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Ayogu CI, Valluru B. Septic arthritis of the native hip joint and septic pulmonary embolism in an adult with sickle cell trait after a complicated dental extraction. BMJ Case Rep 2024; 17:e254945. [PMID: 38802256 DOI: 10.1136/bcr-2023-254945] [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] [Indexed: 05/29/2024] Open
Abstract
Septic arthritis (SA) is a serious infection of the joint which can lead to irreversible destruction of the joint.We report a case of right hip SA with septic pulmonary embolism following a complicated dental extraction in a woman in her early 40s with sickle cell trait (SCT).The patient presented with severe right thigh pain and left jaw pain.Initial workup revealed raised C reactive protein and positive blood cultures. Right hip joint SA was confirmed following intraoperative joint aspiration. The patient had right hip debridement with long-term intravenous antibiotics.The incidence of SA in adults with sickle cell disease is low: 0.3% in a study in France and Brazil and 10.3% incidence of haematogenous osteoarticular infection in children with SCT in West Africa.
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Eades-Brown NT, Oguntoye AO, Aldossary D, Ezenwa MO, Duckworth L, Dede D, Johnson-Mallard V, Yao Y, Gallo A, Wilkie DJ. Adherence to a reproductive health intervention for young adults with sickle cell. J Am Assoc Nurse Pract 2024:01741002-990000000-00207. [PMID: 38408228 DOI: 10.1097/jxx.0000000000000997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 12/29/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND The CHOICES intervention is tailored specifically for young adults with sickle cell disease (SCD) or sickle cell trait (SCT). The face-to-face (F2F) delivery format is feasible with efficacy for improving knowledge about reproductive health for those with SCD or SCT. PURPOSE The purpose of the study was to compare the participant adherence to a remote online CHOICES intervention study (N = 107) and a F2F CHOICES intervention study (N = 234). METHODOLOGY In both studies, participants with SCD or SCT were randomized into experimental or usual care control groups. Descriptive statistics were collected for all participants by group in both studies. Adherence was measured by retention at each data collection time point. Independent t-tests were conducted to compare mean participant adherence of the F2F and online studies postbaseline (6, 12, 18, and 24 months). RESULTS There was a significant difference in mean adherence postbaseline between the studies (p = .005). The results suggest that more research is necessary for proper online participant retention. CONCLUSION Advance practice nurses that are well informed on CHOICES can transmit the availability of this evidence-based intervention to this special population. Special referral for the CHOICES intervention, which is tailored specifically for young adults with SCD or SCT, may increase adherence to the intervention if it comes from trusted health care providers. IMPLICATIONS Nurse practitioners are educators in primary and acute care settings. Encounters with reproductive age populations with SCD or SCT can occur in both settings.
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Affiliation(s)
| | - Anne O Oguntoye
- College of Nursing, University of Florida, Gainesville, Florida
| | - Dalal Aldossary
- College of Nursing, University of Florida, Gainesville, Florida
- Department of Nursing Fundamentals, College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Miriam O Ezenwa
- College of Nursing, University of Florida, Gainesville, Florida
| | | | - Duane Dede
- College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | | | - Yingwei Yao
- College of Nursing, University of Florida, Gainesville, Florida
| | - Agatha Gallo
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois
| | - Diana J Wilkie
- College of Nursing, University of Florida, Gainesville, Florida
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Wilkie DJ, Telisnor G, Powell-Roach K, Rangel AP, Greenlee AL, Ezenwa MO, Gallo AM, Black LV, Gomes de Siqueira A, Dyal BW, Kalyanaraman S, Yao Y. CHOICES for sickle cell reproductive health: A protocol of a randomized preconception intervention model for a single gene disorder. PLoS One 2023; 18:e0294907. [PMID: 38060589 PMCID: PMC10703323 DOI: 10.1371/journal.pone.0294907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/25/2023] [Indexed: 12/18/2023] Open
Abstract
Our long-term goal is to foster genetically informed reproductive health knowledge and behaviors among young adults with sickle cell disease (SCD) or sickle cell trait (SCT) with a web-based, tailored, multimedia intervention called CHOICES. CHOICES is designed to help young adults with SCD or SCT preconception to gain knowledge of genetic inheritance, specify their reproductive health intentions (their parenting plan), and engage in reproductive health behaviors concordant with their parenting plan. In a previous study, we found high acceptability of both the e-Book (usual care control) and CHOICES interventions. We also found sustained (24 months), significant effects on knowledge but not on behavior, most likely because half of the recruited group was not at risk for their children inheriting SCD. Hence, we propose an adequately powered randomized controlled trial with the CHOICES intervention and an e-Book control to compare their effects on genetic inheritance knowledge and at-risk reproductive health behaviors (immediate posttest and at 6, 12, 18, and 24 months). We will conduct subgroup analyses to provide insight into the baseline knowledge and behavior as well as the intervention effects in different demographic or acceptability groups. Given the scalability and low cost of CHOICES, if proved to be effective, it can reach the affected population at low cost.
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Affiliation(s)
- Diana J. Wilkie
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
| | - Guettchina Telisnor
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
| | - Keesha Powell-Roach
- College of Nursing, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Andrea P. Rangel
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
| | - Amelia L. Greenlee
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
| | - Miriam O. Ezenwa
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
| | - Agatha M. Gallo
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
| | - L. Vandy Black
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
| | | | - Brenda W. Dyal
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
| | - Sriram Kalyanaraman
- College of Journalism and Communications, University of Florida, Gainesville, Florida, United States of America
| | - Yingwei Yao
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
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4
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Harancher MR, Sukhwani M, Castro CA, Hsieh MH, Orwig KE. Generation of two isogenic sickle cell disease induced pluripotent stem cell lines from testicular fibroblasts. Stem Cell Res 2023; 73:103257. [PMID: 38000347 PMCID: PMC10845156 DOI: 10.1016/j.scr.2023.103257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 11/12/2023] [Accepted: 11/19/2023] [Indexed: 11/26/2023] Open
Abstract
Curative bone marrow transplantation (BMT) therapies for sickle cell disease (SCD) can cause infertility. The Fertility Preservation Program (FPP) in Pittsburgh cryopreserves testicular tissues for SCD patients prior to BMT in anticipation that those tissues can be thawed in the future and matured to produce sperm. Here, we generated and validated two isogenic patient-derived induced pluripotent stem cell (iPSC) lines from testicular biopsy fibroblasts of a 12-year-old SCD patient.
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Affiliation(s)
- Mitchell R Harancher
- Molecular Genetics and Developmental Biology Graduate Program, University of Pittsburgh School of Medicine, USA; Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, USA
| | - Meena Sukhwani
- Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, USA
| | - Carlos A Castro
- Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, USA
| | | | - Kyle E Orwig
- Molecular Genetics and Developmental Biology Graduate Program, University of Pittsburgh School of Medicine, USA; Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, USA.
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5
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Galadanci AA, Estepp JH, Khan H, Farouk ZL, Caroll Y, Hodges J, Yarima S, Ibrahim UA, Idris IM, Gambo A, Hussaini N, Mukaddas A, DeBaun MR, Galadanci NA. Barriers and Facilitators of Premarital Genetic Counseling for Sickle Cell Disease in Northern Nigeria. J Pediatr Hematol Oncol 2023; 45:e716-e722. [PMID: 37494609 DOI: 10.1097/mph.0000000000002702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 05/24/2023] [Indexed: 07/28/2023]
Abstract
In high-income countries, premarital genetic counseling for Sickle Cell Disease (SCD) is a standard practice. However, in Nigeria, there is no formal premarital genetic counseling program available for SCD. We conducted a series of focus group discussions with health care professionals, patients with SCD, and parents of the patients with or without SCD to gain an understanding of their attitudes and beliefs towards SCD/Sickle Cell Trait and premarital genetic counseling for SCD. Data were analyzed using Charmaz's constructivist grounded theory approach. Two themes were highlighted in the analysis as follows: (1) the difference between the perception of premarital sickle cell screening among individuals with SCD versus the general population, and (2) the personal beliefs and physical challenges that could lead to the avoidance of premarital screening within the general community. Lack of disease-related knowledge, testing facilities, transportation, and stigma associated with the disease were the most commonly perceived barriers to premarital testing. Also, a willingness to receive premarital testing for SCD exists within our community to reduce the spread of the disease and advocate for improved health-related quality of life of patients with SCD. The content and structure of a premarital genetic counseling program in Kano, Northern Nigeria, needs to be developed.
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Affiliation(s)
| | | | - Hamda Khan
- Department of Hematology, St Jude Children's Research Hospital, Memphis
| | - Zubaida L Farouk
- Centre for Infectious Diseases Research, Bayero University, Kano
| | - Yvonne Caroll
- Department of Hematology, St Jude Children's Research Hospital, Memphis
| | - Jason Hodges
- Department of Hematology, St Jude Children's Research Hospital, Memphis
| | | | | | | | - Awwal Gambo
- Department of Pediatrics, Murtala Mohammed Specialist Hospital, Kano Nigeria
| | - Nafiu Hussaini
- Department of Mathematical Sciences, Bayero University Kano
| | | | - Michael R DeBaun
- Department of Pediatrics, Division of Hematology and Oncology, Vanderbilt-Meharry-Matthew Walker Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN
| | - Najibah A Galadanci
- Department of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL
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Mumuni ND, Osman W, Alhassan BA, Alhassan A. Burden experienced by informal caregivers of children with sickle cell disease (SCD): a qualitative exploratory study at Tamale Teaching Hospital, Ghana. BMJ Open 2023; 13:e066311. [PMID: 37024250 PMCID: PMC10083813 DOI: 10.1136/bmjopen-2022-066311] [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] [Indexed: 04/08/2023] Open
Abstract
OBJECTIVE This study sought to explore the burden experienced by informal caregivers in caring for their children with sickle cell disease (SCD). DESIGN A qualitative exploratory design was employed in the study using in-depth interviews. SETTING The study was conducted at the sickle cell clinic of the Tamale Teaching Hospital, Ghana. PARTICIPANTS Data were gathered from 15 purposively selected informal caregivers, whose children with SCD received care at the sickle cell clinic of the Tamale Teaching Hospital, using a semistructured in-depth interview guide in May-June 2021. Their responses were audio-taped, transcribed and analysed using the reflexive thematic analysis approach. RESULTS Five major themes emerged from data analysis. These were: the burden of children's ill-health; financial burden; employment challenges; psychosocial burden and determinants of caregivers' burden. These burdens destabilised the personal lives, financial standing, social relationships, and employment of caregivers in general and that of other immediate family members, thus, impacting family processes and health. CONCLUSIONS Health professionals must devise strategies for counselling, early diagnosis and effective management of children with SCD across Ghana. The Ministry of Health must subsidise medications and laboratory services for children with SCD to help minimise the financial burden on caregivers. Further, counselling and psychological support services must be established in hospitals to assist caregivers to cope effectively.
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Affiliation(s)
- Najart Deborah Mumuni
- Nadowli District Hospital, Ghana Health Service, Nadowli, Upper West Region, Ghana
- Faculty of Paediatric Nursing, Ghana College of Nurses and Midwives (GCNM), Accra, Greater Accra Region, Ghana
| | - Wahab Osman
- Faculty of Paediatric Nursing, Ghana College of Nurses and Midwives (GCNM), Accra, Greater Accra Region, Ghana
- Department of Advanced Nursing Practice, School of Nursing and Midwifery, University for Development Studies, Tamale, Northern Region, Ghana
| | - Basour Adam Alhassan
- Department of General Nursing, School of Nursing and Midwifery, University for Development Studies, Tamale, Northern Region, Ghana
| | - Afizu Alhassan
- Department of General Nursing, Kpembe Nursing and Midwifery Training College, Kpembe, Savannah Region, Ghana
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Oguntoye AO, Eades NT, Aldossary D, Kuenzli G, Gehling G, Ezenwa MO, Johnson-Mallard V, Yao Y, Gallo AM, Wilkie DJ. Tailored Parenting Plans of Young Adults With Sickle Cell Disease or Sickle Cell Trait. Comput Inform Nurs 2022; 40:633-640. [PMID: 35930415 PMCID: PMC9464668 DOI: 10.1097/cin.0000000000000933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Our study purpose was to evaluate the variation and accuracy of tailored parenting plans individually generated as a supplement to reproductive health education on the genetic inheritance of sickle cell disease or sickle cell trait. We present a secondary data analysis of experimental group data from a randomized controlled trial. Participants completed the valid and reliable Internet-based Sickle Cell Reproductive Health Knowledge Parenting Intent Questionnaire. We created a computerized algorithm that used participants' responses to generate tailored parenting plans based on their parenting preferences and partner's sickle cell status. Thirty-one different parenting plans were generated to meet the variety in the participants' preferences. The most frequently generated plan was for participants with sickle cell disease who had a partner with hemoglobin AA, who wanted to be a parent, was not likely to be pregnant, and wanted their child to be sickle cell disease free. More than half of the participants required alteration in their reproductive behavior to achieve their parenting goals. Findings provide insight into the variety and accuracy of computer algorithm-generated parenting plans, which could further guide refinement of the algorithm to produce patient-centered, tailored parenting plans supplemental to Internet-based genetic inheritance education.
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Affiliation(s)
- Anne O Oguntoye
- Author Affiliations: College of Nursing, University of Florida (Drs Oguntoye, Eades, Ezenwa, Johnson-Mallard, Yao, and Wilkie; Mrs Aldossary, Ms Kuenzli, and Mrs Gehling), Gainesville; and College of Nursing, University of Illinois at Chicago (Dr Gallo)
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8
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Hershberger PE, Gallo AM, Adlam K, Steffen AD, Driessnack M, Grotevant HD, Klock SC, Pasch L, Gruss V. Alpha Test of the Donor Conception Tool to Empower Parental Telling and Talking. J Obstet Gynecol Neonatal Nurs 2022; 51:536-547. [PMID: 35922017 PMCID: PMC9474702 DOI: 10.1016/j.jogn.2022.06.039] [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: 01/31/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 10/16/2022] Open
Abstract
OBJECTIVE To conduct an alpha test of the prototype of a digital decision aid to help parents disclose donor conception to their children, the Donor Conception Tool to Empower Parental Telling and Talking (TELL Tool). DESIGN Convergent mixed-methods design. SETTING Virtual interviews in places convenient to the participants. PARTICIPANTS A purposeful sample (N = 16) of nine gamete-donor and embryo-recipient parents and eight clinicians, as one parent was also a clinician. METHODS We conducted cognitive interviews to explore participants' perceptions about the TELL Tool prototype and observe patterns of use. The International Patient Decision Aid Standards (i.e., usability, comprehensibility, and acceptability) guided the development of the qualitative interview guide and directed the qualitative analysis. We also collected data about participants' perceptions and ratings of the helpfulness of each of the prototype's webpages regarding parents' decision making about disclosure. Descriptive statistics were used to analyze the helpfulness ratings before we merged the two data sets to optimize understanding. RESULTS Participants reported that the TELL Tool was a helpful digital decision aid to help parents tell their children how they were conceived. Most (93.7%) webpage rating scores indicated that the content was very helpful or helpful. The participants identified content and technical areas that needed refinement and provided specific recommendations such as adding concise instructions (usability), tailoring adolescent language (comprehensibility), and softening verbiage (acceptability). CONCLUSION Alpha testing guided by the International Patient Decision Aid standards was an essential step in refining and improving the TELL Tool prototype before beta testing.
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9
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Sims AM, Cromartie SJ, Gessner L, Campbell A, Coker T, Wang CJ, Tarini BA. Parents' Experiences and Needs Regarding Infant Sickle Cell Trait Results. Pediatrics 2022; 149:e2021053454. [PMID: 35441211 PMCID: PMC9647577 DOI: 10.1542/peds.2021-053454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Sickle cell trait (SCT) has reproductive implications and can rarely cause health problems. SCT counseling improves parent knowledge but is infrequently received by children with SCT compared with children with cystic fibrosis carrier status. There are no national guidelines on SCT disclosure timing, frequency, or counseling content. Parents' experiences with SCT disclosure and counseling are poorly understood but could inform the development of guidelines. We explored parents' experiences with and desires for SCT disclosure and counseling for their infants with SCT identified via newborn screening. METHODS Parents of infants 2 to 12 months old with SCT were recruited through a state newborn screening program for semistructured interviews to explore their experiences with and desires for SCT disclosure and counseling. Inductive thematic analysis was conducted. RESULTS Sixteen interviews were completed from January to August 2020. Most parents reported that SCT disclosure occurred soon after birth, in person, and by the child's physician. Five themes were identified: parent knowledge before child's SCT disclosure, family planning, the dynamics of SCT disclosure and counseling, emotions and actions after SCT disclosure, and parent desires for the SCT disclosure and counseling process. Two primary parent desires were revealed. Parents want more information about SCT, particularly rare symptomatology, and they want SCT counseling repeated once the child approaches adolescence. CONCLUSION Parents report receiving their child's SCT diagnosis in the early newborn period from their child's doctor but indicate they receive incomplete information. Opportunities exist in primary care pediatrics to better align SCT disclosure timing and counseling content with parent desires.
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Affiliation(s)
- Alexandra M. Sims
- Division of General and Community Pediatrics, Children’s National Hospital, Washington, District of Columbia
- Department of Pediatrics, The George Washington University School of Medicine, Washington, District of Columbia
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | - Lelia Gessner
- Division of General and Community Pediatrics, Children’s National Hospital, Washington, District of Columbia
| | - Andrew Campbell
- Department of Pediatrics, The George Washington University School of Medicine, Washington, District of Columbia
- Division of Hematology, Children's National Hospital, Washington, District of Columbia
| | | | - C. Jason Wang
- Departments of Pediatrics and Medicine, Stanford University School of Medicine, Stanford, California
| | - Beth A. Tarini
- Division of General and Community Pediatrics, Children’s National Hospital, Washington, District of Columbia
- Department of Pediatrics, The George Washington University School of Medicine, Washington, District of Columbia
- Children’s National Research, Children’s National Hospital, Washington, District of Columbia
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Prince A, Cruz-Bendezú A, Gunawansa N, Wade J, Coleman-Cowger VH, Schulkin J, Macri CJ. Practices of sickle cell disease genetic screening and testing in the prenatal population. J Neonatal Perinatal Med 2022; 15:745-751. [PMID: 35811546 DOI: 10.3233/npm-221016] [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] [Indexed: 06/15/2023]
Abstract
BACKGROUND Genetic screening and testing are technologies historically underutilized in Black populations despite predicting diseases like sickle cell disease (SCD), which is predominantly found in Blacks. We surveyed prenatal patients to understand choices, beliefs and experiences surrounding genetic screening and testing, specifically for SCD. METHODS In this cross-sectional study, we surveyed 322 women during prenatal visits. Responses were analyzed to identify barriers to care and education about testing and screening for SCD. Patients rated whether they agreed or disagreed with statements regarding sickle cell health behaviors. We used χ2 tests to compare categorical variables by self-reported race. Binary logistic regression was used to determine the odds ratios and confidence intervals for each outcome. RESULTS Women were a mean (SD) age of 33.3 (6.1). 42.9% of patients self-identified as White while 41.3% of patients self- identified as Black. Screening questions were adjusted for differences in race, insurance, and education levels to show significant differences in responses between Blacks and Whites for screening for SCD (p = 0.047, OR 95% CI = 0.455 [0.210-0.989]) and plans to meet with genetic counselors (p = 0.049, OR 95% CI = 0.299 [0.090-0.993]). The statements "if sickle cell is not in their family, then it is likely not in themselves or their children," was significantly different between Black and White populations (p = 0.011, OR 95% CI = 0.207 [0.081-0.526]). CONCLUSION Our findings suggest gaps in screening, testing, education, and pregnancy management choices between Black and White patients. Research should focus on decreasing these healthcare gaps and improving education that address concerns about SCD for relevant populations.
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Affiliation(s)
- A Prince
- The George Washington School of Medicine and Health Sciences, Washington, DC, USA
| | - A Cruz-Bendezú
- The George Washington School of Medicine and Health Sciences, Washington, DC, USA
| | - N Gunawansa
- The George Washington School of Medicine and Health Sciences, Washington, DC, USA
| | - J Wade
- The George Washington School of Medicine and Health Sciences, Washington, DC, USA
| | | | - J Schulkin
- Pregnancy-Related Care Research Network (PRCRN), University of Washington, Seattle, Washington, USA
| | - C J Macri
- Department of Obstetrics and Gynecology, George Washington University Medical Faculty Associates, Washington, DC, USA
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Acceptable, hopeful, and useful: development and mixed-method evaluation of an educational tool about reproductive options for people with sickle cell disease or trait. J Assist Reprod Genet 2022; 39:183-193. [PMID: 34806131 PMCID: PMC8866599 DOI: 10.1007/s10815-021-02358-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/12/2021] [Indexed: 01/03/2023] Open
Abstract
PURPOSE People with sickle cell disease (SCD) or trait have many reproductive options, some of which decrease the chance of passing SCD to children, including in vitro fertilization with preimplantation genetic testing (IVF + PGT). Few are aware of these options, and educational materials are needed. This study aimed to develop an accessible, non-directive patient education material about reproductive options for those with SCD or trait via a process that incorporated stakeholders from the SCD community. METHODS Multidisciplinary stakeholders guided development and revision of a novel pamphlet. Researchers applied health literacy scales to measure pamphlet understandability. We interviewed nine patients with SCD and six multidisciplinary clinicians to evaluate the pamphlet. Interviews were recorded, transcribed, and coded by a five-member team who developed a codebook and proposed themes that were revised by all research team members. Feedback was incorporated into a revised pamphlet. RESULTS A two-page pamphlet describing reproductive options for people with SCD including IVF + PGT was acceptable to key stakeholders, including people with SCD. Material about this complex topic met health literacy standards, including being written at a 5th grade level. Patients reported feeling hopeful after reviewing the pamphlet, and participants considered the pamphlet useful, clear, and appropriate for distribution in clinics and online. CONCLUSIONS Though awareness of reproductive options for those with SCD or trait is low, patients and providers find a novel pamphlet about this topic acceptable and useful. Educational materials about complex topics including IVF + PGT can be written at a level understandable to the average American.
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12
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Mkoka DA, Nkingi R. Lived Experiences of Adults with Sickle Cell Disease: A Qualitative Study, Dar es Salaam, Tanzania. East Afr Health Res J 2022; 6:189-195. [PMID: 36751678 PMCID: PMC9887503 DOI: 10.24248/eahrj.v6i2.699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 11/25/2022] [Indexed: 01/02/2023] Open
Abstract
Background Sickle Cell Disease (SCD) is most common genetic disorder and its prevalence in sub-Saharan Africa is increasing. Despite increased survival rates, experiences of adults living with SCD in Tanzania is not well explored. This article provides perceived causes of pain crisis, pain self-management approaches and psychosocial implication of SCD. Aim This study aimed at exploring experiences of adults living with SCD regarding pain triggering or aggravating factors; self-management for pain; psychosocial-economical implication of SCD and coping mechanism used by individuals living with SCD. Methods A qualitative study design was chosen using in-depth interviews with adults living with SCD to explore their experience of living with SCD. Fifteen adults aged 18 years and above living with SCD were interviewed. Data were analyzed by using content analysis approach. Findings Four categories emerged that described experiences of individuals with SCD. The four categories are; "Pain Triggering and Aggravating Factors" describing participants' perceived factors causing pain in SCD; "Self-care remedies for the pain" referring to participants' methods for self-management of pain; "Psychosocial-economic impact of illness" referring to participants' experience of implication of illness on social and economic life and "Dealing and coping with illness" referring to experience of participants on management and coping strategies used to live with the illness. Conclusion Individuals with SCD experiences several episodes of pain that affect their quality of life. Pain episode can be triggered or aggravated by various factors. Several approaches are used by individuals with SCD to self-manage the pain including taking rest, drinking plenty of water or using pain relieving medication. Care for individuals with SCD should be comprehensive and include proper management of pain, health education on home-based intervention for sickle cell pain, supportive services to deal with psychosocial implications of SCD and improving coping strategies to live with the illness.
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Affiliation(s)
- Dickson Ally Mkoka
- Department of Clinical Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences (MUHAS), Dar-es-Salaam, Tanzania,Correspondence to Dickson A Mkoka ()
| | - Rehema Nkingi
- Critical Care Nurse Specialist, Muhimbili National Hospital, Dar-es-Salaam, Tanzania
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13
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Aldossary DS, Black V, Ezenwa MO, Gallo AM, Johnson-Mallard VM, Eades NT, Oguntoye AO, Yao Y, Wilkie DJ. Characteristics associated with the perceived likelihood to become parents among young adults with sickle cell disease or sickle cell trait in the USA. J Genet Couns 2021; 31:689-697. [PMID: 34826361 PMCID: PMC9142167 DOI: 10.1002/jgc4.1535] [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: 07/07/2021] [Revised: 10/21/2021] [Accepted: 10/27/2021] [Indexed: 11/08/2022]
Abstract
Individuals with sickle cell disease (SCD) and individuals with sickle cell trait (SCT) have different health trajectories, but it is unknown whether sociodemographic and clinical characteristics are associated with their likelihood to be a parent. The purpose of this study was to examine the sociodemographic and clinical characteristics associated with perceived likelihood-to-parent among a cohort of young adults with SCD or SCT in the USA. The participants were 234 young adults (82 males, 152 females) who had either SCD (n = 138) or SCT (n = 96). The average age was 25.9 years (SD = 4.9), and most participants (87%) were single. Study participants completed the likelihood-to-parent item (0-4 scale) included in the valid and reliable Sickle Cell Reproductive Health Knowledge Parenting Intent and Behavior Questionnaire (SCKnowIQ). The mean likelihood-to-parent score was M = 2.3 (SD = 1.1) and 41% indicated that they were 'very' or 'extremely' likely to be a parent. Bivariate analysis showed that likelihood-to-parent was associated with the participant's sickle cell genotype (p = .03), age (p = .003), educational level (p = .04), income (p = .01), employment (p = .04), number of children (p < .001), health insurance (p = .02), and influenced by others (p < .001). In multiple regression analysis, participants reported higher likelihood-to-parent scores if they had at most 2 children (p = .03), higher income (p = .03), had no insurance (p = .01), and reported higher levels of being influenced by others (p = .001). Additional research is needed to confirm these findings in larger representative samples with more young adult males and to understand the likelihood to become parents over time by implementing longitudinal studies in the SCD and SCT populations. Such research is needed to guide appropriate education and genetic counseling for reproductive decision-making among young adults with SCD or SCT.
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Affiliation(s)
- Dalal S Aldossary
- Department of Nursing Fundamentals, College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.,Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Vandy Black
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Miriam O Ezenwa
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Agatha M Gallo
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
| | | | - Nyema T Eades
- Office of Student Affairs, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Anne O Oguntoye
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida, USA
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14
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Pecker LH, Sharma D, Nero A, Paidas MJ, Ware RE, James AH, Smith-Whitley K. Knowledge gaps in reproductive and sexual health in girls and women with sickle cell disease. Br J Haematol 2021; 194:970-979. [PMID: 34231198 PMCID: PMC8448913 DOI: 10.1111/bjh.17658] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/17/2021] [Accepted: 06/01/2021] [Indexed: 02/02/2023]
Abstract
There is an immediate need to address long-standing questions about the reproductive health of girls and women with sickle cell disease (SCD). There are many SCD-related reproductive risks and uncertainties across girls' and women's reproductive life span, with particularly outstanding concerns about menstruation, contraception, fertility and pregnancy. Extant literature addressing women's reproductive health topics is mostly descriptive; there are few high-quality interventional studies. In 2020, the Centers for Disease Control and Prevention and the Foundation for Women and Girls with Blood Disorders convened an expert panel to assess the knowledge gaps in women's reproductive health in SCD. The panel identified significant limitations to clinical care due to the need for research. The panel also identified prominent barriers to research and care. In this report, we frame these issues, providing a roadmap for investigators, funding agencies, and policy makers to advance care for girls and women with SCD.
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Affiliation(s)
- Lydia H. Pecker
- Johns Hopkins University School of Medicine, Division of Hematology, Department of Medicine & Gynecology & Obstetrics, Baltimore MD
| | - Deva Sharma
- Vanderbilt University Medical Center, Divisions of Transfusion Medicine and Hematology
| | - Alecia Nero
- Department of Medicine, Division of Hematology/Oncology, University of Texas Southwestern
| | - Michael J. Paidas
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Miller School of Medicine
| | - Russell E. Ware
- Division of Pediatric Hematology, Department of Pediatrics, Cincinnati Children’s Hospital
| | - Andra H. James
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Department of Medicine, Division of Hematology, Duke University, Durham, NC
| | - Kim Smith-Whitley
- Division of Hematology, The Children’s Hospital of Philadelphia, Philadelphia, PA
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15
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Kushary S, Ali N, Spencer JB, Dokson J, Hunt WR. Assessment of a novel genetic counselling intervention to inform assisted reproductive technology treatments and other family-building options in adults with cystic fibrosis. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2021; 13:37-45. [PMID: 34195396 PMCID: PMC8239521 DOI: 10.1016/j.rbms.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 04/25/2021] [Accepted: 05/10/2021] [Indexed: 06/13/2023]
Abstract
Many patients with cystic fibrosis (CF) are living well into their adult years and contemplating parenthood. Previous studies have shown that there is an opportunity to improve understanding of inheritance and genetics among individuals with CF. This study explored whether a genetic counselling intervention would be associated with a change in knowledge and/or beliefs about genetics and family-building options. Adults (age ≥ 18 years) presenting to a CF clinic were approached for inclusion. Participants completed a pre-intervention survey to measure their knowledge of CF genetics, as well as perceptions and understanding of assisted reproductive technology treatments and other family-building options. Subjects then partook in a genetic counselling session. Subjects repeated the survey immediately after the session and 1-3 months later. Data analysis used one-way analysis of variance (ANOVA), repeated measures ANOVA and multiple linear regression. Thirty-five subjects [19 (54%) men and 16 (45%) women] with a mean (±standard deviation) age of 28 ± 5.64 years were enrolled in the study. Before the intervention, 61.69% ± 4.50 of knowledge-based questions were answered correctly. Immediately after the intervention, the mean score increased to 77.71% ± 3.23, but this decreased to 69.48% ± 4.02 for the third test (P < 0.05, repeated measures ANOVA). Six individuals changed their family-building preference following the genetic counselling session. A short genetic consultation was associated with a significant improvement in CF-specific genetic knowledge. However, knowledge was not retained fully for a longer time period following the consultation. Multiple discussions regarding fertility options are needed to reinforce the key concepts related to CF genetics and fertility.
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Affiliation(s)
- Sulagna Kushary
- Department of Human Genetics, Emory University, Atlanta, GA, USA
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Nadia Ali
- Department of Human Genetics, Emory University, Atlanta, GA, USA
| | - Jessica B Spencer
- Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA
| | | | - William R Hunt
- Department of Medicine, Emory University, Atlanta, GA, USA
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16
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Johnson-Mallard V, Oguntoye A, Eades N, Aldossary D, Kuenzli G, Ezenwa MO, Gallo AM, Wilkie DJ. Development of an Online Reproductive Health Intervention for Individuals with Sickle Cell Disease or Trait. WOMEN'S HEALTH REPORTS 2021; 2:142-148. [PMID: 34036297 PMCID: PMC8140351 DOI: 10.1089/whr.2020.0098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/23/2021] [Indexed: 11/13/2022]
Abstract
The purpose of this article is to describe the method of developing an internet-based reproductive options intervention to increase informed reproductive decision-making among individuals with sickle cell disease (SCD) or sickle cell trait (SCT). An interprofessional team of graphics and media specialist, nurses, physicians, and researchers collaborated to develop the intervention. Individuals from the community served as advisory board members who reviewed and advised on webpage design, content, delivery, and media. The intervention was theory based, delivered online, and experientially oriented for young adults of reproductive age with SCD or SCT. The intervention was culturally specific, supporting individuals with SCD or SCT in making informed reproductive decisions about transmission of SCD or SCT to their offspring. The intervention could be strengthened to include content on implementing behaviors concordant with informed reproductive decisions. Health care providers can use the result of this study to enhance their knowledge about the complexity of parenting options.
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Affiliation(s)
| | - Anne Oguntoye
- College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Nyema Eades
- College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Dalal Aldossary
- College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Grace Kuenzli
- College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Miriam O Ezenwa
- College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Agatha M Gallo
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Diana J Wilkie
- College of Nursing, University of Florida, Gainesville, Florida, USA
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17
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Smith M, Mercado-Sierra M. Health beliefs as a predictor of screening behaviors among college students. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:460-473. [PMID: 33823751 DOI: 10.1080/19371918.2021.1905130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Twenty million people live with a sickle cell disease (SCD) diagnosis globally; about 100,000 reside in the United States of America (US). Although SCD continues to threaten the health, mostly of particular groups in the US, there is a lack of knowledge on risk factors such as unawareness of carrier status, inheritance patterns, and resistance to SCT screening among childbearing age individuals. A cross-sectional survey design using a modified version of the Health Belief Survey assessed college students' SCD beliefs and screening behaviors. Four hundred sixteen students from a North Texas university campus participated in the survey. Although most participants believed that knowing their carrier status was important, only 26% were aware of their status. Findings demonstrated that health beliefs were a significant predictor of screening behaviors. The Universal, Selective, and Indicated Prevention Approach was suggested as a suitable approach to educate, transform health beliefs, and augment screening participation.
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Affiliation(s)
- Marcella Smith
- School of Social Work, Texas A&M University-Commerce, Commerce, Texas, USA
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18
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Kroger FL, Ernesto IC, Silva MS, Santos OFD, Medeiros RLD, Rodrigues DDOW. Hemoglobin S identification in blood donors: A cross section of prevalence. Hematol Transfus Cell Ther 2021; 44:336-340. [PMID: 33839080 PMCID: PMC9477770 DOI: 10.1016/j.htct.2020.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 10/21/2020] [Accepted: 11/09/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction In Brazil, the sickle cell trait (SCT) has an average prevalence of 4% in the general population and 6–10% among Afro-descendants. Although SCT is highly prevalent, a large segment of the population ignores their status. The Therapeutic Guidelines prohibit the transfusion of SCT red blood cells into patients with hemoglobin disorders or severe acidosis and newborns. Methods This was a cross-sectional study with data from 37,310 blood donation candidates. The study included only eligible first-time donors qualified to be tested for the presence of hemoglobin S (HbS) at the Fundação Hemominas Juiz de Fora, Brazil. The variables studied were gender, skin color, age, type of donation, place of birth, blood type, result of the solubility test for hemoglobin S (HbST) and hemoglobin electrophoresis (HbEF). Statistical analysis was performed using the Q square test and the Kappa index of agreement for comparing biochemical methods. This project was approved by the National Research Ethics Committee. Results The analysis of first-time donor data showed that 7166 were considered eligible. A total of 127 of the 7166 donors were carriers of SCT (1.77%). Among the blood donors, 73.23% were from the local area. The HbST and HbEF were found to be 100% in concordance. Sensitivity was not tested in the present study. Conclusions The HbST is highly specific for identifying the HbS, but sensitivity was not tested in this study. The screening of blood donors for abnormal hemoglobins is useful, helping to detect and counsel heterozygous people. The study seeks to identify the prevalence of SCT in a region of Brazil.
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Affiliation(s)
| | - Ianka Cristina Ernesto
- Faculdade de Medicina da Universidade Presidente Antônio Carlos (UNIPAC), Juiz de Fora, MG, Brazil
| | - Marina Schuffner Silva
- Faculdade de Medicina da Universidade Presidente Antônio Carlos (UNIPAC), Juiz de Fora, MG, Brazil
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19
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Parents of Children with Sickle Cell Disease Are Interested in Preimplantation Genetic Testing. J Pediatr 2020; 223:178-182.e2. [PMID: 32586619 DOI: 10.1016/j.jpeds.2020.04.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/07/2020] [Accepted: 04/10/2020] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To evaluate awareness of and attitudes toward preimplantation genetic testing (PGT) for sickle cell disease (SCD) among parents of children with SCD. STUDY DESIGN Parents of children with SCD were given an educational handbook on PGT before a routine SCD clinic visit. After their clinic visit, parents were asked to complete an anonymous survey. RESULTS Of 83 patents approached, 67 (81%) completed the survey. Only 16 of the 67 parents (24%) were previously aware of PGT for SCD. After our clinic-based education, 65 of the 67 parents (97%) indicated that it was important or very important for parents of children with SCD to know about PGT. Among parents interested in having more children, 29 of 32 (91%) would personally consider using PGT if covered by insurance. CONCLUSIONS Parents of children with SCD are generally not aware of PGT. When educated in clinic, parents viewed information on PGT as valuable. Pediatricians and other health care professionals should inform parents of children with SCD about this reproductive option.
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20
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Thomford NE, Bope CD, Agamah FE, Dzobo K, Owusu Ateko R, Chimusa E, Mazandu GK, Ntumba SB, Dandara C, Wonkam A. Implementing Artificial Intelligence and Digital Health in Resource-Limited Settings? Top 10 Lessons We Learned in Congenital Heart Defects and Cardiology. ACTA ACUST UNITED AC 2020; 24:264-277. [DOI: 10.1089/omi.2019.0142] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Nicholas Ekow Thomford
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Institute for Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- School of Medical Sciences, Department of Medical Biochemistry, University of Cape Coast, Cape Coast, Ghana
| | - Christian Domilongo Bope
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Institute for Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- School of Medical Sciences, Department of Medical Biochemistry, University of Cape Coast, Cape Coast, Ghana
- Department of Mathematics and Computer Sciences, Faculty of Sciences, University of Kinshasa, Kinshasa, D.R. Congo
| | - Francis Edem Agamah
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Institute for Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Kevin Dzobo
- Institute for Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Division of Medical Biochemistry, Department of Integrative Biomedical Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Richmond Owusu Ateko
- University of Ghana Medical School, Department of Chemical Pathology, University of Ghana, Accra, Ghana
| | - Emile Chimusa
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Institute for Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Gaston Kuzamunu Mazandu
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Simon Badibanga Ntumba
- Department of Mathematics and Computer Sciences, Faculty of Sciences, University of Kinshasa, Kinshasa, D.R. Congo
| | - Collet Dandara
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Institute for Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Ambroise Wonkam
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Institute for Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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21
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Schultz CL, Tchume-Johnson T, Jackson T, Enninful-Eghan H, Schapira MM, Smith-Whitley K. Reproductive intentions in mothers of young children with sickle cell disease. Pediatr Blood Cancer 2020; 67:e28227. [PMID: 32065500 DOI: 10.1002/pbc.28227] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 01/16/2020] [Accepted: 01/31/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND Sickle cell disease (SCD) is an autosomal recessive hemoglobinopathy associated with morbidity and mortality. We sought to understand family planning intentions of parents of young children with SCD including the awareness of three reproductive options (adoption, in vitro fertilization with egg/sperm donation [IVFD], in vitro fertilization [IVF] with preimplantation genetic testing [IVF/PGT]) to decrease the risk of having a child with SCD. PROCEDURE Qualitative, semistructured, one-on-one interviews with 18 female parents of young children with SCD at an urban, tertiary care pediatric hospital. RESULTS Half of the parents knew their hemoglobinopathy status or their partner's status before pregnancy. Eight parents chose to have no further children because of fear of SCD in another child. Awareness of reproductive options prior to study enrollment was limited. After brief introduction, 7 parents would consider adoption, 2 IVFD, and 10 IVF/PGT. Desire for a biological child, fear of parental jealousy, ethical or religious considerations, and cost affected the acceptability of these options. Participants universally wanted information about reproductive options available to others prior to pregnancy. CONCLUSIONS There is limited awareness and variable acceptability of alternative reproductive options available to decrease the risk of a future child having SCD. Participants universally endorsed the need for education regarding hemoglobinopathy status, SCD, and reproductive options prior to pregnancy because for many participants having a child with SCD affected their reproductive intentions. Educational interventions to ensure informed reproductive decision making should be sensitive to desires for a biological child, and ethical and financial considerations.
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Affiliation(s)
- Corinna L Schultz
- Department of Hematology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Trudy Tchume-Johnson
- Department of Hematology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Tannoa Jackson
- Department of Hematology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Marilyn M Schapira
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,The Center for Health Equity and Research Promotion, Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | - Kim Smith-Whitley
- Department of Hematology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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22
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Weil LG, Charlton MR, Coppinger C, Daniel Y, Streetly A. Sickle cell disease and thalassaemia antenatal screening programme in England over 10 years: a review from 2007/2008 to 2016/2017. J Clin Pathol 2019; 73:183-190. [PMID: 31771971 DOI: 10.1136/jclinpath-2019-206317] [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: 11/04/2019] [Accepted: 11/05/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To evaluate the antenatal sickle cell and thalassaemia screening programme in England over 10 years from 1 April 2007 to 31 March 2017. METHODS Four routine data sources were used: antenatal screening laboratory data; key performance indicator data from maternity trusts; prenatal diagnosis (PND) laboratory data and data from screening incidents. RESULTS For the 10 years examined a total of 6608 575 booking samples were reported as screened, and 154 196 pregnant women required further testing. There were 3941 reported PND tests of which there were 964 affected fetal results. Antenatal test coverage and Family Origin Questionnaire completion rates are high and increasing; the proportion of tests declined has decreased. However, there is wide variation in the timing of antenatal tests and completeness of follow-up and testing. Since 2014/2015 a lower proportion of PND tests are performed by the programme standard of 12+6 weeks. Results suggest that PND timing affects reproductive choices as those with an affected fetus identified by PND testing earlier are more likely to terminate the pregnancy. CONCLUSIONS The screening programme appears to be widely accepted as part of routine antenatal care in England. However, the timeliness of screening and subsequent PND testing has consistently not met programme standards. Improving timeliness would enable individuals to consider their options to make informed choices for their pregnancies at the appropriate time. This paper reports carrier rates for an almost complete cohort of women which provides important epidemiological information on the genetic profile of women in England.
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Affiliation(s)
- Leonora G Weil
- Health Protection and Medical Directorate, Public Health England, London, UK
| | | | - Cathy Coppinger
- Public Health England Programme Manager, NHS Sickle Cell and Thalassaemia Screening Programme, Public Health England, London, UK
| | - Yvonne Daniel
- Public Health England Scientific Adviser, NHS Sickle Cell and Thalassaemia Screening Programme, Public Health England, London, UK
| | - Allison Streetly
- School of Population Health and Environmental Sciences, King's College London Faculty of Life Sciences and Medicine, London, UK.,Division of Healthcare Public Health, Health Protection and Medical Directorate, Public Health England, London, UK
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23
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Abstract
Uptake of prenatal genetic testing (PGT) is low among those with sickle cell disease (SCD). This study evaluated the association of knowledge and attitudes towards prenatal genetic counseling (PGC), awareness of posttesting intervention options and omission bias with attitudes towards PGT. In addition, we explored changes among knowledge, attitudes, and awareness of options following exposure to an educational, clinical vignette among parents of children with SCD. Parents (n=44) completed a questionnaire and an educational, clinical vignette presenting a detailed account of a pregnant woman with sickle cell trait seeking PGT and PGC was read to each participant. t Tests, Spearman correlations, multivariable regressions, and moderation/mediation analyses were used. More positive attitudes towards PGC (P=0.01), lesser tendency of omission bias (P<0.01) and private insurance (P=0.04) were significant correlates of more positive attitudes towards PGT. Omission bias mediated the relationship of attitudes towards PGC and attitudes towards PGT (95% confidence interval: 0.13, 3.03). Awareness of options (P=0.02), knowledge of PGC (P=0.01) and knowledge of PGT (P=0.01) significantly improved after exposure to the clinical vignette. Patients and families with SCD can benefit from education about the importance of prenatal diagnosis to improve attitudes, address omission bias and promote more informed decisions of PGT.
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24
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Mayo-Gamble TL, Schlundt D, Cunningham-Erves J, Murry VM, Bonnet K, Quasie-Woode D, Mouton CP. Sickle cell carriers' unmet information needs: Beyond knowing trait status. J Genet Couns 2019; 28:812-821. [PMID: 30969464 PMCID: PMC6679751 DOI: 10.1002/jgc4.1124] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 03/08/2019] [Indexed: 11/12/2022]
Abstract
Benefits of identifying sickle cell disease (SCD) carriers include detection of at-risk couples who may be informed on reproductive choices. Studies consistently report insufficient knowledge about the genetic inheritance pattern of SCD among people with sickle cell trait (SCT). This study explored perspectives of adults with SCT on the information needed to make an informed reproductive decision and the recommendations for communicating SCT information. Five focus groups (N = 25) were conducted with African Americans with SCT ages 18-65 years old. Participants were asked about their knowledge of SCT, methods for finding information on SCT, impact of SCT on daily living, and interactions with healthcare providers. An inductive-deductive qualitative analysis was used to analyze the data for emerging themes. Four themes emerged, highlighting the unmet information needs of African American sickle cell carriers: (a) SCT and SCD Education; (b) information sources; (c) improved communication about SCT and SCD; and (d) increased screening strategies. Future studies are needed to determine effective strategies for communicating SCT information and to identify opportunities for education within community and medical settings. Identifying strategies to facilitate access to SCT resources and education could serve as a model for meeting unmet information needs for carriers of other genetic conditions.
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Affiliation(s)
- Tilicia L. Mayo-Gamble
- Department of Health Policy, Management and Behavior, Jiann-Ping Hsu College of Public Health, Georgia Southern University, 501 Forest Drive, P.O. Box 8015, Statesboro, GA, 30415. USA,
| | - David Schlundt
- Department of Psychology, College of Arts and Sciences, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN, 37240, USA, ;
| | - Jennifer Cunningham-Erves
- Department of Internal Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd, Nashville, Tennessee, 37208, USA;
| | - Velma McBride Murry
- Department of Human and Organizational Development, College of Education and Human Development, Vanderbilt University, 230 Appleton Place, Nashville, TN, 37203, USA,
| | - Kemberlee Bonnet
- Department of Psychology, College of Arts and Sciences, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN, 37240, USA, ;
| | - Delores Quasie-Woode
- Department of Health Policy, Management and Behavior, Jiann-Ping Hsu College of Public Health, Georgia Southern University, 501 Forest Drive, Statesboro, GA, 30415, USA,
| | - Charles P. Mouton
- Department of Family Medicine, Office of Academic Affairs, University of Texas Medical Branch, 301 University Boulevard Galveston, TX 77555-0410, USA,
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25
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Reeves SL, Jary HK, Gondhi JP, Kleyn M, Spector-Bagdady K, Dombkowski KJ. Incidence, demographic characteristics, and geographic distribution of sickle cell trait and sickle cell anemia births in Michigan, 1997-2014. Mol Genet Genomic Med 2019; 7:e795. [PMID: 31210022 PMCID: PMC6687629 DOI: 10.1002/mgg3.795] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/22/2019] [Accepted: 04/27/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND This study describes the incidence, demographic characteristics, and geographic distribution of sickle cell anemia (SCA) and sickle cell trait births in Michigan. METHODS Michigan newborn screening records and birth certificates (1997-2014) were used to identify sickle cell trait and SCA births, as well as demographic characteristics and mother's residential address. Incidence was calculated overall and by county. RESULTS During the study period, there were 592 SCA births and 33,404 sickle cell trait births in Michigan. The majority of SCA (86.3%) and trait (80.2%) cases were among children who were black. Children with SCA were born in 23% of Michigan counties; children with trait were born in 93%. CONCLUSION Compared to SCA, sickle cell trait births occur at 50-fold greater incidence and have a substantially expanded geographic distribution. Further research is necessary to understand the most appropriate and impactful use of resources to increase the proportion of families and adults that are aware of their sickle cell trait status.
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Affiliation(s)
- Sarah L Reeves
- Department of Pediatrics, Susan B. Meister Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, Michigan
| | - Hannah K Jary
- Department of Pediatrics, Susan B. Meister Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, Michigan
| | - Jennifer P Gondhi
- Department of Pediatrics, Susan B. Meister Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, Michigan
| | - Mary Kleyn
- Michigan Department of Health and Human Services, Lansing, Michigan
| | - Kayte Spector-Bagdady
- Department of Obstetrics and Gynecology, Center for Bioethics & Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan
| | - Kevin J Dombkowski
- Department of Pediatrics, Susan B. Meister Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, Michigan
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Mayo-Gamble TL, Barnes PA, Cunningham Erves J, Middlestadt SE, Lin HC. 'It means everyone should know their status': exploring lay conceptions of sickle cell trait and sickle cell trait screening among African Americans within middle reproductive age. ETHNICITY & HEALTH 2018; 23:813-829. [PMID: 28277026 DOI: 10.1080/13557858.2017.1295135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE This study examined the meaning of sickle cell trait and sickle cell trait screening from the lay perspective of African Americans. DESIGN AND METHODS African Americans (N = 300), ages 18-35 and unaware of their sickle cell trait status, completed two open-ended questions from a larger survey. One question asked for their understanding of sickle cell trait; the other asked for their understanding of sickle cell trait screening. Content analysis occurred in two phases: (1) In vivo and holistic coding; and (2) focused coding. RESULTS Four categories emerged illustrating lay conceptions of sickle cell trait; (1) Perceived as an illness; (2) Perceived recognition of the inheritance pattern of sickle cell trait; (3) Perceived lack of knowledge of sickle cell trait; and (4) Perceived importance of sickle cell trait. Five categories emerged illustrating lay conceptions for sickle cell trait screening: (1) Perceived recognition that screening means getting tested for sickle cell trait; (2) Perceived lack of knowledge of sickle cell trait screening; (3) Perceived health benefit of sickle cell trait screening; (4) Perceived importance of sickle cell trait screening; and (5) Perceived barriers to sickle cell trait screening. CONCLUSIONS Sickle cell trait and sickle cell trait screening are concepts that are both regarded as important among this high-risk population. However, there is still misunderstanding concerning the hereditary nature and reproductive implications of sickle cell trait. Interventions seeking to improve communication on the need for sickle cell trait screening should begin by identifying what the population at large understands, knows and/or believes to improve their ability to make informed health decisions.
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Affiliation(s)
- Tilicia L Mayo-Gamble
- a Department of Family and Community Medicine , Meharry Medical College , Nashville , USA
| | - Priscilla A Barnes
- b Department of Applied Health Science , Indiana University , Bloomington , USA
| | | | - Susan E Middlestadt
- b Department of Applied Health Science , Indiana University , Bloomington , USA
| | - Hsien-Chang Lin
- b Department of Applied Health Science , Indiana University , Bloomington , USA
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27
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Smith M, Brownell G. Knowledge, beliefs, attitudes, and behaviors regarding sickle cell disease: Implications for prevention. SOCIAL WORK IN PUBLIC HEALTH 2018; 33:299-316. [PMID: 29768104 DOI: 10.1080/19371918.2018.1469064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Sickle cell disease (SCD) is a widespread inherited blood disorder, which leaves lasting effects on the health, social functioning, and finances of individuals, families, communities, and health care systems. A nonexperimental, cross-sectional research design was used to assess 415 college students' knowledge about SCD. Data was obtained through an online survey derived from a modified version of the SCD Knowledge Assessment Tool. The majority of participants (79%) reported previous SCD knowledge; however, 21% of the participants reported no previous SCD knowledge. Results support the need for improved education and awareness for at risk groups. The lack of SCD knowledge among African Americans shows a need for improved, nongendered specific education, awareness, and screening efforts geared toward at-risk populations.
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Affiliation(s)
- Marcella Smith
- a School of Social Work, Texas A&M University-Commerce, Commerce, Texas , USA
| | - Gracie Brownell
- a School of Social Work, Texas A&M University-Commerce, Commerce, Texas , USA
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Al-Balushi AA, Al-Hinai B. Should Premarital Screening for Blood Disorders be an Obligatory Measure in Oman? Sultan Qaboos Univ Med J 2018; 18:e24-e29. [PMID: 29666677 DOI: 10.18295/squmj.2018.18.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 11/06/2017] [Accepted: 12/27/2017] [Indexed: 11/16/2022] Open
Abstract
Due to the high rate of consanguineous marriages in Oman, there is a correspondingly high prevalence of hereditary blood disorders, particularly sickle cell disease and β-thalassaemia. This article proposes the possibility of implementing mandatory premarital carrier screening for blood disorders in Oman, while giving due consideration to potential social and cultural obstacles. Although the implementation of such legislation would require collaboration between different sectors and may negatively affect the autonomy of certain individuals, mandatory premarital screening would help to alleviate the burden of hereditary blood disorders on the national healthcare system, as well as reduce avoidable suffering among carriers and their families.
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Affiliation(s)
- Amal A Al-Balushi
- Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman
| | - Budoor Al-Hinai
- Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman
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29
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Mayo-Gamble TL, Middlestadt SE, Lin HC, Cunningham-Erves J, Barnes P, Jackson PB. Identifying Factors Underlying the Decision for Sickle Cell Carrier Screening Among African Americans Within Middle Reproductive Age. J Genet Couns 2018; 27:1302-1311. [DOI: 10.1007/s10897-018-0255-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/19/2018] [Indexed: 11/29/2022]
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30
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Huang AW, Muneyyirci-Delale O. Reproductive endocrine issues in men with sickle cell anemia. Andrology 2017; 5:679-690. [DOI: 10.1111/andr.12370] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 03/19/2017] [Accepted: 03/22/2017] [Indexed: 02/03/2023]
Affiliation(s)
- A. W. Huang
- Obstetrics and Gynecology; Rutgers New Jersey Medical School; Newark NY USA
| | - O. Muneyyirci-Delale
- Obstetrics and Gynecology; State University of New York Downstate Medical Center; Brooklyn NY USA
- Obstetrics and Gynecology; Kings County Hospital Center; Brooklyn NY USA
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31
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Lewis MR, Macauley RC, Sheehan PR, Staten MA, Phillips LS, Rasouli N, Pittas AG. Management of Hemoglobin Variants Detected Incidentally in HbA1c Testing: A Common Problem Currently Lacking a Standard Approach. Diabetes Care 2017; 40:e8-e9. [PMID: 27899488 PMCID: PMC5250694 DOI: 10.2337/dc16-1667] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 10/24/2016] [Indexed: 02/03/2023]
Affiliation(s)
- Michael R Lewis
- Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT
| | | | - Patricia R Sheehan
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Tufts Medical Center, Boston, MA
| | - Myrlene A Staten
- Kelly Government Solutions for National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Lawrence S Phillips
- Atlanta VA Medical Center, Decatur, GA, and Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Neda Rasouli
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Anastassios G Pittas
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Tufts Medical Center, Boston, MA
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32
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Harrison SE, Walcott CM, Warner TD. Knowledge and Awareness of Sickle Cell Trait Among Young African American Adults. West J Nurs Res 2016; 39:1222-1239. [DOI: 10.1177/0193945916665089] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sickle cell trait (SCT) places individuals at risk of passing an abnormal hemoglobin gene to biological children and is associated with rare but serious complications. The present study sought to examine knowledge of SCT and awareness of personal trait status among 258 young African American adults. Participants were surveyed regarding demographics, medical history, and sources of sickle cell information before completing a trait knowledge questionnaire. Overall, participants possessed significant misinformation about the condition. Women and those who had learned about sickle cell from families displayed higher levels of knowledge. Most participants were uncertain of personal trait status, and many did not wish to be informed of it. Health care providers should be alert that individuals with SCT may be unaware of their condition and potential reproductive and health implications. Screening and reporting procedures should be examined to ensure individuals have access to and control of this vital health information.
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Anie KA, Treadwell MJ, Grant AM, Dennis-Antwi JA, Asafo MK, Lamptey ME, Ojodu J, Yusuf C, Otaigbe A, Ohene-Frempong K. Community engagement to inform the development of a sickle cell counselor training and certification program in Ghana. J Community Genet 2016; 7:195-202. [PMID: 27090687 DOI: 10.1007/s12687-016-0267-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 04/10/2016] [Indexed: 12/22/2022] Open
Abstract
Sickle cell disease (SCD) and sickle cell trait (SCT) are highly prevalent in Africa. Despite public health implications, there is limited understanding of community issues for implementing newborn screening and appropriate family counseling. We conducted a 3-day workshop in Kumasi, Ghana, with community leaders as lay program development advisors to assist the development and implementation of a Sickle Cell Counselor Training and Certification Program. We employed qualitative methods to understand cultural, religious, and psychosocial dimensions of SCD and SCT, including the advisors' attitudes and beliefs in relation to developing a culturally sensitive approach to family education and counseling that is maximally suited to diverse communities in Ghana. We collated advisors' discussions and observations in order to understand community issues and potential challenges and guide strategies for advocacy in SCD family education and counseling. Results from the workshop revealed that community leaders representing diverse communities in Ghana were engaged constructively in discussions about developing a culturally sensitive counselor training program. Key findings included the importance of improved knowledge about SCD among the public and youth in particular, the value of stakeholders such as elders and religious and traditional leaders, and government expectations of reduced SCD births. We submitted a report to the Ministry of Health in Ghana with recommendations for the next steps in developing a national sickle cell counselor training program. We named the program "Genetic Education and Counseling for Sickle Cell Conditions in Ghana" (GENECIS-Ghana). The first GENECIS-Ghana Training and Certification Program Workshop was conducted from June 8 to 12, 2015.
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Affiliation(s)
- Kofi A Anie
- Haematology and Sickle Cell Centre, London North West Healthcare NHS Trust, Central Middlesex Hospital, London, NW10 7NS, UK. .,Imperial College London, London, UK.
| | - Marsha J Treadwell
- University of California San Francisco Benioff Children's Hospital Oakland, Oakland, CA, USA
| | - Althea M Grant
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jemima A Dennis-Antwi
- International Confederation of Midwives Investing in Midwives Program, Accra, Ghana.,Sickle Cell Foundation of Ghana, Kumasi, Ghana
| | - Mabel K Asafo
- Ashanti Region Health Promotion Office, Kumasi, Ghana
| | - Mary E Lamptey
- Sickle Cell Foundation of Ghana, Kumasi, Ghana.,National Newborn Screening Program for Sickle Cell Disease, Accra, Ghana
| | - Jelili Ojodu
- Association of Public Health Laboratories, Silver Spring, MD, USA
| | - Careema Yusuf
- Association of Public Health Laboratories, Silver Spring, MD, USA
| | - Ayo Otaigbe
- Sickle Cell Foundation Nigeria, Lagos, Nigeria
| | - Kwaku Ohene-Frempong
- Sickle Cell Foundation of Ghana, Kumasi, Ghana.,National Newborn Screening Program for Sickle Cell Disease, Accra, Ghana.,Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Hershberger PE, Gallo AM, Molokie R, Thompson AA, Suarez ML, Yao Y, Dallas CM, Wilkie DJ. Toward understanding family-related characteristics of young adults with sickle-cell disease or sickle-cell trait in the USA. J Clin Nurs 2016; 25:1587-97. [PMID: 26970444 DOI: 10.1111/jocn.13144] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2015] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To describe the family-related characteristics of young adults with sickle-cell disease or sickle-cell trait prior to taking part in a randomised controlled trial on sickle-cell reproductive health education. BACKGROUND There is a critical need for educational programmes that target the reproductive needs of young adults with sickle-cell disease or trait. However, little is known about the family-related characteristics (i.e., demographic attributes and reproductive health behaviours) in which these young adults live. DESIGN A descriptive cross-sectional analysis. METHOD At study enrolment, 234 young adults (mean age = 25·9 years, 65% female) completed the SCKnowIQ questionnaire. Descriptive statistics depict the demographic attributes and reproductive health behaviours of young adults with sickle-cell disease (n = 138) or trait (n = 96). For group comparisons, independent t tests or Fisher's tests were used, as appropriate. RESULTS Young adults with sickle-cell trait had significantly higher education, income and health insurance than those with sickle-cell disease. Both groups believed that sickle-cell disease was a severe condition. A majority of young adults with sickle-cell disease (65%) had no children compared to 42% of those with sickle-cell trait. Most young adults (85% sickle-cell disease, 82% sickle-cell trait) were not planning a pregnancy in the next six months, and many used condoms, withdrawal or oral contraceptives. CONCLUSIONS Socioeconomic disparities exist between young adults with sickle-cell disease and sickle-cell trait. Future research that advances education about how and when to communicate appropriate genetic risk information to partners and children especially for young adults with sickle-cell trait would be beneficial. RELEVANCE TO CLINICAL PRACTICE Awareness of the similarities and differences in the family-related characteristics among young adults with sickle-cell disease or trait can allow for more tailored reproductive education.
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Affiliation(s)
- Patricia E Hershberger
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.,College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Agatha M Gallo
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Robert Molokie
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA.,College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.,Jesse Brown VA Medical Center, Chicago, IL, USA
| | - Alexis A Thompson
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Marie L Suarez
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Yingwei Yao
- College of Nursing, University of Florida, Gainesville, FL, USA
| | | | - Diana J Wilkie
- College of Nursing, University of Florida, Gainesville, FL, USA.,Prairieview Trust, College of Nursing, University of Florida, Gainesville, FL, USA.,Center of Excellence in Palliative Care Research, College of Nursing, University of Florida, Gainesville, FL, USA
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35
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Gallo AM, Wilkie DJ, Yao Y, Molokie RE, Stahl C, Hershberger PE, Zhao Z, Suarez ML, Johnson B, Angulo R, Carrasco J, Angulo V, Thompson AA. Reproductive Health CHOICES for Young Adults with Sickle Cell Disease or Trait: Randomized Controlled Trial Outcomes over Two Years. J Genet Couns 2015; 25:325-36. [PMID: 26310871 DOI: 10.1007/s10897-015-9874-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 08/07/2015] [Indexed: 01/31/2023]
Abstract
Interventions to assist reproductive health decision-making in populations affected by sickle cell disease (SCD) or trait (SCT) lack proven efficacy over time. Our aim was to compare effects of CHOICES, a Web-based multimedia education program on implementing informed reproductive plans, and usual care education (e-Book) on reproductive knowledge, intention, and behavior over 24 months. We randomized 234 participants with SCD (n = 138) or SCT (n = 96) (age 18-35 years, 35 % male, 94 % African American) to CHOICES and e-Book groups. Participants completed a sickle cell-specific reproductive measure before and four times after the intervention (6, 12, 18 and 24 months). Compared to the e-Book group the CHOICES group had significantly more improvement in knowledge over time (p = .004) but not intention (p = .18) or behavior (p = .69). At baseline, 114 (48.7 %) participants reported having partners who would not put the couple at risk for their children inheriting SCD. Of the 116 (49.6 %) at-risk participants, a higher poroportion of those who were in the CHOICES group chose partners that reduced their risk by the last visit than the e-Book group (p = .04). Study findings provide important insights for designing a national trial of the CHOICES intervention focusing on subjects whose partner status puts them at risk for having a child with SCD.
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Affiliation(s)
- Agatha M Gallo
- Department of Women, Family and Children Health Science, College of Nursing, University of Illinois at Chicago, 845 S. Damen Avenue, MC 802, Chicago, IL, 60612-7352, USA.
| | - Diana J Wilkie
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, USA.,Department of Biobehavioral Nursing Science, University of Florida, Gainesville, FL, USA
| | - Yingwei Yao
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, USA.,Department of Biobehavioral Nursing Science, University of Florida, Gainesville, FL, USA
| | - Robert E Molokie
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.,Jesse Brown Veterans Administration Medical Center, Chicago, IL, USA
| | - Christiane Stahl
- Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA
| | - Patricia E Hershberger
- Department of Health Systems Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Zhongsheng Zhao
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Marie L Suarez
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Bonnye Johnson
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Rigoberto Angulo
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Jesus Carrasco
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Veronica Angulo
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Alexis A Thompson
- Division of Hematology/Oncology/Stem Cell Transplantation, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Northwestern University-Feinberg School of Medicine, Chicago, IL, USA
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Motivations of women with sickle cell disease for asking their partners to undergo genetic testing. Soc Sci Med 2015; 139:36-43. [DOI: 10.1016/j.socscimed.2015.06.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 06/16/2015] [Accepted: 06/24/2015] [Indexed: 01/16/2023]
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Hershberger PE, Gallo AM, Molokie R, Thompson AA, Suarez ML, Yao Y, Wilkie DJ. Perception of young adults with sickle cell disease or sickle cell trait about participation in the CHOICES randomized controlled trial. J Adv Nurs 2015; 72:1430-40. [PMID: 26073718 DOI: 10.1111/jan.12702] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2015] [Indexed: 11/29/2022]
Abstract
AIMS To gain an in-depth understanding of the perceptions of young adults with sickle cell disease and sickle cell trait about parenthood and participating in the CHOICES randomized controlled trial that used computer-based, educational programmes. BACKGROUND In the USA, there is insufficient education to assure that all young adults with sickle cell disease or sickle cell trait understand genetic inheritance risks and reproductive options to make informed reproductive decisions. To address this educational need, we developed a computer-based, multimedia program (CHOICES) and reformatted usual care into a computer-based (e-Book) program. We then conducted a two-year randomized controlled trial that included a qualitative component that would deepen understanding of young adults' perceptions of parenthood and use of computer-based, educational programmes. DESIGN A qualitative descriptive approach completed after a randomized controlled trial. METHODS Sixty-eight men and women of childbearing age participated in semi-structured interviews at the completion of the randomized controlled trial from 2012-2013. Thematic content analysis guided the qualitative description. RESULTS/FINDINGS Three main themes were identified: (1) increasing knowledge and new ways of thinking and behaving; (2) rethinking parenting plans; and (3) appraising the program design and delivery. Most participants reported increased knowledge and rethinking of their parenting plans and were supportive of computer-based learning. Some participants expressed difficulty in determining individual transmission risks. CONCLUSION Participants perceived the computer programs as beneficial to their learning. Future development of an Internet-based educational programme is warranted, with emphasis on providing tailored education or memory boosters about individual transmission risks.
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Affiliation(s)
- Patricia E Hershberger
- University of Illinois at Chicago, College of Nursing, Illinois, USA.,University of Illinois at Chicago, College of Medicine, Illinois, USA
| | - Agatha M Gallo
- University of Illinois at Chicago, College of Nursing, Illinois, USA
| | - Robert Molokie
- University of Illinois at Chicago, College of Medicine, Illinois, USA.,University of Illinois at Chicago, College of Pharmacy, Illinois, USA.,University of Illinois Hospital and Health Sciences System Comprehensive Sickle Cell Center, Chicago, Illinois, USA
| | - Alexis A Thompson
- Northwestern University-Feinberg School of Medicine, Chicago, Illinois, USA.,Division of Hematology/Oncology/Stem Cell Transplantation, Ann and Robert H. Lurie Children's Hospital of Chicago, Illinois, USA
| | - Marie L Suarez
- University of Illinois at Chicago, College of Nursing, Illinois, USA
| | - Yingwei Yao
- University of Illinois at Chicago, College of Nursing, Illinois, USA
| | - Diana J Wilkie
- University of Illinois at Chicago, College of Nursing, Illinois, USA.,University of Illinois Hospital and Health Sciences System Comprehensive Sickle Cell Center, Chicago, Illinois, USA
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Anderson M, Asnani M. 'The white blood cell always eat the red': how Jamaicans with sickle cell disease understand their illness. ETHNICITY & HEALTH 2015; 21:103-117. [PMID: 25833758 DOI: 10.1080/13557858.2015.1028522] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To explore lay understandings of sickle cell disease (SCD) among Jamaicans living with the illness. There is no qualitative research on this subject in Jamaica, where SCD is the most common genetic disorder. DESIGN Thirty in-depth semi-structured interviews (50% males, 50% urban residence) were conducted with adult patients attending the Sickle Cell Unit in Jamaica. Transcribed data were analysed using thematic analysis. RESULTS Patients' narratives focused on two main themes: lay understandings of how SCD works (using ideas of attack and fortification, and blockage and flow); and what causes the illness (lay ideas of inheritance). The most common description of SCD was that their white blood cells were 'eating/sucking out/feeding on' their red blood cells. Hence, treatment required 'building up' their blood, while a key to good health was ensuring an unimpeded flow of blood. Most participants believed SCD was hereditary, but there were various understandings of the mechanism and probability of its transmission. Belief in the possibility of transmitting SCD was not always a barrier to reproduction, nor did participants always insist on their partner or child being tested. CONCLUSIONS Participants engaged in medical pluralism, a dynamic combination of folk and biomedical beliefs. Their concerns, experiences and interpretations were powerful motivators of reproductive and screening behaviour. Their narratives of SCD transcend the individual to express social, societal and cultural realities. Health care professionals and policy-makers should communicate clearly to ensure understanding, and recognize and engage with their patients' sociocultural context.
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Affiliation(s)
- Moji Anderson
- a a Department of Sociology, Psychology and Social Work , University of the West Indies , Kingston , Jamaica
| | - Monika Asnani
- b b Sickle Cell Unit, Tropical Medicine Research Institute , University of the West Indies , Kingston , Jamaica
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[The impact of screening sickle-cell carriers in the general population. A retrospective study in the Paris screening center]. Rev Epidemiol Sante Publique 2015; 63:77-84. [PMID: 25819994 DOI: 10.1016/j.respe.2015.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 12/01/2014] [Accepted: 02/06/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Since 2006 the CIDD, the Paris information and screening center for sickle-cell disease, provides free assistance for adults who may be at risk of having children with sickle-cell disease. Recently, an increasing number of parents of a silent-carrier newborn detected by systematic neonatal screening are attending the center. We present a retrospective study of the impact of such information and screening on people. METHODS The study involved 81 silent-carrier men and women aged 18 to 45 years, interviewed using a telephone questionnaire (n=70) or during consultation (n=11) one to three years after screening. RESULTS The study group represented 12% of individuals attending the center with the same characteristics. In general, the information delivered concerning sickle-cell disease and silent-carriers was well understood although concerns about personal and family history and the correctness of prior knowledge revealed a lack of information input from the environment (media, schools, health professionals). Poorly assimilated information involved three subjects: the difference between trait and disease; the difference between type of hemoglobin and blood group; and Mendelian transmission. The screening result was not a cause of separation among couples and was often passed on to family or friends. Disparities in adherence to prenatal diagnosis and termination of pregnancy were mainly related to different representations of disease severity. CONCLUSION Joint screening of newborns and their parents is a good measure for adults, who are satisfied with being informed despite the psychological difficulties involved. However the implication for children detected remains a relevant issue because of the persistent perception of the trait as a pseudo-disease and the risk of reification of a biological difference between relatives.
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Genetic education and sickle cell disease: feasibility and efficacy of a program tailored to adolescents. J Pediatr Hematol Oncol 2014; 36:572-7. [PMID: 25089602 DOI: 10.1097/mph.0000000000000226] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Sickle cell disease (SCD) genetic knowledge is important when individuals make reproductive decisions. This study assessed feasibility and efficacy of delivering basic genetic information to 101 adolescents with SCD. Participants completed a questionnaire to test SCD genetic knowledge at 3 timepoints: before genetic education session (pretest), after the session (posttest), and 6 months later (follow-up). Scores at 3 timepoints were compared by Wilcoxon signed-rank tests, and group differences were compared by Wilcoxon-Mann-Whitney and Kruskal-Wallis tests. Participants' median scores significantly increased from pretest to posttest and from pretest to follow-up. Males had a greater change in scores than females. Scores decreased slightly from posttest to follow-up. Participants with HbSS/HbSβ⁰-thal genotype and participants with more prior pain episodes exhibited a smaller increase in median scores than those with HbSC/HbSβ⁺-thal genotype and no prior pain history; however, all groups had substantial gains from pretest to posttest and follow-up tests demonstrating that adolescents with SCD can learn basic genetics. This study established that genetic education can successfully be incorporated in transition to adult care programs for adolescents with SCD. Genetic education should be included in the standard plan of care for adolescents with SCD to assist them in making informed reproductive choices.
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Bediako SM, Lanzkron S, Diener-West M, Onojobi G, Beach MC, Haywood C. The Measure of Sickle Cell Stigma: Initial findings from the Improving Patient Outcomes through Respect and Trust study. J Health Psychol 2014; 21:808-20. [PMID: 24997169 DOI: 10.1177/1359105314539530] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Research about the influence of stigma on health outcomes in sickle cell disease is limited. We administered the recently developed Measure of Sickle Cell Stigma to 262 patients in the United States. The Measure of Sickle Cell Stigma yielded very good internal consistency and four interpretable factors. Significant associations among stigma, pain-related healthcare utilization, and perceived disease severity were observed for three of the four stigma factors (F range = 2.78-5.44). The Measure of Sickle Cell Stigma appears to be a useful tool for measuring disease-specific stigma among adults living with sickle cell disease, and further assessment of its clinical utility is warranted.
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Affiliation(s)
| | | | | | | | - Mary C Beach
- The Johns Hopkins University School of Medicine, USA
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Reproductive health choices for young adults with sickle cell disease or trait: randomized controlled trial immediate posttest effects. Nurs Res 2013; 62:352-61. [PMID: 23995469 DOI: 10.1097/nnr.0b013e3182a0316b] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND People with sickle cell disease (SCD) or sickle cell trait (SCT) may not have information about genetic inheritance needed for making informed reproductive health decisions. CHOICES is a Web-based, multimedia educational intervention that provides information about reproductive options and consequences to help those with SCD or SCT identify and implement an informed parenting plan. Efficacy of CHOICES compared with usual care must be evaluated. OBJECTIVE The purpose was to compare immediate posttest effects of CHOICES versus an attention-control usual care intervention (e-Book) on SCD-/SCT-related reproductive health knowledge, intention, and behavior. METHODS In a randomized controlled study, we recruited subjects with SCD/SCT from clinics, community settings, and online networks with data collected at sites convenient to the 234 subjects with SCD (n = 136) or SCT (n = 98). Their ages ranged from 18 to 35 years; 65% were women, and 94% were African American. Subjects completed a measure of sickle cell reproductive knowledge, intention, and behavior before and immediately after the intervention. RESULTS Compared with the e-Book group, the CHOICES group had significantly higher average knowledge scores and probability of reporting a parenting plan to avoid SCD or SCD and SCT when pretest scores were controlled. Effects on intention and planned behavior were not significant. The CHOICES group showed significant change in their intention and planned behavior, whereas the e-Book group did not show significant change in their intention, but their planned behavior differed significantly. DISCUSSION Initial efficacy findings are encouraging but warrant planned booster sessions and outcome follow-ups to determine sustained intervention efficacy on reproductive health knowledge, intention, and actual behavior of persons with SCD/SCT.
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Gallo AM, Wilkie DJ, Wang E, Labotka RJ, Molokie RE, Stahl C, Hershberger PE, Zhao Z, Suarez ML, Johnson B, Pullum C, Angulo R, Thompson A. Evaluation of the SCKnowIQ tool and reproductive CHOICES intervention among young adults with sickle cell disease or sickle cell trait. Clin Nurs Res 2013; 23:421-41. [PMID: 23572406 DOI: 10.1177/1054773813479377] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The study purpose was to evaluate a computer-based questionnaire (SCKnowIQ) and CHOICES educational intervention using cognitive interviewing with childbearing-aged people with sickle cell disease (SCD) or trait (SCT). Ten control group participants completed the SCKnowIQ twice. Ten intervention group participants completed the SCKnowIQ before and after the CHOICES intervention. Most participants found the questionnaire items appropriate and responded to items as the investigators intended. Participants' responses indicated that the information on SCD and SCT and reproductive options was understandable, balanced, important, and new to some. Internal consistency and test-retest reliability were adequate (.47 to .87) for 4 of the 6 scales, with significant within-group changes in knowledge scores for the intervention group but not for the control group. Findings show evidence for potential efficacy of the intervention, but proof of efficacy requires a larger randomized study.
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Affiliation(s)
- Agatha M Gallo
- University of Illinois at Chicago, College of Nursing, Department of Women, Children and Family Health Science, Chicago, IL, USA Basic and Translational Research Program, Comprehensive Sickle Cell Center, University of Illinois at Chicago, Chicago, IL, USA
| | - Diana J Wilkie
- University of Illinois at Chicago, College of Nursing, Department of Biobehavioral Health Science, Chicago, IL, USA Basic and Translational Research Program, Comprehensive Sickle Cell Center, University of Illinois at Chicago, Chicago, IL, USA
| | - Edward Wang
- University of Illinois at Chicago, College of Applied Health Sciences,Department of Biomedical and Health Information Sciences, Chicago, IL, USA
| | - Richard J Labotka
- University of Illinois at Chicago Department of Pediatrics, Chicago, IL, USA
| | - Robert E Molokie
- University of Illinois at Chicago, College of Medicine, Department of Medicine, Division of Hematology/Oncology, Chicago, IL, USA Jesse Brown Veteran's Administration Medical Center, Chicago, IL, USA Basic and Translational Research Program, Comprehensive Sickle Cell Center, University of Illinois at Chicago, Chicago, IL, USA
| | - Christiane Stahl
- University of Illinois at Chicago, College of Medicine, Department of Pediatrics, General Pediatrics and Adolescent Medicine, Chicago, IL, USA
| | - Patricia E Hershberger
- University of Illinois at Chicago, College of Nursing, Department of Women, Children and Family Health Science, Chicago, IL, USA
| | - Zhongsheng Zhao
- University of Illinois at Chicago, College of Nursing, Department of Biobehavioral Health Science, Chicago, IL, USA
| | - Marie L Suarez
- University of Illinois at Chicago, College of Nursing, Department of Biobehavioral Health Science, Chicago, IL, USA
| | - Bonnye Johnson
- Basic and Translational Research Program, Comprehensive Sickle Cell Center, University of Illinois at Chicago, Chicago, IL, USA
| | - Cherese Pullum
- University of Illinois at Chicago, College of Nursing, Department of Biobehavioral Health Science, Chicago, IL, USA
| | - Rigoberto Angulo
- University of Illinois at Chicago, College of Nursing, Department of Biobehavioral Health Science, Chicago, IL, USA
| | - Alexis Thompson
- Northwestern University Feinberg School of Medicine, Division of Pediatric Hematology, Oncology, Stem Cell Transplantation; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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Christopher SA, Collins JL, Farrell MH. Effort required to contact primary care providers after newborn screening identifies sickle cell trait. J Natl Med Assoc 2012; 104:528-34. [PMID: 23560355 PMCID: PMC3880776 DOI: 10.1016/s0027-9684(15)30219-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
People with heterozygous status for sickle cell disease (also called sickle cell trait) are essentially healthy, but evidence of rare health problems has increased interest in screening adolescents and young adults prior to enlisting in athletics or military service. Ironically, almost everyone with sickle cell trait is already identified during routine newborn screening for sickle cell disease, but this identification may never reach the parents. As part of a larger statewide study of communication after newborn screening, we decided to document the amount of labor required to connect sickle cell trait screening results with primary care providers (PCPs). Case review methods examined records and call logs from the first 150 cases in a 42-month project. Our study procedures identified PCPs for 136 of 150 infants (90.6%); a total of 266 phone calls were needed. We identified 9 categories of experiences, ranging from incorrect baby names to restrictions on accepting Medicaid patients. Cases demonstrate that it is possible to connect with most PCPs after newborn screening despite warnings about difficulties with this population. Success was due to persistence, relationships with clinics and hospitals, and Internet search capabilities. If sickle cell trait identification is necessary to protect health, then only modest increases in effort will be needed to reduce disparities in service.
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Affiliation(s)
- Stephanie A. Christopher
- Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Phone number: 414-955-8381, After hours phone number: 414-407-0122
| | - Jenelle L. Collins
- Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Phone number: 414-955-8381, After hours phone number: 414-407-0122
| | - Michael H. Farrell
- Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Phone number: 414-955-8381, After hours phone number: 414-407-0122
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Guedes C. [Reproductive decisions and newborn screening: the perspective of female caregivers of children with sickle cell disease]. CIENCIA & SAUDE COLETIVA 2012; 17:2367-76. [PMID: 22996887 DOI: 10.1590/s1413-81232012000900017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 04/06/2012] [Indexed: 11/22/2022] Open
Abstract
One of the goals of the Brazilian Newborn Screening Program created in 2001 was to inform couples with the possibility of having children with sickle cell diseases regarding reproductive decision-making. This article presents the reproductive choices and analyzes the notion of biomedical reproductive risk of female caregivers of children with sickle cell disease participating in a newborn screening program. Qualitative data collected between 2006 and 2008 was based on interviews with 50 female caregivers of children with sickle cell disease participating on the Federal District Newborn Screening Program. The research revealed the following perceptions underlying reproductive decisions: women who want to have other children even with the risk of recurrence of the disease; women who do not want to have any more children; and women whose reproductive plans are still being considered on the basis of the information provided by the newborn screening program. The study revealed that women's reproductive choices are based on the experience of child care and self care. The notion of reproductive risk is built in order to strengthen women's decisions together with their family and other social groups to which they belong.
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Affiliation(s)
- Cristiano Guedes
- Universidade de Brasília, Caixa Postal 8011, Setor Sudoeste, 70673-970 Brasilia DF.
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46
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Smith M, Aguirre RTP. Reproductive attitudes and behaviors in people with sickle cell disease or sickle cell trait: a qualitative interpretive meta-synthesis. SOCIAL WORK IN HEALTH CARE 2012; 51:757-779. [PMID: 23078010 DOI: 10.1080/00981389.2012.693580] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Sickle cell disease (SCD) is a serious and life threatening disorder. The literature on informed reproductive decisions among people with SCD is limited, suggesting that there is a lack of awareness about SCD and Sickle cell trait status (SCT) among high-risk populations. The purpose of this qualitative interpretive meta-synthesis (QIMS) is to examine the reproductive attitudes and behaviors in people with SCD or SCT to create effective genetic counseling programs to inform reproductive decision making. Three studies were included in the QIMS for a total sample of 79 participants. The majority of the sample was African American, ages 16 to 63. Other demographic characteristics of the study populations and data collection methods used in these studies varied. Seven themes on reproductive attitudes and behaviors among people with SCD or SCT emerged: lack of awareness or education about SCD and SCT; men who deny having SCT; attitudes toward learning one's SCT status; rationales for learning a partner's SCT status prior to commencing a relationship; valuing relationships over SCD risk; learning one's own and partner's SCT status; and the consequences of not asking about partners' SCT status. Implications for prevention programming involving improved education and awareness about the disease and reproduction are discussed.
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Affiliation(s)
- Marcella Smith
- School of Social Work, The University of Texas at Arlington, Arlington, Texas 76019, USA
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