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Bello RS, Walsh MT, Harper B, Amos CE, Oestman K, Nutt S, Galindez M, Block K, Rechis R, Bednar EM, Tektiridis J, Foxhall L, Moreno M, Shete S, Hawk E. Creating and Activating an Implementation Community to Drive HPV Vaccine Uptake in Texas: The Role of an NCI-Designated Cancer Center. Vaccines (Basel) 2023; 11:1128. [PMID: 37376517 DOI: 10.3390/vaccines11061128] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/09/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
The University of Texas MD Anderson Cancer Center, a comprehensive cancer center designated by the National Cancer Institute (NCI), defines its service population area as the State of Texas (29.1 M), the second most populous state in the country and the state with the greatest number of uninsured residents in the United States. Consistent with a novel and formal commitment to prevention as part of its core mission, alongside clear opportunities in Texas to drive vaccine uptake, MD Anderson assembled a transdisciplinary team to develop an institutional Framework to increase adolescent HPV vaccination and reduce HPV-related cancer burden. The Framework was developed and activated through a four-phase approach aligned with the NCI Cancer Center Support Grant Community Outreach and Engagement component. MD Anderson identified collaborators through data-driven outreach and constructed a portfolio of collaborative multi-sector initiatives through review processes designed to assess readiness, impact and sustainability. The result is an implementation community of 78 institutions collaboratively implementing 12 initiatives within a shared measurement framework impacting 18 counties. This paper describes a structured and rigorous process to set up the implementation of a multi-year investment in evidence-based strategies to increase HPV vaccination that solves challenges preventing implementation of recommended strategies and to encourage similar initiative replication.
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Affiliation(s)
- Rosalind S Bello
- The HPV Vaccination Initiative, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Office of Health Policy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Michael T Walsh
- The HPV Vaccination Initiative, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Impact Evaluation Core, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Joint Center on Geospatial Analysis & Health, Houston, TX 77030, USA
| | - Blake Harper
- The HPV Vaccination Initiative, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Charles E Amos
- The HPV Vaccination Initiative, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Office of Health Policy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Katherine Oestman
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Stephanie Nutt
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Impact Evaluation Core, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Joint Center on Geospatial Analysis & Health, Houston, TX 77030, USA
| | - Marcita Galindez
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Impact Evaluation Core, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Joint Center on Geospatial Analysis & Health, Houston, TX 77030, USA
| | - Kaitlyn Block
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ruth Rechis
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Impact Evaluation Core, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Erica M Bednar
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jennifer Tektiridis
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Lewis Foxhall
- Office of Health Policy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Mark Moreno
- Government Relations, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sanjay Shete
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ernest Hawk
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Ng A, Gupta E, Bansal S, Fontillas RC, Amos CE, Williams JL, Dibaj S, Bruera E. Cancer Patients' Perception of Usefulness of Wearable Exercise Trackers. PM R 2020; 13:845-851. [PMID: 32844592 DOI: 10.1002/pmrj.12475] [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] [Received: 11/12/2019] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To determine the feasibility and perception of usefulness of wearable trackers in inpatient and outpatient cancer rehabilitation patients. DESIGN Prospective study. SETTING Acute inpatient rehabilitation and outpatient clinic at a tertiary cancer center. PARTICIPANTS Adult cancer patients (N = 100). INTERVENTIONS Participants were provided with wearable trackers for the duration of the study. MAIN OUTCOME MEASURES Survey regarding feasibility (as defined as equal or more than two-thirds of participants reporting use of the wearable tracker) and usefulness of the wearable tracker and Edmonton Symptom Assessment Scale (ESAS-FS) in both inpatient and outpatient populations. Activity minutes, number of steps, heart rate, and sleep data were collected from the wearable tracker. RESULTS Patients reported the use of a wearable tracker is feasible, with 48/50 (96%) outpatients and 47/50 (94%) inpatients reported wearing the wearable tracker daily and 37/49 (76%) outpatients and 29/50 (58%) inpatients reported that they would continue to wear the wearable tracker after this study. The majority of cancer patients (41/49 [84%] of outpatient and 33/50 [66%] of inpatient patients) reported that the wearable tracker was useful and 41/49 (84%) outpatients and 27/50 (54%) inpatients perceived the wearable tracker as helping to increase physical activity. CONCLUSIONS The use of wearable trackers in cancer patients is feasible and patients perceive wearable trackers as useful in both the inpatient and outpatient rehabilitation setting. Physical activity in these patients was better in the outpatient population, as expected because of less medical acuity.
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Affiliation(s)
- Amy Ng
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ekta Gupta
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Swati Bansal
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rhodora C Fontillas
- Department of Rehabilitation and Physical Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Charles E Amos
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Janet L Williams
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Seyedeh Dibaj
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Yennurajalingam S, Amos CE, Weru J, Addo Opare-Lokko EBVND, Arthur JA, Nguyen K, Soyannwo O, Chidebe RCW, Williams JL, Lu Z, Baker E, Arora S, Bruera E, Reddy S. Extension for Community Healthcare Outcomes-Palliative Care in Africa Program: Improving Access to Quality Palliative Care. J Glob Oncol 2020; 5:1-8. [PMID: 31335237 PMCID: PMC6776016 DOI: 10.1200/jgo.19.00128] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
PURPOSE There is limited access to quality palliative care (PC) for patients with
advanced cancer in sub-Saharan Africa. Our aim was to describe the
development of the Project Extension for Community Healthcare
Outcomes-Palliative Care in Africa (ECHO-PACA) program and describe a
preliminary evaluation of attitudes and knowledge of participants regarding
the ability of the program to deliver quality PC. METHODS An interdisciplinary team at the MD Anderson Cancer Center, guided by experts
in PC in sub-Saharan Africa, adapted a standardized curriculum based on PC
needs in the region. Participants were then recruited, and monthly
telementoring sessions were held for 16 months. The monthly telementoring
sessions consisted of case presentations, discussions, and didactic
lectures. Program participants came from 14 clinics and teaching hospitals
in Ghana, Kenya, Nigeria, South Africa, and Zambia. Participants were
surveyed at the beginning, midpoint, and end of the 16-month program to
evaluate changes in attitudes and knowledge of PC. RESULTS The median number of participants per session was 30. Thirty-three (83%) of
40 initial participants completed the feedback survey. Health care
providers’ self-reported confidence in providing PC increased with
participation in the Project ECHO-PACA clinic. There was significant
improvement in the participants’ attitudes and knowledge, especially
in titrating opioids for pain control (P = .042),
appropriate use of non-opioid analgesics (P = .012),
and identifying and addressing communication issues related to end-of-life
care (P = .014). CONCLUSION Project ECHO-PACA was a successful approach for disseminating knowledge about
PC. The participants were adherent to ECHO PACA clinics and the completion
of feedback surveys. Future studies should evaluate the impact of Project
ECHO-PACA on changes in provider practice as well as patient outcomes.
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Affiliation(s)
| | - Charles E Amos
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - John Weru
- Aga Khan University Hospital, Nairobi, Kenya
| | | | | | - Kristy Nguyen
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | - Zhanni Lu
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ellen Baker
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Eduardo Bruera
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Suresh Reddy
- University of Texas MD Anderson Cancer Center, Houston, TX
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Abstract
This study offers cross-sectional analysis of data collected from the Alcohol and Substance Abuse Awareness and Use Study (ASAAUS). Data collection took place in October 2003 via a self-administered survey. Students who reported sexual abuse history in or around campus were 4 times more likely to report current amphetamine, cocaine, hallucinogen, opiate, or designer drug use compared to students with no sexual abuse history. Logistic regression analyses indicated that lifetime drug use was significantly associated with sexual abuse history (OR = 2.2, p < .05). While the relationships tested in this study are exploratory, they provide evidence for an important connection between sexual abuse and substance use among African-American college students.
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Affiliation(s)
- Queen Martin
- Prairie View A&M University, Department of Health and Performance, Prairie View, TX, USA
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