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Tiase VL, Richards G, Taft T, Stevens L, Balbin C, Kaphingst KA, Fagerlin A, Caverly T, Kukhareva P, Flynn M, Butler JM, Kawamoto K. Patient Perspectives on a Patient-Facing Tool for Lung Cancer Screening. Health Expect 2024; 27:e14143. [PMID: 38992907 PMCID: PMC11239535 DOI: 10.1111/hex.14143] [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: 03/08/2024] [Revised: 06/02/2024] [Accepted: 06/27/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Individuals with high risk for lung cancer may benefit from lung cancer screening, but there are associated risks as well as benefits. Shared decision-making (SDM) tools with personalized information may provide key support for patients. Understanding patient perspectives on educational tools to facilitate SDM for lung cancer screening may support tool development. AIM This study aimed to explore patient perspectives related to a SDM tool for lung cancer screening using a qualitative approach. METHODS We elicited patient perspectives by showing a provider-facing SDM tool. Focus group interviews that ranged in duration from 1.5 to 2 h were conducted with 23 individuals with high risk for lung cancer. Data were interpreted inductively using thematic analysis to identify patients' thoughts on and desires for a patient-facing SDM tool. RESULTS The findings highlight that patients would like to have educational information related to lung cancer screening. We identified several key themes to be considered in the future development of patient-facing tools: barriers to acceptance, preference against screening and seeking empowerment. One further theme illustrated effects of patient-provider relationship as a limitation to meeting lung cancer screening information needs. Participants also noted several suggestions for the design of technology decision aids. CONCLUSION These findings suggest that patients desire additional information on lung cancer screening in advance of clinical visits. However, there are several issues that must be considered in the design and development of technology to meet the information needs of patients for lung cancer screening decisions. PATIENT OR PUBLIC CONTRIBUTION Patients, service users, caregivers or members of the public were not involved in the study design, conduct, analysis or interpretation of the data. However, clinical experts in health communication provided detailed feedback on the study protocol, including the focus group approach. The study findings contribute to a better understanding of patient expectations for lung cancer screening decisions and may inform future development of tools for SDM.
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Affiliation(s)
- Victoria L Tiase
- Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA
| | - Grace Richards
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA
| | - Teresa Taft
- Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA
| | - Leticia Stevens
- Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA
| | - Christian Balbin
- Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA
| | - Kimberly A Kaphingst
- Department of Communication and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| | - Angela Fagerlin
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Tanner Caverly
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Polina Kukhareva
- Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA
| | - Michael Flynn
- Departments of Internal Medicine and Pediatrics, Community Physicians Group, University of Utah Health, Salt Lake City, Utah, USA
| | - Jorie M Butler
- Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA
| | - Kensaku Kawamoto
- Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA
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Romanian young adult perceptions on using heated tobacco products following exposure to direct marketing methods. NPJ Prim Care Respir Med 2023; 33:8. [PMID: 36864067 PMCID: PMC9981255 DOI: 10.1038/s41533-023-00333-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/17/2023] [Indexed: 03/04/2023] Open
Abstract
Heated tobacco products have a rapid uptake, especially among young people, mostly where advertising is unregulated, as is the case in Romania. This qualitative study explores the influence of direct marketing methods of heated tobacco products on young people, their perception and behaviour towards smoking. We have carried out 19 interviews with smokers of heated tobacco products (HTPs) or/and combustible cigarettes (CCs) or non-smokers (NS), aged 18-26. Using the thematic analysis, we have identified three overarching themes: (1) people, places, and subjects of marketing, (2) engagement with risk narratives and (3) social body, family bonds, and autonomous self. Even if most of the participants have been exposed to a mix of marketing methods, they did not acknowledge the influence that marketing has on their decision to experience smoking. Young adults' decision to use heated tobacco products seems to be influenced by a cluster of reasons: overcoming the legislation gap which prohibits indoor use of combustible cigarettes but not heated tobacco products; the attractivity of the product (novelty, inviting appearance, technological appeal and price) and presumed less damaging effects on health.
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The development and validation of scales to measure the presence of a teachable moment following a cardiovascular disease event. Prev Med Rep 2022; 28:101876. [PMID: 35801000 PMCID: PMC9254119 DOI: 10.1016/j.pmedr.2022.101876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 06/07/2022] [Accepted: 06/24/2022] [Indexed: 11/22/2022] Open
Abstract
Investigating cardiac events as teachable moments is a promising venture. Validated measures to conduct research on teachable moments are lacking. We developed scales that demonstrate validity and reliability. The scales could be employed in research on teachable moments and behavior change. Clinicians could use the scales to foster conversation around lifestyle.
Better conceptually-driven research is necessary to learn more about 1) the characteristics of life events as teachable moments (TMs) and 2) the potential of life events to evoke lifestyle change intention (LCI). This study aimed to develop and validate two scales for the purposes of TM research in the context of cardiovascular disease (CVD): the CardiacTM and CardiacLCI-scales. After the initial development of items based on a theoretical framework and literature search, six experts rated the content validity of both scales as sufficient. The item list was further adjusted after think-aloud sessions with two CVD patients. The resulting scales were presented online in a cross-sectional survey, which yielded 625 responses of Dutch CVD patients (June 2020). To test construct validity, we conducted Exploratory Factor Analysis (EFA) with Varimax rotation on a random split-half of the sample (n = 300) and evaluated the factor structure with Confirmatory Factor Analysis (CFA) on the holdout sample (n = 325). EFA and CFA on the CardiacTM-scale (α = 0.88) revealed a 28-item six-factor structure explaining 61.0% of the variance, with adequate goodness-of-fit statistics (CFI = 0.87; TLI = 0.85; SRMR = 0.07) and internally reliable factors (Affective impact, Risk CVD, Changed self-concept, CVD group identity, Risk non-communicable disease, Anticipated regret). The CardiacLCI-scale (α = 0.81) revealed an 11-item two-factor structure explaining 51.5% of the variance, with adequate model fit (CFI = 0.92; TLI = 0.90; SRMR = 0.08) and internally reliable factors (Event-related lifestyle change and General healthy lifestyle). The scales may be used to expand knowledge around life events as TMs and to support conversation regarding lifestyle after cardiac and other life events.
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Fathizadeh S, Karimy M, Tavousi M, Zamani-Alavijeh F. Exploring the facilitators and barriers to high-risk behaviors among school transportation drivers: a qualitative study. BMC Public Health 2022; 22:1245. [PMID: 35739485 PMCID: PMC9229906 DOI: 10.1186/s12889-022-13630-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/14/2022] [Indexed: 12/03/2022] Open
Abstract
Background School transportation (ST) crashes are associated with serious adverse consequences, particularly for students in developing countries. High-risk behaviors (HRBs) of ST drivers are a major factor contributing to ST crashes. This study aimed at exploring the facilitators and barriers to HRBs among ST drivers. Methods This qualitative study was conducted in 2019–2020. Participants were ST drivers, students, parents, and school staff purposively selected from Tehran, Iran. Data were collected through in-depth semi-structured interviews and focus group discussions and were concurrently analyzed through conventional content analysis. Findings Participants were fifteen ST drivers with a mean age of 45 ± 10.2 years and 24 students, parents, and school staff with a mean age of 28.62 ± 16.08 years. The facilitators and barriers to HRBs came into five main categories, namely previous experiences of HRBs, perceived gains and risks of HRBs, motivating and inhibiting feelings and emotions, positive and negative subjective norms, and perceived mastery in driving. Conclusion A wide range of facilitators and barriers can affect HRBs among ST drivers. Strategies for preventing HRBs among ST drivers should be multidimensional and individualized and should focus on strengthening the barriers and removing the facilitators to HRBs.
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Affiliation(s)
- Shadi Fathizadeh
- Student Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahmood Karimy
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Mahmoud Tavousi
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Fereshteh Zamani-Alavijeh
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
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Edmonds KA, Rose JP. Exploring the impact of dimensional comparisons in health contexts. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2022. [DOI: 10.1111/spc3.12669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Jason P. Rose
- Department of Psychology University of Toledo Toledo OH USA
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Latif A, Murray RL, Waters C, Leonardi-Bee J. Understanding willingness to access and experiences of NHS Stop Smoking Services: a qualitative systematic review with meta-aggregation synthesis. Public Health 2021; 194:216-222. [PMID: 33962099 DOI: 10.1016/j.puhe.2021.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/04/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVES NHS Stop Smoking Services (NHS-SSS) have been available in the United Kingdom (UK) since 2000. The service has proven to be effective, however uptake remains below aspirations. Understanding people's willingness and reasons for accessing and engaging with NHS-SSS is, therefore, important. The aim of this systematic review is to summarise the findings from qualitative research to understand people's views, perceptions and willingness to access NHS-SSS. STUDY DESIGN Qualitative systematic review with meta-aggregation synthesis. METHODS Four electronic databases were searched for published qualitative studies, from Jan 2000 to Jan 2020. Following the screening, data extraction and quality assessment, data synthesis was conducted using meta-aggregation based on a patient-centred theoretical framework. We explored five 'demand-side' dimensions of service accessibility: the ability to perceive, seek, reach, pay and engage. Confidence in the synthesised findings relating to dependability and credibility was established using CONQual. RESULTS Seventeen studies were included in the review. Twelve categories emerged, contributing to five synthesised statements, all with a CONQual rating of moderate confidence. Access and willingness to use NHS-SSS were found to be related to an individual's readiness to perceive that smoking is a problem for which a solution should be sought, their ability to seek a perceived effective treatment, to conveniently reach NHS-SSS, their perceptions around associated costs and tailoring care to improve engagement with individuals. CONCLUSIONS By using a theoretical framework incorporating healthcare access, this study provides policymakers valuable insights into people's willingness to access these services. Willingness to access NHS-SSS is multifaceted, nuanced and complex. Strategies to promote NHS-SSS uptake should include making services more attractive, relevant and responsive to individual perceptions around smoking and health. Given the higher prevalence of smoking in less affluent socioeconomic groups and in some ethnic minority groups, the importance of having a comprehensive and inclusive tobacco control policy, one that is linguistically and culturally sensitive, cannot be overstated.
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Affiliation(s)
- Asam Latif
- UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
| | - Rachel L Murray
- UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
| | - Claire Waters
- Public Health Wales, Health Improvement Division, Cardiff, Wales, UK.
| | - Jo Leonardi-Bee
- UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
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Froggatt S, Reissland N, Covey J. Risk perception of cigarette and e-cigarette use during pregnancy: A qualitative postpartum perspective. Midwifery 2020; 94:102917. [PMID: 33387740 DOI: 10.1016/j.midw.2020.102917] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 11/26/2020] [Accepted: 12/17/2020] [Indexed: 11/30/2022]
Abstract
AIM The aim of this exploratory qualitative analysis is to assess the perceptions of risks of cigarette and e-cigarette use during pregnancy. BACKGROUND An important public health aim is a reduction of smoking at time of delivery (SATOD) from 10.6% to less than 6% by 2022 in the United Kingdom (UK). In order to successfully meet this target, we need to have a better understanding of the perceived risks associated with cigarette smoking. Additionally, the use of e-cigarettes is increasing in the general population, with pregnant women being supported to use such products if it helps them remain smoke free. However, in contrast to cigarette smoking, there is little definitive research assessing the safety of e-cigarette use during pregnancy, with most information disregarding the health of the growing fetus. E-cigarettes are of special interest, given they are an unlicensed product for use during pregnancy, yet women are being supported to use them as a method of harm reduction. A better understanding of perceived risks is essential. METHOD Fourteen interviews were conducted one month postpartum with women who smoked during pregnancy and continued to smoke after the birth. Thematic analysis was conducted. FINDINGS Two themes emerged for cigarette smoking; health and justifications. Six themes were identified for e-cigarette use; the unknown, experience, comparison to cigarettes, the product, advice and healthier option. A range of subthemes are discussed. CONCLUSION Women provided a range of justifications for continuing to smoke during pregnancy. Women felt e-cigarettes were a riskier option than continuing to smoke.
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Affiliation(s)
- Suzanne Froggatt
- Psychology Department, Durham University, Science Site, South Road, Durham DH1 3LE, England.
| | - Nadja Reissland
- Psychology Department, Durham University, Science Site, South Road, Durham DH1 3LE, England.
| | - Judith Covey
- Psychology Department, Durham University, Science Site, South Road, Durham DH1 3LE, England.
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Ozbas S, Onur R, Alkan MA. Behavior and attitudes towards smoking among teachers in Turkey. J Public Health (Oxf) 2019. [DOI: 10.1007/s10389-018-0961-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Alexander AC, Obong’o CO, Chavan PP, Dillon PJ, Kedia SK. Addicted to the ‘life of methamphetamine’: Perceived barriers to sustained methamphetamine recovery. DRUGS: EDUCATION, PREVENTION AND POLICY 2018. [DOI: 10.1080/09687637.2017.1282423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Adam C. Alexander
- School of Public Health, University of Memphis, Memphis, TN, USA and
| | | | - Prachi P. Chavan
- School of Public Health, University of Memphis, Memphis, TN, USA and
| | - Patrick J. Dillon
- School of Communication Studies, Kent State University, North Canton, OH, USA
| | - Satish K. Kedia
- School of Public Health, University of Memphis, Memphis, TN, USA and
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Nayak P, Pechacek TF, Slovic P, Eriksen MP. Regretting Ever Starting to Smoke: Results from a 2014 National Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E390. [PMID: 28383508 PMCID: PMC5409591 DOI: 10.3390/ijerph14040390] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 03/28/2017] [Accepted: 03/29/2017] [Indexed: 11/16/2022]
Abstract
Background: The majority of smokers regret ever starting to smoke, yet the vast majority continue to smoke despite the fact that smoking kills nearly 50% of lifetime users. This study examined the relationships between regret and smoker characteristics, quit history, risk perceptions, experiential thinking, and beliefs and intentions at time of smoking initiation. Methods: Data from the 2014 Tobacco Products and Risk Perceptions Survey, a nationally representative survey of United States adults, were analyzed to provide the latest prevalence estimates of regret and potential predictors. Relationships among predictor variables and regret were analyzed using correlations, t-tests, and multinomial logistic regression. Results: The majority of smokers (71.5%) regretted starting to smoke. Being older and non-Hispanic white were significant predictors of regret. Smokers having a high intention to quit, having made quit attempts in the past year, worrying about getting lung cancer, believing smoking every day can be risky for your health, perceiving a risk of being diagnosed with lung cancer during one's lifetime, and considering themselves addicted to cigarettes were significant predictors of regret for smoking initiation. Conclusions: This study provides updated prevalence data on regret using a national sample, and confirms that regret is associated with perceived risk. The findings from this study can be used to inform smoking intervention programs and support the inclusion of smoker regret in cost-benefit analyses of the economic impact of tobacco regulations.
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Affiliation(s)
- Pratibha Nayak
- Georgia State University's Tobacco Center of Regulatory Science, Atlanta, GA 30308, USA.
| | - Terry F Pechacek
- Georgia State University's Tobacco Center of Regulatory Science, Atlanta, GA 30308, USA.
- Division of Health Management & Policy, Georgia State University, Atlanta, GA 30303, USA.
| | - Paul Slovic
- Department of Psychology, University of Oregon, Eugene, OR 97403, USA.
| | - Michael P Eriksen
- Georgia State University's Tobacco Center of Regulatory Science, Atlanta, GA 30308, USA.
- Division of Health Management & Policy, Georgia State University, Atlanta, GA 30303, USA.
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