Burwood, Australia
| | - Rachel Sutherland
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
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Jo EJ, Kim S. Factors Affecting Fear of Cancer Recurrence in Hematopoietic Stem Cell Transplant Patients. ASIAN ONCOLOGY NURSING 2021. [DOI: 10.5388/aon.2021.21.2.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Eun Jin Jo
- Department of Nursing, Graduate School, Yonsei University, Seoul, Korea
| | - Sanghee Kim
- College of Nursing & Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea
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Borreani C, Alfieri S, Farina L, Bianchi E, Corradini P. Fear of cancer recurrence in haematological cancer patients: exploring socio-demographic, psychological, existential and disease-related factors. Support Care Cancer 2020; 28:5973-5982. [PMID: 32285261 DOI: 10.1007/s00520-020-05434-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 03/27/2020] [Indexed: 01/02/2023]
Abstract
PURPOSE This study aims to explore the relation between the dimension of fear of cancer recurrence (FCR) in haematological cancer patients relapse-free for at least 2 years and socio-demographic, related to the disease, psychological and existential factors. METHODS A sample of 75 haematological cancer patients agreed to participate in the study through a self-reported online questionnaire (51.9% males). A total of 70.1% had a low recurrence risk. The questionnaire included socio-demographic (gender, age, civil status, level of education and number of children), related to the disease (diagnosis, therapeutic line and years since diagnosis), psychological (anxiety and depression), existential (purpose in life; PIL) factors and Fear of Cancer Recurrence Concerns Inventory (FCRI). Simple and multiple linear regressions were conducted for the analyses, and we performed some preliminary analysis on the reliability of the FCRI. FINDINGS A total of 53.3% of participants showed clinical levels of FCR on the severity dimension, which was higher than found in previous research in other cancer patients. The coping strategies, triggers, severity and psychological distress dimensions showed higher mean values. Women, patients with indolent non-Hodgkin lymphomas, years since diagnosis, anxiety and purpose in life are significantly related to one or more dimensions of FCRI. IMPLICATIONS It is important that the clinicians have at their disposal multiple possibilities to help patients cope with haematological cancer. If future research will confirm the results of this study, the negative correlation between FCR and PIL can suggest indications for planning interventions based on a salutogenic approach.
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Affiliation(s)
- C Borreani
- Clinical Psychology Unit, Fondazione IRCSS "Istituto Nazionale dei Tumori", Via Giacomo Venezian 1, 20133, Milan, Italy
| | - S Alfieri
- Clinical Psychology Unit, Fondazione IRCSS "Istituto Nazionale dei Tumori", Via Giacomo Venezian 1, 20133, Milan, Italy.
| | - L Farina
- Haematological Unit, Fondazione IRCSS "Istituto Nazionale dei Tumori", Milan, Italy
| | - E Bianchi
- Clinical Psychology Unit, Fondazione IRCSS "Istituto Nazionale dei Tumori", Via Giacomo Venezian 1, 20133, Milan, Italy
| | - P Corradini
- Haematological Unit, Fondazione IRCSS "Istituto Nazionale dei Tumori", Milan, Italy
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Piil K, Jarden M, Pii KH. Research agenda for life-threatening cancer. Eur J Cancer Care (Engl) 2018; 28:e12935. [PMID: 30345723 DOI: 10.1111/ecc.12935] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 08/28/2018] [Accepted: 09/02/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of this study was to identify future research agendas that reflect the concerns and unexplored areas of interest for patients with life-threatening cancer, their relatives and the clinical specialists during the cancer trajectory. METHODS Six focus group discussions were conducted addressing two different cancer trajectories: primary malignant brain tumour and acute leukaemia. For each of the two cancer trajectories, separate FGIs were carried out with patients, relatives and clinical specialists to identify important concerns, challenges and uncertainties. The FGIs were video/audio-recorded, transcribed and thematically analysed within and across FGI groups to construct research topics. Finally, the literature was reviewed for existing evidence concerning the identified research topic(s) to strengthen the suggested research agendas. RESULTS New research agendas related to high-grade glioma brain tumour and acute leukaemia with corresponding research questions were formulated within the topics of supportive care/palliation, education/information, rehabilitation, complementary and alternative therapy and organization of health care. CONCLUSION User involvement in identifying research agendas has the potential to improve quality of care for patients and caregivers across the cancer trajectory, while minimizing the gap in research between the healthcare user and healthcare provider.
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Affiliation(s)
- Karin Piil
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,University Hospitals Center for Health Research (UCSF) and Center for Integrated Rehabilitation of Cancer Patients (CIRE), Copenhagen, Denmark.,Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Mary Jarden
- University Hospitals Center for Health Research (UCSF) and Center for Integrated Rehabilitation of Cancer Patients (CIRE), Copenhagen, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Kathrine Hoffmann Pii
- Copenhagen University College, Institute of Nursing and Nutrition, Copenhagen, Denmark
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Yu FF, Bai YN, He H, Zhu L, Zhang RL, Jiao HX, Li QY, Fu JF. Identifying the unmet supportive care needs, with concomitant influencing factors, in adult acute leukemia patients in China. Eur J Oncol Nurs 2017; 30:67-74. [DOI: 10.1016/j.ejon.2017.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 02/17/2017] [Accepted: 07/03/2017] [Indexed: 12/26/2022]
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Rankin NM, McGregor D, Butow PN, White K, Phillips JL, Young JM, Pearson SA, York S, Shaw T. Adapting the nominal group technique for priority setting of evidence-practice gaps in implementation science. BMC Med Res Methodol 2016; 16:110. [PMID: 27566679 PMCID: PMC5002198 DOI: 10.1186/s12874-016-0210-7] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 08/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are a variety of methods for priority setting in health research but few studies have addressed how to prioritise the gaps that exist between research evidence and clinical practice. This study aimed to build a suite of robust, evidence based techniques and tools for use in implementation science projects. We applied the priority setting methodology in lung cancer care as an example. METHODS We reviewed existing techniques and tools for priority setting in health research and the criteria used to prioritise items. An expert interdisciplinary consensus group comprised of health service, cancer and nursing researchers iteratively reviewed and adapted the techniques and tools. We tested these on evidence-practice gaps identified for lung cancer. The tools were pilot tested and finalised. A brief process evaluation was conducted. RESULTS We based our priority setting on the Nominal Group Technique (NGT). The adapted tools included a matrix for individuals to privately rate priority gaps; the same matrix was used for group discussion and reaching consensus. An investment exercise was used to validate allocation of priorities across the gaps. We describe the NGT process, criteria and tool adaptations and process evaluation results. CONCLUSIONS The modified NGT process, criteria and tools contribute to building a suite of methods that can be applied in prioritising evidence-practice gaps. These methods could be adapted for other health settings within the broader context of implementation science projects.
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Affiliation(s)
- Nicole M. Rankin
- Sydney Catalyst Translational Cancer Research Cente, The University of Sydney, Level 6, 119-143 Missenden Road, Camperdown, NSW 2050 Australia
| | - Deborah McGregor
- Sydney Catalyst Translational Cancer Research Cente, The University of Sydney, Level 6, 119-143 Missenden Road, Camperdown, NSW 2050 Australia
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Phyllis N. Butow
- Psycho-Oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, Australia
- Centre for Medical Psychology & Evidence-based Decision-making, The University of Sydney, Sydney, Australia
| | - Kate White
- Cancer Nursing Research Unit (CNRU), Sydney Nursing School, Sydney Local Health District and The University of Sydney, Sydney, Australia
| | - Jane L. Phillips
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Jane M. Young
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- RPA Institute of Academic Surgery, Sydney Local Health District, NSW Ministry of Health, Sydney, Australia
| | - Sallie A. Pearson
- Medicines Policy Research Unit, Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Sarah York
- Sydney Catalyst Translational Cancer Research Cente, The University of Sydney, Level 6, 119-143 Missenden Road, Camperdown, NSW 2050 Australia
| | - Tim Shaw
- Sydney Catalyst Translational Cancer Research Cente, The University of Sydney, Level 6, 119-143 Missenden Road, Camperdown, NSW 2050 Australia
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
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Abstract
INTRODUCTION Patient involvement in healthcare has expanded from the clinical practice setting to include collaboration during the research process. There has been a growing international interest in patient and public involvement in setting research priorities to reduce the risk of discrepancy between what patients with cancer and their relatives experience as important unanswered questions and those which are actually researched. This study aims to challenge the conventional research process by inviting patients with life-threatening cancer (primary malignant brain tumours or acute leukaemia), relatives and patient organisations to join forces with clinical specialists and researchers to identify, discuss and prioritise supportive care and rehabilitation issues in future research. METHODS AND ANALYSIS This is an exploratory qualitative study comprising two sets of three focus group interviews (FGIs): one set for primary malignant brain tumours and the other for acute leukaemia. Separate FGIs will be carried out with patients and relatives including representation from patient organisations and clinical specialists to identify important unanswered questions and research topics within each group. The FGIs will be video/audio recorded, transcribed and thematically analysed. This study will contribute to a patient-centred research agenda that captures issues that patients, their relatives, clinical specialists and researchers consider important. ETHICS AND DISSEMINATION The study is registered at the Danish Data Protection Agency (number: 2012-58-0004) and the Scientific Ethics Review Committee of the Capital Region of Denmark (number: H-15001485). Papers will be published describing the methods applied and the supportive care and rehabilitation issues that are identified as important for future research. TRIAL REGISTRATION NUMBER ISRCTN57131943; Pre-results.
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Affiliation(s)
- Karin Piil
- University Hospitals Center for Health Research (UCSF) and Center for Integrated Rehabilitation of Cancer Patients (CIRE), Copenhagen, Denmark
- Department of Neurosurgery, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Mary Jarden
- University Hospitals Center for Health Research (UCSF) and Center for Integrated Rehabilitation of Cancer Patients (CIRE), Copenhagen, Denmark
- Faculty of Health and Medical Sciences, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Medlow S, Patterson P. Determining research priorities for adolescent and young adult cancer in Australia. Eur J Cancer Care (Engl) 2015; 24:590-9. [PMID: 25684198 DOI: 10.1111/ecc.12291] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2014] [Indexed: 12/26/2022]
Abstract
The Australian Youth Cancer Service (YCS) is part of a growing international movement to provide advocacy and better targeted health-care services for adolescents and young adults (AYAs) with cancer. One of the key initiatives of the YCS is to determine and implement priorities within Australian AYA cancer research. The YCS used the value-weighting online survey technique of allocating 100 hypothetical units of funding across pre-determined topics of research in order to determine Australian consumers' and health professionals' AYA cancer research priorities. A total of 101 participants (26 consumers and 75 health professionals) took part in the online survey. Biomedical and Clinical Medicine Research was allocated the greatest proportion of available funding. A number of priority populations were also identified, although these were distributed across pre-treatment and post-treatment stages. The preferences of consumers and health professionals to invest available AYA cancer research funds in Biomedical and Clinical Medicine Research will be an important consideration in guiding the Australian YCS decision-making process in the immediate future. 'Prevention, screening and early detection' was also an important research funding target, along with survivorship populations.
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Affiliation(s)
- S Medlow
- Department of Research and Evaluation and Social Policy, CanTeen Australia, Sydney, New South Wales, Australia
| | - P Patterson
- Department of Research and Evaluation and Social Policy, CanTeen Australia, Sydney, New South Wales, Australia.,Cancer Nursing Research Unit, University of Sydney, Sydney, New South Wales, Australia
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Fradgley EA, Paul CL, Bryant J, Roos IA, Henskens FA, Paul DJ. Consumer participation in quality improvements for chronic disease care: development and evaluation of an interactive patient-centered survey to identify preferred service initiatives. J Med Internet Res 2014; 16:e292. [PMID: 25532217 PMCID: PMC4285719 DOI: 10.2196/jmir.3545] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 09/02/2014] [Accepted: 11/06/2014] [Indexed: 11/16/2022] Open
Abstract
Background With increasing attention given to the quality of chronic disease care, a measurement approach that empowers consumers to participate in improving quality of care and enables health services to systematically introduce patient-centered initiatives is needed. A Web-based survey with complex adaptive questioning and interactive survey items would allow consumers to easily identify and prioritize detailed service initiatives. Objective The aim was to develop and test a Web-based survey capable of identifying and prioritizing patient-centered initiatives in chronic disease outpatient services. Testing included (1) test-retest reliability, (2) patient-perceived acceptability of the survey content and delivery mode, and (3) average completion time, completion rates, and Flesch-Kincaid reading score. Methods In Phase I, the Web-based Consumer Preferences Survey was developed based on a structured literature review and iterative feedback from expert groups of service providers and consumers. The touchscreen survey contained 23 general initiatives, 110 specific initiatives available through adaptive questioning, and a relative prioritization exercise. In Phase II, a pilot study was conducted within 4 outpatient clinics to evaluate the reliability properties, patient-perceived acceptability, and feasibility of the survey. Eligible participants were approached to complete the survey while waiting for an appointment or receiving intravenous therapy. The age and gender of nonconsenters was estimated to ascertain consent bias. Participants with a subsequent appointment within 14 days were asked to complete the survey for a second time. Results A total of 741 of 1042 individuals consented to participate (71.11% consent), 529 of 741 completed all survey content (78.9% completion), and 39 of 68 completed the test-retest component. Substantial or moderate reliability (Cohen’s kappa>0.4) was reported for 16 of 20 general initiatives with observed percentage agreement ranging from 82.1%-100.0%. The majority of participants indicated the Web-based survey was easy to complete (97.9%, 531/543) and comprehensive (93.1%, 505/543). Participants also reported the interactive relative prioritization exercise was easy to complete (97.0%, 189/195) and helped them to decide which initiatives were of most importance (84.6%, 165/195). Average completion time was 8.54 minutes (SD 3.91) and the Flesch-Kincaid reading level was 6.8. Overall, 84.6% (447/529) of participants indicated a willingness to complete a similar survey again. Conclusions The Web-based Consumer Preferences Survey is sufficiently reliable and highly acceptable to patients. Based on completion times and reading level, this tool could be integrated in routine clinical practice and allows consumers to easily participate in quality evaluation. Results provide a comprehensive list of patient-prioritized initiatives for patients with major chronic conditions and delivers practice-ready evidence to guide improvements in patient-centered care.
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Affiliation(s)
- Elizabeth A Fradgley
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health & Hunter Medical Research Institute, University of Newcastle, Callaghan, Australia.
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Abstract
BACKGROUND Patients with acute leukemia (AL) require immediate and aggressive inpatient treatment that results in many weeks to months of hospitalization. Thus, it is not surprising that distress has been found in as many as 45.5% of patients. Although distress is a regularly reported outcome measure in clinical research, currently, there is a lack of a clear, consistent, and universal definition of this concept. OBJECTIVE The purposes of this article were to examine the current state of the science surrounding the concept of distress and to propose a model of distress for patients with AL. INTERVENTIONS/METHODS The Walker and Avant framework was used to guide the analysis of the concept of distress in patients with AL. The findings from this analysis were then used to generate a model guided by the current science. RESULTS Distress in AL is generally accepted as multidimensional, quantifiable, subjective, and temporal. Antecedents to distress include demographics, intrinsic factors, social support, disease progression, treatment, and communication. Consequences to distress include decreased quality of life, patient outcomes, as well as the severity of physical and psychological symptoms. CONCLUSIONS Distress is an outcome measure that is frequently assessed and reported within the literature. The operationalization of distress varies by investigator, limiting its generalizability. IMPLICATIONS FOR PRACTICE The proposed conceptual model may be used to guide further research on distress in patients with AL at high risk for negative outcomes. Improved understanding of patient distress may guide interventions aimed at managing the psychosocial needs for patients receiving treatment for AL.
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Affiliation(s)
- Tara A Albrecht
- Author Affiliation: School of Nursing, University of Pittsburgh, Pennsylvania
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Smits R, Bryant J, Sanson-Fisher R, Tzelepis F, Henskens F, Paul C, Stevenson W. Tailored and integrated Web-based tools for improving psychosocial outcomes of cancer patients: the DoTTI development framework. J Med Internet Res 2014; 16:e76. [PMID: 24641991 PMCID: PMC3971205 DOI: 10.2196/jmir.2849] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 11/14/2013] [Accepted: 01/20/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Effective communication with cancer patients and their families about their disease, treatment options, and possible outcomes may improve psychosocial outcomes. However, traditional approaches to providing information to patients, including verbal information and written booklets, have a number of shortcomings centered on their limited ability to meet patient preferences and literacy levels. New-generation Web-based technologies offer an innovative and pragmatic solution for overcoming these limitations by providing a platform for interactive information seeking, information sharing, and user-centered tailoring. OBJECTIVE The primary goal of this paper is to discuss the advantages of comprehensive and iterative Web-based technologies for health information provision and propose a four-phase framework for the development of Web-based information tools. METHODS The proposed framework draws on our experience of constructing a Web-based information tool for hematological cancer patients and their families. The framework is based on principles for the development and evaluation of complex interventions and draws on the Agile methodology of software programming that emphasizes collaboration and iteration throughout the development process. RESULTS The DoTTI framework provides a model for a comprehensive and iterative approach to the development of Web-based informational tools for patients. The process involves 4 phases of development: (1) Design and development, (2) Testing early iterations, (3) Testing for effectiveness, and (4) Integration and implementation. At each step, stakeholders (including researchers, clinicians, consumers, and programmers) are engaged in consultations to review progress, provide feedback on versions of the Web-based tool, and based on feedback, determine the appropriate next steps in development. CONCLUSIONS This 4-phase framework is evidence-informed and consumer-centered and could be applied widely to develop Web-based programs for a diverse range of diseases.
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Swash B, Hulbert-Williams N, Bramwell R. Unmet psychosocial needs in haematological cancer: a systematic review. Support Care Cancer 2014; 22:1131-41. [PMID: 24464526 DOI: 10.1007/s00520-014-2123-5] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 01/06/2014] [Indexed: 01/06/2023]
Abstract
PURPOSE Psychosocial need implies a desire or requirement for support that underlies a person's psychological, social and emotional wellbeing. This is not a new concept in the wider cancer literature, yet remains a relatively unexplored area in relation to haematological malignancies. The well-recognised differences between haematological and other types of cancer diagnosis warrant further investigation to try and highlight the potential differences in the needs of this patient group. METHOD A systematic review of key online databases and psycho-oncology journals was conducted to identify papers that formally assessed unmet psychosocial needs in adults with a diagnosis of haematological cancer. The breadth of methodologies of included studies made a meta-analytical approach unfeasible, therefore studies were analysed using a narrative synthesis approach. RESULTS Eighteen studies were found to be relevant and a specific focus was placed on those papers that looked solely at participants with a haematological diagnosis. The key areas of need identified were: psychological need, notably fear of recurrence; information needs; and needs relating to both family and healthcare professionals. Fear of recurrence was the most commonly identified psychosocial need within this literature. CONCLUSIONS The clinical implications of these findings highlight the need for more widespread access to psychological support for haematology patients and for more to be done to tackle patients' fears and concerns throughout the course of their illness. Assessment and identification of unmet needs is an important step enabling the development of clinical services that support and maintain psychological wellbeing through treatment and into survivorship.
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Affiliation(s)
- B Swash
- Department of Psychology, University of Chester, Chritchley Building, Parkgate Road, Chester, CH1 4BJ, UK,
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Albrecht TA, Rosenzweig M. Management of Cancer Related Distress in Patients with a Hematological Malignancy. J Hosp Palliat Nurs 2012; 14:462-468. [PMID: 23002383 PMCID: PMC3445415 DOI: 10.1097/njh.0b013e318268d04e] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Patients with hematologic malignancies often require urgent, aggressive, and lengthy chemotherapy treatment. These treatment regimens, divided into cycles, result in extended, often isolating periods of hospitalization where any direct clinical benefit for the patient, such as remission or "no evidence of disease" is not immediately declared. Consequently, this population is at a high risk of experiencing severe levels of cancer related distress. Cancer related distress is a complex psychosocial phenomenon that has consequences for patients, their families as well as the healthcare staff. Thus the importance of prevention, early recognition, treatment and management is unquestionable. Nurses have an important role to help identify and manage the presence of cancer related distress in these patients, as well as their family's. Nurses should work proactively in close partnership with an interdisciplinary team to effectively provide the necessary support for patients experiencing or who are at risk for high levels of cancer related distress. This case study and subsequent discussion illustrates the symptom management needs and challenges related to cancer related distress in the patient with a hematologic malignancy. Current evidence-based practice guidelines for the assessment and management of cancer related distress will be presented.
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Affiliation(s)
- Tara A Albrecht
- Interdisciplinary Training of Nurse Scientists in Cancer Survivorship Research (T32NR011972), University of Pittsburgh, School of Nursing, Pittsburgh, PA
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PAUL CHRISTINELOUISE, BONEVSKI BILLIE, TURON HEIDIERIN, BRYANT JAMIE. The balancing act: Experts' opinions about the relative resourcing of tobacco control efforts for the general population versus disadvantaged populations. Drug Alcohol Rev 2012; 31:602-7. [DOI: 10.1111/j.1465-3362.2012.00454.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Clinton-McHarg T, Paul C, Sanson-Fisher R, D'Este C, Williamson A. Determining research priorities for young people with haematological cancer: a value-weighting approach. Eur J Cancer 2010; 46:3263-70. [PMID: 20634057 DOI: 10.1016/j.ejca.2010.06.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Revised: 06/07/2010] [Accepted: 06/08/2010] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Haematological malignancies account for a third of all cancers affecting adolescents and young adults (AYAs). Funding agencies are regularly faced with the dilemma of how to deploy resources in order to provide the greatest possible benefit to this patient group. This study used a value-weighting approach to quantify the stakeholders' perceptions about how resources should be allocated to best improve outcomes for AYA patients and their families. METHODS One hundred and fifty seven participants (112 health care providers, researchers and other professionals and 45 patients and carers) were invited to complete a web-based value-weighting questionnaire and indicate how they would allocate 100 units of funding among various research approaches, areas and populations. RESULTS Eighty participants (51%) completed the questionnaire. Strategic research was allocated a significantly higher proportion of funding than investigator-driven research. For research areas, clinical medicine and psychosocial research were allocated the highest proportion of funding. Within research populations, AYAs who were newly diagnosed, relapsed or finished treatment were allocated the largest proportion of funds. Psychosocial research which focussed on identifying risk and resilience, developing psychosocial measures, translating research into practice and improving the treatment centre was allocated funding slightly above other items, however the difference was not significant. DISCUSSION To improve potential congruence between the views of stakeholders and funding agencies, research funding for AYA haematological cancer patients and their families could be targeted towards newly diagnosed patients and those who have relapsed. Research in the areas of clinical medicine and psychosocial care is perceived to be of utmost value.
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Affiliation(s)
- Tara Clinton-McHarg
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Level 2 David Maddison Building, University Drive, Callaghan, NSW 2308, Australia.
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