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Capaldi JM, Shabanian J, Finster LB, Asher A, Wertheimer JC, Zebrack BJ, Shirazipour CH. Post-traumatic stress symptoms, post-traumatic stress disorder, and post-traumatic growth among cancer survivors: a systematic scoping review of interventions. Health Psychol Rev 2024; 18:41-74. [PMID: 36632776 DOI: 10.1080/17437199.2022.2162947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/21/2022] [Indexed: 01/13/2023]
Abstract
The detrimental effects of Post-Traumatic Stress Symptoms (PTSS) and Post-Traumatic Stress Disorder (PTSD) and the benefits of Post-Traumatic Growth (PTG) are well established for cancer survivors. Increased cancer survival rates necessitate an understanding of how these two paradoxical outcomes, PTSS/PTSD and PTG, are targeted through interventions. This systematic scoping review aims to (a) examine existing evidence on interventions targeting PTSS/PTSD and/or PTG among cancer survivors and (b) identify knowledge gaps to inform future research. Following the six steps of a scoping review, 76 articles met the inclusion criteria. Quantitative articles were examined using descriptive analysis. Frequency counts of the collated data were tabulated into summary tables. Qualitative articles were reviewed using meta-synthesis. Most articles were quantitative (n = 52) and targeted PTG (n = 68) through promising intervention approaches such as psychotherapy, mindfulness, physical activity, and psilocybin-assisted therapy. Three key implications for future research and practice were synthesized: (1) mechanistic considerations for intervention design that provide a roadmap for rigorous and theoretically-grounded research; (2) the need for improved representation of cancer survivors in trials; and (3) potential facilitators of intervention efficacy. Together, these findings can direct future research to optimize interventions to reduce PTSS/PTSD and promote PTG achievement among cancer survivors.
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Affiliation(s)
- Jessica M Capaldi
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Julia Shabanian
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Laurel B Finster
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Arash Asher
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | - Celina H Shirazipour
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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Shabanian J, Capaldi JM, Luna-Lupercio B, Finster LJ, Noskoff K, Gan H, Davies S, Whiteway SL, Shirazipour CH. Healthcare providers' promotion of physical activity among child and adolescent cancer survivors: strategies and challenges. J Cancer Surviv 2023; 17:1546-1560. [PMID: 35759086 PMCID: PMC9244136 DOI: 10.1007/s11764-022-01218-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/19/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE This study aims to investigate how healthcare providers (HCPs) promote physical activity (PA) to child and adolescent cancer survivors. METHODS Semi-structured interviews were conducted with HCPs (n = 16; women n = 12; men n = 4) who provide care for cancer survivor youth (age 3 to 18). Participants represented 7 professions, including child life specialists, oncologists, nurse practitioners, physical therapists, and social workers. A reflexive thematic analysis was conducted to explore the techniques that HCPs use to promote PA for this patient population and ways PA promotion can improve. RESULTS HCPs use five strategies to promote PA to cancer survivor youth: (1) broadening the definition of PA, (2) tailoring PA recommendations, (3) including families, (4) connecting patients to programming, and (5) promoting patient motivation. CONCLUSIONS This research highlights techniques that HCPs use to promote PA to young cancer survivors and reveals the need for additional ways to support HCPs to improve PA promotion for child and adolescent cancer survivors. While HCPs emphasized the importance of PA for this patient population, they navigate barriers that limit the quality of PA discussions. IMPLICATIONS FOR CANCER SURVIVORS Further research should explore interventions to improve PA promotion and PA participation among child and adolescent cancer survivors. By understanding the perspectives of HCPs, patients, and their families, PA promotion strategies can be improved, and more programs that support both patients and practitioners may be developed.
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Affiliation(s)
- Julia Shabanian
- Cedars-Sinai Medical Center, Cancer Research Center for Health Equity, 700 N San Vicente Blvd, 5th Floor, West Hollywood, CA, 90069, USA
| | - Jessica M Capaldi
- Cedars-Sinai Medical Center, Cancer Research Center for Health Equity, 700 N San Vicente Blvd, 5th Floor, West Hollywood, CA, 90069, USA
| | - Bianca Luna-Lupercio
- Cedars-Sinai Medical Center, Cancer Research Center for Health Equity, 700 N San Vicente Blvd, 5th Floor, West Hollywood, CA, 90069, USA
| | - Laurel J Finster
- Cedars-Sinai Medical Center, Cancer Research Center for Health Equity, 700 N San Vicente Blvd, 5th Floor, West Hollywood, CA, 90069, USA
| | | | - Hilary Gan
- Teen Cancer America, Los Angeles, CA, USA
| | | | - Susan L Whiteway
- Walter Reed National Military Medical Center, Bethesda, MD, USA
- Uniformed Services University Health Sciences, Bethesda, MD, USA
| | - Celina H Shirazipour
- Cedars-Sinai Medical Center, Cancer Research Center for Health Equity, 700 N San Vicente Blvd, 5th Floor, West Hollywood, CA, 90069, USA.
- Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
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Gresham G, Raines C, Asher A, Freedland SJ, Shirazipour CH, Sleight AG. Can high-intensity interval training impact tumor suppression and inflammatory response in prostate cancer survivors? Prostate Cancer Prostatic Dis 2023; 26:643-645. [PMID: 37002380 DOI: 10.1038/s41391-023-00661-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/15/2023] [Accepted: 03/10/2023] [Indexed: 04/07/2023]
Affiliation(s)
- Gillian Gresham
- Cedars-Sinai Cancer, Cedars-Sinai Health System, Los Angeles, CA, USA.
| | - Carolina Raines
- Cedars-Sinai Cancer, Cedars-Sinai Health System, Los Angeles, CA, USA
| | - Arash Asher
- Cedars-Sinai Cancer, Cedars-Sinai Health System, Los Angeles, CA, USA
| | | | | | - Alix G Sleight
- Cedars-Sinai Cancer, Cedars-Sinai Health System, Los Angeles, CA, USA
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Duong A, Roberts L, Cramm H, Evans MB, Mayhew E, Latimer-Cheung AE, Aiken A, Shirazipour CH. I AM FAMILY: Understanding the adapted sport experiences of family members of military personnel with physical and psychological illnesses and injuries through the lens of the Invictus Games. Psychol Sport Exerc 2023; 68:102457. [PMID: 37665901 DOI: 10.1016/j.psychsport.2023.102457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 09/06/2023]
Abstract
Family are influential actors in adapted sport participation. However, little is known about their experiences with adapted sport. The current study sought to explore the experiences of families in adapted sport through the context of the Invictus Games, an international adapted sport competition for military personnel with physical and psychological illnesses and injuries that is unique in its inclusion of family programming. Family members (n = 21; partners, parents, siblings, and children) of Invictus Games Toronto 2017 competitors participated in semi-structured interviews. Data were analyzed using reflexive thematic analysis. Three themes were identified: recognition of family experiences during service and after onset of disability; creating a sense of belonging; and improving family knowledge and perceptions. This study provides insight regarding how adapted sport events can support the well-being of both individuals with illnesses and injuries and their families.
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Affiliation(s)
- Amber Duong
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA; School of Medicine, University of California Irvine, Irvine, USA
| | - Lauren Roberts
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Heidi Cramm
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - M Blair Evans
- Department of Psychology, Western University, London, Canada
| | - Emily Mayhew
- Department of Bioengineering, Imperial College London, London, UK
| | | | - Alice Aiken
- School of Physiotherapy, Dalhousie University, Halifax, Canada
| | - Celina H Shirazipour
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA.
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Shirazipour CH, Stone RC, Lithopoulos A, Capaldi JM, Latimer-Cheung AE. Examining the Impact of the Rio 2016 Paralympic Games on Explicit Perceptions of Paralympians and Individuals with Disabilities. Health Commun 2023; 38:1501-1507. [PMID: 34984933 DOI: 10.1080/10410236.2021.2017107] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
One of the goals of the Paralympic Games is to improve social attitudes toward individuals with physical disabilities (PD) through exposure to parasport and Paralympic mass media messaging. This study assessed whether this goal is achieved by examining changes in explicit perceptions toward Paralympians and individuals with PD over the course of the Rio 2016 Paralympics. Adults without PD (n = 119) were randomized into two groups: (1) an exposure group that was e-mailed local Paralympic Games coverage information before each day of the Games; and (2) a control group that received no e-mails about coverage. All participants completed measures assessing explicit perceptions (i.e., warmth and competence) of Paralympians and individuals with PD two weeks before, two weeks after, and three months following the Games. Exposure to Paralympic media was also assessed. No differences were present between groups for time spent watching the Games, explicit perceptions, or demographics (ps > .05). Thus, data was collapsed across groups for the main analyses. Repeated measure ANOVAs with Bonferroni adjustments indicated that explicit perceptions of warmth decreased over time for both Paralympians and individuals with PD (p ≤ .005). However, Paralympians were rated as significantly more competent and warmer than individuals with PD (ps < .001) at each timepoint. Findings suggest that public exposure to the Paralympics may have more value for Paralympians than the larger disability community. Further research should explore how to disseminate communication regarding the Paralympics to improve social attitudes and optimize integration of all people with disabilities in society.
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Affiliation(s)
- Celina H Shirazipour
- Department of Medicine, Cedars-Sinai Medical Center
- Department of Medicine, University of California Los Angeles
| | - Rachael C Stone
- School of Kinesiology and Health Studies, Queen's University
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Shirazipour CH, Raines C, Liu E, Ruggieri RM, Capaldi JM, Luna-Lupercio B, Diniz MA, Gresham G, Bhowmick N, Haile RW, Asher A. Benefits of nature-based walking for breast cancer survivors. BMJ Open 2023; 13:e071041. [PMID: 37328178 PMCID: PMC10277127 DOI: 10.1136/bmjopen-2022-071041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 05/31/2023] [Indexed: 06/18/2023] Open
Abstract
INTRODUCTION Physical activity (PA) promotes significant physical and psychosocial benefits for breast cancer survivors. While evidence exists regarding recommendations for the frequency, duration and intensity of exercise that optimise PA benefits for cancer survivors, the role of the environment in achieving optimal outcomes has yet to be determined. This paper presents a protocol for a clinical trial to evaluate the feasibility of a 3-month nature-based walking programme for breast cancer survivors. Secondary outcomes assessed include the impact of the intervention on fitness, quality of life outcomes, and biomarkers of ageing and inflammation. METHODS AND ANALYSIS The trial is a 12-week single-arm pilot study. Twenty female breast cancer survivors will engage in a supervised moderate intensity walking intervention in small groups in a nature reserve for 50 minutes three times per week. Data will be collected at baseline and end of study, and include assessment of inflammatory cytokines and anti-inflammatory myokines (TNF-α, IL-1ß, IL-6, CRP, TGF-ß, IL-10, IL-13), as well as ageing (DNA methylation, ageing genes) biomarkers; surveys (Patient-Reported Outcomes Measurement Information System-29, Functional Assessment of Cancer Therapy-General, Post-Traumatic Growth Inventory); and fitness assessments (6 min Walk Test, Grip-Strength, One Repetition-Maximum Leg Press). Participants will also complete weekly surveys assessing social support and participate in an exit interview. This is an important first step for future research on the influence of exercise environment on cancer survivor PA outcomes. ETHICS AND DISSEMINATION This study was approved by the Cedars Sinai Medical Center Institutional Review Board (IIT2020-20). Findings will be disseminated through academic manuscripts, conferences, and community presentations. TRIAL REGISTRATION NUMBER NCT04896580.
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Affiliation(s)
- Celina H Shirazipour
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Carolina Raines
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Eileen Liu
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Rachel M Ruggieri
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jessica M Capaldi
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Bianca Luna-Lupercio
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Marcio A Diniz
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Gillian Gresham
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Neil Bhowmick
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Robert W Haile
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Arash Asher
- Department of Physical Medicine and Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Shirazipour CH, Ruggieri-Bacani RM, Lockshon L, Waring C, Jarman A, Cruz N, Bresee C, Fong AJ, Lin PH, Gresham G, Asher A, Freedland SJ. The Streaming Web-Based Exercise at Home Study for Breast and Prostate Cancer Survivors: A Feasibility Study Protocol. Methods Protoc 2023; 6:mps6030051. [PMID: 37218911 DOI: 10.3390/mps6030051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Despite the known benefits of physical activity in cancer survivors, adherence to exercise guidelines remains low. Known barriers to adhering to guidelines include a lack of time and an unwillingness to return to treatment facilities. Virtual exercise programming could assist in mitigating these barriers. This protocol presents a single arm pilot study exploring the feasibility of personalized Zoom-delivered exercise training for breast and prostate cancer survivors. A secondary objective is to determine the preliminary efficacy of participation on body composition, estimated VO2max, hand grip, one repetition maximum leg press, resting heart rate, resting blood pressure, exercise self-efficacy, and intentions to remain active. METHODS Breast (n = 10) and prostate (n = 10) cancer survivors will participate in a 24-week feasibility study, including (1) 12 weeks of one-on-one virtual personal training with an exercise physiologist (EP) via Zoom, and (2) individual exercise for a 12-week follow-up period using recordings of Zoom sessions for guidance. Physical assessments and surveys will be implemented at baseline, 12 weeks, and at the end of the study (24 weeks from baseline). CONCLUSIONS While virtual exercise programming became popularized during the pandemic, evidence is still required to understand whether it can successfully address barriers and promote participation.
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Affiliation(s)
- Celina H Shirazipour
- Cedars-Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
| | | | - Laura Lockshon
- Cedars-Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Christopher Waring
- Cedars-Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Aubrey Jarman
- Cedars-Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Novalyn Cruz
- Cedars-Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Catherine Bresee
- Cedars-Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Angela J Fong
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA
| | - Pao-Hwa Lin
- Department of Medicine, Duke University, Durham, NC 27708, USA
| | - Gillian Gresham
- Cedars-Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Arash Asher
- Cedars-Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Stephen J Freedland
- Cedars-Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Urology Section, Durham VA Medical Center, Durham, NC 27705, USA
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Asher A, Shirazipour CH, Capaldi JM, Kim S, Diniz M, Jones B, Wertheimer J. A 6-Week Program to Strengthen Resiliency Among Women With Metastatic Cancer: A Randomized Clinical Trial. Oncologist 2023:7146116. [PMID: 37104871 PMCID: PMC10400157 DOI: 10.1093/oncolo/oyad091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/14/2023] [Indexed: 04/29/2023] Open
Abstract
PURPOSE The objective of this study was to evaluate the effect of an intervention (Growing Resilience And CouragE; GRACE) on spiritual well-being, quality of life, and general well-being in women with metastatic cancers reporting existential or spiritual distress. PATIENTS AND METHODS Prospective, randomized, wait-list control clinical trial. Women with metastatic cancer experiencing existential or spiritual concerns were randomized to GRACE or waitlist control. Survey data were collected at baseline, end of program, and 1-month follow-up. Participants included English-speaking women, 18 or older, with metastatic cancer, existential or spiritual concerns, and reasonable medical stability. Eighty-one women were assessed for eligibility; 10 were excluded (not meeting exclusion criteria, refusal to participate, and death). The primary outcome was spiritual well-being measured pre- and post-program. Secondary measures assessed quality of life, anxiety, depression, hopelessness, and loneliness. RESULTS Seventy-one women (aged 47-72) were enrolled (GRACE n = 37, waitlist control n = 34). GRACE participants demonstrated significant improvements in spiritual well-being compared to control at end of program (parameter estimate (PE), 16.67, 95% CI, 13.17, 20.16) and 1-month follow-up (PE, 10.31, 95% CI, 6.73, 13.89). Additionally, significant improvements were demonstrated in quality of life at the end of program (PE, 8.51, 95% CI, 4.26, 12.76) and 1-month follow-up (PE, 6.17, 95% CI, 1.75, 10.58). GRACE participants also demonstrated improved depression and hopelessness at follow-up, as well as improved anxiety. CONCLUSIONS Findings suggest the value of evidence-based psychoeducational and experiential interventions for improving the well-being and quality of life of women with advanced cancer. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02707510.
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Affiliation(s)
- Arash Asher
- Department of Medicine and Physical Medicine and Rehabilitation and Patient and Family Support Program at Cedars-Sinai Cancer, Los Angeles, CA, USA
| | - Celina H Shirazipour
- Division of Population Sciences, Cedars-Sinai Cancer, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Jessica M Capaldi
- Division of Population Sciences, Cedars-Sinai Cancer, Los Angeles, CA, USA
| | - Sungjin Kim
- Biostatistics Research Center, Samuel Oschin Comprehensive Cancer Center and Departments of Medicine and Biomedical Sciences, Los Angeles, CA, USA
| | - Marcio Diniz
- Biostatistics Research Center, Samuel Oschin Comprehensive Cancer Center and Departments of Medicine and Biomedical Sciences, Los Angeles, CA, USA
| | - Bronwen Jones
- Department of Spiritual Care, Cedars-Sinai Cancer, Los Angeles, CA, USA
| | - Jeffrey Wertheimer
- Department of Physical Medicine and Rehabilitation at Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Luna-Lupercio B, Foley A, Caceres NA, Herrera E, Wiens-Cook G, Calsavara V, Surani Z, Salvy SJ, Haile R, Shirazipour CH. Abstract 1979: Examining stereotype perceptions of colorectal cancer in the Latino community. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-1979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Purpose: Colorectal cancer (CRC) screening is significantly lower in the Hispanic community compared to non-Hispanic whites. Qualitative research has suggested that cultural attitudes towards cancer may be a potential barrier to screening. The purpose of the study was to quantitatively examine explicit stereotypes about CRC and CRC screening within the Hispanic community using the stereotype content model.
Methods: A one-time online cross-sectional survey was administered to individuals self-identifying as Hispanic living across the United States. Based on participant preference, the survey was completed in English or Spanish. In counterbalanced order, participants were asked to read brief paragraphs about a control target, a target with CRC, and a target undergoing colonoscopy CRC screening. The target was a Hispanic individual assigned a gender-neutral name. Other than the one sentence with CRC-related information in the CRC and CRC screening paragraphs, all the paragraphs were identical describing the individual, their family, and their hobbies. After each paragraph, participants were asked to rate the target on validated surveys assessing warmth and competence, two indicators of explicit stereotypes. Data was analyzed using linear mixed-effects models, which were fitted to evaluate the effect of each target on warmth and competence, controlling for age, gender, race, Hispanic heritage, cancer exposure, and randomization.
Results: The target condition was not statistically significantly associated with the Warmth and Competence outcomes when the models were fitted considering only the main effects. However, in the presence of interactions the condition was associated with the outcomes. Specifically, the analysis yielded a significant fixed effect for the interaction between target condition and participant age, such that younger participants had greater perceptions of warmth [F(2, 511.93)=7.045, p=0.001] and competence [F(2, 522.73)=11.129, p<0.001] towards the target undergoing cancer screening. The analysis also yielded a further significant effect for the interaction between target condition and Hispanic heritage with differences in perceptions of warmth between those born in the USA and participants born in Central and South America or in Europe [(F(2, 520.16)=2.299, p=0.02)].
Conclusion: Findings highlight the importance of understanding the heterogeneity within the Hispanic community when seeking to address stigma towards CRC. First, there are differences in explicit perceptions based on generation, suggesting the need for age-appropriate cancer prevention initiatives. Second, the findings demonstrate the need to account for diverse cultural perspectives of cancer screening based on country of origin. Thus, this research supports the importance of respecting the diversity within the Hispanic community and tailoring cancer prevention interventions accordingly.
Citation Format: Bianca Luna-Lupercio, Aidan Foley, Nenette A. Caceres, Ergueen Herrera, Galen Wiens-Cook, Vinicius Calsavara, Zul Surani, Sarah-Jeanne Salvy, Robert Haile, Celina H. Shirazipour. Examining stereotype perceptions of colorectal cancer in the Latino community [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1979.
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Affiliation(s)
| | - Aidan Foley
- 1Cedars-Sinai Medical Center, Los Angeles, CA
| | | | | | | | | | - Zul Surani
- 1Cedars-Sinai Medical Center, Los Angeles, CA
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Shirazipour CH, Raines C, Diniz MA, Salvy SJ, Haile RW, Freedland SJ, Asher A, Tomasone JR, Gresham G. The 24-Hour Movement Paradigm: An integrated approach to the measurement and promotion of daily activity in cancer clinical trials. Contemp Clin Trials Commun 2023; 32:101081. [PMID: 36875555 PMCID: PMC9974421 DOI: 10.1016/j.conctc.2023.101081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/11/2023] [Accepted: 01/28/2023] [Indexed: 02/02/2023] Open
Abstract
Increased physical activity (PA), improved sleep, and decreased sedentary behavior (SB) are essential components of supportive care for cancer survivors. However, researchers and health care professionals have achieved limited success in improving these behaviors among cancer survivors. One potential reasoning is that, over the past two decades, guidelines for promoting and measuring PA, sleep, and SB have been largely siloed. With greater understanding of these three behaviors, health behavior researchers have recently developed a new paradigm: the 24-Hour movement approach. This approach considers PA, SB, and sleep as movement behaviors along a continuum that represent low through vigorous intensity activity. Together these three behaviors form the sum of an individual's movement across a 24-hour day. While this paradigm has been studied in the general population, its usage is still limited in cancer populations. Here, we seek to highlight (a) the potential benefits of this new paradigm for clinical trial design in oncology; (b) how this approach can allow for greater integration of wearable technology as a means of assessing and monitoring patient health outside the clinical setting, improving patient autonomy through self-monitoring of movement behavior. Ultimately, implementation of the 24-Hour movement paradigm will allow health behavior research in oncology to better promote and assess critical health behaviors to support the long-term well-being for cancer patients and survivors.
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Affiliation(s)
- Celina H. Shirazipour
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
- University of California Los Angeles, Los Angeles, CA, USA
| | | | | | - Sarah-Jeanne Salvy
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
- University of Southern California, Los Angeles, CA, USA
| | | | | | - Arash Asher
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Corey JJ, Shirazipour CH, Fricke M, Evans B. Physiotherapists' role in physical activity promotion: Qualitative reflections of patients and providers. Physiother Theory Pract 2023; 39:814-826. [PMID: 35129059 DOI: 10.1080/09593985.2022.2031361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/11/2021] [Accepted: 12/22/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Physiotherapists are often important figures in the lives of people with physical disabilities and chronic conditions, yet gaps in understanding remain regarding how therapists promote physical activity and leverage existing community-based recreation programs. PURPOSE We used qualitative methods to explore experiences of physiotherapists as well as individuals with disabilities and chronic conditions receiving physiotherapy, with a focus on strategies to promote physical activity and the extent that therapists leverage community-based resources and programs. METHODS Semi-structured interviews were completed with nine physiotherapists (six American and three Canadian) and eight individuals with a physical disability (all Americans). RESULTS Participants reflected on the salience of physical activity promotion throughout physiotherapy but also highlighted barriers. Three themes explored idealized and problematic experiences with physical activity promotion in therapy: 1) individualized promotion of physical activity; 2) increasing physical activity options for patients via engagement with the community; and 3) options for physical activity in the community. Differences were also noted between therapist and patient participants and when contrasting across countries (i.e. funding models). For instance, physiotherapists in publicly funded contexts relied more heavily on engagement with accessible community-based programming than privately funded counterparts. CONCLUSION Therapists should further integrate patient perspectives when considering physical activity promotion. Additional research is needed to explore how therapists incorporate community-based programs into health promotion while further understanding the extent that these strategies align with the scope of physiotherapy practice in varying contexts.
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Affiliation(s)
- Jacob J Corey
- Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | - Celina H Shirazipour
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Moni Fricke
- Department of Physical Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Blair Evans
- Department of Psychology, Faculty of Social Science, Western University, London, ON, Canada
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12
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Cáceres NA, Shirazipour CH, Herrera E, Figueiredo JC, Salvy SJ. Exploring Latino Promotores/a de Salud (Community Health Workers) knowledge, attitudes, and perceptions of COVID-19 vaccines. SSM Qual Res Health 2022; 2:100033. [PMID: 34904136 PMCID: PMC8654703 DOI: 10.1016/j.ssmqr.2021.100033] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/04/2021] [Accepted: 12/07/2021] [Indexed: 01/12/2023]
Abstract
Promotoras/promotores (i.e., community health workers) are uniquely positioned to provide much needed COVID-19 education and outreach in Latino communities, particularly in areas with disparities in vaccination rates. This study used qualitative methods to explore promotoras perspectives on COVID-19 vaccines, with a focus on understanding how vaccine knowledge and viewpoints among Latino communities can formulate recommendations to improve uptake of vaccination. Promotoras (N=22) were recruited to participate in semi-structured focus groups conducted virtually. Reflexive thematic analysis identified three overarching themes: (1) prevalence of misinformation (related to lack of trustworthy information, mistrust in the government, immigration status concerns, and conspiracy theories); (2) hesitancy (related to health concerns and eligibility confusion); and (3) recommendations for improving vaccine uptake. Delays in vaccination were not strictly due to doubts or fears but were also related to access barriers. The themes provide insight into the Latino communities' perceptions of COVID-19 vaccines and reasons why some remain unvaccinated. Promotoras' perspectives are integral to the development of strategies and approaches to address COVID-19 vaccine hesitancy, uptake, and implementation among underserved communities.
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Affiliation(s)
- Nenette A. Cáceres
- Corresponding author. 700 N. San Vicente Blvd, Suite G-599, West Hollywood, CA 90069, USA
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13
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Finster LJ, Shirazipour CH, Escobedo LA, Cockburn M, Surani Z, Haile RW. Addressing Health Disparities Across the Cancer Continuum—a Los Angeles Approach to Achieving Equity. Front Oncol 2022; 12:912832. [PMID: 35865462 PMCID: PMC9295745 DOI: 10.3389/fonc.2022.912832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/07/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Different models have been developed to address inequities across the cancer care continuum. However, there remains a scarcity of best practices on understanding and responding to the burden of cancer in a defined catchment area.As such, the National Cancer Institute (NCI) recently provided a framework to maximize the impact on cancer burden, including a greater focus on community outreach and engagement. In this paper, we describe how Cedars Sinai Cancer (CSC), a health system that serves one of the most diverse counties in the US, implemented the framework to define its catchment area, characterize its population, identify high risk priority groups, and make decisions to address health disparities. Methods We provide a review of the methods used to assess socio-ecological levels of influence. Data were reviewed from numerous national, statewide, and county sources and supplemented by locally administered questionnaires, heat maps, and community profile summaries to gain more localized snapshots of cancer disparities in Los Angeles County. Lastly, feedback was solicited from external peer groups, community stakeholders, and key decision-makers, and the proposed catchment area was aligned with the State’s Cancer Plan and the NCI Catchment Area and Community Outreach and Engagement Mandate. Results The selected CSC catchment area meets NCI criteria and has potential to demonstrate impact both at the population level and within specialty populations. As a result, strategies are being developed to organize community outreach and engagement, as well as research across basic, clinical, and population sciences to guide cancer control and prevention efforts. Discussion To maintain a high level of cultural inclusion and sensitivity, multiple layers of data are needed to understand localized pictures of cancer disparities and underlying causes. Community engagement remains essential to implementing policy, best practice, and translational science for broader impact. Impact The clinical and translation work conducted at any cancer center requires an understanding of the determinants of health that contribute to the differences in cancer incidence and mortality among different groups. The NCI-aligned approach that we highlight is critical to support the design of future cancer control strategies that address and possibly reduce local health inequities.
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Affiliation(s)
- Laurel J. Finster
- Cancer Research Center for Health Equity, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- *Correspondence: Laurel J. Finster,
| | - Celina H. Shirazipour
- Cancer Research Center for Health Equity, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Loraine A. Escobedo
- Cancer Research Center for Health Equity, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Myles Cockburn
- Norris Comprehensive Cancer Center, University of Southern California, Keck School of Medicine, Los Angeles, CA, United States
| | - Zul Surani
- Cancer Research Center for Health Equity, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Robert W. Haile
- Cancer Research Center for Health Equity, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
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14
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Miller S, Shirazipour CH, Holmes AF, Salvy SJ, de la Haye K. Diet and Physical Activity Behaviors of Families Receiving Maternal and Child Health Services: The Perspective of the Home Visitor. J Healthy Eat Act Living 2022; 2:9-22. [PMID: 35928431 PMCID: PMC9348138 DOI: 10.51250/jheal.v2i1.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Women and children enrolled in federally funded home visitation services are at an increased risk for unhealthy diet and physical activity patterns. Home visitors have a privileged relationship with their clients and hold a unique perspective of the multilevel influences surrounding these behaviors. This study explored the question: "What are home visitors' perspectives and experiences with their families' diet and physical activity behaviors?" Home visitors enrolled in a larger trial were invited to participate in focus group sessions (n=13). Topics covered their clients' constraints and capacity building opportunities for healthful diet and activity practices. Reflexive thematic analysis was used to analyze the data. The home visitors discussed key influences on diet and activity, and three overarching themes were identified: (a) acute periods of crises and mental health issues; (b) the role of the mother within the family; and (c) support and barriers within mothers' broader social network. The themes identified in this study highlight the complex, multidimensional influences on the dietary and physical activity patterns of these families, and pinpoint key areas of opportunity for intervention.
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Affiliation(s)
- Sydney Miller
- Department of Population and Public Health Sciences, University of Southern California,
U.S.A
| | - Celina H. Shirazipour
- Research Center for Health Equity, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA,
U.S.A
- Department of Medicine, University of California Los Angeles,
U.S.A
| | - Aimee Fata Holmes
- Research Center for Health Equity, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA,
U.S.A
| | - Sarah-Jeanne Salvy
- Research Center for Health Equity, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA,
U.S.A
| | - Kayla de la Haye
- Department of Population and Public Health Sciences, University of Southern California,
U.S.A
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15
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Figueiredo JC, Ihenacho U, Merin NM, Hamid O, Darrah J, Gong J, Paquette R, Mita AC, Vescio R, Mehmi I, Basho R, Salvy SJ, Shirazipour CH, Caceres N, Finster LJ, Coleman B, Arnow HU, Florindez L, Sobhani K, Prostko JC, Frias EC, Stewart JL, Merchant A, Reckamp KL. SARS-CoV-2 vaccine uptake, perspectives, and adverse reactions following vaccination in patients with cancer undergoing treatment. Ann Oncol 2022; 33:109-111. [PMID: 34687893 PMCID: PMC8527840 DOI: 10.1016/j.annonc.2021.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/02/2021] [Accepted: 10/13/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- J C Figueiredo
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA.
| | - U Ihenacho
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA; Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - N M Merin
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - O Hamid
- The Angeles Clinic and Research Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - J Darrah
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - J Gong
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - R Paquette
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - A C Mita
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - R Vescio
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - I Mehmi
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - R Basho
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - S J Salvy
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - C H Shirazipour
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA; Department of Medicine, University of California Los Angeles, Los Angeles, USA
| | - N Caceres
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - L J Finster
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - B Coleman
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, USA
| | - H U Arnow
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, USA
| | - L Florindez
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, USA
| | - K Sobhani
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | | | - E C Frias
- Abbott Diagnostics, Abbott Park, USA
| | | | - A Merchant
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - K L Reckamp
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA.
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16
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Myers JS, Shirazipour CH, Wertheimer JC, Asher A. Feasibility Pilot Study of a Virtual Intervention for Survivors With Decreased Perceived Cognitive Function After Cancer Treatment. Oncol Nurs Forum 2022; 49:90-95. [PMID: 34914683 DOI: 10.1188/22.onf.90-95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Many cancer survivors report issues with cognitive function following diagnosis and treatment. The purpose of this single-arm pilot study was to test the feasibility and acceptability of virtual delivery of a cognitive rehabilitation intervention for participants in virtual groups. SAMPLE & SETTING 37 adult cancer survivors reporting impaired cognitive function following primary treatment were enrolled from Cedars-Sinai Medical Center and affiliates, the University of Kansas Cancer Center, and the Masonic Cancer Alliance. METHODS & VARIABLES Two cohorts attended six weekly virtual sessions and completed pre- and postintervention patient-reported outcome questionnaires designed to measure perceived cognitive function, loneliness, and determinants of behavior change for exercise, sleep, and mindfulness. RESULTS Postintervention scores for perceived cognitive function, determinants of behavior change, and loneliness ratings significantly improved. IMPLICATIONS FOR NURSING Evidence continues to build in support of cognitive rehabilitation interventions for cancer survivors. Nurses play an important role in terms of patient identification, participation, and facilitation.
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17
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Martin Ginis KA, van der Ploeg HP, Foster C, Lai B, McBride CB, Ng K, Pratt M, Shirazipour CH, Smith B, Vásquez PM, Heath GW. Participation of people living with disabilities in physical activity: a global perspective. Lancet 2021; 398:443-455. [PMID: 34302764 DOI: 10.1016/s0140-6736(21)01164-8] [Citation(s) in RCA: 127] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/13/2021] [Accepted: 05/07/2021] [Indexed: 12/14/2022]
Abstract
Approximately 1·5 billion people worldwide live with a physical, mental, sensory, or intellectual disability, about 80% of which are in low-income and middle-income countries. This Series paper provides a global overview of the prevalence, benefits, and promotion policies for physical activity for people living with disabilities (PLWD). PLWD are 16-62% less likely to meet physical activity guidelines and are at higher risk of serious health problems related to inactivity than people without disabilities. Meta-analyses have shown that physical activity has beneficial effects on cardiovascular fitness (average standardised mean difference [SMD] 0·69 [95% CI 0·31-1·01]), musculoskeletal fitness (0·59 [0·31-0·87]), cardiometabolic risk factors (0·39 [0·04-0·75]), and brain and mental health outcomes (0·47 [0·21-0·73]). These meta-analyses also show that health benefits can be achieved even with less than 150 min of physical activity per week, and suggest that some physical activity is better than none. Meta-analyses of interventions to increase physical activity for PLWD have reported effect sizes ranging from SMD 0·29 (95% CI 0·17-0·41, k=10) to 1·00 (0·46-1·53, k=10). There is increasing awareness among policy makers of the needs of PLWD for full participation in physical activity. Physical activity action plans worldwide must be adequately resourced, monitored, and enforced to truly advance the fundamental rights of PLWD to fully participate in physical activity.
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Affiliation(s)
- Kathleen A Martin Ginis
- Department of Medicine and Centre for Chronic Disease Prevention and Management and International Collaboration on Repair Discoveries, Faculty of Medicine, School of Health and Exercise Sciences, Faculty of Health and Social Development, and Reichwald Health Sciences Centre, University of British Columbia, Kelowna, BC, Canada.
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC Vrije Universiteit Amsterdam, Amsterdam, Netherlands; Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Byron Lai
- Division of Pediatric Rehabilitation Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Kwok Ng
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland; Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Michael Pratt
- Institute for Public Health and Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA
| | - Celina H Shirazipour
- Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Brett Smith
- School of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Priscilla M Vásquez
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, USA
| | - Gregory W Heath
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, USA
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18
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Brown DMY, Ross T, Leo J, Buliung RN, Shirazipour CH, Latimer-Cheung AE, Arbour-Nicitopoulos KP. A Scoping Review of Evidence-Informed Recommendations for Designing Inclusive Playgrounds. Front Rehabilit Sci 2021; 2:664595. [PMID: 36188796 PMCID: PMC9397725 DOI: 10.3389/fresc.2021.664595] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 03/05/2021] [Indexed: 11/13/2022]
Abstract
Background: Playgrounds provide children with many sensory, motor, and socioemotional experiences that are critical to child development. Unfortunately, playgrounds also represent an environment where children with disabilities experience barriers to accessing play. Structures and materials that are prominently found in almost all playground designs (e.g., swings, slides, sand) can present as obstacles for many children with disabilities to engage in independent play.Aims: This scoping review engaged in the empirical literature to address the research question, “What are the evidence-informed recommendations for designing inclusive playgrounds to enable participation for children with disabilities?” Consideration was given not only to the physical design of playgrounds, but also the playgrounds' surrounding built and social environments.Methods: A systematic search of Medline, PsycINFO, CINAHL, EMBase, ERIC and Scopus was conducted. Only peer-reviewed literature published in English between January 1990 and January 2021, with a primary focus on inclusive playground structure design related to any type of disability were included. Data extraction included the study author(s), year of publication, country of origin, purpose, disability types considered, methods, sample characteristics and key findings. Key findings were synthesized into evidence-informed recommendations, which were later collated, using inductive content analysis, into five broader thematically congruent groups.Results: Thirty-five studies were included using case study (n = 17); observational (n = 6); survey (n = 5); experimental (n = 4); and multiple study (n = 3) designs. Thirteen evidence-based recommendations and one promising practice were categorized into five broad playground elements: entry points; surfacing and paths; features to foster inclusive play; staffing/supervision; and design process.Conclusion: These recommendations build upon previous design-based best-practices that focused exclusively on the physical design of the playground. Our recommendations have implications for how future playgrounds should be designed to maximize usability and inclusiveness and the overall playground experiences for children with disabilities.
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Affiliation(s)
- Denver M. Y. Brown
- Faculty of Kinesiology and Physical Education, Mental Health and Physical Activity Research Centre, University of Toronto, Toronto, ON, Canada
| | - Timothy Ross
- Department of Geography and Planning, University of Toronto, Toronto, ON, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Jennifer Leo
- The Steadward Centre for Personal and Physical Achievement, University of Alberta, Faculty of Kinesiology, Sport, and Recreation, Edmonton, AB, Canada
| | - Ron N. Buliung
- Department of Geography, Geomatics and Environment, University of Toronto Mississauga, Mississauga, ON, Canada
| | - Celina H. Shirazipour
- Cancer Research Center for Health Equity, Cedar-Sinai Medical Center, Los Angeles, CA, United States
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | | | - Kelly P. Arbour-Nicitopoulos
- Faculty of Kinesiology and Physical Education, Mental Health and Physical Activity Research Centre, University of Toronto, Toronto, ON, Canada
- *Correspondence: Kelly P. Arbour-Nicitopoulos
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19
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Fakolade AO, Latimer-Cheung AE, Shirazipour CH. Quality participation: Perspectives of physical activity service providers for veterans with disabilities. Disabil Health J 2021; 14:101094. [PMID: 33811009 DOI: 10.1016/j.dhjo.2021.101094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Current physical activity promotion efforts have focused on increasing the number of available programs and frequency of veterans' participation in physical activity (quantity of participation). The perspectives of service providers who provide physical activity programming for veterans with disabilities regarding quality participation have yet to be explored. OBJECTIVE The objective of this study was to explore the perspectives of service providers regarding what constitutes quality participation in the physical activity domain for veterans with disabilities. METHODS Twenty-two service providers with experience delivering physical activity programming for military personnel with disabilities were recruited using maximum variation sampling to participate in semi-structured interviews. The interviews explored their experiences of delivering physical activity programming to service members and veterans with disabilities, as well as their perspective of what constitutes a quality physical activity experience for their program participants. Data were analyzed using reflexive thematic analysis. RESULTS Four themes were identified: 1) a sense of community and shared values; 2) drivers of their own experiences; 3) forging new strengths; and 4) responsibility to the community. CONCLUSIONS These findings could provide researchers and service providers, including practitioners and rehabilitation specialists, with the foundations necessary for designing, implementing and evaluating physical activity programs that support full participation for veterans with disabilities.
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Affiliation(s)
| | | | - Celina H Shirazipour
- Research Centre for Health Equity, Cedars-Sinai Medical Center, Los Angeles, USA; Department of Medicine, University of California Los Angeles, Los Angeles, USA
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20
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Shirazipour CH, Freedland SJ. Obesity, visceral adiposity, and prostate cancer: What is the role of lifestyle interventions? Cancer 2019; 125:2730-2731. [PMID: 31179532 DOI: 10.1002/cncr.32165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/25/2019] [Accepted: 03/28/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Celina H Shirazipour
- Division of Hematology/Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Stephen J Freedland
- Division of Hematology/Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California.,Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California.,Urology Section, Durham VA Medical Center, Durham, North Carolina
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21
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Shirazipour CH, Tomasone JR, Martin Ginis KA. Enhancing health care professionals' and trainees' knowledge of physical activity guidelines for adults with and without SCI. J Spinal Cord Med 2019; 42:534-539. [PMID: 29323622 PMCID: PMC6718934 DOI: 10.1080/10790268.2017.1414348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Background: Health care providers (HCPs) are preferred sources of physical activity (PA) information; however, minimal research has explored HCPs' knowledge of spinal cord injury (SCI) PA guidelines, and no research has examined HCP trainees' PA guideline knowledge. Objective: The current study explored HCPs' and trainees' initial knowledge of PA guidelines for both adults with SCI and the general population, and the utility of an event-based intervention for improving this knowledge. Methods: Participants (HCPs n = 129; trainees n = 573) reported guideline knowledge for both sets of guidelines (SCI and general population) immediately after, one-month, and six-months following the intervention. Frequencies determined guideline knowledge at each timepoint, while chi-squared tests examined differences in knowledge of both guidelines, as well as knowledge differences in the short- and long-term. Results: Results demonstrated that HCPs and trainees lack knowledge of PA guidelines, particularly guidelines for adults with SCI. The results further suggest that a single event-based intervention is not effective for improving long-term guideline knowledge. Conclusion: Suggestions are made for future research with the aim of improving interventions that target HCP and HCP trainees' long-term guideline knowledge for adults with SCI and the general population.
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Affiliation(s)
- Celina H. Shirazipour
- School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada
| | - Jennifer R. Tomasone
- School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada,Correspondence to: Jennifer R. Tomasone, School of Kinesiology & Health Studies, 28 Division Street, Queen's University, Kingston, ON K7L 3N6, Canada; Ph: 613-533-6000 ext 79193. E-mail:
| | - Kathleen A. Martin Ginis
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
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22
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Shirazipour CH, Tennant EM, Aiken AB, Latimer-Cheung AE. Psychosocial Aspects of Physical Activity Participation for Military Personnel with Illness and Injury: A Scoping Review. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/21635781.2019.1611508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Emily M. Tennant
- School of Kinesiology & Health Studies, Queen’s University, Kingston, Ontario, Canada
| | - Alice B. Aiken
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Amy E. Latimer-Cheung
- School of Kinesiology & Health Studies, Queen’s University, Kingston, Ontario, Canada
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23
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Shirazipour CH, Latimer-Cheung AE, Aiken AB. Quality physical activity experiences for military Veterans with a physical disability: Exploring the relationship among program conditions, elements, and outcomes. Journal of Military, Veteran and Family Health 2019. [DOI: 10.3138/jmvfh.2018-0017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: In this study, we evaluate the physical activity (PA) participation of Veterans with a physical disability, particularly the role of experiential elements of quality participation in facilitating desired program outcomes. We hypothesized that quality elements would mediate the relationship between quality program conditions and participation outcomes. Methods: Forty-nine Veterans with a physical disability (mean age = 43.61 [SD 8.81] y) completed questionnaires before and after PA event participation, as well as at a 3-month follow-up. Results: Results demonstrated that an indicator of the quality element belongingness mediated the relationship between coach interpersonal skills and two PA indicators (i.e., planning and intentions) after event participation. The same quality indicator also mediated the relationship between coach interpersonal skills and family integration after event participation and at the 3-month follow-up. Discussion: These findings provide preliminary evidence linking quality PA program conditions and elements to PA participation outcomes.
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Affiliation(s)
- Celina H. Shirazipour
- Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, California, USA
- School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada
| | - Amy E. Latimer-Cheung
- School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada
| | - Alice B. Aiken
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
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Shirazipour CH, Evans MB, Leo J, Lithopoulos A, Martin Ginis KA, Latimer-Cheung AE. Program conditions that foster quality physical activity participation experiences for people with a physical disability: a systematic review. Disabil Rehabil 2018; 42:147-155. [DOI: 10.1080/09638288.2018.1494215] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - M. Blair Evans
- Kinesiology Department, Pennsylvania State University, University Park, PA, USA
| | | | | | - Kathleen A. Martin Ginis
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
- International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Centre (BSCC), University of British Columbia, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Kelowna, British Columbia, Canada
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Shirazipour CH, Aiken AB, Latimer-Cheung AE. Exploring strategies used to deliver physical activity experiences to Veterans with a physical disability. Disabil Rehabil 2017; 40:3198-3205. [DOI: 10.1080/09638288.2017.1377297] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Celina H. Shirazipour
- School of Kinesiology and Health Studies, Queen’s University, Kingston, Canada
- Faculty of Health, Dalhousie University, Halifax, Canada
| | - Alice B. Aiken
- Faculty of Health, Dalhousie University, Halifax, Canada
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Shirazipour CH, Latimer-Cheung AE, Arbour-Nicitopoulos KP. An exploratory qualitative investigation of psychosocial determinants of parental decisions to support sport participation for youth with a mobility impairment. Res Dev Disabil 2015; 45-46:400-410. [PMID: 26311496 DOI: 10.1016/j.ridd.2015.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 07/15/2015] [Accepted: 08/03/2015] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Parents of youth with a mobility impairment (MI) have an important influence on their children's sport participation. The current study consists of an exploratory qualitative investigation of the relevance of HAPA for understanding parental support behaviours for youth with MI's sport participation. METHODS Parents of youth athletes (Mage=11.10; SD=2.77) and non-athletes (Mage=11.50; SD=3.84) participated in semi-structured interviews with question development guided by the Health Action Process Approach (HAPA). RESULTS Constructs from HAPA were expressed as relevant to parental decisions, with differing subthemes emerging based upon parental group (i.e. parents of non-athletes or parents of athletes). Other constructs that emerged included barriers, facilitators, and resources. DISCUSSION Constructs from the motivational phase of HAPA were relevant for parents of athletes and non-athletes, while the volitional phase demonstrated utility for understanding the views of parents of athletes. Differences between the patterns of responses of both groups were apparent in how the constructs were expressed. Findings identify key areas for research, as well as practical applications. For example, future programs can target parental positions on specific HAPA constructs (e.g. risk perceptions) where differences were found between both groups of parents in order to promote parental decisions that support their children's sport participation.
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Affiliation(s)
- Celina H Shirazipour
- School of Kinesiology & Health Studies, Queen's University, 28 Division St, Kingston, ON, Canada K7L 3N6
| | - Amy E Latimer-Cheung
- School of Kinesiology & Health Studies, Queen's University, 28 Division St, Kingston, ON, Canada K7L 3N6.
| | - Kelly P Arbour-Nicitopoulos
- Faculty of Kinesiology & Physical Education, University of Toronto, 55 Harbord Street, Warren Steven Building 2041, Toronto, ON, Canada M5S 2W6
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Shirazipour CH, Baillie CPT, Galaviz K, Jarvis JW, Latimer-Cheung AE. Evaluating the theoretical content of online physical activity information for people with multiple sclerosis. Int J MS Care 2015; 17:91-100. [PMID: 25892979 DOI: 10.7224/1537-2073.2013-048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Physical activity can aid people with multiple sclerosis (MS) in managing symptoms and maintaining functional abilities. The Internet is a preferred source of physical activity information for people with MS and, therefore, a method for the dissemination of behavior change techniques. The purpose of this study was to examine the coverage and quality of physical activity behavior change techniques delivered on the Internet for adults with MS using Abraham and Michie's taxonomy of behavior change techniques. METHODS Using the taxonomy, 20 websites were coded for quality (ie, accuracy of information) and coverage (ie, completeness of information) of theoretical behavior change techniques. RESULTS RESULTS indicated that most websites covered a mean of 8.05 (SD 3.86, range 3-16) techniques out of a possible 20. Only one of the techniques, provide information on behavior-health link and consequences, was delivered on all websites. The websites demonstrated low mean coverage and quality across all behavior change techniques, with means of 0.64 (SD 0.67) and 0.62 (SD 0.37) on a scale of 0 to 2, respectively. However, coverage and quality improved when websites were examined solely for the techniques that they covered, as opposed to all 20 techniques. CONCLUSIONS This study, which examined quality and coverage of physical activity behavior change techniques described online for people with MS, illustrated that the dissemination of these techniques requires improvement.
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Affiliation(s)
- Celina H Shirazipour
- School of Kinesiology & Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Colin P T Baillie
- School of Kinesiology & Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Karla Galaviz
- School of Kinesiology & Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Jocelyn W Jarvis
- School of Kinesiology & Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Amy E Latimer-Cheung
- School of Kinesiology & Health Studies, Queen's University, Kingston, Ontario, Canada
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