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Oestman K, Rechis R, Williams PA, Brown JA, Treiman K, Zulkiewicz B, Walsh MT, Basen-Engquist K, Rodriguez T, Chennisi C, Macneish A, Neff A, Pomeroy M, Bhojani FA, Hawk E. Reducing risk for chronic disease: evaluation of a collective community approach to sustainable evidence-based health programming. BMC Public Health 2024; 24:240. [PMID: 38245669 PMCID: PMC10799505 DOI: 10.1186/s12889-024-17670-3] [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] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 01/04/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Community initiatives can shape health behaviors, such as physical activity and dietary habits, across a population and help reduce the risk of developing chronic disease. To achieve this goal and impact health outcomes, Pasadena Vibrant Community aimed to engage communities in an ongoing dialogue about the importance of healthy behaviors, implement and advance community-based strategies to promote health, and improve diet and physical activity behaviors. The initiative was centered around a collaboration between a backbone organization, steering committee, and 7 collaborating organizations funded to implement multicomponent, evidence-based programs.. The common agenda was detailed in a community action plan, which included 19 interventions targeting healthy eating and active living among adults and youth in Pasadena, Texas. METHODS A mixed methods evaluation of the initiative was conducted over 4 years. Data sources included document reviews of quarterly progress reports (n = 86) and supplemental data reports (n = 16) provided by collaborating organizations, annual Steering Committee surveys (n = 4), and interviews conducted with staff from a subset of Collaborating Organizations (n = 4). RESULTS The initiative reached over 50,000 community members per year through 19 evidence-based interventions and impacted health outcomes, including knowledge and adoption of healthy eating practices and increased physical activity. Thirty-one systems-level changes were implemented during the initiative, including 16 environmental changes. Steering Committee meetings and shared goals enabled connections, communication, and cooperation, which allowed Collaborating Organizations to address challenges and combine resources to deliver their programs. CONCLUSIONS Community initiatives can effectively permeate the community by reaching individuals, improving physical activity and dietary habits, and ensuring sustainability. Based on the experience reported here, the success of a community initiative can be facilitated if collaborating organizations come together to implement evidence-based interventions and tailor them to the community, and if they are empowered by significant leadership and supportive collaboration and aligned by a common agenda.
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Affiliation(s)
- Katherine Oestman
- The University of Texas MD Anderson Cancer Center, 7007 Bertner Ave Unit 1628, Houston, TX, 77030, USA
| | - Ruth Rechis
- The University of Texas MD Anderson Cancer Center, 7007 Bertner Ave Unit 1628, Houston, TX, 77030, USA.
| | - Pamela A Williams
- RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Jill A Brown
- RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Katherine Treiman
- RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Brittany Zulkiewicz
- RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Michael T Walsh
- The University of Texas MD Anderson Cancer Center, 7007 Bertner Ave Unit 1628, Houston, TX, 77030, USA
| | - Karen Basen-Engquist
- The University of Texas MD Anderson Cancer Center, 7007 Bertner Ave Unit 1628, Houston, TX, 77030, USA
| | - Trina Rodriguez
- City of Pasadena Texas Parks and Recreation Department, 3111 San Augustine Avenue, Pasadena, TX, 77503, USA
| | - Catherine Chennisi
- Harris County Public Health, 2223 West Loop South, Houston, TX, 77027, USA
| | - Amber Macneish
- Pasadena Independent School District, 1515 Cherrybrook Lane, Pasadena, TX, 77502, USA
| | - Alise Neff
- Pasadena Independent School District, 1515 Cherrybrook Lane, Pasadena, TX, 77502, USA
| | - Mike Pomeroy
- Brighter Bites, 535 Portwall Street, Houston, TX, 77029, USA
| | - Faiyaz A Bhojani
- Shell USA, Inc, 150 N. Dairy Ashford Road, Houston, TX, 77002, USA
| | - Ernest Hawk
- The University of Texas MD Anderson Cancer Center, 7007 Bertner Ave Unit 1628, Houston, TX, 77030, USA
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Finney Rutten LJ, Zhu X, Treiman K, Madson G, Southwell B, Helmueller L, Alam S, Gates C, Squiers L. Attitudes and Experiential Factors Associated with Completion of mt-sDNA Test Kit for Colorectal Cancer Screening. J Patient Exp 2023; 10:23743735231213765. [PMID: 38026067 PMCID: PMC10666720 DOI: 10.1177/23743735231213765] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Colorectal cancer (CRC) is the third leading cause of cancer-related deaths in the United States. Despite the availability of multiple screening options, CRC screening is underutilized. We conducted a survey of patients (n = 2973) who were prescribed the multi-target stool DNA (mt-sDNA) screening test (commercialized as Cologuard® and manufactured by Exact Sciences Corporation) to understand attitudes and experiences that influence test completion and likelihood of future test completion. Using exploratory factor analyses, we developed three scales: Perceived Effectiveness, Perceived Ease of Use, and Perceived Comfort.
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Affiliation(s)
| | - Xuan Zhu
- Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | - Shama Alam
- Exact Sciences Corporation, Madison, WI, USA
| | - Carlye Gates
- RTI International, Research Triangle Park, NC, USA
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3
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Kataria I, Siddiqui M, Treiman K, Foley S, Anand M, Biswas S, Shastri D, Bhatla N, Radhakrishnan D, Mamidi P, Sankaranarayanan R. Awareness, perceptions, and choices of physicians pertaining to human papillomavirus (HPV) vaccination in India: A formative research study. Vaccine X 2022; 12:100228. [PMID: 36317080 PMCID: PMC9617192 DOI: 10.1016/j.jvacx.2022.100228] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 08/26/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction India accounts for one-fifth of the global burden of cervical cancer cases and mortality. A safe and effective vaccine to prevent human papillomavirus (HPV) infections, the primary cause of cervical malignancies, is available in India but multiple barriers lead to its low uptake in the country. Physicians are a key stakeholder and communicator in the Indian health system and have the potential to increase HPV vaccine uptake. Objective We undertook formative research to understand awareness, perceptions and choices of physicians when recommending the HPV vaccine to parents of adolescent girls. Methods We conducted in-depth interviews with 32 physicians in two districts of West Bengal. Data collection was carried out between July and August 2019. The data was transcribed, coded, and analyzed using NVivo software using the thematic analysis technique. Results Our findings suggest that while physicians are generally aware about the burden of cervical cancer and its prevention by HPV vaccination, they face several barriers to recommending the HPV vaccine routinely and strongly. These include the lack of national-level guidance on the age eligibility and dosage, lack of practice-level opportunities such as well or non-sick visits and other routine adolescent vaccines, practice-level barriers like out-of-pocket cost and vaccine availability, and perceived parental hesitancy arising from reluctance to discuss cervical cancer, its prevention, and HPV vaccination. Conclusions Physicians in our study exhibited hesitancy when recommending the HPV vaccine. They also faced logistical barriers. It is important that the barriers pertaining to when and how physicians recommend the vaccine be tackled through further education, policy change, and development and implementation of interventions that are evidenced-based.
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Affiliation(s)
- Ishu Kataria
- Center for Global Noncommunicable Diseases, RTI International, New Delhi, India
| | | | | | - Shaylen Foley
- American Cancer Society, Atlanta, GA, United States,Corresponding author.
| | - Meenu Anand
- American Cancer Society, Atlanta, GA, United States
| | | | | | - Neerja Bhatla
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Pavan Mamidi
- Centre for Social & Behaviour Change, Ashoka University, New Delhi, India
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Street RL, Treiman K, Wu Q, Kranzler EC, Moultrie R, Mack N, Garcia R. Managing uncertainty and responding to difficult emotions: Cancer patients' perspectives on clinician response during the COVID-19 pandemic. Patient Educ Couns 2022; 105:2137-2144. [PMID: 35393231 PMCID: PMC8968177 DOI: 10.1016/j.pec.2022.03.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 01/07/2022] [Revised: 02/24/2022] [Accepted: 03/08/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Patients undergoing cancer treatment during the COVID-19 pandemic have experienced stress and uncertainty with respect to disruptions in cancer care and COVID-19 related risks. We examined whether clinicians' responsiveness to patients' uncertainty and difficult emotions were associated with better health and well-being. METHODS Patients were recruited from cancer support communities and a market research firm. Respondents assessed clinicians communication that addressed uncertainty and difficult emotions. Health status measures included mental and physical health, coping during the pandemic, and psychological distress. RESULTS 317 respondents participated in the study. Patients' perceptions of their clinicians responsiveness to patient uncertainty and negative emotions were associated with better mental health, physical health, coping, and less psychological distress (all p-values <0.001). Respondents with greater self-efficacy and social support also reported better health. CONCLUSION Even when controlling for patients' personal and health-related characteristics, clinicians' communication addressing patients' uncertainty and difficult emotions predicted better health, better coping, and less psychological distress. Access to social support and self-efficacy also were associated with better health status. PRACTICE IMPLICATIONS Clinicians' communication focused on helping with uncertainty and difficult emotions is important to cancer patients, especially during the pandemic. Clinicians should also direct patients to resources for social support and patient empowerment.
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Affiliation(s)
| | | | | | - Elissa C Kranzler
- Cancer Support Community (Formerly), Currently Fors Marsh Group, USA
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Flythe JE, Forfang D, Gedney N, White DM, Wilkie C, Cavanaugh KL, Harris RC, Unruh M, Squillaci G, West M, Mansfield C, Soloe CS, Treiman K, Wood D, Hurst FP, Neuland CY, Saha A, Sheldon M, Tarver ME. Development of a Patient Preference Survey for Wearable Kidney Replacement Therapy Devices. Kidney360 2022; 3:1197-1209. [PMID: 35919522 PMCID: PMC9337889 DOI: 10.34067/kid.0001862022] [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] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/03/2022] [Indexed: 01/11/2023]
Abstract
Background Recent innovations have the potential to disrupt the current paradigm for kidney failure treatment. The US Food and Drug Administration is committed to incorporating valid scientific evidence about how patients weigh the benefits and risks of new devices into their decision making, but to date, premarket submission of patient preference information (PPI) has been limited for kidney devices. With input from stakeholders, we developed a survey intended to yield valid PPI, capturing how patients trade off the potential benefits and risks of wearable dialysis devices and in-center hemodialysis. Methods We conducted concept elicitation interviews with individuals receiving dialysis to inform instrument content. After instrument drafting, we conducted two rounds of pretest interviews to evaluate survey face validity, comprehensibility, and perceived relevance. We pilot tested the survey with in-center hemodialysis patients to assess comprehensibility and usability further. Throughout, we used participant input to guide survey refinements. Results Thirty-six individuals receiving in-center or home dialysis participated in concept elicitation (N=20) and pretest (N=16) interviews. Participants identified reduced fatigue, lower treatment burden, and enhanced freedom as important benefits of a wearable device, and many expressed concerns about risks related to device disconnection-specifically bleeding and infection. We drafted a survey that included descriptions of the risks of serious bleeding and serious infection and an assessment of respondent willingness to wait for a safer device. Input from pretest interviewees led to various instrument modifications, including treatment descriptions, item wording, and risk-level explanations. Pilot testing of the updated survey among 24 in-center hemodialysis patients demonstrated acceptable survey comprehensibility and usability, although 50% of patients required some assistance. Conclusions The final survey is a 54-item web-based instrument that will yield estimates of the maximal acceptable risk for the described wearable device and willingness to wait for wearable devices with lower risk.
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Affiliation(s)
- Jennifer E. Flythe
- University of North Carolina (UNC) Kidney Center, Division of Nephrology and Hypertension, Department of Medicine, UNC School of Medicine, Chapel Hill, North Carolina,Cecil G. Sheps Center for Health Services Research, UNC, Chapel Hill, North Carolina
| | - Derek Forfang
- Kidney Health Initiative Patient and Family Partnership Council, San Pablo, California
| | | | - David M. White
- Kidney Health Initiative Patient and Family Partnership Council, Hillcrest Heights, Maryland
| | - Caroline Wilkie
- Kidney Health Initiative Patient and Family Partnership Council, Punta Gorda, Florida
| | - Kerri L. Cavanaugh
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee,Center for Effective Health Communication, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Raymond C. Harris
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mark Unruh
- School of Medicine, University of New Mexico, Albuquerque, New Mexico
| | - Grace Squillaci
- Kidney Health Initiative and American Society of Nephrology, Washington, DC
| | - Melissa West
- Kidney Health Initiative and American Society of Nephrology, Washington, DC
| | - Carol Mansfield
- RTI Health Solutions, Research Triangle Park, North Carolina
| | - Cindy S. Soloe
- RTI Health Solutions, Research Triangle Park, North Carolina
| | | | - Dallas Wood
- RTI Health Solutions, Research Triangle Park, North Carolina
| | - Frank P. Hurst
- Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland
| | - Carolyn Y. Neuland
- Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland
| | - Anindita Saha
- Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland
| | - Murray Sheldon
- Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland
| | - Michelle E. Tarver
- Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland
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Mark TL, Treiman K, Padwa H, Henretty K, Tzeng J, Gilbert M. Addiction Treatment and Telehealth: Review of Efficacy and Provider Insights During the COVID-19 Pandemic. Psychiatr Serv 2022; 73:484-491. [PMID: 34644125 DOI: 10.1176/appi.ps.202100088] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [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: 11/30/2022]
Abstract
OBJECTIVE Addiction treatment via telehealth expanded to unprecedented levels during the COVID-19 pandemic. This study aimed to clarify whether the research evidence on the efficacy of telehealth-delivered substance use disorder treatment and the experience of providers using telehealth during the pandemic support continued use of telehealth after the pandemic and, if so, under what circumstances. METHODS Data sources included a literature review on the efficacy of telehealth for substance use disorder treatment, responses to a 2020 online survey from 100 California addiction treatment providers, and interviews with 30 California treatment providers and other stakeholders. RESULTS Eight published studies were identified that compared addiction treatment via telehealth with in-person treatment. Seven found telehealth treatment as effective but not more effective than in-person treatment in terms of retention, therapeutic alliance, and substance use. One Canadian study found that telehealth facilitated methadone prescribing and improved retention. In the survey results reported here, California addiction treatment providers said that more than 50% of their patients were being treated via telehealth for intensive outpatient treatment, individual counseling, group counseling, and intake assessment. They were most confident that individual counseling via telehealth was as effective as in-person individual counseling and less sure about the relative effectiveness of telehealth-delivered medication management, group counseling, and intake assessments. CONCLUSIONS Telehealth may help engage patients in addiction treatment by improving access and convenience. Additional research is needed to confirm that benefit and to determine how best to tailor telehealth to each patient's circumstances and with what mix of in-person and telehealth services.
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Affiliation(s)
- Tami L Mark
- RTI International, Rockville, Maryland (Mark, Treiman), and Research Triangle Park, North Carolina (Henretty, Tzeng); Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles (Padwa, Gilbert)
| | - Katherine Treiman
- RTI International, Rockville, Maryland (Mark, Treiman), and Research Triangle Park, North Carolina (Henretty, Tzeng); Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles (Padwa, Gilbert)
| | - Howard Padwa
- RTI International, Rockville, Maryland (Mark, Treiman), and Research Triangle Park, North Carolina (Henretty, Tzeng); Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles (Padwa, Gilbert)
| | - Kristen Henretty
- RTI International, Rockville, Maryland (Mark, Treiman), and Research Triangle Park, North Carolina (Henretty, Tzeng); Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles (Padwa, Gilbert)
| | - Janice Tzeng
- RTI International, Rockville, Maryland (Mark, Treiman), and Research Triangle Park, North Carolina (Henretty, Tzeng); Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles (Padwa, Gilbert)
| | - Marylou Gilbert
- RTI International, Rockville, Maryland (Mark, Treiman), and Research Triangle Park, North Carolina (Henretty, Tzeng); Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles (Padwa, Gilbert)
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Treiman K, Kranzler EC, Moultrie R, Arena L, Mack N, Fortune E, Garcia R, Street RL. Patients’ Experiences with Cancer Care: Impact of the COVID-19 Pandemic. J Patient Exp 2022; 9:23743735221092567. [PMID: 35480966 PMCID: PMC9036334 DOI: 10.1177/23743735221092567] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 12/24/2022] Open
Abstract
The COVID-19 pandemic heightened the psychosocial impact of a cancer diagnosis as patients face concerns about the risk of infection and serious disease and uncertainties about the impact on their treatment. We conducted an online survey (n = 317) and focus groups (n = 19) with patients to examine their experiences with cancer care during the pandemic. Most survey respondents (68%) reported one or more disruptions or delays in care, including appointments switched to telehealth (49%). Patients perceived both benefits (e.g., convenience) and drawbacks (e.g., more impersonal) to telehealth. For many patients, COVID-19-related restrictions on bringing family members to support them during appointments was a major concern and left them feeling alone and vulnerable during treatment. Patients’ self-reported coping during the pandemic was positively associated with age, education, and income (P < .05 for each) and better communication with their doctors during telehealth sessions (P < .001). Study findings highlight the importance of patient-centered care and communication to help patients cope with the challenges of the pandemic. Further research is needed to develop guidelines for use of telehealth as part of patient-centered cancer care.
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Affiliation(s)
- Katherine Treiman
- Translation Health Science Division, RTI International, Research Triangle Park, NC, USA
| | - Elissa C. Kranzler
- Fors Marsh Group, formerly Cancer Support Community, Philadelphia, PA, USA
| | - Rebecca Moultrie
- Translation Health Science Division, RTI International, Research Triangle Park, NC, USA
| | - Laura Arena
- Translation Health Science Division, RTI International, Research Triangle Park, NC, USA
| | - Nicole Mack
- Social Statistics Program, RTI International, Research Triangle Park, NC, USA
| | - Erica Fortune
- Cancer Support Community, Research and Training Institute, Philadelphia, PA, USA
| | - Reese Garcia
- Fight Colorectal Cancer, Research Advocacy Training and Support Program, Springfield, MO, USA
| | - Richard L Street
- Department of Communication, Texas A&M University, College Station, TX, USA
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8
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Street RL, Treiman K, Kranzler EC, Moultrie R, Arena L, Mack N, Garcia R. Oncology patients' communication experiences during COVID-19: comparing telehealth consultations to in-person visits. Support Care Cancer 2022; 30:4769-4780. [PMID: 35141772 PMCID: PMC9046548 DOI: 10.1007/s00520-022-06897-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/02/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE The COVID-19 pandemic created significant disruptions in cancer care, much of which was transitioned to telehealth. Because telehealth alters the way clinicians and patients interact with one another, this investigation examined patients' perceptions of their communication with clinicians during the pandemic. METHOD Patients were recruited from the Cancer Support Community, Fight Colorectal Cancer, and a market research firm to participate in an online survey. In addition to demographic and health-related information, respondents completed measures of patient-centered communication and evaluated how their communication in telehealth sessions compared with in-person visits. RESULTS From October to December 2020, 227 respondents (65.6% female, 64.6% Non-Hispanic White, 33.5% had 6 or more telehealth sessions, 55% were 50 or older) reported having some of their cancer care provided via telehealth. Respondents who were of racial/ethnic minorities, male, had more telehealth sessions, or had poorer mental health reported less patient-centered communication with clinicians. Most patients thought communication in telehealth sessions was "about the same" as in-person visits with respect to good communication (59%). However, patients thinking communication in telehealth sessions was "better" than in-person visits were more likely to be Hispanic (49%), Non-Hispanic Black (41%), under 50 years of age (32%), male (40%), and had more telehealth sessions (34%). CONCLUSION Respondents reporting less patient-centered communication during the pandemic-e.g., persons of racial/ethnic minorities and males-were also more likely to evaluate communication in telehealth sessions as better than in-person visits. Further research is needed to understand reasons underlying this finding. Cancer care clinicians should take into account patient preferences regarding telehealth care, which may be particularly important for racial and ethnic minority patients.
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Affiliation(s)
| | | | - Elissa C Kranzler
- Cancer Support Community (formerly), currently Fors Marsh Group, Arlington, VA, USA
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Squiers L, Brown S, Hauser K, Lynch M, Treiman K, Polen K, Amoozegar J, Quiroz R, Tong V, Waddell L, Gilboa S. Perceptions of Health Care, Information, and Social Support Among Women Affected by Zika Virus Infection During Pregnancy in Two U.S. States. Matern Child Health J 2021; 25:1836-1841. [PMID: 34669099 PMCID: PMC10562980 DOI: 10.1007/s10995-021-03272-7] [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] [Accepted: 09/24/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To understand the information needs and experiences with health care and social support among women with confirmed or possible Zika virus infection during pregnancy. METHODS We conducted in-depth interviews with 18 women whose pregnancies were part of surveillance efforts in two states, Pennsylvania and Virginia. Using a semi-structured guide available in English and Spanish, we asked women about their experiences. We conducted a thematic analysis using NVivo 11. RESULTS Only one participant reported that her infant had been diagnosed with health problems related to congenital Zika virus infection. Most participants said they received the information they needed about Zika virus and their infant's medical care. Most participants primarily spoke Spanish and described satisfactory experiences communicating with providers, either using a mix of Spanish and English or using an interpreter. Coordination of care and clear communication among different providers was a key factor in participants' satisfaction with health care received. Participants noted high levels of stress around the uncertainty associated with Zika virus exposure during pregnancy. CONCLUSIONS FOR PRACTICE Although participants reported satisfaction with care, they also reported high levels of anxiety and challenges coping with the uncertainties along their journeys. Study findings support the need for guidance for providers about how to talk with women about Zika virus infection during pregnancy and specifically how to discuss the uncertainties about diagnosis and outcomes.
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Affiliation(s)
- Linda Squiers
- Center for Communication Science, RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA.
| | - Shea Brown
- Virginia Department of Health, Harrisburg, PA, USA
| | | | - Molly Lynch
- Center for Communication Science, RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA
| | - Katherine Treiman
- Center for Communication Science, RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA
| | - Kara Polen
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jacqueline Amoozegar
- Center for Communication Science, RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA
| | - Rosanna Quiroz
- Center for Communication Science, RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA
| | - Van Tong
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Suzanne Gilboa
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
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10
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Mark TL, Hinde JM, Barnosky A, Joshi V, Padwa H, Treiman K. Is implementation of ASAM-based addiction treatment assessments associated with improved 30-day retention and substance use? Drug Alcohol Depend 2021; 226:108868. [PMID: 34237614 DOI: 10.1016/j.drugalcdep.2021.108868] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/04/2021] [Accepted: 06/08/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND The American Society of Addiction Medicine (ASAM) criteria were developed to provide a systematic, evidence-based, and transparent approach to addiction treatment assessment and level-of-care recommendations. In 2017, California began a Medicaid demonstration that required that providers in participating counties to adopt ASAM-based intake assessments and level-of-care criteria. We hypothesized that ASAM implementation would increase the proportion of patients retained in addiction treatment and successfully completing their treatment plan. METHODS We implemented a comparative interrupted time series analysis with 407,792 treatment episodes by Medicaid beneficiaries in specialty addiction treatment settings from 2015 to mid-2019. We compared the change in retention rates and successful completion rates in counties that adopted ASAM-based assessments relative to counties that did not adopt ASAM-based assessments and used only clinical judgment for level-of-care decisions. Treatment retention was defined as staying in addiction treatment for at least 30 days. Successful completion of the treatment plan was determined by the patient's clinician. RESULTS After one year, ASAM implementation was associated with a 9% increase in 30-day retention among treatment episodes that started in a residential setting, but no change in retention among episodes starting in outpatient settings. We found no statistically significant association between ASAM adoption and successful treatment completion. CONCLUSIONS Implementation of ASAM-based assessment may lead to improved retention for individuals who begin treatment in residential treatment, which may be encouraging to the many state Medicaid programs that are adopting ASAM-based criteria. More research is needed to clarify the mechanism by which ASAM leads to improved outcomes and to clarify how to maximize the potential benefits of ASAM, such as through patient-centered implementation.
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Affiliation(s)
- Tami L Mark
- RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, 27709-2194, United States.
| | - Jesse M Hinde
- RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, 27709-2194, United States
| | - Alan Barnosky
- RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, 27709-2194, United States
| | - Vandana Joshi
- University of California, Los Angeles, Integrated Substance Abuse Programs, 11075 Santa Monica Blvd, Los Angeles, CA, 90095-1759, United States
| | - Howard Padwa
- University of California, Los Angeles, Integrated Substance Abuse Programs, 11075 Santa Monica Blvd, Los Angeles, CA, 90095-1759, United States
| | - Katherine Treiman
- RTI International, 6110 Executive Blvd, #900, Rockville, MD, 20852, United States
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Crotty K, Lee M, Treiman K, Sae-Hau M, Wines C, Viator C, Weiss E. Health insurance, blood cancer, and outcomes: a literature review. Am J Manag Care 2021; 27:SP241-SP244. [PMID: 34407362 DOI: 10.37765/ajmc.2021.88733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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12
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Rechis R, Oestman KB, Caballero E, Brewster A, Walsh MT, Basen-Engquist K, Gershenwald JE, Tektiridis JH, Moreno M, Williams PA, Treiman K, Garza PD, Hawk E. Be Well Communities™: mobilizing communities to promote wellness and stop cancer before it starts. Cancer Causes Control 2021; 32:859-870. [PMID: 34037915 PMCID: PMC8236479 DOI: 10.1007/s10552-021-01439-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 04/24/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Increasingly, cancer centers are delivering population-based approaches to narrow the gap between known cancer prevention strategies and their effective implementation. Leveraging successful healthy community initiatives, MD Anderson developed Be Well Communities™, a model that implements evidence-based actions to directly impact people's lives. METHODS In partnership with local organizations, MD Anderson's Be Well Communities team executed and evaluated 16 evidence-based interventions to address community priorities in healthy diets, physical activity, and sun safety. Evaluation included assessing the effectiveness of evidence-based interventions, stakeholders' perceptions of collaboration, and the population-level impact on dietary and physical activity behaviors among students using the School Physical Activity and Nutrition Survey and the System for Observing Fitness Instruction Time. Two-tailed t-tests were used to compare tested parameters at baseline and follow-up. p values less than .05 were considered significant. RESULTS This model achieved its early outcomes, including effectively implementing evidence-based interventions, building strong partnerships, increasing access to healthy foods, improving the built environment, and increasing healthy food and water consumption and moderate to vigorous physical activity among students (p < .001). CONCLUSIONS Be Well Communities is an effective model for positively impacting community health which could be leveraged by others to deliver evidence-based actions to improve population health.
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Affiliation(s)
- Ruth Rechis
- Cancer Prevention and Control Platform, Unit 1364, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.
| | - Katherine B Oestman
- Cancer Prevention and Control Platform, Unit 1364, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Elizabeth Caballero
- Cancer Prevention and Control Platform, Unit 1364, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | | | - Michael T Walsh
- Cancer Prevention and Control Platform, Unit 1364, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | | | | | | | | | | | | | - Priscila D Garza
- Goose Creek Consolidated Independent School District, Baytown, TX, USA
| | - Ernest Hawk
- Division of Cancer Prevention & Population Sciences, Houston, TX, USA
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13
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Padwa H, Treiman K, Mark TL, Tzeng J, Gilbert M. Assessing Assessments: Substance use disorder treatment providers' perceptions of intake assessments. Subst Abus 2021; 43:451-457. [PMID: 34282997 DOI: 10.1080/08897077.2021.1946891] [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: 10/20/2022]
Abstract
Background: Assessments to determine patients' treatment needs and preferences when they begin substance use disorder (SUD) treatment are essential. The objectives of this paper are to identify the perspectives of providers who conduct assessments on (1) assessments' utility in determining the level of care where patients will receive treatment, (2) strategies to engage patients in treatment during assessments, and (3) assessment strengths and shortcomings. Methods: Semi-structured interviews were conducted with 30 California treatment providers who routinely perform SUD assessments for Medicaid beneficiaries. Interviews asked about the utility of assessment tools in determining appropriate levels of care, patient engagement during assessments, and strengths and shortcomings of intake assessment processes. Interviews were audio-recorded, transcribed, and analyzed by multiple researchers using template analysis. Results: Providers reported that assessments linked to level-of-care decision rules sometimes generate recommendations inconsistent with their clinical judgment, and that the timing of assessments can influence the quality of the information collected. Providers described engagement strategies that help patients feel more comfortable during assessments and that encourage more thoughtful and accurate responses. Providers valued assessments that helped ensure comprehensive collection of patient information, that allowed flexibility to probe for additional information and context, and that facilitated treatment planning. Providers did not like assessments that were long and repetitive or those that did not collect detailed information about patients' mental health and recovery environments. Conclusions: Assessments can be improved if providers conduct them in a manner that makes patients feel comfortable while building trust and rapport. Ensuring that assessments are not long or repetitive and giving comprehensive assessments once patients have developed trusting relationships with treatment programs can improve assessment processes. Further research is needed to optimize SUD assessments.
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Affiliation(s)
- Howard Padwa
- Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Tami L Mark
- RTI International, Research Triangle Park, NC, USA
| | - Janice Tzeng
- RTI International, Research Triangle Park, NC, USA
| | - Marylou Gilbert
- Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, CA, USA
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Henretty K, Padwa H, Treiman K, Gilbert M, Mark TL. Impact of the Coronavirus Pandemic on Substance Use Disorder Treatment: Findings from a Survey of Specialty Providers in California. Subst Abuse 2021; 15:11782218211028655. [PMID: 34285496 PMCID: PMC8264730 DOI: 10.1177/11782218211028655] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/10/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND As the coronavirus pandemic public health emergency begins to ebb in the United States, policymakers and providers need to evaluate how the addiction treatment system functioned during the public health emergency and draw lessons for future emergencies. One important question is whether the pandemic curtailed the use of addiction treatment and the extent to which telehealth was able to mitigate access barriers. METHODS To begin to answer this question, we conducted a survey of specialty addiction treatment providers in California from June 2020 through July 2020. The survey focused specifically on provider organizations that served Medicaid beneficiaries. RESULTS Of the 133 respondents, 50% reported a decrease in patients since the stay-at-home order in March 2020, with the largest decline among new patients, and 58% said more patients were relapsing. Eighty-one percent of providers said that telemedicine use had increased since the stay-at-home order. Most said that telemedicine had moderately (48%) or completely (30%) addressed access barriers. CONCLUSION More efforts are needed to ensure that patients, and in particular new patients, receive addiction treatment during public health emergencies.
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Affiliation(s)
| | - Howard Padwa
- Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA
| | | | - Marylou Gilbert
- Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA
| | - Tami L Mark
- RTI International, Research Triangle Park, NC, USA
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15
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Sae-Hau M, Disare K, Michaels M, Gentile A, Szumita L, Treiman K, Weiss ES. Overcoming Barriers to Clinical Trial Participation: Outcomes of a National Clinical Trial Matching and Navigation Service for Patients With a Blood Cancer. JCO Oncol Pract 2021; 17:e1866-e1878. [PMID: 34077244 DOI: 10.1200/op.20.01068] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE There are numerous barriers to cancer clinical trial participation in the United States. This paper describes the approach and outcomes of The Leukemia & Lymphoma Society's Clinical Trial Support Center (CTSC), whose nurse navigators assist patients with a blood cancer and their oncologists by identifying all appropriate trials based on clinical data and patient preference, facilitating informed and shared decision making, and minimizing enrollment barriers. METHODS Data on patients served from October 2017 to October 2019 were analyzed using bivariate and multivariate analyses to determine demographic and clinical characteristics associated with enrollment. Reasons for nonenrollment were examined. RESULTS The CTSC opened 906 patient cases during this time frame. Among all US patients with a closed case (n = 750), the clinical trial enrollment rate was 16.1%. Among those with a known enrollment outcome after a trial search (n = 537), the enrollment rate was 22.5%. Multivariate analysis controlling for variables significant in bivariate analyses (insurance, treatment status, Eastern Cooperative Oncology Group performance status, and urban or rural residence) revealed that patients with Medicaid were less likely to enroll than those with private or commercial insurance (adjusted odds ratio, 0.054; CI, 0.003 to 0.899), and patients in treatment or maintenance were less likely to enroll than those relapsed or refractory to most recent therapy (adjusted odds ratio, 0.312; CI, 0.139 to 0.702). Primary reasons for nonenrollment were preference for standard of care (66.3%) and patient passed away (16.1%). CONCLUSION The CTSC is an effective, replicable model for addressing multilevel barriers to clinical trial participation. The findings highlight the need to increase opportunities for trial participation sooner after diagnosis and among patients with Medicaid.
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Affiliation(s)
| | - Kate Disare
- The Leukemia & Lymphoma Society, Rye Brook, NY
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16
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Treiman K, Husick C, Sarris-Esquivel N, Sae-Hau M, Barnhart M, Disare K, Gupta C, Halpern M, Suvada K, Weiss E. Meeting the Information and Support Needs of Blood Cancer Patients and Caregivers: A Longitudinal Study of a Model of Patient-Centered Information Delivery. J Cancer Educ 2021; 36:538-546. [PMID: 31820416 DOI: 10.1007/s13187-019-01662-8] [Citation(s) in RCA: 2] [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] [Indexed: 06/10/2023]
Abstract
Access to reliable, up-to-date information and resources can assist individuals managing and living with cancer. The Leukemia & Lymphoma Society, through its Information Resource Center, provides personalized information and support to individuals affected by blood cancer. To examine its value and impact, we conducted qualitative interviews (n = 18) and an online survey of patients and caregivers (N = 515) after they talked with an Information Resource Center Information Specialist by phone, with a follow-up survey about 6 months later. Respondents most commonly contacted the Information Resource Center to get referrals to support programs (40.4%) and to obtain information about getting a second opinion (36.5%) and financial assistance (36.2%). After talking with an Information Specialist, respondents felt more hopeful (85.9%), more confident in managing care (82.9%), and more knowledgeable about their diagnosis (49.5%) and financial resources (42.4%). After speaking with an Information Specialist, respondents changed how they advocated for themselves/loved one (23.8%), changed how they communicated with doctors/other providers and family/friends (both 15.9%), received financial assistance (22.2%), and took other actions. Among respondents who took actions, most said that the conversation(s) had positively impacted the action. Respondents who spoke with an Information Specialist more than once were more likely to report positive impacts, including changing how they advocate for themselves/loved one and communicate with providers (both p < 0.05). Respondents diagnosed more recently were also more likely to report positive impact, including changing the way they communicate with providers (p < 0.05). Findings highlight the value of cancer helplines and suggest ways they can be most effective.
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Affiliation(s)
- Katherine Treiman
- RTI International, 6001 Executive Blvd., Rockville, MD, 20852-3907, USA.
| | - Caroline Husick
- RTI International, 3040 Cornwallis Rd., Research Triangle Park, NC, 27709-2194, USA
| | | | - Maria Sae-Hau
- The Leukemia & Lymphoma Society, 3 International Drive, Suite 200, Rye Brook, NY, 10573, USA
| | - Meredith Barnhart
- The Leukemia & Lymphoma Society, 3 International Drive, Suite 200, Rye Brook, NY, 10573, USA
| | - Kate Disare
- The Leukemia & Lymphoma Society, 3 International Drive, Suite 200, Rye Brook, NY, 10573, USA
| | - Catherine Gupta
- RTI Health Solutions, 3040 Cornwallis Rd., Research Triangle Park, NC, 27709-2194, USA
| | - Michael Halpern
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Dr., Room 3E4342, Bethesda, MD, 20892-9762, USA
| | - Kara Suvada
- RTI International, 3040 Cornwallis Rd., Research Triangle Park, NC, 27709-2194, USA
| | - Elisa Weiss
- The Leukemia & Lymphoma Society, 3 International Drive, Suite 200, Rye Brook, NY, 10573, USA
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17
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Treiman K, Padwa H, Mark TL, Tzeng J, Gilbert M. “The assessment really helps you with the first step in recovery.” What do clients think substance use disorder treatment intake assessments should look like? Subst Abus 2021; 42:880-887. [DOI: 10.1080/08897077.2021.1878085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
| | - Howard Padwa
- University of California, Integrated Substance Abuse Programs, Los Angeles, California, USA
| | | | | | - Marylou Gilbert
- University of California, Integrated Substance Abuse Programs, Los Angeles, California, USA
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18
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Peinado S, Treiman K, Uhrig JD, Taylor JC, Stryker JE. Effectively Communicating About HIV and Other Health Disparities: Findings From a Literature Review and Future Directions. Front Commun (Lausanne) 2020; 5:10.3389/fcomm.2020.539174. [PMID: 33594338 PMCID: PMC7884094 DOI: 10.3389/fcomm.2020.539174] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Despite significant progress in the prevention and treatment of HIV, disparities in rates of infection remain among key groups in the United States, including blacks and African Americans; Hispanics/Latinos; and men who have sex with men (MSM). The U.S. Department of Health and Human Services' initiative, Ending the HIV Epidemic: A Plan for America, calls for addressing HIV-related disparities and reducing stigma and discrimination associated with HIV. The goal of this literature review was to identify approaches for effectively communicating about health disparities across the HIV care continuum. We reviewed the literature to investigate strategies used to communicate health disparities and to identify potential unintended adverse effects resulting from this messaging. Messages about health disparities often target subgroups at higher risk and can be framed in a variety of ways (e.g., social comparison, progress, impact, etiological). Studies have examined the effects of message framing on the risk perceptions, emotional reactions, and behaviors of individuals exposed to the messaging. The evidence points to several potential unintended adverse effects of using social comparison framing and individual responsibility framing to communicate about health disparities, and visual images and exemplars to target messages to higher-risk subgroups. There is not yet a clear evidence-based approach for communicating about health disparities and avoiding potential unintended effects. However, we offer recommendations for communicating about HIV-related disparities based on our findings. Because we found limited literature that addressed our research questions in the context of HIV, we propose a research agenda to build an evidence base for developing effective messages about HIV-related disparities.
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Affiliation(s)
- Susana Peinado
- Center for Communication Science, RTI International, Durham, NC, United States
| | - Katherine Treiman
- Center for Communication Science, RTI International, Durham, NC, United States
| | - Jennifer D. Uhrig
- Center for Communication Science, RTI International, Durham, NC, United States
| | - Jocelyn Coleman Taylor
- Prevention Communication Branch, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jo Ellen Stryker
- Prevention Communication Branch, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
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19
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Lynch M, Peinado S, Treiman K, McDaniel C, Vinci A, Creek E. Information needs across the family planning continuum: A survey of women with chronic autoimmune inflammatory conditions. Patient Educ Couns 2020; 103:103-111. [PMID: 31444093 DOI: 10.1016/j.pec.2019.08.005] [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: 05/10/2019] [Revised: 07/30/2019] [Accepted: 08/03/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE This study assessed the information needs of women with chronic autoimmune inflammatory conditions across the pregnancy continuum. METHODS We conducted a web-based survey with women about information needs related to family planning. Eligible participants were female, aged 18-44, had a diagnosis of a chronic inflammatory condition, and were at one of three pregnancy stages (planning, currently pregnant, or postpartum). RESULTS The survey yielded 209 responses. Respondents had high levels of information needs and were active information seekers. Many respondents reported difficulty finding the information they need. Over half (56.9%) reported receiving conflicting information from different doctors, and a majority of those respondents reported doing their own research. Respondents expressed the greatest interest in resources that facilitated connections to other women and their experiences (87.4%). Pregnancy stage was significantly associated with information needs and preferences; respondents in the planning stage of pregnancy had higher information needs, reported more dissatisfaction with communication with doctors, and were less connected to pregnancy resources. PRACTICE IMPLICATIONS Both providers and health/advocacy organizations have a role in improving information around this topic, such as developing and disseminating resources tailored to pregnancy status and supporting patient-centered communication around family planning.
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Affiliation(s)
- Molly Lynch
- RTI International, Research Triangle Park, NC, USA.
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20
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McCormack LA, Wylie A, Moultrie R, Furberg RD, Wheeler AC, Treiman K, Bailey DB, Raspa M. Supporting informed clinical trial decisions: Results from a randomized controlled trial evaluating a digital decision support tool for those with intellectual disability. PLoS One 2019; 14:e0223801. [PMID: 31644588 PMCID: PMC6808417 DOI: 10.1371/journal.pone.0223801] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 09/28/2019] [Indexed: 11/19/2022] Open
Abstract
Background Informed consent requires that individuals understand the nature of the study, risks and benefits of participation. Individuals with intellectual disabilities (ID) have cognitive and adaptive impairments that may affect their ability to provide informed consent. New treatments and clinical trials for fragile X syndrome, the most commonly known inherited cause of ID, necessitate the development of methods to improve the informed consent process. The goal of this study was to compare the efficacy of a digital decision support tool with that of standard practice for informed consent and to examine whether the tool can improve decisional capacity for higher functioning individuals. Methods Participants (N = 89; mean age = 21.2 years) were allocated to the experimental group (consenting information provided via the digital decision support tool), or the comparison group (information provided via standard practice). Participants were assessed on four aspects of decisional capacity (Understanding, Appreciating, Reasoning, and Expressing a choice). We used regression analyses to test the impact of the tool on each outcome, repeating the analyses on the higher functioning subsample. Results No differences existed in any domain of decisional capacity for the sample in full. However, participants in the higher IQ subsample who used the tool scored better on Understanding after adjustment (β = 0.25, p = 0.04), but not on Appreciating or Reasoning. No differences by experimental group existed in the decision to join the hypothetical trial for the full sample or higher functioning subsample. Conclusions A decision support tool shows promise for individuals with fragile X syndrome with higher cognitive abilities. Future studies should examine the level of cognitive ability needed for sufficient understanding, whether these findings can be translated to other clinical populations, and the impact of the tool in larger trials and on trial retention.
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Affiliation(s)
- Lauren A. McCormack
- Public Health Research Division, RTI International, Research Triangle Park, North Carolina, United States of America
- * E-mail:
| | - Amanda Wylie
- Center for Newborn Screening, RTI International, Research Triangle Park, North Carolina, United States of America
| | - Rebecca Moultrie
- Public Health Research Division, RTI International, Research Triangle Park, North Carolina, United States of America
| | - Robert D. Furberg
- Health Quality & Analytics, RTI International, Research Triangle Park, North Carolina, United States of America
| | - Anne C. Wheeler
- Center for Newborn Screening, RTI International, Research Triangle Park, North Carolina, United States of America
| | - Katherine Treiman
- Public Health Research Division, RTI International, Research Triangle Park, North Carolina, United States of America
| | - Donald B. Bailey
- Center for Newborn Screening, RTI International, Research Triangle Park, North Carolina, United States of America
| | - Melissa Raspa
- Center for Newborn Screening, RTI International, Research Triangle Park, North Carolina, United States of America
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21
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Perry RJ, Treiman K, Teixeira-Poit SM, Kish-Doto J, Hoerger TJ, Tardif-Douglin M. Satisfaction with Financial Incentives for Chronic Disease Prevention. Am J Health Behav 2018; 42:46-59. [PMID: 30158000 DOI: 10.5993/ajhb.42.6.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
ObjectiveWe examined Medicaid enrollees' experiences and satisfaction with financial incentives-based chronic disease prevention programs in 10 states. MethodsThis cross-site study of the Medicaid Incentives for Prevention of Chronic Diseases model used a mixed-methods approach to assess Medicaid enrollees' experiences and satisfaction with the incentive programs. We conducted 31 in-person focus groups with 212 program participants, followed by a mail survey in English and Spanish (N = 2274). We used both the qualitative focus group data and the quantitative survey data to examine participant satisfaction with the incentives, along with differences by program and incentive characteristics. ResultsOverall, focus group and survey findings aligned, with participants reporting satisfaction with program incentives. Participants felt that the incentives helped them make positive changes to improve their health. Nevertheless, satisfaction varied considerably depending on characteristics of the program, such as the form and magnitude of the incentive, health focus of the program, and program delivery method. ConclusionsProgram and incentive characteristics play key roles in participants' satisfaction and experience with incentive-based, chronic disease prevention programs. Further research is required to examine the optimal design of incentive programs to support sustained behavior change.
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22
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Treiman K, McCormack L, Wagner L, Roach N, Moultrie R, Sanoff H, Bann C, Street RL, Ashok M, Reeve BB. Factors affecting the communication experiences of newly diagnosed colorectal cancer patients. Patient Educ Couns 2018; 101:1585-1593. [PMID: 29803565 DOI: 10.1016/j.pec.2018.04.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 01/16/2018] [Revised: 04/05/2018] [Accepted: 04/23/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE This study assessed patient-centered communication (PCC) among newly diagnosed colorectal cancer patients. PCC, a key part of patient-centered care, contributes directly and indirectly to health-related quality of life, satisfaction with care, and other outcomes. METHODS We conducted a survey of patients in North Carolina, using a theoretically-based and validated measure that provides an overall PCC score and subscale scores for six PCC functions. RESULTS A total of 501 patients participated. The highest scores were for the PCC functions of Fostering Healing Relationships, Exchanging Information, and Making Decisions. The lowest scores were for the functions of Managing Uncertainty and Enabling Self-Management, yet these were functions respondents rated as most important. Respondents who thought about more than one health professional (versus oncologist) reported better communication. PCC also varied by treatment type, mental and physical health status, age, race, and education. CONCLUSION Most patients reported good communication overall, however patients in poor physical health and mental health reported worse communication. The quality of communication varied across the PCC functions. PRACTICE IMPLICATIONS Health professionals need to use a PCC approach that builds trust, respects the patient, provides salient information that patients can understand, provides emotional support, and facilitates the patient's engagement in care.
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Affiliation(s)
- Katherine Treiman
- RTI International, Research Triangle Park, NC, United States (Treiman at RTI International, 6110 Executive Blvd, Rockville, MD 20850).
| | - Lauren McCormack
- RTI International, Research Triangle Park, NC, United States (Treiman at RTI International, 6110 Executive Blvd, Rockville, MD 20850)
| | - Laura Wagner
- RTI International, Research Triangle Park, NC, United States (Treiman at RTI International, 6110 Executive Blvd, Rockville, MD 20850)
| | - Nancy Roach
- Fight Colorectal Cancer, Alexandria, VA, United States
| | - Rebecca Moultrie
- RTI International, Research Triangle Park, NC, United States (Treiman at RTI International, 6110 Executive Blvd, Rockville, MD 20850)
| | - Hannah Sanoff
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States
| | - Carla Bann
- RTI International, Research Triangle Park, NC, United States (Treiman at RTI International, 6110 Executive Blvd, Rockville, MD 20850)
| | - Richard L Street
- Department of Communication, Texas A&M University, College Station, TX, United States
| | - Mahima Ashok
- RTI International, Research Triangle Park, NC, United States (Treiman at RTI International, 6110 Executive Blvd, Rockville, MD 20850)
| | - Bryce B Reeve
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States; Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
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Narayan A, Bann C, Treiman K, Soloe C. Fertility and cancer: Understanding the barriers to accessing information and resources. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.7_suppl.116] [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: 11/20/2022] Open
Abstract
116 Background: Some cancer treatments may lead to infertility in individuals diagnosed during their reproductive years. Infertility can affect a cancer survivor’s long-term quality of life by causing depression as well as reduced life satisfaction and increased anxiety. Addressing fertility concerns is a major component of survivorship care. Methods: In 2017 LIVESTRONG launched a national survey to assess whether patients are being informed about potential fertility risks due to a cancer diagnosis and/or related treatments; whether they are receiving necessary education and access to resources to make informed decisions about fertility preservation; and the financial burden of fertility preservation. A total of 1,064 people diagnosed with cancer between ages of 15-39 during 2006 to 2017 responded to the survey. Results: Seventy-nine percent of respondents said a health professional had discussed fertility issues with them, but only 51% were referred to a fertility specialist. Respondents diagnosed between 2011 and 2017 were more likely to report fertility discussions compared to those diagnosed between 2006 and 2010 (84% vs. 69%; p<.001), and to be referred to a fertility specialist (58% vs. 33%, p <.0001). More educated respondents and those with health insurance at time of diagnosis were more likely to report fertility discussions than those who did not (96% vs. 85%; p=.04). The most frequently discussed topics were possible risks to fertility (89%), methods of fertility preservation (70%), whether the respondent wanted any/or more children (64%), and timing for fertility preservation (50%). Insurance and financial issues were less frequently discussed: costs of fertility preservation (37%), insurance coverage (26%), and financial assistance (30%). Forty-four percent did not take steps to preserve their fertility. Conclusions: Many respondents reported not preserving fertility before treatment because they were not referred to a fertility specialist (30%) or insurance did not cover the costs (20%). All patients diagnosed in their reproductive years should be informed of infertility risks and receive information/resources on preservation options, regardless of education, income level, and insurance status.
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Affiliation(s)
| | - Carla Bann
- RTI International, Research Triangle Park, NC
| | | | - Cindy Soloe
- RTI International, Research Triangle Park, NC
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24
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Treiman K, McCormack L, Olmsted M, Roach N, Reeve BB, Martens CE, Moultrie RR, Sanoff H. Engaging Patient Advocates and Other Stakeholders to Design Measures of Patient-Centered Communication in Cancer Care. Patient 2017; 10:93-103. [PMID: 27658673 DOI: 10.1007/s40271-016-0188-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Patient-centered communication (PCC) is an essential component of patient-centered care and contributes to patient satisfaction, health-related quality of life, and other important patient outcomes. OBJECTIVE The aim of this study was to develop and test survey questions to assess patients' experiences with PCC in cancer care. METHODS We used a conceptual model developed by the National Cancer Institute as our framework. The survey questions align with the six core functions of PCC defined in the model: Exchanging Information, Managing Uncertainty, Enabling Patient Self-Management, Fostering Healing Relationships, Making Decisions, and Responding to Emotions. The study focused on colorectal cancer patients. We conducted two rounds of cognitive interviewing to evaluate patients' ability to understand and provide valid answers to the PCC questions. Interviews were conducted in Maryland and North Carolina in 2014. We involved a patient advocacy group, Fight Colorectal Cancer, and a multidisciplinary panel of stakeholders throughout the measurement development process to ensure that the survey questions capture aspects of PCC that are important to patients and meet the needs of potential end users, including researchers, healthcare organizations, and health professionals. RESULTS Patient and other stakeholder input informed revisions of draft survey questions, including changes to survey instructions, frame of reference for questions, response scales, and language. CONCLUSION This study demonstrated the feasibility and value of engaging patients and other stakeholders in a measurement development study. The Patient-Centered Outcomes Research Institute (PCORI) conceptual model of patient-centered outcomes research provides a useful guide for patient engagement in research. Research funders should call for meaningful roles for patients and other stakeholders in health research, including in the development of patient-centered outcomes.
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Affiliation(s)
- Katherine Treiman
- RTI International, 3040 E. Cornwallis Road, PO Box 12194, Research Triangle Park, NC, 27709-2194, USA. .,RTI International, 6110 Executive Blvd, Rockville, MD, 20852, USA.
| | - Lauren McCormack
- RTI International, 3040 E. Cornwallis Road, PO Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Murrey Olmsted
- RTI International, 3040 E. Cornwallis Road, PO Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Nancy Roach
- Fight Colorectal Cancer, Alexandria, VA, 22314, USA
| | - Bryce B Reeve
- University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Christa E Martens
- University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Rebecca R Moultrie
- RTI International, 3040 E. Cornwallis Road, PO Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Hanna Sanoff
- University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
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Reeve BB, Thissen DM, Bann CM, Mack N, Treiman K, Sanoff HK, Roach N, Magnus BE, He J, Wagner LK, Moultrie R, Jackson KD, Mann C, McCormack LA. Psychometric evaluation and design of patient-centered communication measures for cancer care settings. Patient Educ Couns 2017; 100:1322-1328. [PMID: 28214167 DOI: 10.1016/j.pec.2017.02.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [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: 09/29/2016] [Revised: 02/01/2017] [Accepted: 02/09/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To evaluate the psychometric properties of questions that assess patient perceptions of patient-provider communication and design measures of patient-centered communication (PCC). METHODS Participants (adults with colon or rectal cancer living in North Carolina) completed a survey at 2 to 3 months post-diagnosis. The survey included 87 questions in six PCC Functions: Exchanging Information, Fostering Health Relationships, Making Decisions, Responding to Emotions, Enabling Patient Self-Management, and Managing Uncertainty. For each Function we conducted factor analyses, item response theory modeling, and tests for differential item functioning, and assessed reliability and construct validity. RESULTS Participants included 501 respondents; 46% had a high school education or less. Reliability within each Function ranged from 0.90 to 0.96. The PCC-Ca-36 (36-question survey; reliability=0.94) and PCC-Ca-6 (6-question survey; reliability=0.92) measures differentiated between individuals with poor and good health (i.e., known-groups validity) and were highly correlated with the HINTS communication scale (i.e., convergent validity). CONCLUSION This study provides theory-grounded PCC measures found to be reliable and valid in colorectal cancer patients in North Carolina. Future work should evaluate measure validity over time and in other cancer populations. PRACTICE IMPLICATIONS The PCC-Ca-36 and PCC-Ca-6 measures may be used for surveillance, intervention research, and quality improvement initiatives.
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Affiliation(s)
- Bryce B Reeve
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 101 E. Weaver Street, Suite 220, Carrboro, NC, 27510, USA; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1105-B McGavran-Greenberg Hall, CB#7411, Chapel Hill, NC, 27599-7411, USA.
| | - David M Thissen
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB #3270, Davie Hall, Chapel Hill, NC 27599-3270, USA.
| | - Carla M Bann
- Division of Statistical and Data Sciences, RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC, 27709-2194, USA.
| | - Nicole Mack
- Division of Statistical and Data Sciences, RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC, 27709-2194, USA.
| | - Katherine Treiman
- Center for Communication Science, RTI International, 6110 Executive Blvd, Rockville, MD 20850, USA.
| | - Hanna K Sanoff
- Department of Medicine, University of North Carolina at Chapel Hill, 170 Manning Drive, Chapel Hill, NC, 27599, USA.
| | - Nancy Roach
- Fight Colorectal Cancer, 1414 Prince Street, Suite 204, Alexandria, VA, 22314, USA.
| | - Brooke E Magnus
- Department of Psychology, Marquette University, 317 Cramer Hall, Milwaukee, WI, 53233, USA.
| | - Jason He
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB #3270, Davie Hall, Chapel Hill, NC 27599-3270, USA.
| | - Laura K Wagner
- Public Health Research Division, RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC, 27709-2194, USA.
| | - Rebecca Moultrie
- Public Health Research Division, RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC, 27709-2194, USA.
| | - Kathryn D Jackson
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 101 E. Weaver Street, Suite 220, Carrboro, NC, 27510, USA.
| | - Courtney Mann
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 101 E. Weaver Street, Suite 220, Carrboro, NC, 27510, USA.
| | - Lauren A McCormack
- Public Health Research Division, RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC, 27709-2194, USA.
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Bann CM, Treiman K, Squiers L, Tzeng J, Nutt S, Arvey S, McGoldrick D, Rechis R. Cancer Survivors' Use of Fertility Preservation. J Womens Health (Larchmt) 2015; 24:1030-7. [DOI: 10.1089/jwh.2014.5160] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Carla M. Bann
- RTI International, Research Triangle Park, North Carolina
| | | | - Linda Squiers
- RTI International, Research Triangle Park, North Carolina
| | - Janice Tzeng
- RTI International, Research Triangle Park, North Carolina
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Hemingway B, Arvey SR, Rechis R, Squiers L, Eargle E, Treiman K. Self-efficacy through survivorship: Results from the LIVESTRONG Cancer Navigation Study. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.9577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Wilson EK, Krieger KE, Koo HP, Minnis AM, Treiman K. Feasibility and acceptability of a computer-based tool to improve contraceptive counseling. Contraception 2014; 90:72-8. [PMID: 24815097 DOI: 10.1016/j.contraception.2014.02.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 12/26/2013] [Revised: 02/19/2014] [Accepted: 02/27/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The objective was to test the feasibility and acceptability of a computerized tool, Smart Choices, designed to enhance the quality of contraceptive counseling in family planning clinics. The tool includes (a) a questionnaire completed by patients and summarized in a printout for providers and (b) a birth control guide patients explore to learn about various contraceptive methods. STUDY DESIGN In 2 family planning clinics, we conducted interviews with 125 women who used the Smart Choices computerized tool and 7 providers. RESULTS Smart Choices integrated into clinic flow well in one clinic, but less well in the other, which had very short waiting times. Patients were generally enthusiastic about Smart Choices, including its helpfulness in preparing them and their providers for the counseling session and increasing their knowledge of contraceptive methods. Providers varied in how much they used the printout and in their opinions about its usefulness. Some felt its usefulness was limited because it overlapped with the clinic's intake forms or because it did not match with their concept of counseling needs. Others felt it provided valuable information not collected by intake forms and more honest information. Some found Smart Choices to be most helpful with patients who were unsure what method they wanted. CONCLUSIONS Smart Choices is feasible to implement and well received by patients, but modifications are needed to increase provider enthusiasm for this tool. IMPLICATIONS The Smart Choices tool requires refinement before widespread dissemination.
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McCormack L, Treiman K, Bann C, Williams-Piehota P, Driscoll D, Poehlman J, Soloe C, Lohr K, Sheridan S, Golin C, Cykert S, Harris R. Translating medical evidence to promote informed health care decisions. Health Serv Res 2011; 46:1200-23. [PMID: 21352225 PMCID: PMC3165184 DOI: 10.1111/j.1475-6773.2011.01248.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To examine the effects of a community-based intervention on decisions about prostate-specific antigen (PSA) screening using multiple measures of informed decision making (IDM). DATA SOURCES/STUDY SETTING Nonequivalent control group time series design collecting primary data in late 2004 and 2005. STUDY DESIGN We developed a multimodal intervention designed to convey the medical uncertainty about the benefits of PSA screening and early treatment and the limited predictive ability of both the PSA test and pathological specimens collected from prostate biopsy. We examined (1) patients' recognition that there is a decision to be made about PSA screening, (2) prostate cancer knowledge levels, (3) their preferred and actual levels of participation in decision making about screening at three points in time, and (4) screening decision. DATA COLLECTION Baseline data collection occurred in community-based organizations. These organizations served as recruiting sources and as sites for the intervention. We collected follow-up data by mail with telephone reminders. PRINCIPAL FINDINGS Our intervention was associated with greater recognition of the PSA test as a decision to be made, levels of knowledge, both preferred and actual levels of involvement in decision making, but did not have an impact on the screening decision. CONCLUSIONS Community-based interventions can influence key measures of IDM about PSA screening.
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Affiliation(s)
- Lauren McCormack
- RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA.
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McCormack LA, Treiman K, Rupert D, Williams-Piehota P, Nadler E, Arora NK, Lawrence W, Street RL. Measuring patient-centered communication in cancer care: a literature review and the development of a systematic approach. Soc Sci Med 2011; 72:1085-95. [PMID: 21376443 DOI: 10.1016/j.socscimed.2011.01.020] [Citation(s) in RCA: 206] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Revised: 11/07/2010] [Accepted: 01/15/2011] [Indexed: 11/19/2022]
Abstract
Patient-centered communication (PCC) is a critical element of patient-centered care, which the Institute of Medicine (Committee on Quality of Health Care in America, 2001) promulgates as essential to improving healthcare delivery. Consequently, the US National Cancer Institute's Strategic Plan for Leading the Nation (2006) calls for assessing the delivery of PCC in cancer care. However, no comprehensive measure of PCC exists, and stakeholders continue to embrace different conceptualizations and assumptions about how to measure it. Our approach was grounded in the PCC conceptual framework presented in a recent US National Cancer Institute monograph (Epstein & Street, 2007). In this study, we developed a comprehensive inventory of domains and subdomains for PCC by reviewing relevant literature and theories, interviewing a limited number of cancer patients, and consulting experts. The resulting measurement domains are organized under the six core functions specified in the PCC conceptual framework: exchanging information, fostering healing relationships, recognizing and responding to emotions, managing uncertainty, making decisions, and enabling patient self-management. These domains represent a promising platform for operationalizing the complicated PCC construct. Although this study focused specifically on cancer care, the PCC measurements are relevant to other clinical contexts and illnesses, given that patient-centered care is a goal across all healthcare. Finally, we discuss considerations for developing PCC measures for research, quality assessment, and surveillance purposes. United States Department of Health and Human Services, National Institutes of Health, National Cancer Institute (2006). The NCI Strategic Plan for Leading the Nation: To Eliminate the Suffering and Death Due to Cancer. NIH Publication No. 06-5773.
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Affiliation(s)
- Lauren A McCormack
- Health Communication Program, RTI International, 3040 Cornwallis Road, RTP, NC 27709, USA.
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Williams-Piehota PA, McCormack LA, Treiman K, Bann CM. Health information styles among participants in a prostate cancer screening informed decision-making intervention. Health Educ Res 2008; 23:440-453. [PMID: 18385197 DOI: 10.1093/her/cyn011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The purpose of this study was to assess the usefulness of a health information styles segmentation strategy in understanding audience subgroups. We examined the health information styles of men participating in a prostate cancer screening informed decision-making (IDM) intervention and assessed intervention effects on men with distinct health information styles. We classified participants into three health information style groups based on their independence in health decision making (independent versus doctor dependent) and engagement in health enhancement (active versus passive): independent active (IA), doctor-dependent active (DDA) and passive. We developed profiles of men in these groups: IAs tended to be white and more highly educated and to have greater baseline prostate cancer knowledge; DDAs were older, less healthy and more likely to have visited a doctor in the past year and passives tended to be younger, not to have had a recent prostate-specific antigen test and to have lower self-efficacy related to communication with doctors and less positive interactions with doctors. All groups significantly increased their prostate cancer knowledge after the intervention, but passives exhibited the greatest increase in knowledge at a 6-month follow-up. The health information styles segmentation strategy used in this study offers a viable framework for segmenting audiences.
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Rutten LJF, Squiers L, Treiman K. Requests for information by family and friends of cancer patients calling the National Cancer Institute's Cancer Information Service. Psychooncology 2007; 15:664-72. [PMID: 16302290 DOI: 10.1002/pon.995] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE To characterize their information needs, we examined the main topics of inquiry and discussion (subjects of interaction, SOI) of calls made by family and friends of cancer patients to the National Cancer Institute's Cancer Information Service's (CIS) 1-800-4-CANCER telephone information service and summarized differences by sociodemographic characteristics. DESIGN AND ANALYSIS Data from 26 789 family or friends of cancer patients calling the CIS between September 2002 and August 2003 were analyzed. Frequencies, chi(2)'s, and logistic regressions were conducted to ascertain sample characteristics and sociodemographic correlates of each SOI. RESULTS AND CONCLUSIONS The greatest proportion of calls concerned specific treatment information (54.9%) and general cancer site information (36.9%). Calls about specific treatment information were more likely among Asians, Hawaiian Natives, and Pacific Islanders (OR = 1.23, 1.04-1.45), and those with higher education (OR = 1.21, 1.18-1.25). As age increased, the odds of calls about specific treatment information also increased (OR = 1.05, 1.03-1.07). Females (OR = 0.78, 0.72-0.84), Hispanics (OR = 0.77, 0.67-0.89), African-Americans (OR = 0.68, 0.61-0.76), and American-Indians and Alaskan Natives (OR = 0.74, 0.58-0.93) were less likely to inquire about specific treatment information. Inquiries about general cancer site information were more likely among females (OR = 1.14, 1.06-1.23) and less likely among younger callers (OR = 0.95, 0.93-0.97) and African-Americans (OR = 0.87, 0.78-0.98). Differences in inquiries made by sociodemographic subgroups can inform the CIS' and other cancer-related organizations' efforts to develop and disseminate cancer information for family and friends of cancer patients.
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Affiliation(s)
- Lila J Finney Rutten
- Health Communication and Informatics Research Branch, Behavioral Research Program, Division of Cancer Control and Population Science, National Cancer Institute-SAIC-Frederick, Bethesda, MD 20892-7361, USA.
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La Porta M, Hagood H, Kornfeld J, Treiman K. Partnership as a means for reaching special populations: evaluating the NCI's CIS Partnership Program. J Cancer Educ 2007; 22:S35-40. [PMID: 17571999 DOI: 10.1007/bf03174344] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
BACKGROUND The National Cancer Institute's (NCI's) Cancer Information Service (CIS) Partnership Program involves collaboration with over 900 organizations and coalitions serving minority and medically underserved populations. Cancer Information Service collaborations are categorized into three types: networking, educational program, and program development partnerships. METHODS A survey of CIS partnership organizations (n = 288). RESULTS Most respondents reported that partnerships with CIS are collaborative and make good use of their organization's skills and resources, and most perceive that the benefits of partnership outweigh any drawbacks. More than one-quarter say partnerships have not done a good job evaluating collaborative activities. Results vary among three types of partnerships. CONCLUSIONS Evaluation of the CIS Partnership Program presents an opportunity to examine how a large-scale and multi-faceted partnership effort has been implemented, how it is evaluated, and initial indicators of program success. Organizations, health professionals, and community leaders interested in effective partnerships can use these findings to strengthen collaborations and maximize outcomes.
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Affiliation(s)
- Madeline La Porta
- The Cancer Information Service, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-8322, USA.
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La Porta M, Hagood H, Kornfeld J, Treiman K. Evaluating the NCI's Cancer Information Service Contact Centers: meeting and exceeding the expectations of the public. J Cancer Educ 2007; 22:S18-25. [PMID: 17571996 DOI: 10.1007/bf03174342] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The National Cancer Institute's (NCI's) Cancer Information Service (CIS) provides cancer information to the public via 1-800-4-CANCER, a smoking quitline, and online. The 2003 National User Survey assessed satisfaction and outcomes among users contacting NCI's CIS by telephone and LiveHelp, an instant messaging service. Ninety-five percent of respondents were very satisfied/satisfied and 88% said their expectations had been met/exceeded. Users reported increased knowledge and self-efficacy. Most had discussed CIS information with a health professional or planned to do so. Of those who contacted CIS about smoking/tobacco use, 14% had quit and 35% cut back. The CIS provides a highly valued, effective service for patients and health professionals.
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Affiliation(s)
- Madeline La Porta
- The Cancer Information Service, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-8322, USA.
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La Porta M, Hagood H, Patt J, Hodorowski JK, Treiman K. The NCI's Cancer Information Service: meeting the public's cancer information needs via the internet. J Cancer Educ 2007; 22:S26-34. [PMID: 17571998 DOI: 10.1007/bf03174343] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The Cancer Information Service (CIS) of the National Cancer Institute (NCI) added e-mail and instant chat to its telephone service (1-800-4-CANCER, 1-877-44U-QUIT). While most CIS contacts are still via telephone, internet contacts have increased from 9000 in 2001 to over 20,000 in 2006. The NCI leveraged 30 years of CIS telephone experience to understand the needs of Internet information seekers. Online users are more likely to contact CIS on behalf of someone else. Instant chat users are younger and more educated than telephone users. They report high satisfaction levels, increased knowledge, and other positive effects from their interactions. Patients and their families can benefit from awareness of CIS online services and health care providers can be confident in directing them to CIS.
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Affiliation(s)
- Madeline La Porta
- The Cancer Information Service, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-8322, USA.
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Squiers L, Bright MA, Rutten LJF, Atienza AA, Treiman K, Moser RP, Hesse B. Awareness of the National Cancer Institute's Cancer Information Service: results from the Health Information National Trends Survey (HINTS). J Health Commun 2006; 11 Suppl 1:117-33. [PMID: 16641078 DOI: 10.1080/10810730600637517] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Established in 1975, the National Cancer Institute's (NCI's) Cancer Information Service (CIS) is a national information and education network that serves the nation by providing the latest scientific cancer information to the American public. The purpose of this study was to determine the public's awareness of the CIS and other national cancer and health organizations by analyzing data from the NCI's Health Information National Trends Survey (HINTS 2003). This study also examined sociodemographic, health, and communication correlates of awareness of CIS and other national health organizations: American Cancer Society (ACS), National Institutes of Health (NIH), and NCI. Results indicated that awareness of the CIS was low (32.8%). Some subgroups were more likely to be aware of the CIS than others. When comparing awareness levels of the four national health organizations, marked differences in patterns of awareness among specific subgroups emerged for many sociodemographic variables. For example, minority groups were significantly more aware of the CIS than Whites; however, for all three other organizations a greater percentage of Whites were aware of each organization. For the NIH, NCI, and ACS, respondents in the highest income group were most aware of each organization and, as income level increased awareness also increased. The CIS, respondents with the lowest income levels, however, were more aware of the CIS compared with middle- and high-income groups. A similar pattern was found for other sociodemographic variables. Results of this study will guide the development of a targeted promotional campaign for the CIS.
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Affiliation(s)
- Linda Squiers
- Office of Cancer Information Service, National Cancer Institute, Bethesda, Maryland 20850, USA.
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Squiers L, Finney Rutten LJ, Treiman K, Bright MA, Hesse B. Cancer patients' information needs across the cancer care continuum: evidence from the cancer information service. J Health Commun 2005; 10 Suppl 1:15-34. [PMID: 16377598 DOI: 10.1080/10810730500263620] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
This study examines the information needs of cancer patients who contacted the National Cancer Institute's (NCI's) Cancer Information Service (CIS) via a toll-free telephone number. Records from 19,030 calls received from cancer patients between September 2002 and August 2003 were analyzed to determine differences in subjects of interaction (main topics of inquiry and discussion) for subgroups of patients based on demographic characteristics and stage along the cancer care continuum (pretreatment, in-treatment, post-treatment, recurrence). Females were more likely than males to inquire about cancer screening/diagnosis, support services, psychosocial issues, and general cancer site information, but they were less likely to seek specific cancer treatment information. Older patients were more likely than younger patients to seek specific treatment information, but they were less interested in support services, psychosocial issues, and prevention/risk factors. Compared with White callers, Hispanics and most minorities were more likely to seek support service information, and African Americans were more likely to have questions related to psychosocial issues. Compared with patients in treatment, patients in recurrence were more likely to seek specific treatment information; patients not in treatment were more likely to seek medical referral information; and patients in post-treatment were more likely to seek screening/diagnosis and prevention/risk factor information. Findings will help the CIS and other cancer-focused organizations address the distinct information needs of different subsets of cancer patients.
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Affiliation(s)
- Linda Squiers
- Cancer Information Service, National Cancer Institute, Bethesda, Maryland 20850, USA
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Havas S, Treiman K, Langenberg P, Ballesteros M, Anliker J, Damron D, Feldman R. Factors associated with fruit and vegetable consumption among women participating in WIC. J Am Diet Assoc 1998; 98:1141-8. [PMID: 9787720 DOI: 10.1016/s0002-8223(98)00264-8] [Citation(s) in RCA: 96] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The purpose of this analysis was to assess to what extent sociodemographic and psychosocial characteristics predict consumption of fruits and vegetables in women served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). DESIGN Baseline survey data were analyzed for women enrolled in the Maryland WIC 5 A Day Promotion Program, a study sponsored by the National Cancer Institute. Sociodemographic variables included age, race, education, marital status, working status, pregnancy status, and smoking status. Psychosocial variables included self-efficacy, knowledge, attitudes, social support, and perceived barriers to consuming 5 or more servings daily of fruits and vegetables. SUBJECTS/SETTING Analyses are based on 3,122 women enrolled at 15 WIC sites in Baltimore and 6 counties in Maryland. STATISTICAL ANALYSES PERFORMED Because psychosocial characteristics were measured on different scales and varied in dispersion, we standardized scores for these variables. Multiple regression analyses were then performed to assess contributions of the sociodemographic variables and the standardized psychosocial variable scores to the variance in consumption of fruits and vegetables. RESULTS Sociodemographic variables were not powerful predictors of fruit and vegetable consumption. In contrast, an increase of 1 standard deviation in self-efficacy resulted in a mean increase of 0.76 servings, and an increase of 1 standard deviation in perceived barriers resulted in a decrease of 0.50 servings. About 21% of the variance in consumption was explained by all of the variables examined. APPLICATIONS Dietitians and intervention programs should focus on increasing clients' self-efficacy, positive attitudes, and knowledge relating to fruits and vegetables while trying to reduce perceived barriers to consumption of fruits and vegetables.
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Affiliation(s)
- S Havas
- Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201, USA
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Havas S, Damron D, Treiman K, Anliker J, Langenberg P, Hammad TA, Ballesteros M, Freimuth V, Feldman R. The Maryland WIC 5 A Day Promotion Program Pilot Study: Rationale, Results, and Lessons Learned. ACTA ACUST UNITED AC 1997. [DOI: 10.1016/s0022-3182(97)70249-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Alexander LL, Treiman K, Clarke P. A national survey of nurse practitioner chlamydia knowledge and treatment practices of female patients. Nurse Pract 1996; 21:48-54. [PMID: 8734625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Chlamydia is the most prevalent sexually transmitted disease in the United States, with over 4 million new infections presenting each year. The disease presents disproportionate problems for women who are generally asymptomatic; chlamydia is more difficult to diagnose in women than men. Untreated infections in women evolve into serious reproductive tract sequelae, including pelvic inflammatory disease, chronic pain, infertility, ectopic pregnancy, and neonatal complications. The bright side to this epidemic is that these sequelae are preventable. Chlamydia is both treatable and easily cured when it is detected. A national mailed survey of NPs was conducted to ascertain current chlamydia knowledge levels and clinical practices with female patients. Survey findings indicate that NPs are fairly knowledgeable about the infection and NP clinical practices are generally consistent with Centers for Disease Control and Prevention recommendations for chlamydia diagnostics and treatment. However, the survey identified NP deficits in screening and treatment practices for pregnant women. These findings are disturbing given the serious risks associated with failure to promptly diagnose and treat prenatal infections. The survey highlights the need for continuing professional education about chlamydia and other sexually transmitted infections.
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Affiliation(s)
- L L Alexander
- Department of Health Education, University of Maryland, USA
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Treiman K, Freimuth V, Damron D, Lasswell A, Anliker J, Havas S, Langenberg P, Feldman R. Attitudes and Behaviors Related to Fruits and Vegetables among Low-income Women in the WIC Program. ACTA ACUST UNITED AC 1996. [DOI: 10.1016/s0022-3182(96)70050-x] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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