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Feinberg IZ, Gajra A, Hetherington L, McCarthy KS. Simplifying informed consent as a universal precaution. Sci Rep 2024; 14:13195. [PMID: 38851754 PMCID: PMC11162480 DOI: 10.1038/s41598-024-64139-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 06/05/2024] [Indexed: 06/10/2024] Open
Abstract
One barrier to participating in clinical research is that patients with low literacy skills (1 in 5 US adults) may struggle to understand the informed consent document (ICD). Writing consents using health literacy and plain language guidelines including simplified syntax and semantics can increase understandability and facilitate inclusivity of research populations with literacy challenges. Our study aim was to evaluate a simplified ICD for understandability while considering factors known to relate to comprehension (reading skills and working memory). We performed an on-line survey of 192 adults ages 18-77 in Georgia. Participants performed significantly better on the simplified ICD test. We built an additional model with all version x measure interactions (i.e., age, sex, race, urbanicity, GMVT, WM). This model did not significantly improve model fit, F < 1.00, suggesting that individual differences did not moderate the effect of simplification. Our findings suggest that using plain language and simplified syntax and semantics in ICD as a universal precaution may reduce cognitive reading burden for adults regardless of differences in reading skill or working memory. Increasing understandability in ICD may help improve targets for clinical trial enrollment.
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Affiliation(s)
- Iris Z Feinberg
- Department of Learning Sciences, College of Education and Human Development, Georgia State University, Atlanta, GA, USA.
| | - Ajeet Gajra
- Hematology Oncology Associates of CNY, East Syracuse, NY, USA
| | | | - Kathryn S McCarthy
- Department of Learning Sciences, College of Education and Human Development, Georgia State University, Atlanta, GA, USA
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Cureton JL, Spates K, James T, Lloyd C. Readiness of a U.S. Black community to address suicide. DEATH STUDIES 2023; 48:197-206. [PMID: 37226926 DOI: 10.1080/07481187.2023.2214888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Communities need to be ready to address increased suicide among Black Americans. The Community Readiness Model (CRM) provides an established assessment for marginalized communities facing suicide. CRM assessment of the Northeast Ohio Black community involved interviews with 25 representatives, analysis using rating scales, co-scoring, and calculation. Results include a marginal overall score and low to average scores for five dimensions: knowledge of efforts to address suicide, leadership, community climate, knowledge of suicide, and resources. The vague awareness readiness stage indicates the community is unclear about what can be done to address suicide and has not taken ownership of the issue. We highlight implications for mental health practice, prevention and funding campaigns, and consultation with community leadership for culturally informed prevention strategies targeting areas of lowest readiness. Future research should use expanded designs to examine readiness changes from intervention in this and other Black communities.
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Affiliation(s)
- Jenny L Cureton
- Counselor Education and Supervision, Kent State University, Kent, Ohio, USA
| | - Kamesha Spates
- Africana Studies, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Tierra James
- Sociology, Anthropology & Social Work, College of Liberal Arts, Auburn University, Auburn, Alabama, USA
| | - Christina Lloyd
- Counselor Education and Supervision, Kent State University, Kent, Ohio, USA
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Zhang X, Liu X, Wang L. Evaluating Community Capability to Prevent and Control COVID-19 Pandemic in Shenyang, China: An Empirical Study Based on a Modified Framework of Community Readiness Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3996. [PMID: 36901006 PMCID: PMC10002099 DOI: 10.3390/ijerph20053996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 02/16/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Community plays a crucial role in the successful prevention and control of the COVID-19 pandemic in China. However, evaluation of community capability to fight against COVID-19 is rarely reported. The present study provides a first attempt to assess community capability to combat COVID-19 in Shenyang, the capital city of Liaoning province in Northeast China, based on a modified framework of a community readiness model. We conducted semi-structured interviews with ninety key informants from fifteen randomly selected urban communities to collect the data. The empirical results indicate that the overall level of community capability for epidemic prevention and control in Shenyang was at the stage of preparation. The specific levels of the fifteen communities ranged from the stages of preplanning to preparation to initiation. Concerning the level of each dimension, community knowledge about the issue, leadership, and community attachment exhibited significant disparities between communities, while there were slight differences among communities on community efforts, community knowledge of efforts, and community resources. In addition, leadership demonstrated the highest overall level among all the six dimensions, followed by community attachment and community knowledge of efforts. Community resources displayed the lowest level, followed by community efforts. This study not only extends the application of the modified community readiness model to evaluate community capability of epidemic prevention in the Chinese community context, but also offers practical implications for enhancing Chinese communities' capabilities to deal with various future public health emergencies.
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Affiliation(s)
- Xiaojie Zhang
- Department of Public Administration, School of Humanities & Law, Northeastern University, Shenyang 110169, China
| | - Xiaoyu Liu
- Department of Public Administration, School of Humanities & Law, Northeastern University, Shenyang 110169, China
| | - Lili Wang
- Party School of Weihai Municipal Committee of Communist Party of China, Weihai 264213, China
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McPhee NJ, Nightingale CE, Harris SJ, Segelov E, Ristevski E. Barriers and enablers to cancer clinical trial participation and initiatives to improve opportunities for rural cancer patients: A scoping review. Clin Trials 2022; 19:464-476. [PMID: 35586873 DOI: 10.1177/17407745221090733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Claire E Nightingale
- Monash Rural Health, Monash University, Bendigo, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Samuel J Harris
- Department of Medical Oncology, Bendigo Health, Bendigo, VIC, Australia
| | - Eva Segelov
- Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Monash University, Clayton, VIC, Australia.,Department of Oncology, Monash Health, Clayton, VIC, Australia
| | - Eli Ristevski
- Monash Rural Health, Monash University, Warragul, VIC, Australia
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Harris KJ, Brown B, Shankle L, Tryon M, Pedersen M, Panarella SK, Swaney G. Community Readiness Model for Prevention Planning: Addressing Childhood Obesity in American Indian Reservation Communities. J Racial Ethn Health Disparities 2019; 6:1144-1156. [PMID: 31332689 DOI: 10.1007/s40615-019-00616-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 07/03/2019] [Accepted: 07/11/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The community readiness model (CRM) is a stage-matched assessment protocol to assess community readiness to address a public health issue. To identify appropriate, culturally sensitive, and community-specific intervention strategies for preventing obesity in children, researchers, and community members formed a partnership to address childhood obesity within one American Indian Reservation. METHODS The CRM guided 30 interviews in five communities to direct the team's efforts in addressing obesity among children residing on the reservation. Interviews were scored across six dimensions on an anchored scale of one through nine; scores were then averaged to determine an overall readiness score for each community. A thematic analysis of interview responses aided in interpretation of the readiness scores and identified areas for prevention planning and intervention development. RESULTS The overall community readiness score for the communities was 2.9 (SD = 0.5), which falls between 2 (denial/resistance) and 3 (vague awareness) on the anchored rating scale. The thematic analysis resulted in a hierarchal classification scheme with six broad themes that corresponded to the CRM dimensions and 13 sub-themes. DISCUSSION The low readiness scores directed the team to implement corresponding strategies to increase awareness, while the thematic analysis suggested that action-based approaches might also be appropriate. The narrow range of scores suggest that community-wide assessments may be sufficient unless specific information is needed for each region of the community. The CRM may be an effective way to assess community readiness to address childhood obesity on an American Indian Reservation.
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Affiliation(s)
- Kari Jo Harris
- School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA.
| | - Blakely Brown
- School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Lindsey Shankle
- Oregon Rural Practice-Based Research Network, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Mail Code L222, Portland, OR, 97239, USA
| | - Michael Tryon
- Summit Medical Fitness Center, 205 Sunnyview Lane, Kalispell, MT, 59901, USA
| | - Maja Pedersen
- School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | | | - Gyda Swaney
- Department of Psychology, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
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Ofili EO, Schanberg LE, Hutchinson B, Sogade F, Fergus I, Duncan P, Hargrove J, Artis A, Onyekwere O, Batchelor W, Williams M, Oduwole A, Onwuanyi A, Ojutalayo F, Cross JA, Seto TB, Okafor H, Pemu P, Immergluck L, Foreman M, Mensah EA, Quarshie A, Mubasher M, Baker A, Ngare A, Dent A, Malouhi M, Tchounwou P, Lee J, Hayes T, Abdelrahim M, Sarpong D, Fernandez-Repollet E, Sodeke SO, Hernandez A, Thomas K, Dennos A, Smith D, Gbadebo D, Ajuluchikwu J, Kong BW, McCollough C, Weiler SR, Natter MD, Mandl KD, Murphy S. The Association of Black Cardiologists (ABC) Cardiovascular Implementation Study (CVIS): A Research Registry Integrating Social Determinants to Support Care for Underserved Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091631. [PMID: 31083298 PMCID: PMC6539418 DOI: 10.3390/ijerph16091631] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 02/14/2019] [Accepted: 02/28/2019] [Indexed: 01/12/2023]
Abstract
African Americans, other minorities and underserved populations are consistently under- represented in clinical trials. Such underrepresentation results in a gap in the evidence base, and health disparities. The ABC Cardiovascular Implementation Study (CVIS) is a comprehensive prospective cohort registry that integrates social determinants of health. ABC CVIS uses real world clinical practice data to address critical gaps in care by facilitating robust participation of African Americans and other minorities in clinical trials. ABC CVIS will include diverse patients from collaborating ABC member private practices, as well as patients from academic health centers and Federally Qualified Health Centers (FQHCs). This paper describes the rationale and design of the ABC CVIS Registry. The registry will: (1) prospectively collect socio-demographic, clinical and biospecimen data from enrolled adults, adolescents and children with prioritized cardiovascular diseases; (2) Evaluate the safety and clinical outcomes of new therapeutic agents, including post marketing surveillance and pharmacovigilance; (3) Support National Institutes of Health (NIH) and industry sponsored research; (4) Support Quality Measures standards from the Center for Medicare and Medicaid Services (CMS) and Commercial Health Plans. The registry will utilize novel data and technology tools to facilitate mobile health technology application programming interface (API) to health system or practice electronic health records (EHR). Long term, CVIS will become the most comprehensive patient registry for underserved diverse patients with cardiovascular disease (CVD) and co morbid conditions, providing real world data to address health disparities. At least 10,000 patients will be enrolled from 50 sites across the United States.
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Affiliation(s)
- Elizabeth O Ofili
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Laura E Schanberg
- Department of Pediatrics, Duke Clinical Research Institute, Duke University School of Medicine, 2400 Pratt St., Durham, NC 27705, USA.
| | - Barbara Hutchinson
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Felix Sogade
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Icilma Fergus
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Phillip Duncan
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Joe Hargrove
- Department of Pediatrics, Duke Clinical Research Institute, Duke University School of Medicine, 2400 Pratt St., Durham, NC 27705, USA.
| | - Andre Artis
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Osita Onyekwere
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Wayne Batchelor
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Marcus Williams
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Adefisayo Oduwole
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Anekwe Onwuanyi
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Folake Ojutalayo
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Jo Ann Cross
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Todd B Seto
- Department of Academic Affairs and Research, The Queen's Medical Center, 1301 Punchbowl Street, Honolulu, HI 96813, USA.
| | - Henry Okafor
- Department of Medicine, Meharry Medical College,1818 Albion St, Nashville, TN 37208, USA.
| | - Priscilla Pemu
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Lilly Immergluck
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Marilyn Foreman
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Ernest Alema Mensah
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Alexander Quarshie
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Mohamed Mubasher
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Almelida Baker
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Alnida Ngare
- RCMI Data Coordinating Center, Jackson State University, 1400 John R. Lynch Street, Jackson, MS 39217, USA.
| | - Andrew Dent
- RCMI Data Coordinating Center, Jackson State University, 1400 John R. Lynch Street, Jackson, MS 39217, USA.
| | - Mohamad Malouhi
- RCMI Data Coordinating Center, Jackson State University, 1400 John R. Lynch Street, Jackson, MS 39217, USA.
| | - Paul Tchounwou
- RCMI Data Coordinating Center, Jackson State University, 1400 John R. Lynch Street, Jackson, MS 39217, USA.
| | - Jae Lee
- RCMI Data Coordinating Center, Jackson State University, 1400 John R. Lynch Street, Jackson, MS 39217, USA.
| | - Traci Hayes
- RCMI Data Coordinating Center, Jackson State University, 1400 John R. Lynch Street, Jackson, MS 39217, USA.
| | - Muna Abdelrahim
- RCMI Data Coordinating Center, Jackson State University, 1400 John R. Lynch Street, Jackson, MS 39217, USA.
| | - Daniel Sarpong
- Department of Biostatistics, College of Pharmacy, Xavier University of Louisiana, 1 Drexel Drive, New Orleans, LA 70125, USA.
| | - Emma Fernandez-Repollet
- Department of Pharmacology and Toxicology, University of Puerto Rico Medical Sciences Campus, P.O. Box 365067, San Juan, PR 00936, Puerto Rico.
| | - Stephen O Sodeke
- Department of Bioethics, Tuskegee University, 1200 W. Montgomery Rd., Tuskegee, AL 36088, USA.
| | - Adrian Hernandez
- Department of Pediatrics, Duke Clinical Research Institute, Duke University School of Medicine, 2400 Pratt St., Durham, NC 27705, USA.
| | - Kevin Thomas
- Department of Pediatrics, Duke Clinical Research Institute, Duke University School of Medicine, 2400 Pratt St., Durham, NC 27705, USA.
| | - Anne Dennos
- Department of Pediatrics, Duke Clinical Research Institute, Duke University School of Medicine, 2400 Pratt St., Durham, NC 27705, USA.
| | - David Smith
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - David Gbadebo
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Janet Ajuluchikwu
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
- Department of Medicine, College of Medicine of the University of Lagos, Private Mail Bag 12003, Idi Araba, Lagos, Nigeria.
| | - B Waine Kong
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Cassandra McCollough
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Sarah R Weiler
- Department of Pediatrics and Computational Health Informatics, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Marc D Natter
- Department of Pediatrics and Computational Health Informatics, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Kenneth D Mandl
- Department of Pediatrics and Computational Health Informatics, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Shawn Murphy
- Department of Pediatrics and Computational Health Informatics, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
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Åhström M, Larsson N, Lindberg L. Change of Community Readiness Over Time: Measurements of Reduction of Parental Support and Availability of Alcohol in Seven Communities. Health Promot Pract 2016; 17:586-95. [PMID: 27095038 DOI: 10.1177/1524839916632741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim To test the possibility of identifying community readiness changes over time. Method Key responders in seven municipalities in Stockholm County were interviewed about the availability of alcohol and parental support. The results were analyzed with paired t tests. Changes in community readiness were assessed. Ninety-three key responders from the participating communities were interviewed three times each, resulting in a total of 315 interviews. Data were collected on three occasions separated by ten months from semistructured telephone interviews based on the community readiness model. Findings Significant readiness changes were found for both issues from baseline to the first follow-up. In terms of the six dimensions of community readiness, significant differences were evident from baseline to the first follow-up for parental support and the reduction of alcohol availability. Apart from knowledge of reduced alcohol availability, there were no significant changes in overall readiness or in the dimensions from the first follow-up to the second. The findings of this study are discussed in relation to earlier studies. Conclusion In communities with an initial vague awareness of issues, a change in readiness level occurs in less than a year.
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Affiliation(s)
| | | | - Lene Lindberg
- Stockholm County Council, Solna, Sweden Karolinska Institutet, Stockholm, Sweden
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Kesten JM, Griffiths PL, Cameron N. A critical discussion of the Community Readiness Model using a case study of childhood obesity prevention in England. HEALTH & SOCIAL CARE IN THE COMMUNITY 2015; 23:262-271. [PMID: 25429845 DOI: 10.1111/hsc.12139] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/20/2014] [Indexed: 06/04/2023]
Abstract
Recent reforms to the public health system in England aim to generate co-ordinated action between local authorities, healthcare systems and communities to target local health priorities. To support this effort, researchers must contribute and evaluate appropriate strategies for designing interventions tailored to community-specific needs. One strategy is to apply the Community Readiness Model (CRM), which uses key informant interviews to assess a community's readiness to address local issues. This article presents a critical discussion of the CRM developed from a case study of obesity prevention in pre-adolescent girls within a community in the United Kingdom. Data were collected between February and November 2011. We offer lessons learnt and recommendations relating to (i) modifications to the interview guide; (ii) key informant identification; (iii) conducting interviews to theoretical saturation; (iv) using key informants to define their community; (v) key informant's ability to respond on behalf of the community; (vi) using a qualitative model with a quantitative scoring system; and (vii) the optimum application of transcript scoring. In conclusion, the CRM can help researchers, health professionals and local authorities identify the priorities of a community. It is recommended that users of the model be careful to identify and recruit suitable key informants with the help of the community under study, select an appropriate 'community' and utilise the qualitative findings to strengthen the interpretation of the readiness score.
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Affiliation(s)
- Joanna May Kesten
- Centre for Global Health and Human Development, Loughborough University, Loughborough, UK
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A systematic review of community readiness tool applications: implications for reporting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:3453-68. [PMID: 25811769 PMCID: PMC4410196 DOI: 10.3390/ijerph120403453] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 02/13/2015] [Accepted: 02/26/2015] [Indexed: 11/17/2022]
Abstract
Background: A systematic review characterised and synthesised applications of the Community Readiness Tool (CRT) and synthesised quantitative results for readiness applications at multiple time points. Methods: Eleven databases in OvidSP and EBSCHOhost were searched to retrieve CRT applications. Information from primary studies was extracted independently by two researchers. Results: Forty applications of the CRT met inclusion criteria focussing on 14 different health and social issues. The community of interest was most often defined solely on the basis of its geographical location (52.5%). Most studies used the CRT to plan (85%) and/or evaluate programs (40%). The CRT protocol was modified in 40% of studies. Six applications evaluated readiness at multiple time points, however limited reporting in primary studies precluded any synthesis of results. Applications identified methodological rigour, contextual information and community engagement as strengths, and time and resource costs as limitations. Conclusions: The CRT is well suited for planning and evaluating complex community health interventions given its flexibility to accommodate diverse definitions of community and issues. CRT applications would benefit from improved reporting; reporting recommendations for use of the CRT are outlined.
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London L, Hurtado-de-Mendoza A, Song M, Nagirimadugu A, Luta G, Sheppard VB. Motivators and barriers to Latinas' participation in clinical trials: the role of contextual factors. Contemp Clin Trials 2015; 40:74-80. [PMID: 25433203 PMCID: PMC4357359 DOI: 10.1016/j.cct.2014.11.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 11/14/2014] [Accepted: 11/18/2014] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Latinas are underrepresented in clinical trials despite the rise in Hispanic population. This study examines the factors associated with Latinas' willingness to participate in preventive breast cancer randomized clinical trials (RCTs). METHODS Women self-identifying as Latina, over age 40, with no prior history of breast cancer were eligible. Using the Behavior Model for Vulnerable Populations, we administered a survey (n=168) to assess predisposing (e.g., knowledge), enabling (e.g., trust) and need factors (e.g., risk perception). Intention to participate was defined using a lenient (maybe, probably or definitely) and a stringent criterion (probably and definitely). Chi-square tests and logistic regression models examined the associations of predisposing, enabling, and need factors with women's intentions to participate in RCTs. RESULTS Most participants (74.9%) were monolingual Spanish-speaking immigrants. Most (83.9%) reported willing to participate in clinical trials using the lenient definition (vs. 43.1% under the stringent definition). Using the lenient definition, the odds of willing to participate in RCTs were significantly lower for unmarried women (OR=.25, 95% CI=.08-.79) and those with lower cancer risk perceptions (OR=.20, 95% CI=.06-.63), while being significantly higher for women with lower language acculturation (OR=6.2, 95% CI=1.8-20.9). Using the stringent definition, women who did not endorse a motivation to enroll to help family members (if they had cancer) had significantly lower odds to report intent (OR=.33, 95% CI=.13-.86). CONCLUSION Many RCTs may have limited generalizability due to the low representation of minorities. Culturally targeted interventions that address the importance of family for Latinos may ultimately increase their participation in RCTs.
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Affiliation(s)
- Laricca London
- Department of Microbiology, Howard University College of Medicine, Washington, DC, USA
| | - Alejandra Hurtado-de-Mendoza
- Department of Oncology, Georgetown University Medical Center and Georgetown-Lombardi Comprehensive Cancer Center, Breast Cancer Program, Washington, DC, USA
| | - Minna Song
- Department of Oncology, Georgetown University Medical Center and Georgetown-Lombardi Comprehensive Cancer Center, Breast Cancer Program, Washington, DC, USA
| | - Ankita Nagirimadugu
- Department of Oncology, Georgetown University Medical Center and Georgetown-Lombardi Comprehensive Cancer Center, Breast Cancer Program, Washington, DC, USA
| | - Gheorghe Luta
- Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University Medical Center and Georgetown-Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, Washington, DC, USA
| | - Vanessa B Sheppard
- Department of Oncology, Georgetown University Medical Center and Georgetown-Lombardi Comprehensive Cancer Center, Breast Cancer Program, Washington, DC, USA.
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Frerichs L, Brittin J, Stewart C, Robbins R, Riggs C, Mayberger S, Cervantes A, Huang TTK. SaludableOmaha: development of a youth advocacy initiative to increase community readiness for obesity prevention, 2011-2012. Prev Chronic Dis 2013; 9:E173. [PMID: 23217590 PMCID: PMC3523892 DOI: 10.5888/pcd9.120095] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood obesity rates in minority populations continue to rise despite leveling national trends. Although interventions that address social and environmental factors exist, processes that create demand for policy and environmental change within communities have not been identified. COMMUNITY CONTEXT We developed a pilot program in South Omaha, a Nebraska Latino community, based on the community readiness model (CRM), called SaludableOmaha. We used CRM to explore the potential of youth advocacy to shift individual and community norms regarding obesity prevention in South Omaha and to advocate for health-promoting community environments. METHODS We used CRM to assess supply and demand for health programs, engage the community, determine the community's baseline readiness to address childhood obesity, and guide youth advocacy program development. We conducted our project in 2 phases. In the first, we trained a cohort of youth. In the second, the youth cohort created and launched a Latino health movement, branded as SaludableOmaha. A third phase, which is currently under way, is directed at institutionalizing youth advocacy in communities. OUTCOME At baseline, the community studied was at a low stage of readiness for change. Our program generated infrastructure and materials to support the growth and institutionalization of youth advocacy as a means of increasing community readiness for addressing obesity prevention. INTERPRETATION CRM is an important tool for addressing issues such as childhood obesity in underserved communities because it provides a framework for matching interventions to the community. Community partnerships such as SaludableOmaha can aid the adoption of obesity prevention programs.
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Affiliation(s)
- Leah Frerichs
- University of Nebraska Medical Center, Omaha, NE, USA
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12
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Wallington SF, Luta G, Noone AM, Caicedo L, Lopez-Class M, Sheppard V, Spencer C, Mandelblatt J. Assessing the awareness of and willingness to participate in cancer clinical trials among immigrant Latinos. J Community Health 2012; 37:335-43. [PMID: 21805372 DOI: 10.1007/s10900-011-9450-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Clinical trials are considered the gold standard of evidence about the efficacy of cancer prevention, early detection, and treatment interventions. A paucity of data exists on determinants of clinical trial participation in the growing US Latino population despite poor cancer outcomes in this group. This study seeks to describe correlates of awareness of and willingness to participate in clinical trials among largely Central, North, and South American Latinos using safety-net clinics. Between June 2007 and November 2008, we conducted an interviewer-administered, Spanish-language cross-sectional survey (n = 944). Logistic regression was used to assess effects of health information sources and psychosocial variables on awareness of and intention to participate in clinical trials. Analyses were completed in spring 2010. While only 48% knew what a clinical trial was, when explained, 65% indicated a willingness to participate. Providers were the most common source of health information. Use of Internet for health information, trust in health information, and higher education each independently increased the odds of clinical trial awareness, but obtaining information from providers did not. Contacting the Cancer Information Service and psychosocial factors were each independently associated with intent to join a clinical trial, while demographic factors were not. Information channels such as the Internet may be effective in conveying clinical trial information to Latinos. Providers being cited as the most common source of health information but not being associated with knowledge about or intent to participate in trials suggests a missed opportunity for communication to this population.
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Affiliation(s)
- Sherrie Flynt Wallington
- Lombardi Comprehensive Cancer Center, Georgetown University School of Medicine, Research Building, W326A, 3970 Reservoir Rd, NW, Washington, DC 20057, USA.
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Godlew BJ, Furlong P. Transparency as a Means to Increase Clinical Trial Enrollment. ACTA ACUST UNITED AC 2010. [DOI: 10.1177/009286151004400308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
There is a growing interest in community-based participatory research (CBPR) methods to address issues of health disparities. Although the success of CBPR is dependent upon the formation of community-researcher partnerships, new researchers as well as seasoned investigators who are transitioning to CBPR often lack the skills needed to develop and maintain these partnerships. The purpose of the article is to discuss the competencies needed by new researchers to form successful CBPR partnerships. The author presents a series of strategic steps that are useful in establishing academic-community partnerships and in initiating, maintaining and sustaining CBPR projects. These steps include suggestions regarding community engagement, selection of community advisory board members, outreach, the community's role in problem identification, selection of research methodologies, considerations related to the community setting, need for flexibility and patience, 'insider vs. outsider' conflicts, commitment and training issues, timing concerns for tenure-track faculty and the process of community empowerment. Community-based participatory research is both rewarding and time consuming, for both the researcher and members of the community. Given its promise to address health disparities, it is imperative that researchers acquire the skills needed to develop and cultivate durable community-researcher partnerships.
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