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Linder LA, Challinor J. Pediatric Oncology Nurse-Led Research and Evidence-Based Practice: Global Exemplars to Reduce Disparity. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2023; 40:281-285. [PMID: 37971201 DOI: 10.1177/27527530231190371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Affiliation(s)
- Lauri A Linder
- University of Utah College of Nursing, Salt Lake City, UT, USA
- Clinical Nurse Specialist, Primary Children's Hospital, Salt Lake City, UT, USA
| | - Julia Challinor
- School of Nursing, University of California San Francisco, San Francisco, CA, USA
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Fox L, Santaolalla A, Handford J, Sullivan R, Torode J, Vanderpuye V, Pramesh C, Mula-Hussain L, AlWaheidi S, Makaroff LE, Kaur R, Mackay C, Mukherji D, Van Hemelrijck M. Redefining Cancer Research Priorities in Low- and Middle-Income Countries in the Post-COVID-19 Global Context: A Modified Delphi Consensus Process. JCO Glob Oncol 2023; 9:e2300111. [PMID: 37561978 PMCID: PMC10857688 DOI: 10.1200/go.23.00111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/24/2023] [Accepted: 06/07/2023] [Indexed: 08/12/2023] Open
Abstract
PURPOSE The post-COVID-19 funding landscape for cancer research globally has become increasingly challenging, particularly in resource-challenged regions (RCRs) lacking strong research ecosystems. We aimed to produce a list of priority areas for cancer research in countries with limited resources, informed by researchers and patients. METHODS Cancer experts in lower-resource health care systems (as defined by the World Bank as low- and middle-income countries; N = 151) were contacted to participate in a modified consensus-seeking Delphi survey, comprising two rounds. In round 1, participants (n = 69) rated predetermined areas of potential research priority (ARPs) for importance and suggested missing ARPs. In round 2, the same participants (n = 49) rated an integrated list of predetermined and suggested ARPs from round 1, then undertook a forced choice priority ranking exercise. Composite voting scores (T-scores) were used to rank the ARPs. Importance ratings were summarized descriptively. Findings were discussed with international patient advocacy organization representatives. RESULTS The top ARP was research into strategies adapting guidelines or treatment strategies in line with available resources (particularly systemic therapy) (T = 83). Others included cancer registries (T = 62); prevention (T = 52); end-of-life care (T = 53); and value-based and affordable care (T = 51). The top COVID-19/cancer ARP was strategies to incorporate what has been learned during the pandemic that can be maintained posteriorly (T = 36). Others included treatment schedule interruption (T = 24); cost-effective reduction of COVID-19 morbidity/mortality (T = 19); and pandemic preparedness (T = 18). CONCLUSION Areas of strategic priority favored by cancer researchers in RCRs are related to adaptive treatment guidelines; sustainable implementation of cancer registries; prevention strategies; value-based and affordable cancer care; investments in research capacity building; epidemiologic work on local risk factors for cancer; and combatting inequities of prevention and care access.
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Affiliation(s)
- Louis Fox
- Translational Oncology and Urology Research (TOUR), Centre for Cancer, Society and Public Health, King's College London, London, United Kingdom
| | - Aida Santaolalla
- Translational Oncology and Urology Research (TOUR), Centre for Cancer, Society and Public Health, King's College London, London, United Kingdom
| | - Jasmine Handford
- Translational Oncology and Urology Research (TOUR), Centre for Cancer, Society and Public Health, King's College London, London, United Kingdom
| | - Richard Sullivan
- Global Oncology Group, Centre for Cancer, Society and Public Health, King's College London, London, United Kingdom
| | - Julie Torode
- Global Oncology Group, Centre for Cancer, Society and Public Health, King's College London, London, United Kingdom
| | - Verna Vanderpuye
- National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - C.S. Pramesh
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Layth Mula-Hussain
- Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Oman
| | - Shaymaa AlWaheidi
- Global Oncology Group, Centre for Cancer, Society and Public Health, King's College London, London, United Kingdom
| | | | - Ranjit Kaur
- Advanced Breast Cancer Global Alliance, Petaling Jaya, Malaysia
| | - Clara Mackay
- World Ovarian Cancer Coalition, Toronto, ON, Canada
| | - Deborah Mukherji
- Naef K Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), Centre for Cancer, Society and Public Health, King's College London, London, United Kingdom
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Cardone C, Arnold D. The Cancer Treatment Gap in Lower- to Middle-Income Countries. Oncology 2023; 101 Suppl 1:2-4. [PMID: 37044080 PMCID: PMC10413785 DOI: 10.1159/000530416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 03/10/2023] [Indexed: 04/14/2023]
Affiliation(s)
- Claudia Cardone
- Experimental Clinical Abdominal Oncology Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Napoli, Italy
| | - Dirk Arnold
- Department of Hematology, Oncology, Palliative Care and Rheumatology, Asklepios Tumorzentrum Hamburg, AK Altona, Hamburg, Germany
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Shelley D, Alvarez GG, Nguyen T, Nguyen N, Goldsamt L, Cleland C, Tozan Y, Shuter J, Armstrong-Hough M. Adapting a tobacco cessation treatment intervention and implementation strategies to enhance implementation effectiveness and clinical outcomes in the context of HIV care in Vietnam: a case study. Implement Sci Commun 2022; 3:112. [PMID: 36253834 PMCID: PMC9574833 DOI: 10.1186/s43058-022-00361-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoking rates remain high in Vietnam, particularly among people living with HIV/AIDS (PLWH), but tobacco cessation services are not available in outpatient HIV clinics (OPCs). The research team is conducting a type II hybrid randomized controlled trial (RCT) comparing the cost-effectiveness of three tobacco cessation interventions among PLWH receiving care in HIV clinics in Vietnam. The study is simultaneously evaluating the implementation processes and outcomes of strategies aimed at increasing the implementation of tobacco dependence treatment (TDT) in the context of HIV care. This paper describes the systematic, theory-driven process of adapting intervention components and implementation strategies with demonstrated effectiveness in high-income countries, and more recently in Vietnam, to a new population (i.e., PLWH) and new clinical setting, prior to launching the trial. METHODS Data collection and analyses were guided by two implementation science frameworks and the socio-ecological model. Qualitative interviews were conducted with 13 health care providers and 24 patients in three OPCs. Workflow analyses were conducted in each OPC. Qualitative data were analyzed using rapid qualitative analysis procedures. Based on findings, components of the intervention and implementation strategies were adapted, followed by a 3-month pilot study in one OPC with 16 patients randomized to one of two intervention arms. RESULTS The primary adaptations included modifying the TDT intervention counseling content to address barriers to quitting among PLWH and Vietnamese sociocultural norms that support smoking cessation. Implementation strategies (i.e., training and system changes) were adapted to respond to provider- and clinic-level determinants of implementation effectiveness (e.g., knowledge gaps, OPC resource constraints, staffing structure, compatibility). CONCLUSIONS Adaptations were facilitated through a mixed method, stakeholder (patient and health care provider, district health leader)-engaged evaluation of context-specific influences on intervention and implementation effectiveness. This data-driven approach to refining and adapting components aimed to optimize intervention effectiveness and implementation in the context of HIV care. Balancing pragmatism with rigor through the use of rapid analysis procedures and multiple methods increased the feasibility of the adaptation process. TRIAL REGISTRATION ClinicalTrials.gov NCT05162911 . Registered on December 16, 2021.
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Affiliation(s)
- Donna Shelley
- School of Global Public Health, New York University, 708 Broadway, New York, NY, USA.
| | | | - Trang Nguyen
- Institute of Social and Medical Studies, 810 CT1A ĐN1, Ham Nghi Street, My Dinh 2 Ward, South Tu Liem District, Hanoi, Vietnam
| | - Nam Nguyen
- Institute of Social and Medical Studies, 810 CT1A ĐN1, Ham Nghi Street, My Dinh 2 Ward, South Tu Liem District, Hanoi, Vietnam
| | - Lloyd Goldsamt
- Rory Meyers College of Nursing, New York University, 433 First Avenue, 7th Floor, New York, NY, USA
| | - Charles Cleland
- Grossman School of Medicine, New York University, 180 Madison Avenue, 2-53, New York, NY, 10016, USA
| | - Yesim Tozan
- School of Global Public Health, New York University, 708 Broadway, New York, NY, USA
| | - Jonathan Shuter
- Albert Einstein College of Medicine, Montefiore Medical Center, 111 East 210th Street, Schiff Pavilion, Bronx, NY, USA
| | - Mari Armstrong-Hough
- School of Global Public Health, New York University, 708 Broadway, New York, NY, USA
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