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Carroll JK, Hester CM, Lutgen CB, Callen E, Hunt S, Lanigan AM, Bartlett-Esquilant G, Irwin G, Jones WA, Loskutova N, Mabachi NM, Okuyemi KS, Peterson LE, Smith RE, Tabel C, Weidner A. Research interests of family physicians applying for research training. BMC Med Educ 2023; 23:617. [PMID: 37644437 PMCID: PMC10466687 DOI: 10.1186/s12909-023-04562-0] [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] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 07/31/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND There is an ongoing need for research to support the practice of high quality family medicine. The Family Medicine Discovers Rapid Cycle Scientific Discovery and Innovation (FMD RapSDI) program is designed to build capacity for family medicine scientific discovery and innovation in the United States. Our objective was to describe the applicants and research questions submitted to the RapSDI program in 2019 and 2020. METHODS Descriptive analysis for applicant characteristics and rapid qualitative analysis using principles of grounded theory and content analysis to examine the research questions and associated themes. We examined differences by year of application submission and the applicant's career stage. RESULTS Sixty-five family physicians submitted 70 applications to the RapSDI program; 45 in 2019 and 25 in 2020. 41% of applicants were in practice for five years or less (n = 27), 18% (n = 12) were in in practice 6-10 years, and 40% (n = 26) were ≥ 11 years in practice. With significant diversity in questions, the most common themes were studies of new innovations (n = 20, 28%), interventions to reduce cost (n = 20, 28%), improving screening or diagnosis (n = 19, 27%), ways to address mental or behavioral health (n = 18, 26%), and improving care for vulnerable populations (n = 18, 26%). CONCLUSION Applicants proposed a range of research questions and described why family medicine is optimally suited to address the questions. Applicants had a desire to develop knowledge to help other family physicians, their patients, and their communities. Findings from this study can help inform other family medicine research capacity building initiatives.
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Affiliation(s)
- Jennifer K Carroll
- Department of Family Medicine, University of Colorado, 12631 East 17th Ave Box F496, Aurora, CO, 80045, USA.
| | | | - Cory B Lutgen
- American Academy of Family Physicians, Leawood, KS, USA
| | | | - Sharon Hunt
- American Academy of Family Physicians, Leawood, KS, USA
| | | | | | - Gretchen Irwin
- University of Kansas School of Medicine, Wichita, KS, USA
| | - Warren A Jones
- University of Mississippi School of Medicine, Jackson, MS, USA
- The Jones Group of Mississippi, Jackson, MS, USA
| | | | | | - Kolawole S Okuyemi
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | | | - Cheri Tabel
- American Academy of Family Physicians, Leawood, KS, USA
| | - Amanda Weidner
- Association of Departments of Family Medicine, Leawood, KS, USA
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Odukoya OO, Odediran OO, Rogers CR, Ogunsola F, Okuyemi KS. Exploring the barriers and facilitators towards physical activity among church members in Lagos, Nigeria: a qualitative study. Afr Health Sci 2023; 23:572-581. [PMID: 38223576 PMCID: PMC10782367 DOI: 10.4314/ahs.v23i2.66] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024] Open
Abstract
Background Physical inactivity is substantially linked to the rise in the global burden of non-communicable diseases. Faith-based organizations are recognized as potential partners for sustainable health interventions. Objective This study aims to explore the facilitators and barriers towards physical activity among adult church members in Lagos, Nigeria. Methods Sixteen focus group discussions (n-163) were conducted among adult male and female church members in twelve Anglican churches. The discussions were audio-taped, transcribed verbatim and analysed along with the field notes for themes using sequential approach with the aid of the Dedoose® software. Results Individual facilitators of PA included self-discipline, and personal habits. Individual barriers were laziness, ill-health, fear of injury and pre-existing health conditions. Organizational facilitators included biblical verses promoting PA, while deterring factors were lack of safe spaces for PA and poor knowledge among church leadership. The community-level facilitators included pro-physical activity cultural practices, while the prevailing practice hiring house-helps, high costs of gym membership and gender norms discouraging men from participating in household chores served as deterring community-level factors. Environmental facilitators were the availability of safe spaces for PA while deterring factors were city living and high traffic density. Conclusion Several multi-level factors influence physical activity among church members. While it is pertinent to address personal factors, family and community factors also promote PA, therefore, group-level interventions may be warranted. Strategies that address the socio-cultural norms that serve as barriers to PA should also be included in the design of church-based PA programmes.
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Affiliation(s)
- Oluwakemi Ololade Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos& Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Omoladun Olukemi Odediran
- Department of Community Health and Primary Care, College of Medicine, University of Lagos& Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Charles R Rogers
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Folasade Ogunsola
- Department of Microbiology and Parasitology, College of Medicine, University of Lagos, Nigeria
| | - Kolawole S Okuyemi
- Department of Community Health and Primary Care, College of Medicine, University of Lagos& Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Department of Microbiology and Parasitology, College of Medicine, University of Lagos, Nigeria
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Bhattacharya M, Ojo-Fati O, Everson-Rose SA, Thomas JL, Miller JM, Ogedegbe G, Jean-Louis G, Joseph AM, Okuyemi KS. Smoking reduction among homeless smokers in a randomized controlled trial targeting cessation. Addict Behav 2022; 133:107373. [PMID: 35689905 DOI: 10.1016/j.addbeh.2022.107373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Homeless populations have high rates of smoking and unique barriers to quitting. General cessation strategies have been unsuccessful in this population. Smoking reduction may be a good intermediate goal. We conducted a secondary analysis to identify predictors of smoking reduction in a cohort of homeless smokers enrolled in a 26-week randomized clinical trial (RCT) targeting smoking cessation. METHODS Data are from an RCT comparing motivational interviewing counseling plus nicotine replacement therapy (NRT) to brief advice to quit (standard care) plus NRT among homeless smokers. Using bivariate analyses and multinomial logistic regression, we compared demographics, health and psychosocial variables, tobacco use, substance use, and NRT adherence among those who reported: quitting; reducing smoking by 50-99%; and not reducing smoking by 50%. RESULTS Of 324 participants who completed 26-week follow-up, 18.8% and 63.9% self-reported quitting and reducing, respectively. Compared to those who did not reduce smoking, participants reporting reducing indicated higher baseline cigarette use (OR=1.08; CI:1.04-1.12) and menthol use (OR=2.24; CI:1.05-4.77). Compared to participants who reduced, participants reporting quitting were more likely to be male (OR=1.998; CI:1.00-3.98), experience more housing instability (OR=1.97; CI:1.08-3.59), indicate higher importance of quitting (OR=1.27; CI:1.041.55), have higher NRT adherence (OR=1.75; CI:1.00-3.06), and lower odds of reported illicit drug use (OR=0.48; CI:0.24-0.95). CONCLUSIONS Over half of participants reduced smoking by at least 50%, indicating reduction is feasible among homeless smokers. Further research is required to understand the impact of reduction on future cessation attempts in homeless smokers. This study shows that reduction is achievable and may be a valid intermediate goal.
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Affiliation(s)
- Manami Bhattacharya
- University of Minnesota, Department of Health Policy and Management, Minneapolis, MN 55455, USA.
| | - Olamide Ojo-Fati
- California Department of Public Health, Sacramento, CA, United States
| | | | - Janet L Thomas
- University of Minnesota, Department of Medicine, Minneapolis, MN, United States
| | - Jonathan M Miller
- University of Minnesota, Department of Health Policy and Management, Minneapolis, MN 55455, USA
| | - Gbenga Ogedegbe
- New York University, Department of Population Health, New York, NY, United States
| | - Girardin Jean-Louis
- New York University, Department of Population Health, New York, NY, United States
| | - Anne M Joseph
- University of Minnesota, Department of Medicine, Minneapolis, MN, United States
| | - Kolawole S Okuyemi
- University of Utah, Department of Family & Preventive Medicine, Salt Lake City, UT, United States.
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Faseru B, Fagan P, Okuyemi KS. Additional Benefits of Maintaining a Healthy Lifestyle After Quitting Smoking. JAMA Netw Open 2022; 5:e2232784. [PMID: 36136337 DOI: 10.1001/jamanetworkopen.2022.32784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Babalola Faseru
- Department of Population Health, University of Kansas Medical Center, Kansas City
| | - Pebbles Fagan
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock
| | - Kolawole S Okuyemi
- Department of Family & Preventive Medicine, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah
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Odukoya OO, Abdiwahab EA, Olubodun T, Azagba S, Ogunsola FT, Okuyemi KS. Implementing a smoking cessation intervention for people experiencing homelessness: Participants’ preferences, feedback, and satisfaction with the ‘power to quit’ program. PLoS One 2022; 17:e0268653. [PMID: 35749343 PMCID: PMC9231781 DOI: 10.1371/journal.pone.0268653] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 04/08/2022] [Indexed: 12/04/2022] Open
Abstract
Background Smoking rates among populations experiencing homelessness are three times higher than in the general population. Developing smoking cessation interventions for people experiencing homelessness is often challenging. Understanding participant perceptions of such interventions may provide valuable insights for intervention development and implementation. We assessed participants’ satisfaction and preferences for the Power to Quit (PTQ) program. Methods PTQ was a 26-week community-based smoking-cessation RCT among people experiencing homelessness. A total of 315 of the 430 enrolled participants completed the 26 week-study feedback survey. Overall program satisfaction was measured on a 5-point Likert scale by asking the question “Overall, how satisfied were you with the Power to Quit Program?” Analyses were conducted to identify factors associated with overall program satisfaction. Results Participants were mostly male (74.9%), African American (59.0%), 40 years and older (78.2%), and not married or living with a partner (94.9%). Visa gift cards were the most preferred incentive followed by bus tokens and Subway restaurant coupons. The patch and counseling were the top-ranked intervention component, 55.3% rated the patch as very helpful; 59.4% felt counseling sessions was very helpful; 48.6% found reminder phone calls or messages most helpful for appointment reminders. Majority (78.7%) said they were very satisfied overall, 80.0% were very satisfied with the program schedule, and 85.4% were very satisfied with program staff. Race and age at smoking initiation were predictors of overall program satisfaction. African American/Black participants were 1.9 times more likely to be satisfied with the program compared to White participants. Conclusion Majority of the participants of PTQ were satisfied with the program. This study supports the acceptability of a smoking cessation program implemented in a population experiencing homelessness. The high rate of satisfaction among African American participants may be in part because of race concordance between participants, study staff, and community advisory board. Including staff that have a shared lived experience with participants in a smoking cessation study may improve the participant satisfaction within such studies.
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Affiliation(s)
- Oluwakemi Ololade Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos State, Nigeria
- * E-mail:
| | - Ekland A. Abdiwahab
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | - Tope Olubodun
- Department of Community Health and Primary Care, Lagos University Teaching Hospital, Lagos, Lagos State, Nigeria
| | - Sunday Azagba
- Department of Family & Preventive Medicine, University of Utah, Salt Lake City, Utah, United States of America
| | | | - Kolawole S. Okuyemi
- Department of Family & Preventive Medicine, University of Utah, Salt Lake City, Utah, United States of America
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Odukoya OO, Jeet G, Adebusoye B, Idowu O, Ogunsola FT, Okuyemi KS. Targeted faith-based and faith-placed interventions for noncommunicable disease prevention and control in low- and middle-income countries: a systematic review protocol. Syst Rev 2022; 11:119. [PMID: 35690788 PMCID: PMC9188080 DOI: 10.1186/s13643-022-01981-w] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low- and middle-income countries (LMICs) bear a disproportionately high burden of noncommunicable diseases (NCDs) with severe socioeconomic consequences. Targeted interventions that are faith-based or take place in faith-based settings are historically viable for health promotion and disease prevention programmes. However, evidence of their effectiveness often comes from high-income countries. This paper outlines the protocol for the systematic review of faith-based and faith-placed interventions for NCDs in low- and middle-income countries. OBJECTIVE To determine the effectiveness of faith-based and faith-placed interventions or interventions within faith-based settings targeted at NCDs and/or their risk factors in LMICs. METHODS We will conduct a systematic search of PubMed, Embase, Scopus, WHO Library, and grey literature to locate published and unpublished studies. We will consider quantitative studies that report on interventions (a) with faith-based components or that take place in faith-based settings (b) for the prevention and control of one or more of the top ten NCDs listed in the Global Burden of Disease or their known risk factors (c) occurring among adults aged 18 and above (d) that take place in one or more LMICs. We will screen the titles, abstracts, and full text of articles for eligibility. Included articles will be critically appraised for quality and the inclusion of faith-based components by at least two independent reviewers. Data extraction will be performed for study characteristics and findings. A meta-analysis will be used to synthesize the results; if impossible, a narrative synthesis will be performed. DISCUSSION This review will attempt to synthesize up-to-date evidence to guide effective decision-making, allocation of health resources, and the design of future trials to test the efficacy of NCD interventions in faith-based settings. The study will increase the understanding of the existing evidence, highlight the need for additional evidence, and guide possible directions for future collaborations between public health professionals and faith-based health service providers. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020186299.
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Affiliation(s)
- Oluwakemi Ololade Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria.
- Department of Family & Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA.
| | - Gursimer Jeet
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Busola Adebusoye
- Lifespan and Population Health Academics Unit, Clinical Sciences Building, City Hospital Campus, University of Nottingham, Nottingham, UK
| | - Oluwaseun Idowu
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | | | - Kolawole S Okuyemi
- Department of Family & Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA
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Odukoya OO, Odediran O, Rogers CR, Ogunsola F, Okuyemi KS. Barriers and Facilitators of Fruit and Vegetable Consumption among Nigerian Adults in a Faith-Based Setting: A Pre-Intervention Qualitative Inquiry. Asian Pac J Cancer Prev 2022; 23:1505-1511. [PMID: 35633531 PMCID: PMC9587891 DOI: 10.31557/apjcp.2022.23.5.1505] [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: 01/22/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Inadequate consumption of fruit and vegetable is a risk factor for morbidity and mortality associated with non-communicable diseases (NCDs). An understanding of the barriers and facilitators to consumption is important for effectiveness of intervention in Africa. We present insights among church members before developing a church-based multi-component intervention to address the inadequate consumption of fruit and vegetable. METHODS We conducted eighteen focus group discussions among 163 church members. All discussions were audio-taped, transcribed verbatim, and were analyzed for thematic content. RESULTS We identified five main themes; Personal: awareness and knowledge of benefits, choice, habits, and curiosity, dietary restrictions and gastrointestinal symptoms following fruit and vegetable consumption. Familial: practices promoting the ready availability of fruit and vegetables in the home or habits that encourage children to eat vegetables as they transition into adulthood, pre-existing health problems of family members and the long preparation time of some traditional vegetables. Socio-cultural: Cultural practices that encourage F&V consumption, the high cost of fruits and vegetables, alternatives foregone, and cultural taboos. Environmental: inadequate farmland and storage facilities, seasonality of several fruit and vegetables, and sharp practices of force-ripening with chemicals. Church-related: inadequate space provided by the church for arable cultivation and lack of knowledge of the benefits among church leaders, church activities that involve serving fruits and vegetables and the biblical support for the consumption of fruits and vegetables. CONCLUSION It is essential to leverage practices that promote fruit and vegetable intake and address barriers mentioned by the participants when designing such interventions.
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Affiliation(s)
- Oluwakemi O Odukoya
- Public Health Physician, Department of Community Health and Primary Care, College of Medicine, University of Lagos& Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Omoladun Odediran
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Nigeria
| | - Charles R Rogers
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, 375 Chipeta Way, Suite A, UT 84108, USA
| | - Folasade Ogunsola
- Department of Microbiology and Parasitology, College of Medicine, University of Lagos, Nigeria
| | - Kolawole S Okuyemi
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, 375 Chipeta Way, Suite A, UT 84108, USA
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Okuyemi KS, Ojo-Fati O, Aremu TO, Friedrichsen SC, Grude L, Oyenuga M, Shyne M, Murphy SE, Hatsukami D, Joseph AM. A Randomized Trial of Nicotine versus No-nicotine E-cigarettes Among African American Smokers: Changes in Smoking and Tobacco Biomarkers. Nicotine Tob Res 2022; 24:555-563. [PMID: 34669956 DOI: 10.1093/ntr/ntab212] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 04/20/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The objective of this clinical trial was to compare the effects of e-cigarettes with and without nicotine on patterns of combustible cigarette use and biomarkers of exposure to tobacco toxicants among African American smokers. METHODS African American smokers (n = 234) were enrolled in a 12-week, single blind, randomized controlled trial and assigned to ad lib use of nicotine e-cigarettes with or without menthol (2.4% nicotine [equivalent to combustible cigarettes], n = 118), or no-nicotine e-cigarettes (n = 116) for 6 weeks. Surveys were administered at baseline, 2, 6, and 12 weeks, and urinary biomarkers 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and total nicotine equivalents (TNE) were assessed at baseline and 6 weeks. RESULTS Participants smoked an average of 11.4 cigarettes per day (CPD) and 88% used menthol cigarettes at baseline. At Week 6, the nicotine group reported using e-cigarettes 9.1 times per day compared to 11.4 times in the no-nicotine group (p = 0.42). Combustible cigarette smoking decreased 3.0 CPD in the nicotine group compared to 2.7 CPD in the no-nicotine group (p = 0.74). Neither TNE nor NNAL changed significantly between baseline and Week 6. There were no differences in nicotine withdrawal symptoms between treatment groups. Smoking reduction persisted in both groups at Week 12. CONCLUSIONS Contrary to our hypotheses, nicotine e-cigarettes did not significantly reduce the use of combustible cigarettes compared to no-nicotine e-cigarettes in this cohort of African American smokers. Findings suggest e-cigarettes are modestly associated with the decreased use of combustible cigarettes among non-treatment seeking smokers, regardless of nicotine content, but without a reduction in tobacco toxicants. IMPLICATIONS Although e-cigarettes have the potential to reduce harm if substituted for combusted cigarettes (or if they promoted cessation) because of lower levels of tobacco toxicants, this study suggests ad lib use of e-cigarettes among African American smokers, with or without nicotine, results in modest smoking reduction but does not change toxicant exposure in a cohort where smoking cessation or reduction is not the goal. These data suggest that testing future harm reduction interventions using e-cigarettes should include more specific behavioral change coaching, including substituting for or completely stopping combusted cigarettes. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov - NCT03084315.
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Affiliation(s)
- Kolawole S Okuyemi
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Olamide Ojo-Fati
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Taiwo O Aremu
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Samantha C Friedrichsen
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Lindsay Grude
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Mosunmoluwa Oyenuga
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Michael Shyne
- Biostatistical Design and Analysis Center, University of Minnesota, Minneapolis, MN, USA
| | - Sharon E Murphy
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN, USA
| | - Dorothy Hatsukami
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Anne M Joseph
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
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Weber-Main AM, Engler J, McGee R, Egger MJ, Jones HP, Wood CV, Boman K, Wu J, Langi AK, Okuyemi KS. Variations of a group coaching intervention to support early-career biomedical researchers in Grant proposal development: a pragmatic, four-arm, group-randomized trial. BMC Med Educ 2022; 22:28. [PMID: 35012538 PMCID: PMC8744062 DOI: 10.1186/s12909-021-03093-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/23/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND Funded grant proposals provide biomedical researchers with the resources needed to build their research programs, support trainees, and advance public health. Studies using National Institutes of Health (NIH) data have found that investigators from underrepresented groups in the biomedical workforce are awarded NIH research grants at disproportionately lower rates. Grant writing training initiatives are available, but there is a dearth of rigorous research to determine the effectiveness of such interventions and to discern their essential features. METHODS This 2 × 2, unblinded, group-randomized study compares the effectiveness of variations of an NIH-focused, grant writing, group coaching intervention for biomedical postdoctoral fellows and early-career faculty. The key study outcomes are proposal submission rates and funding rates. Participants, drawn from across the United States, are enrolled as dyads with a self-selected scientific advisor in their content area, then placed into coaching groups led by senior NIH-funded investigators who are trained in the intervention's coaching practices. Target enrollment is 72 coaching groups of 4-5 dyads each. Groups are randomized to one of four intervention arms that differ on two factors: [1] duration of coaching support (regular dose = 5 months of group coaching, versus extended dose = regular dose plus an additional 18 months of one-on-one coaching); and [2] mode of engaging scientific advisors with the regular dose group coaching process (unstructured versus structured engagement). Intervention variations were informed by programs previously offered by the NIH National Research Mentoring Network. Participant data are collected via written surveys (baseline and 6, 12, 18, and 24 months after start of the regular dose) and semi-structured interviews (end of regular dose and 24 months). Quantitative analyses will be intention-to-treat, using a 2-sided test of equality of the effects of each factor. An inductive, constant comparison analysis of interview transcripts will be used to identify contextual factors -- associated with individual participants, their engagement with the coaching intervention, and their institutional setting - that influence intervention effectiveness. DISCUSSION Results of this study will provide an empirical basis for a readily translatable coaching approach to supporting the essential grant writing activities of faculty, fellows, and other research trainees, including those from underrepresented groups.
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Affiliation(s)
- Anne Marie Weber-Main
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN 55455 USA
| | | | - Richard McGee
- Faculty Affairs, Northwestern University Feinberg School of Medicine, Chicago, IL 60611 USA
| | - Marlene J. Egger
- Department of Family and Preventive Medicine, Division of Public Health, University of Utah School of Medicine, Salt Lake City, UT 84108 USA
| | - Harlan P. Jones
- Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Christine V. Wood
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611 USA
| | - Kristin Boman
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108 USA
| | - Jiqiang Wu
- Department of Family and Preventive Medicine, Division of Public Health, University of Utah, Salt Lake City, 84108 USA
| | - Andrew K. Langi
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108 USA
| | - Kolawole S. Okuyemi
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108 USA
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Bress AP, Cohen JB, Anstey DE, Conroy MB, Ferdinand KC, Fontil V, Margolis KL, Muntner P, Millar MM, Okuyemi KS, Rakotz MK, Reynolds K, Safford MM, Shimbo D, Stuligross J, Green BB, Mohanty AF. Inequities in Hypertension Control in the United States Exposed and Exacerbated by COVID-19 and the Role of Home Blood Pressure and Virtual Health Care During and After the COVID-19 Pandemic. J Am Heart Assoc 2021; 10:e020997. [PMID: 34006116 PMCID: PMC8483507 DOI: 10.1161/jaha.121.020997] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The COVID‐19 pandemic is a public health crisis, having killed more than 514 000 US adults as of March 2, 2021. COVID‐19 mitigation strategies have unintended consequences on managing chronic conditions such as hypertension, a leading cause of cardiovascular disease and health disparities in the United States. During the first wave of the pandemic in the United States, the combination of observed racial/ethnic inequities in COVID‐19 deaths and social unrest reinvigorated a national conversation about systemic racism in health care and society. The 4th Annual University of Utah Translational Hypertension Symposium gathered frontline clinicians, researchers, and leaders from diverse backgrounds to discuss the intersection of these 2 critical social and public health phenomena and to highlight preexisting disparities in hypertension treatment and control exacerbated by COVID‐19. The discussion underscored environmental and socioeconomic factors that are deeply embedded in US health care and research that impact inequities in hypertension. Structural racism plays a central role at both the health system and individual levels. At the same time, virtual healthcare platforms are being accelerated into widespread use by COVID‐19, which may widen the divide in healthcare access across levels of wealth, geography, and education. Blood pressure control rates are declining, especially among communities of color and those without health insurance or access to health care. Hypertension awareness, therapeutic lifestyle changes, and evidence‐based pharmacotherapy are essential. There is a need to improve the implementation of community‐based interventions and blood pressure self‐monitoring, which can help build patient trust and increase healthcare engagement.
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Affiliation(s)
- Adam P Bress
- Department of Population Health Sciences Division of Health System Innovation and Research University of Utah School of Medicine Salt Lake City UT
| | - Jordana B Cohen
- Department of Medicine Renal-Electrolyte and Hypertension Division Perelman School of Medicine at the University of Pennsylvania Philadelphia PA.,Department of Biostatistics, Epidemiology, and Informatics Perelman School of Medicine University of Pennsylvania Philadelphia PA
| | - David Edmund Anstey
- Division of Cardiology Department of Medicine Columbia University Medical Center New York NY
| | - Molly B Conroy
- Division of General Internal Medicine, Department of Internal Medicine University of Utah School of Medicine Salt Lake City UT
| | | | - Valy Fontil
- Division of General Internal Medicine Department of Medicine Zuckerberg San Francisco General HospitalUniversity of California San Francisco CA.,Center for Vulnerable Populations Zuckerberg San Francisco General HospitalUniversity of California San Francisco CA
| | | | - Paul Muntner
- Department of Epidemiology School of Public Health University of Alabama at Birmingham Birmingham AL
| | - Morgan M Millar
- Division of General Internal Medicine, Department of Internal Medicine University of Utah School of Medicine Salt Lake City UT
| | - Kolawole S Okuyemi
- Department of Family & Preventive Medicine University of Utah School of Medicine Salt Lake City UT
| | | | - Kristi Reynolds
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA Pasadena CA.,Kaiser Permanente Bernard J. Tyson School of Medicine Pasadena CA
| | - Monika M Safford
- Department of Medicine Joan and Sanford I Weill Medical College of Cornell University New York NY
| | - Daichi Shimbo
- Division of Cardiology Department of Medicine Columbia University Medical Center New York NY
| | | | - Beverly B Green
- Kaiser Permanente Washington Health Research Institute Seattle WA
| | - April F Mohanty
- Division of General Internal Medicine, Department of Internal Medicine University of Utah School of Medicine Salt Lake City UT.,Informatics Decision-Enhancement, and Analytic Sciences Center (IDEAS) VA Salt Lake City Health Care System Salt Lake City UT
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11
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Kotlyar M, Shanley R, Dufresne SR, Corcoran GA, Okuyemi KS, Mills AM, Hatsukami DK. Effects on smoking behavior of switching menthol smokers to non-menthol cigarettes. Nicotine Tob Res 2021; 23:1921-1927. [PMID: 33983396 DOI: 10.1093/ntr/ntab090] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 05/06/2021] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Bans of menthol characterizing flavor in cigarettes have been implemented in some localities and have been proposed more broadly. One proposed benefit of such a ban is to increase cessation rates among current menthol smokers. There is currently relatively limited data regarding how smoking behavior changes if menthol smokers switch to non-menthol cigarettes. METHODS African American menthol smokers interested in quitting smoking were randomized to either continue smoking menthol (n=60) or switch to non-menthol cigarettes (n=62) for one month prior to a cessation attempt. Cessation results were reported previously; this analysis reports the results from the pre-cessation visits at which amount smoked, exhaled carbon monoxide concentration (CO), urinary cotinine concentrations and subjective measures were assessed. RESULTS Over the four-week study period, those switching to non-menthol (vs. continuing to smoke menthol) cigarettes smoked fewer cigarettes per day (mean ratio: 0.86; 95% CI: 0.76, 0.98; p=0.02), reported lower withdrawal symptom severity (mean difference -1.29; 95% CI: -2.6 to -0.01; p=0.05) and higher perceived effectiveness of their skills for quitting smoking (mean difference 0.56; 95% CI: 0.02 to 1.10; p=0.05). No significant differences were found between groups in exhaled CO, urinary cotinine concentrations or most other subjective effects including support for a ban on menthol characterizing flavor in cigarettes. CONCLUSIONS These results suggest that were menthol cigarettes no longer available, those that switch to non-menthol cigarettes would not change their smoking behavior in a way that is likely to be more hazardous, with some indicators suggesting that there may be some benefit. IMPLICATIONS A ban on menthol characterizing flavor in cigarettes has been proposed as a potential means by which to increase smoking cessation rates among current menthol cigarette smokers. This study evaluated how African American menthol cigarette smokers adjusted their smoking behavior after switching to non-menthol cigarettes. Although the overall differences between groups were modest, they were in a direction consistent with decreased smoking suggesting that current smokers would not adjust their behavior in a way that is likely to be more hazardous, with some indicators suggesting that there may be some benefits.
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Affiliation(s)
- Michael Kotlyar
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota.,Masonic Cancer Center, University of Minnesota, Minneapolis.,Department of Psychiatry and Behavioral Sciences, University of Minnesota
| | - Ryan Shanley
- Biostatistics Core, Masonic Cancer Center, University of Minnesota, Minneapolis
| | - Sheena R Dufresne
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota
| | - Gretchen A Corcoran
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota
| | - Kolawole S Okuyemi
- Currently at the University of Utah, Department of Family and Preventive Medicine
| | - Anne M Mills
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota
| | - Dorothy K Hatsukami
- Masonic Cancer Center, University of Minnesota, Minneapolis.,Department of Psychiatry and Behavioral Sciences, University of Minnesota
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12
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Weber-Main AM, McGee R, Eide Boman K, Hemming J, Hall M, Unold T, Harwood EM, Risner LE, Smith A, Lawson K, Engler J, Steer CJ, Buchwald D, Jones HP, Manson SM, Ofili E, Schwartz NB, Vishwanatha JK, Okuyemi KS. Grant application outcomes for biomedical researchers who participated in the National Research Mentoring Network's Grant Writing Coaching Programs. PLoS One 2020; 15:e0241851. [PMID: 33166315 PMCID: PMC7652313 DOI: 10.1371/journal.pone.0241851] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 03/25/2020] [Accepted: 10/21/2020] [Indexed: 11/24/2022] Open
Abstract
Background A diverse research workforce is essential for catalyzing biomedical advancements, but this workforce goal is hindered by persistent sex and racial/ethnic disparities among investigators receiving research grants from the National Institutes of Health (NIH). In response, the NIH-funded National Research Mentoring Network implemented a Grant Writing Coaching Program (GCP) to provide diverse cohorts of early-career investigators across the United States with intensive coaching throughout the proposal development process. We evaluated the GCP’s national reach and short-term impact on participants’ proposal submissions and funding outcomes. Methods The GCP was delivered as six similar but distinct models. All models began with an in-person group session, followed by a series of coaching sessions over 4 to 12 months. Participants were surveyed at 6-, 12- and 18-months after program completion to assess proposal outcomes (submissions, awards). Self-reported data were verified and supplemented by searches of public repositories of awarded grants when available. Submission and award rates were derived from counts of participants who submitted or were awarded at least one grant proposal in a category (NIH, other federal, non-federal). Results From June 2015 through March 2019, 545 investigators (67% female, 61% under-represented racial/ethnic minority, URM) from 187 different institutions participated in the GCP. Among them, 324 (59% of participants) submitted at least one grant application and 134 (41% of submitters) received funding. A total of 164 grants were awarded, the majority being from the NIH (93, 56%). Of the 74 R01 (or similar) NIH research proposals submitted by GCP participants, 16 have been funded thus far (56% to URM, 75% to women). This 22% award rate exceeded the 2016–2018 NIH success rates for new R01s. Conclusion Inter- and intra-institutional grant writing coaching groups are a feasible and effective approach to supporting the grant acquisition efforts of early-career biomedical investigators, including women and those from URM groups.
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Affiliation(s)
- Anne Marie Weber-Main
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, United States of America
- * E-mail: (AMWM); (KSO)
| | - Richard McGee
- Department of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Kristin Eide Boman
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Japera Hemming
- Clinical Research Center, Morehouse School of Medicine, Atlanta, Georgia, United States of America
| | - Meldra Hall
- Clinical Research Center, Morehouse School of Medicine, Atlanta, Georgia, United States of America
| | - Thaddeus Unold
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, United States of America
| | - Eileen M. Harwood
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, United States of America
| | - Laurie E. Risner
- Department of Pediatrics, University of Chicago, Chicago, Illinois, United States of America
| | - Ann Smith
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Kimberly Lawson
- Clinical Research Center, Morehouse School of Medicine, Atlanta, Georgia, United States of America
| | - Jeffrey Engler
- Council of Graduate Schools, Washington, District of Columbia, United States of America
| | - Clifford J. Steer
- Department of Medicine and Department of Genetics, Cell Biology, and Development, University of Minnesota Medical School, Minneapolis, Minnesota, United States of America
| | - Dedra Buchwald
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, United States of America
| | - Harlan P. Jones
- Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, Texas, United States of America
| | - Spero M. Manson
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Elizabeth Ofili
- Department of Medicine, Morehouse School of Medicine, Atlanta, Georgia, United States of America
| | - Nancy B. Schwartz
- Department of Pediatrics and Department of Biochemistry and Molecular Biology, University of Chicago, Chicago, Illinois, United States of America
| | - Jamboor K. Vishwanatha
- Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, Texas, United States of America
| | - Kolawole S. Okuyemi
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
- * E-mail: (AMWM); (KSO)
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13
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Kotlyar M, Shanley R, Dufresne SR, Corcoran GA, Okuyemi KS, Mills AM, Hatsukami DK. Effects on time to lapse of switching menthol smokers to non-menthol cigarettes prior to a cessation attempt: a pilot study. Tob Control 2020; 30:574-577. [PMID: 32719011 DOI: 10.1136/tobaccocontrol-2020-055689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 02/06/2020] [Revised: 05/18/2020] [Accepted: 06/02/2020] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Menthol smokers (particularly African-Americans) have lower cessation success rates than non-menthol smokers. With bans being considered on characterising menthol flavour in cigarettes, data are needed regarding how switching to non-menthol cigarettes impacts cessation measures. METHODS In this randomised pilot study, African-American menthol cigarette smokers interested in quitting smoking either continued smoking menthol cigarettes (n=60) or switched to non-menthol cigarettes (n=62) for a 1-month period prior to a cessation attempt. The primary endpoint was time to smoking lapse (ie, time from quitting until any smoking). Additional endpoints included time to smoking relapse (ie, number of days from quitting until the first of seven consecutive smoking days) and difference between groups in subjective measures. RESULTS After attempting to quit, the non-menthol cigarette group had indications of delayed time to lapse (HR 0.82; 95% CI 0.55 to 1.22; p=0.33) and time to relapse (HR 0.67; 95% CI 0.42 to 1.06; p=0.09), although these were not statistically significant. Post hoc analyses suggest that observed differences were largely due to a smaller proportion of participants in the non-menthol group relapsing within the first day of quitting (21% vs 40%; p=0.05). Values of other measures assessed postcessation were largely similar between groups. CONCLUSIONS These data suggest that among African-American smokers, a menthol cigarette ban would not undermine short-term cessation measures and may result in some benefits. Future research is needed to assess longer term cessation rates and to identify interventions to maximise cessation success in the event of a menthol ban. TRIAL REGISTRATION NUMBER NCT02342327.
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Affiliation(s)
- Michael Kotlyar
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota, USA .,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ryan Shanley
- Biostatistics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sheena R Dufresne
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota, USA
| | - Gretchen A Corcoran
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kolawole S Okuyemi
- Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, Utah, USA
| | - Anne M Mills
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota, USA
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Odukoya OO, Manortey S, Takemoto M, Alder S, Okuyemi KS. Body, Soul and Spirit, an adaptation of two evidence-based interventions to promote physical activity and healthy eating among adults in churches in Lagos Nigeria: a three-arm cluster randomized controlled pilot trial. Pilot Feasibility Stud 2020; 6:59. [PMID: 32391167 PMCID: PMC7203804 DOI: 10.1186/s40814-020-00600-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/09/2019] [Accepted: 04/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical inactivity and unhealthy eating are two leading behavioral risk factors contributing to preventable non-communicable diseases (NCDs). Evidence-based interventions (EBI) using community-engaged approaches to address these risks abound in high-income countries. Comparatively, evidence of such interventions is sparse in low- and middle-income countries, where NCD mortality is greater. This paper describes the protocol for the development of the cultural adaptation and pilot testing of a combination of two EBI (i.e., Body and Soul and the Healthy Body Healthy Spirit), in church-based settings in Lagos, Nigeria. In addition, we describe the development of the inclusion of an additional component, i.e., faith-based text messages, into one of the treatment arms. Our objective is to assess the feasibility of developing and implementing the adapted interventions with the ultimate aim of developing a fully powered trial. METHODS This pilot study will assess the design and implementation of a three-arm cluster-randomized pilot trial in 12 randomly selected Anglican churches (4 in each arm). First, we will design a cultural adaptation of the two EBI's to form a multifaceted combined intervention known as the Body Soul and Spirit. The second treatment arm, i.e., Body Soul and Spirit Plus, will retain all the components of Body Soul and Spirit with the inclusion of faith-based text messages using mobile phones. Participants in the control arm will receive information leaflets designed to increase physical activity and healthy food consumption. The outcome measures include participant recruitment and retention, program participation and satisfaction, and data collection completion rates. The outcomes for the proposed definitive trial will be the number of servings of fruit and vegetables and minutes of moderate to vigorous physical activity per day will be assessed at baseline, 3 and 6-month follow-up. Implementation outcomes will be assessed using qualitative and quantitative methods. DISCUSSION The study will enhance the understanding of how best to design and implement behavioral interventions in church-based settings using community-based participatory approaches. It will also inform the development of a definitive randomized controlled trial. TRIAL REGISTRATION Pan African Clinical Trials Registry on 12th July 2018. PACTR201807136835945. Available at https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3481.
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Affiliation(s)
- Oluwakemi Ololade Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, State, Lagos, Nigeria
- Non-Communicable Disease Research Group, University of Lagos, State, Lagos, Nigeria
- Department of Family Medicine and Public Health, School of Medicine, UC San Diego, San Diego, CA USA
| | | | - Michelle Takemoto
- Department of Family Medicine and Public Health, School of Medicine, UC San Diego, San Diego, CA USA
| | - Steve Alder
- ENSIGN School of Public Health, Kpong, Ghana
- Department of Family and Preventive Medicine, University of Utah School Of Medicine, Salt Lake City, UT USA
| | - Kolawole S. Okuyemi
- Department of Family and Preventive Medicine, University of Utah School Of Medicine, Salt Lake City, UT USA
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15
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Davis DR, Hickman NJ, Choi K, Robinson CD, Patten CA, Fagan P, Okuyemi KS, Nahvi S. Impact of the Society for Research on Nicotine and Tobacco Health Disparities Network's Scholarship on Professional Development of Its Recipients. Nicotine Tob Res 2020; 22:141-143. [PMID: 30476316 PMCID: PMC7297010 DOI: 10.1093/ntr/nty253] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 11/21/2018] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Diversifying the workforce is an important strategy to reducing health disparities. Since 2007, the Society for Research on Nicotine and Tobacco (SRNT) Health Disparities Network has funded a travel scholarship to promote inclusion, professional development, and diversity among investigators interested in tobacco-related health disparities research. This study examined indicators of productivity among former scholarship recipients.Methods: Scholarship recipients between 2007 and 2014 were invited to complete a survey online. The survey assessed demographic characteristics, academic productivity, and perceived professional benefit resulting from the scholarship.Results: Of the 117 scholarships recipients, 89 (77%) responded. Respondents were 67% female and had a mean age of 37.8 years. Twenty eight percent were African American, 25% Asian American, and 17% Latino. Most respondents worked in academia (80%) and nearly three-quarters (74%) reported publishing manuscripts on tobacco-related disparities, with a mean of 3.8 (SD 4.4) disparities-related publications since receiving the scholarship. Respondents' work focused on a wide range of health disparities topics and nearly all respondents reported that the scholarship removed barriers to attending the meeting and reported professional benefit from receiving the travel scholarship. Following receipt of the SRNT travel scholarship, a diverse group of scientists demonstrated scholarly productivity, professional development, and advancement of health disparities research. Similar efforts are encouraged in other professional societies. IMPLICATIONS This study examines the productivity of early career recipients of the SRNT Health Disparities Scholarship. Results suggest that the investment in annual travel scholarships by a professional organization is an important support system for emerging scientists from diverse backgrounds. This investment may help to advance the science of health disparities and engage researchers in an area where there are critical gaps in the research workforce.
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Affiliation(s)
- Danielle R Davis
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT
| | - Norval J Hickman
- Tobacco-Related Disease Research Program, University of California Office of the President, Oakland, CA
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD
| | - Cendrine D Robinson
- Behavioral Health and Reintegration Rehabilitation Research and Development Department of Veterans Affairs Washington, DC
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Pebbles Fagan
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Kolawole S Okuyemi
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Shadi Nahvi
- Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
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16
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Agaku IT, Odani S, Okuyemi KS, Armour B. Disparities in current cigarette smoking among US adults, 2002-2016. Tob Control 2019; 29:269-276. [PMID: 31147473 DOI: 10.1136/tobaccocontrol-2019-054948] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 01/14/2019] [Revised: 03/13/2019] [Accepted: 03/19/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND To assess disparities in current (past 30 days) cigarette smoking among US adults aged ≥ 18 years during 2002-2016. METHODS Nine indicators associated with social disadvantage were analysed from the 2002 to 2016 National Survey on Drug Use and Health: education, annual family income, sex, race/ethnicity, urbanicity, serious psychological distress, health insurance, public assistance, and employment status. Using descriptive and multivariable analyses, we measured trends in smoking overall and within the assessed variables. We also evaluated effect of interactions on disparities and estimated the excess number of smokers attributable to disparities. RESULTS During 2002-2016, current cigarette smoking prevalence declined overall (27.5%-20.7%; p trend < 0.01), and among all subgroups except Medicare insurees and American Indians/Alaska Natives (AI/ANs). Overall inequalities in cigarette smoking grew even wider or remained unchanged for several indicators during the study period. In 2016, comparing groups with the least versus the most social advantage, the single largest disparity in current smoking prevalence was seen by race/ethnicity (prevalence ratio = 5.1, AI/ANs vs Asians). Education differences alone explained 38.0% of the observed racial/ethnic disparity in smoking prevalence. Interactions were also present; compared with the population-averaged prevalence among all AI/AN individuals (34.0%), prevalence was much higher among AI/ANs with <high school diploma (53.0%), unemployed (58.0%), or with serious psychological distress (66.9%). The burden of smoking attributable to race/ethnic disparities in smoking prevalence was an estimated 27.6 million smokers. CONCLUSIONS Overall smoking inequality increased or remained unchanged because of slower declines in smoking prevalence among disadvantaged groups. Targeted interventions among high-risk groups can narrow disparities.
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Affiliation(s)
- Israel T Agaku
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Satomi Odani
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Kolawole S Okuyemi
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Brian Armour
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
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Harwood EM, Jones AR, Erickson D, Buchwald D, Johnson-Hemming J, Jones HP, Manson S, McGee R, Smith A, Steer CJ, Vishwanatha JK, Weber-Main AM, Okuyemi KS. Early career biomedical grantsmanship self-efficacy: validation of an abbreviated self-assessment tool. Ann N Y Acad Sci 2018; 1445:17-26. [PMID: 30515830 PMCID: PMC6551308 DOI: 10.1111/nyas.13995] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 02/07/2018] [Revised: 11/09/2018] [Accepted: 11/21/2018] [Indexed: 10/27/2022]
Abstract
A hallmark of success for early career biomedical researchers is the acquisition of research funding. There are marked disparities among principal investigators who submit grants and the likelihood of receiving national funding. The National Research Mentoring Network was funded by the National Institutes of Health to diversify the biomedical research workforce and included grantsmanship training for early career researchers. Self-efficacy in developing research grant applications is significantly improved over time with training and experience. We created a 19-item self-efficacy assessment inventory. Our aims were to confirm the internal consistency of a three-factor solution for grantsmanship confidence and to test the likelihood that self-efficacy influences grant proposal submission timing. We gathered data from 190 diverse biomedical trainees who completed NRMN grantsmanship training between August 2015 and June 2017. Findings revealed high internal consistency for items in each of three factors. There was a statistically significant association between self-efficacy mean scores and grant submission timing predicting that, for every one-point increase in the mean score, the odds of submitting a grant 6 months post-training increased by 69%. An abbreviated inventory of grantsmanship skills self-efficacy is a promising tool for monitoring changes over time in early career researchers and for promoting tailored grantsmanship interventions.
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Affiliation(s)
- Eileen M Harwood
- Division of Epidemiology and Community Health, University of Minnesota Twin Cities, Minneapolis, Minnesota
| | - Amy R Jones
- Dakota County Public Health Department, West St. Paul, Minnesota
| | - Darin Erickson
- Division of Epidemiology and Community Health, University of Minnesota Twin Cities, Minneapolis, Minnesota
| | - Dedra Buchwald
- The Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
| | | | - Harlan P Jones
- Health Science Center, University of North Texas, Fort Worth, Texas
| | - Spero Manson
- Public Health and Psychiatry, University of Colorado - Anschutz Medical Campus, Aurora, Colorado
| | - Richard McGee
- Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ann Smith
- Minority Health and Health Disparities Research Center, University of South Alabama Medical Center, Mobile, Alabama
| | - Clifford J Steer
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Jamboor K Vishwanatha
- Department of Microbiology, Immunology and Genetics, University of North Texas, Fort Worth, Texas
| | - Anne M Weber-Main
- Division of General Internal Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Kolawole S Okuyemi
- Department of Family and Preventative Medicine, University of Utah, Salt Lake City, Utah
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18
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Tan MM, Okuyemi KS, Resnicow K, Dietz NA, Antoni MH, Webb Hooper M. Association between smoking cessation and weight gain in treatment-seeking African Americans. Addict Behav 2018; 81:84-90. [PMID: 29452980 DOI: 10.1016/j.addbeh.2018.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/31/2018] [Accepted: 02/02/2018] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Research has shown that African Americans gain more than average weight after smoking cessation. However, African Americans have been underrepresented in post-cessation weight gain research. The current study examined 1) the pattern of weight gain and 2) the association between smoking status and weight gain in a sample of African Americans seeking smoking cessation treatment. METHODS Data were drawn from a randomized controlled trial testing the efficacy of a 4-week culturally specific smoking cessation cognitive behavioral therapy (CBT) intervention among African American smokers (N = 342). Weight was measured and self-reported smoking status was biochemically verified at baseline, end of counseling, 3-, 6-, and 12-month follow-ups. Random effects multilevel modeling was used to examine weight gain over twelve months post CBT, and a fully unconditional model tested the pattern of weight gain over time. Smoking status was included as a time-varying factor to examine its effect on weight gain, controlling for potential confounding variables. RESULTS Weight significantly increased among those who remained abstinent over 12 months post CBT [average gain of seven lbs. (three kg)]. Controlling for covariates, abstinence was predictive of the rate of weight gain for those with high weight concern. CONCLUSIONS Weight gain among African American abstainers was comparable to the average post-cessation weight gain observed among the general population. It is possible that exposure to CBT (culturally specific or standard) may have mitigated excessive weight gain. Future research should assess predictors of weight gain in African American smokers to inform future smoking cessation interventions and help elucidate factors that contribute to tobacco- and obesity-related health disparities.
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Sorkness CA, Pfund C, Ofili EO, Okuyemi KS, Vishwanatha JK, Zavala ME, Pesavento T, Fernandez M, Tissera A, Deveci A, Javier D, Short A, Cooper P, Jones H, Manson S, Buchwald D, Eide K, Gouldy A, Kelly E, Langford N, McGee R, Steer C, Unold T, Weber-Main AM, Báez A, Stiles J, Pemu P, Thompson W, Gwathmey J, Lawson K, Johnson J, Hall M, Paulsen D, Fouad M, Smith A, Luna R, Wilson D, Adelsberger G, Simenson D, Cook A, Feliu-Mojer M, Harwood E, Jones A, Branchaw J, Thomas S, Butz A, Byars-Winston A, House S, McDaniels M, Quinn S, Rogers J, Spencer K, Utzerath E, Duplicate Of Weber-Main, Womack V. A new approach to mentoring for research careers: the National Research Mentoring Network. BMC Proc 2017; 11:22. [PMID: 29375663 PMCID: PMC5773914 DOI: 10.1186/s12919-017-0083-8] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [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: 11/10/2022] Open
Abstract
Background and purpose Effective mentorship is critical to the success of early stage investigators, and has been linked to enhanced mentee productivity, self-efficacy, and career satisfaction. The mission of the National Research Mentoring Network (NRMN) is to provide all trainees across the biomedical, behavioral, clinical, and social sciences with evidence-based mentorship and professional development programming that emphasizes the benefits and challenges of diversity, inclusivity, and culture within mentoring relationships, and more broadly the research workforce. The purpose of this paper is to describe the structure and activities of NRMN. Key highlights NRMN serves as a national training hub for mentors and mentees striving to improve their relationships by better aligning expectations, promoting professional development, maintaining effective communication, addressing equity and inclusion, assessing understanding, fostering independence, and cultivating ethical behavior. Training is offered in-person at institutions, regional training, or national meetings, as well as via synchronous and asynchronous platforms; the growing training demand is being met by a cadre of NRMN Master Facilitators. NRMN offers career stage-focused coaching models for grant writing, and other professional development programs. NRMN partners with diverse stakeholders from the NIH-sponsored Diversity Program Consortium (DPC), as well as organizations outside the DPC to work synergistically towards common diversity goals. NRMN offers a virtual portal to the Network and all NRMN program offerings for mentees and mentors across career development stages. NRMNet provides access to a wide array of mentoring experiences and resources including MyNRMN, Guided Virtual Mentorship Program, news, training calendar, videos, and workshops. National scale and sustainability are being addressed by NRMN "Coaches-in-Training" offerings for more senior researchers to implement coaching models across the nation. "Shark Tanks" provide intensive review and coaching for early career health disparities investigators, focusing on grant writing for graduate students, postdoctoral trainees, and junior faculty. Implications Partners from diverse perspectives are building the national capacity and sparking the institutional changes necessary to truly diversify and transform the biomedical research workforce. NRMN works to leverage resources towards the goals of sustainability, scalability, and expanded reach.
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Affiliation(s)
- Christine A Sorkness
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA
| | - Christine Pfund
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA
| | - Elizabeth O Ofili
- 2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA
| | - Kolawole S Okuyemi
- 3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA
| | - Jamboor K Vishwanatha
- 4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | | | - Maria Elena Zavala
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Theresa Pesavento
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Mary Fernandez
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Anthony Tissera
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Alp Deveci
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Damaris Javier
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Alexis Short
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Paige Cooper
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Harlan Jones
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Spero Manson
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Dedra Buchwald
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Kristin Eide
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Andrea Gouldy
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Erin Kelly
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Nicole Langford
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Richard McGee
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Clifford Steer
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Thad Unold
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Anne Marie Weber-Main
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Adriana Báez
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Jonathan Stiles
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Priscilla Pemu
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Winston Thompson
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Judith Gwathmey
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Kimberly Lawson
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Japera Johnson
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Meldra Hall
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Douglas Paulsen
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Mona Fouad
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Ann Smith
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Rafael Luna
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Donald Wilson
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Greg Adelsberger
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Drew Simenson
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Abby Cook
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Monica Feliu-Mojer
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Eileen Harwood
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Amy Jones
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Janet Branchaw
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Stephen Thomas
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Amanda Butz
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Angela Byars-Winston
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Stephanie House
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Melissa McDaniels
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Sandra Quinn
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Jenna Rogers
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Kim Spencer
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Emily Utzerath
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Duplicate Of Weber-Main
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Veronica Womack
- 1Institute for Clinical and Translational Research, University of Wisconsin, Madison, WI 53705 USA.,2Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310 USA.,3Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA.,4Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
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Jones HP, McGee R, Weber-Main AM, Buchwald DS, Manson SM, Vishwanatha JK, Okuyemi KS. Enhancing research careers: an example of a US national diversity-focused, grant-writing training and coaching experiment. BMC Proc 2017; 11:16. [PMID: 29375659 PMCID: PMC5773888 DOI: 10.1186/s12919-017-0084-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 12/02/2022] Open
Abstract
Background and purpose Preparing a successful research proposal is one of the most complex skills required of professional scientists, yet this skill is rarely if ever, taught. A major goal of the National Research Mentoring Network (NRMN) in the United States (U.S.) is to support the professional advancement of postdoctoral fellows and junior faculty from diverse populations by offering intensive coaching in the development of grant proposals early in their careers. This article highlights the National Institutes of Health’s (NIH) NRMN initiative to prepare diverse constituencies of early-stage biomedicine scientists for research careers by implementation of an evidence-based nationwide program of comprehensive grant writing and professional development. Program and key highlights NRMN delivers four unique but complementary coaching models: the Proposal Preparation Program from the University of Minnesota (UMN); Grantwriters Coaching Groups from Northwestern University (NU); Grantwriting Uncovered: Maximizing Strategies, Help, Opportunities, Experiences from the University of Colorado Anschutz Medical Campus (UC) and Washington State University (WSU); and Steps Towards Academic Research from the University of North Texas Health Science Center (UNTHSC). Because these programs cater to scientists at different career stages, rather than employ a single approach, each is uniquely tailored to test its efficacy at the national level. The first two models prioritize scientists with reasonably well-developed research projects who are ready to write proposals for specific NIH research competitions. The other two models target postdoctoral fellows and early-career faculty who need more extensive guidance in proposal development plans. To achieve scalability, all programs also recruit faculty as Coaches-in-Training to learn approaches and acquire particular group facilitation skills required by each model. Implications These efforts exemplify NRMN’s potential to enhance the career development of diverse trainees on a national scale, building research skills, competitiveness for obtaining faculty positions and capacities that will result in high quality research proposals from a diverse pool of applicants, thereby advancing innovations in science and diversifying the U.S. biomedical workforce.
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Affiliation(s)
- Harlan P Jones
- 1Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Richard McGee
- 2Feinberg School of Medicine, Northwestern University, Chicago, IL 60611 USA
| | - Anne Marie Weber-Main
- 3Department of Medicine, University of Minnesota Medical School, Minneapolis, MN 55455 USA
| | - Dedra S Buchwald
- 4Initiative for Research and Education to Advance Community Health, Washington State University, Seattle, WA 98164 USA
| | - Spero M Manson
- 5Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045 USA
| | - Jamboor K Vishwanatha
- 1Center for Diversity and International Programs, University of North Texas Health Science Center, Fort Worth, TX 76107 USA
| | - Kolawole S Okuyemi
- 6Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108 USA
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21
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Rogers CR, Robinson CD, Arroyo C, Obidike OJ, Sewali B, Okuyemi KS. Colorectal Cancer Screening Uptake's Association With Psychosocial and Sociodemographic Factors Among Homeless Blacks and Whites. Health Educ Behav 2017; 44:928-936. [PMID: 28978252 DOI: 10.1177/1090198117734284] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 11/16/2022]
Abstract
The homeless represent an extremely disadvantaged population that fare worse than minority groups in access to preventive services and health, and minority groups fare worse than Whites. Early detection screening for colorectal cancer (CRC) saves lives, but empirical data about CRC screening practices among homeless Blacks and Whites are limited. Psychosocial risk factors may serve as a barrier to CRC screening completion among homeless Black individuals. A secondary data analysis of a randomized clinical trial for smoking cessation among homeless smokers was conducted to determine whether psychosocial factors and sociodemographic factors were more highly associated with CRC screening uptake among homeless Blacks than among their White counterparts. Study participants ( N = 124) were surveyed on their CRC screening status, sociodemographic variables, and psychosocial correlate measures including anxiety, depression, hopelessness, depression severity, and perceived stress. Associations between these factors were examined with logistic regression. White participants who were currently disabled/unable to work were 6.2 times more likely to ever receive CRC screening than those who were employed. Black participants with public health insurance coverage were 90% less likely to ever obtain CRC screening than participants without health insurance. Black and White participants had similar levels of anxiety symptoms, depression, and hopelessness, yet depression was the only psychosocial variable negatively associated with CRC screening status. Black and White participants with symptoms of depression were 58% less likely to complete screening than those without depression. Mental health risk and sociodemographic factors may serve as barriers to CRC screening among homeless Blacks and Whites.
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Affiliation(s)
| | | | | | | | - Barrett Sewali
- 5 Uganda National Expanded Programme on Immunisation, Kampala, Uganda, Africa
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22
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Pinsker EA, Call KT, Tanaka A, Kahin AA, Dar SI, Ganey A, DuBois DK, Okuyemi KS. The Development of Culturally Appropriate Tobacco Prevention Videos Targeted Toward Somali Youth. Prog Community Health Partnersh 2017; 11:129-136. [PMID: 28736405 DOI: 10.1353/cpr.2017.0017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Approximately 18% of Somali youth in Minnesota intend to use tobacco in the next year and youth perceive that 64% of their peers smoke. High perceived prevalence increases tobacco use intentions and initiation, indicating that Somali youth-targeted tobacco prevention efforts are needed. OBJECTIVES To develop a Somali youth-targeted tobacco prevention intervention using a community-based participatory research (CBPR) approach. METHODS Three focus groups were conducted to inform the development of a tobacco prevention intervention. Three tobacco prevention videos were developed. Twenty interviews were conducted to evaluate the videos. LESSONS LEARNED It was essential to partner with Somali youth to develop the videos. Recruitment and development of the videos were facilitated through collaborating with trusted, existing community programs. CONCLUSIONS A CBPR approach can be used to develop a culturally tailored intervention. It was important to involve academic and community partners in all stages of the research project.
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Ojo-Fati O, Joseph AM, Ig-Izevbekhai J, Thomas JL, Everson-Rose SA, Pratt R, Raymond N, Cooney NL, Luo X, Okuyemi KS. Practical issues regarding implementing a randomized clinical trial in a homeless population: strategies and lessons learned. Trials 2017; 18:305. [PMID: 28679430 PMCID: PMC5498931 DOI: 10.1186/s13063-017-2046-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 06/14/2017] [Indexed: 12/03/2022] Open
Abstract
Abstract There is a critical need for objective data to guide effective health promotion and care for homeless populations. However, many investigators exclude homeless populations from clinical trials due to practical concerns about conducting research with this population. This report is based on our experience and lessons learned while conducting two large NIH-funded randomized controlled trials targeting smoking cessation among persons who are homeless. The current report also addresses challenges when conducting clinical trials among homeless populations and offers potential solutions. Homeless individuals face several challenges including the need to negotiate daily access to food, clothing, and shelter. Some of the critical issues investigators encounter include recruitment and retention obstacles; cognitive impairment, mental health and substance abuse disorders; transportation and scheduling challenges; issues pertaining to adequate study compensation; the need for safety protocols for study staff; and issues related to protecting the wellbeing of these potentially vulnerable adults. Anticipating realistic conditions in which to conduct studies with participants who are homeless will help investigators to design efficient protocols and may improve the feasibility of conducting clinical trials involving homeless populations and the quality of the data collected by the researchers. Trial registration ClinicalTrials.gov, ID: NCT00786149. Registered on 5 November 2008; ClinicalTrials.gov, ID: NCT01932996. Registered on 20 November 2014.
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Affiliation(s)
- Olamide Ojo-Fati
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St. SE, Suite 166, Minneapolis, MN, 55414, USA. .,Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware St. SE, Suite 166, Minneapolis, MN, 55414, USA.
| | - Anne M Joseph
- Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware St. SE, Suite 166, Minneapolis, MN, 55414, USA.,Department of Medicine, University of Minnesota Medical School, 717 Delaware St. SE, Suite 166, Minneapolis, MN, 55414, USA
| | - Jed Ig-Izevbekhai
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St. SE, Suite 166, Minneapolis, MN, 55414, USA.,Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware St. SE, Suite 166, Minneapolis, MN, 55414, USA
| | - Janet L Thomas
- Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware St. SE, Suite 166, Minneapolis, MN, 55414, USA.,Department of Medicine, University of Minnesota Medical School, 717 Delaware St. SE, Suite 166, Minneapolis, MN, 55414, USA
| | - Susan A Everson-Rose
- Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware St. SE, Suite 166, Minneapolis, MN, 55414, USA.,Department of Medicine, University of Minnesota Medical School, 717 Delaware St. SE, Suite 166, Minneapolis, MN, 55414, USA
| | - Rebekah Pratt
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St. SE, Suite 166, Minneapolis, MN, 55414, USA.,Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware St. SE, Suite 166, Minneapolis, MN, 55414, USA
| | - Nancy Raymond
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St. SE, Suite 166, Minneapolis, MN, 55414, USA.,Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware St. SE, Suite 166, Minneapolis, MN, 55414, USA.,Department of Psychiatry, University of Minnesota Medical School, 2450 Riverside Ave., F282/2AW, Minneapolis, MN, 55454, USA
| | - Ned L Cooney
- Department of Psychiatry, Yale University School of Medicine, 300 George St., Suite 901, New Haven, CT, 06511, USA
| | - Xianghua Luo
- Division of Biostatistics, School of Public Health, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN, 55455, USA.,Biostatistics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Kolawole S Okuyemi
- Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware St. SE, Suite 166, Minneapolis, MN, 55414, USA.,Department of Family & Preventive Medicine, University of Utah, 375 Chipeta, Suite A, Salt Lake, UT, 84108, USA
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Robinson CD, Muench C, Brede E, Endrighi R, Szeto EH, Sells JR, Lammers JP, Okuyemi KS, Waters AJ. Effect of attentional retraining on cognition, craving, and smoking in African American smokers. Psychol Addict Behav 2017. [PMID: 28627913 DOI: 10.1037/adb0000286] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
African American cigarette smokers have lower rates of cessation than Whites and live in communities with a higher number of tobacco advertisements. Exposure to smoking cues may promote smoking and undermine cessation. It may be possible to reduce attention to smoking cues ("attentional bias"). In this study, we investigated the effect of attentional retraining (AR) on attentional bias and smoking in African American smokers. Nontreatment- seeking African American smokers (N = 64) were randomly assigned to an AR or control condition. Participants were given a mobile device for 2 weeks and prompted to complete up to 3 AR (or control) trainings per day. Participants completed assessments of attentional bias, craving, and smoking both in the lab and in the field. Participants in the AR and control conditions completed an average of 29.07 AR (SD = 12.48) and 30.61 control training tasks (SD = 13.07), respectively. AR reduced attentional bias assessed in the laboratory, F(1, 126) = 9.20, p = .003, and field, F(1, 374) = 6.18, p = .01. This effect generalized to new stimuli, but not to new tasks. AR did not significantly reduce craving or biological measures of smoking. Smoking assessed on the mobile device declined over days in the AR group, F(1, 26) = 10.95, p = .003, but not in the control group, F(1, 27) = 0.02, p = .89. Two weeks of AR administered on a mobile device reduced attentional bias in African American smokers and had mixed effects on smoking. (PsycINFO Database Record
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Affiliation(s)
- Cendrine D Robinson
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | | | - Emily Brede
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Romano Endrighi
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Edwin H Szeto
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Joanna R Sells
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - John P Lammers
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Kolawole S Okuyemi
- Department of Family Medicine and Community Health, University of Minnesota
| | - Andrew J Waters
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
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Abstract
This study examined factors that influence use of cancer screening by Somali men residing in Minnesota, USA. To better understand why recent immigrants are disproportionately less likely to use screening services, we used the health belief model to explore knowledge, beliefs, and attitudes surrounding cancer screening. We conducted a qualitative study comprised of 20 key informant interviews with Somali community leaders and 8 focus groups with Somali men (n = 44). Somali men commonly believe they are protected from cancer by religious beliefs. This belief, along with a lack of knowledge about screening, increased the likelihood to refrain from screening. Identifying the association between religion and health behaviors may lead to more targeted interventions to address existing disparities in cancer screening in the growing US immigrant population.
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Affiliation(s)
- Barrett Sewali
- Department of Family Medicine and Community Health, 717 Delaware St. SE. Ste. 166, Minneapolis, MN, 55414, USA,
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26
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Ghebre RG, Sewali B, Osman S, Adawe A, Nguyen HT, Okuyemi KS, Joseph A. Cervical cancer: barriers to screening in the Somali community in Minnesota. J Immigr Minor Health 2016; 17:722-8. [PMID: 25073605 DOI: 10.1007/s10903-014-0080-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study examined barriers to and facilitators of cervical cancer screening among Somali immigrant women in Minnesota. We adopted the socioecological framework to illustrate screening barriers at multiple levels. We conducted 23 semi-structured key informant interviews and used a thematic exploratory approach to analyze the data. Barriers were classified into individual, community or health systems levels. Obstacles included lack of knowledge, religious beliefs, fatalism, fear, embarrassment, and lack of trust in the interpreters. Participants described a need for training of healthcare providers on issues surrounding Somali women's cultural practices and sexual health. Identifying individual, community, or health system barriers and addressing them concurrently may increase use of cancer screening services among Somali women. Future interventions need to address multilevel barriers with multilevel approaches to improve utilization of cervical cancer screening services in underserved immigrant populations in the United States.
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Affiliation(s)
- Rahel G Ghebre
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Minnesota, Minneapolis, MN, USA
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Ojo-Fati O, Thomas JL, Vogel RI, Ogedegbe O, Jean-Louis G, Okuyemi KS. Predictors of Adherence to Nicotine Replacement Therapy (Nicotine Patch) Among Homeless Persons Enrolled in a Randomized Controlled Trial Targeting Smoking Cessation. J Fam Med 2016; 3:1079. [PMID: 28580456 PMCID: PMC5453676] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Adherence to smoking cessation treatment is generally low, especially among socio-economically disadvantaged groups including individuals experiencing homelessness and those with mental illnesses. Despite the high smoking rates in homeless populations (~70%) no study to date has systematically examined predictors of adherence to nicotine replacement therapy (NRT) in this population. OBJECTIVE The aim of this secondary analysis was to identify predictors of adherence to NRT in a smoking cessation trial conducted among homeless smokers. METHODS Secondary analysis of data from a randomized controlled trial enrolling 430 persons who were homeless and current cigarette smokers. Participants were assigned to one of the two study conditions to enhance smoking cessation: Motivational Interviewing (MI; 6 sessions of MI + 8 weeks of NRT) or Standard Care (Brief advice to quit+ 8 weeks of NRT). The primary outcome for the current analysis was adherence to NRT at end of treatment (8 weeks following randomization). Adherence was defined as a total score of zero on a modified Morisky adherence scale). Demographic and baseline psychosocial, tobacco-related, and substance abuse measures were compared between those who did and did not adhere to NRT. RESULTS After adjusting for confounders, smokers who were depressed at baseline (OR=0.58, 95% CI, 0.38-0.87, p=0.01), had lower confidence to quit (OR=1.10, 95% CI, 1.01-1.19, p=0.04), were less motivated to adhere (OR=1.04, 95% CI, 1.00-1.07, p=0.04), and were less likely to be adherent to NRT. Further, age of initial smoking was positively associated with adherence status (OR= 0.83, 95% CI, 0.69-0.99, p=0.04). CONCLUSION These results suggest that smoking cessation programs conducted in this population may target increased adherence to NRT by addressing both depression and motivation to quit. TRIAL REGISTRATION clinicaltrials.gov: NCT00786149.
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Affiliation(s)
- O Ojo-Fati
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
- Program in Health Disparities Research, University Of Minnesota, Minneapolis, MN, USA
| | - J L Thomas
- Program in Health Disparities Research, University Of Minnesota, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - R I Vogel
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, MN, USA
| | - O Ogedegbe
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - G Jean-Louis
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - K S Okuyemi
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
- Program in Health Disparities Research, University Of Minnesota, Minneapolis, MN, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
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Abstract
BACKGROUND Tobacco use is higher among homeless individuals than the general population. Homeless individuals are also more likely to have symptoms of depression. Depression symptoms may add to the burden of homelessness by increasing psychological distress and serve as a barrier to quitting smoking. OBJECTIVES The primary goal of this study is to assess the impact of depression symptoms on psychological distress in homeless smokers. The effect of depression symptoms on abstinence and the effect of Motivational Interviewing (MI) on cessation among smokers is also explored. METHODS Homeless smokers (N = 430) enrolled in a smoking cessation study were randomized to Motivational Interviewing (MI) or standard care (SC). Participants received nicotine replacement therapy and were followed for 26 weeks. Participants were categorized into a depression symptoms (DS) group or control group using the Patient Health Questionnaire-9. Between group differences of perceived stress, hopelessness, confidence, craving and abstinence were assessed at weeks 8 and 26. The interaction between depression symptoms (levels: DS and control) and the intervention (levels: MI and SC) was also assessed. RESULTS Homeless smokers in the DS group reported higher levels of hopelessness, perceived stress, and craving. There was no effect of DS status on abstinence at week 8 or week 26. There was no significant interaction between depression symptoms (DS vs. Control) and the intervention (MI vs. SC). CONCLUSION Despite reporting greater psychological distress, homeless smokers with depression symptoms in this sample had abstinence levels similar to the control group. Future research should explore protective factors among depressed smokers.
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Affiliation(s)
- Cendrine D Robinson
- a Department of Medical and Clinical Psychology , Uniformed Services University of the Heath Sciences, Bethesda, Maryland, USA
| | - Charles R Rogers
- b University of Minnesota Medical School , Minneapolis , Minnesota , USA
| | - Kolawole S Okuyemi
- b University of Minnesota Medical School , Minneapolis , Minnesota , USA
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29
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Affiliation(s)
- Kolawole S Okuyemi
- Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN;
| | - Lorraine R Reitzel
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX
| | - Pebbles Fagan
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, Honolulu, HI
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Sewali BP, Askhir A, Belinson J, Vogel RI, Okuyemi KS, Joseph A, Ghebre RG. Abstract PR03: Clinic-based Pap test versus HPV home test among Somali immigrant women in Minnesota: A randomized controlled trail. Cancer Epidemiol Biomarkers Prev 2015. [DOI: 10.1158/1538-7755.disp14-pr03] [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: 11/16/2022] Open
Abstract
Abstract
Objective: It is unknown whether the Somali immigrant population in the United States may use the home-based HPV DNA self-collection as an acceptable method to cervical cancer screening. We aimed to determine the proportions of successful completion of cervical cancer screening using home collection kit versus clinic based Pap test.
Methods: We conducted a randomized controlled pilot study among Somali women in the Minneapolis and St. Paul metro area in Minnesota. Participants were randomly assigned in a 1:1 ratio to either the standard of care clinic based Pap test group or the home based HPV test group. Univariate and multivariate logistic regression models were conducted to explore factors associated with test completion.
Results: A total of 63 Somali women, were included in the final analysis. The mean age was 55 years and majority were married, 41% had no formal education, primarily spoke Somali, with an annual household income ≤ $25,000. Using intention to treat analysis, the odds of those assigned to the home group to complete the HPV test were 6.8 times more likely than those is the pap group within 3 months of study entry (Odds Ratio (OR)=6.82; 95% Confidence Interval (CI): 2.24-20.71) p = 0.0002). After adjusting for other potential confounders, women randomized to the home based HPV group were about 14 times more likely to complete screening than those assigned to the clinic based Pap group (OR: 14.18 [95% CI: 2.73-73.51], p=0.002). In addition, women who reported having friends/family members to talk with about cancer screening were approximately 3 times more likely to complete screening than those who do not, though this was not statistically significant after multivariate adjustment (OR: 3.14 [0.72-13.67], p=0.127). Finally, women who have lived in the US longer were more likely to complete screening remained statistically significant after adjustment (OR per 1 year longer: 1.23 [1.05-1.44], p=0.011).
Conclusions: Our study highlights several important factors that potentially could improve cervical cancer screening among Somali immigrant women in Minnesota. The use of a self-sampling HPV kit has the potential to increase screening in this community, as it potentially addresses some major sociocultural barriers such as; lack of privacy created by the need for an interpreter during a clinic based Pap test. Future research should explore the potential of using the home based HPV test kits as an initial approach to encourage use of cervical cancer screening in the Somali community.
This abstract was also presented as Poster B65.
Citation Format: Barrett P. Sewali, Asli Askhir, Jerome Belinson, Rachel I. Vogel, Kolawole S. Okuyemi, Anne Joseph, Rahel G. Ghebre. Clinic-based Pap test versus HPV home test among Somali immigrant women in Minnesota: A randomized controlled trail. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr PR03.
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Affiliation(s)
| | | | - Jerome Belinson
- 3Cleveland Clinic Women's Health Institute and Preventive Oncology International Inc., Cleveland, OH
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Ojo-Fati O, John F, Thomas J, Joseph AM, Raymond NC, Cooney NL, Pratt R, Rogers CR, Everson-Rose SA, Luo X, Okuyemi KS. Integrating smoking cessation and alcohol use treatment in homeless populations: study protocol for a randomized controlled trial. Trials 2015; 16:385. [PMID: 26320081 PMCID: PMC4552980 DOI: 10.1186/s13063-015-0858-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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] [Received: 03/13/2015] [Accepted: 07/10/2015] [Indexed: 12/02/2022] Open
Abstract
Background Despite progress in reducing cigarette smoking in the general U.S. population, smoking rates, cancer morbidity and related heart disease remain strikingly high among the poor and underserved. Homeless individuals’ cigarette smoking rate remains an alarming 70 % or greater, and this population is generally untreated with smoking cessation interventions. Furthermore, the majority of homeless smokers also abuse alcohol and other drugs, which makes quitting more difficult and magnifies the health consequences of tobacco use. Methods/Design Participants will be randomized to one of three groups, including (1) an integrated intensive smoking plus alcohol intervention using cognitive behavioral therapy (CBT), (2) intensive smoking intervention using CBT or (3) usual care (i.e., brief smoking cessation and brief alcohol counseling). All participants will receive 12-week treatment with a nicotine patch plus nicotine gum or lozenge. Counseling will include weekly individual sessions for 3 months, followed by monthly booster group sessions for 3 months. The primary smoking outcome is cotinine-verified 7-day smoking abstinence at follow-up week 52, and the primary alcohol outcome will be breathalyzer-verified 90-day alcohol abstinence at week 52. Discussion This study protocol describes the design of the first community-based controlled trial (n = 645) designed to examine the efficacy of integrating alcohol abuse treatment with smoking cessation among homeless smokers. To further address the gap in effectiveness of evidence-based smoking cessation interventions in the homeless population, we are conducting a renewed smoking cessation clinical trial called Power to Quit among smokers experiencing homelessness. Trial registration ClinicalTrials.gov Identifier: NCT01932996. Date of registration: 20 November 2014.
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Affiliation(s)
- Olamide Ojo-Fati
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
| | - Florence John
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
| | - Janet Thomas
- Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Department of Medicine, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
| | - Anne M Joseph
- Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Department of Medicine, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
| | - Nancy C Raymond
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Department of Psychiatry, University of Minnesota Medical School, Medical School, Academic Affairs, 420 Delaware Street SE, Minneapolis, MN, 55455, USA.
| | - Ned L Cooney
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, CT, 06511, USA.
| | - Rebekah Pratt
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
| | - Charles R Rogers
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
| | - Susan A Everson-Rose
- Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Department of Medicine, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
| | - Xianghua Luo
- Division of Biostatistics, School of Public Health, University of Minnesota, A460 Mayo Building, MMC 303, 420 Delaware Street SE, Minneapolis, MN, 55455, USA.
| | - Kolawole S Okuyemi
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA. .,Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
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Sewali B, Harcourt N, Everson-Rose SA, Leduc RE, Osman S, Allen ML, Okuyemi KS. Prevalence of cardiovascular risk factors across six African Immigrant Groups in Minnesota. BMC Public Health 2015; 15:411. [PMID: 25895917 PMCID: PMC4409770 DOI: 10.1186/s12889-015-1740-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 04/08/2015] [Indexed: 11/17/2022] Open
Abstract
Background Although African immigrants represent a large and growing segment of the U.S. population, there are little or no data available on the prevalence of cardiovascular disease (CVD) risk factors among this diverse population. This study compared the prevalence of self-reported CVD risk factors and health behaviors and examined the associations between immigration related characteristics and CVD risk factors and health behaviors across six African immigrants groups. Methods Data were from 996 African immigrants in the U.S., (37.9% Somalis; 26.8% Ethiopians; 14% Liberians; 8.5% Sudanese; 5.1% Kenyans and 7.8% others group) from a cross-sectional survey conducted in the Twin cities of Minnesota. Logistic regression models estimated the associations of demographic characteristics, and immigration-related factors (length of stay in the United states, English proficiency, income and health insurance) with prevalence of CVD risk factors (overweight/obese; hypertension and diabetes mellitus) and self-reported health behaviors (cigarette smoking, physical inactivity, conscious effort to exercise and eating a healthy diet). Results We found a relatively low self-reported prevalence of diabetes, hypertension, and smoking. However, significant differences were noted by country of origin. Using Somalis as our referent country of origin group, we found that Liberians and Kenyans were more likely to report having diabetes or hypertension. On all measures of health behaviors, Liberians were more likely to engage in more health protective behaviors than other individuals. Conclusions Although African immigrants have different prevalence rates for CVD risk factors and health behaviors, there is a need to further explore the differences observed by country of emigration.
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Affiliation(s)
- Barrett Sewali
- Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, MN, 55414, USA. .,Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St. SE. Ste. 166, Minneapolis, MN, 55414, USA.
| | - Nonyelum Harcourt
- Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, MN, 55414, USA. .,Department of Medicine, Cardiology Division, University of Minnesota, Minneapolis, MN, 55414, USA.
| | - Susan A Everson-Rose
- Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, MN, 55414, USA. .,Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, 55414, USA.
| | - Robert E Leduc
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, 55414, USA.
| | - Sirad Osman
- New American Community Services, Minneapolis, MN, 55104, USA.
| | - Michele L Allen
- Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, MN, 55414, USA. .,Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St. SE. Ste. 166, Minneapolis, MN, 55414, USA.
| | - Kolawole S Okuyemi
- Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, MN, 55414, USA. .,Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St. SE. Ste. 166, Minneapolis, MN, 55414, USA. .,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55414, USA.
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McClelland S, Ukwuoma OI, Lunos S, Okuyemi KS. Mortality of Dandy-Walker syndrome in the United States: Analysis by race, gender, and insurance status. J Neurosci Rural Pract 2015; 6:182-5. [PMID: 25883477 PMCID: PMC4387808 DOI: 10.4103/0976-3147.153224] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Dandy-Walker syndrome (DWS) is a congenital disorder often diagnosed in early childhood. Typically manifesting with signs/symptoms of increased intracranial pressure, DWS is catastrophic unless timely neurosurgical care can be administered via cerebrospinal fluid (CSF) drainage. The rates of mortality, adverse discharge disposition (ADD), and CSF drainage in DWS may not be uniform regardless of race, gender or insurance status; such differences could reflect disparities in access to neurosurgical care. This study examines these issues on a nationwide level. MATERIALS AND METHODS The Kids' Inpatient Database spanning 1997-2003 was used for analysis. Only patients admitted for DWS (ICD-9-CM = 742.3) were included. Multivariate analysis was adjusted for several variables, including patient age, race, sex, admission type, primary payer, income, and hospital volume. RESULTS More than 14,000 DWS patients were included. Increasing age predicted reduced mortality (OR = 0.87; P < 0.05), ADD (OR = 0.96; P < 0.05), and decreased likelihood of receiving CSF drainage (OR = 0.86; P < 0.0001). Elective admission type predicted reduced mortality (OR = 0.29; P = 0.0008), ADD (OR = 0.68; P < 0.05), and increased CSF drainage (OR = 2.02; P < 0.0001). African-American race (OR = 1.20; P < 0.05) and private insurance (OR = 1.18; P < 0.05) each predicted increased likelihood of receiving CSF drainage, but were not predictors of mortality or ADD. Gender, income, and hospital volume were not significant predictors of DWS outcome. CONCLUSION Increasing age and elective admissions each decrease mortality and ADD associated with DWS. African-American race and private insurance status increase access to CSF drainage. These findings contradict previous literature citing African-American race as a risk factor for mortality in DWS, and emphasize the role of private insurance in obtaining access to potentially lifesaving operative care.
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Affiliation(s)
- Shearwood McClelland
- Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Onyinyechi I Ukwuoma
- Department of Pediatrics, Brookdale University Hospital and Medical Center, New York, USA
| | - Scott Lunos
- Biostatistics Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Kolawole S Okuyemi
- Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, Minnesota, USA ; Department of Family Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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Xiao RS, Hayes RB, Waring ME, Geller AC, Churchill LC, Okuyemi KS, Adams M, Huggett KN, Ockene JK. Tobacco counseling experience prior to starting medical school, tobacco treatment self-efficacy and knowledge among first-year medical students in the United States. Prev Med 2015; 73:119-24. [PMID: 25666737 PMCID: PMC4378235 DOI: 10.1016/j.ypmed.2015.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 12/30/2014] [Accepted: 02/01/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To explore students' tobacco dependence counseling experiences prior to medical school and their associations with tobacco counseling self-efficacy, and familiarity with and perceived effectiveness of tobacco dependence treatment among first-year medical students in the United States. METHOD In 2010, 1266 first-year medical students from 10 US medical schools completed a survey reporting their clinical experiences with specific tobacco counseling skills (e.g., 5As) prior to medical school. The survey also included questions on tobacco counseling self-efficacy, perceived physician impact on smokers, and familiarity and effectiveness of tobacco-related treatments. RESULTS Half (50.4%) reported some tobacco counseling experiences prior to medical school (i.e. at least one 5A). Students with prior counseling experiences were more likely to have higher tobacco counseling self-efficacy, and greater familiarity with medication treatment, nicotine replacement treatment, and behavioral counseling for smoking cessation, compared to those with no prior experiences. Perceived physician impact on patient smoking outcomes did not differ by prior tobacco counseling experiences. CONCLUSIONS Many first-year medical students may already be primed to learn tobacco dependence counseling skills. Enhancing early exposure to learning these skills in medical school is likely to be beneficial to the skillset of our future physicians.
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Affiliation(s)
- Rui S Xiao
- Clinical and Population Health Research Program, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA; Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA.
| | - Rashelle B Hayes
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue, Worcester, MA 01655, USA
| | - Molly E Waring
- Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA
| | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
| | - Linda C Churchill
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue, Worcester, MA 01655, USA
| | - Kolawole S Okuyemi
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Michael Adams
- Division of General Internal Medicine, Department of Medicine, Georgetown University Hospital, USA
| | | | - Judith K Ockene
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue, Worcester, MA 01655, USA
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Hayes RB, Geller AC, Crawford SL, Jolicoeur DG, Churchill LC, Okuyemi KS, David SP, Adams M, Waugh J, Allen SS, Leone FT, Fauver R, Leung K, Liu Q, Ockene JK. Medical school curriculum characteristics associated with intentions and frequency of tobacco dependence treatment among 3rd year U.S. medical students. Prev Med 2015; 72:56-63. [PMID: 25572623 PMCID: PMC4562320 DOI: 10.1016/j.ypmed.2014.12.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 07/25/2014] [Revised: 12/20/2014] [Accepted: 12/26/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Physicians play a critical role in addressing tobacco dependence, yet report limited training. Tobacco dependence treatment curricula for medical students could improve performance in this area. This study identified student and medical school tobacco treatment curricula characteristics associated with intentions and use of the 5As for tobacco treatment among 3rd year U.S. medical students. METHODS Third year medical students (N=1065, 49.3% male) from 10 U.S. medical schools completed a survey in 2009-2010 assessing student characteristics, including demographics, tobacco treatment knowledge, and self-efficacy. Tobacco curricula characteristics assessed included amount and type of classroom instruction, frequency of tobacco treatment observation, instruction, and perception of preceptors as role models. RESULTS Greater tobacco treatment knowledge, self-efficacy, and curriculum-specific variables were associated with 5A intentions, while younger age, tobacco treatment self-efficacy, intentions, and each curriculum-specific variable were associated with greater 5A behaviors. When controlling for important student variables, greater frequency of receiving 5A instruction (OR=1.07; 95%CI 1.01-1.12) and perception of preceptors as excellent role models in tobacco treatment (OR=1.35; 95%CI 1.04-1.75) were significant curriculum predictors of 5A intentions. Greater 5A instruction (B=.06 (.03); p<.05) and observation of tobacco treatment (B=.35 (.02); p<.001) were significant curriculum predictors of greater 5A behaviors. CONCLUSIONS Greater exposure to tobacco treatment teaching during medical school is associated with both greater intentions to use and practice tobacco 5As. Clerkship preceptors, or those physicians who provide training to medical students, may be particularly influential when they personally model and instruct students in tobacco dependence treatment.
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Affiliation(s)
- Rashelle B Hayes
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
| | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, United States
| | - Sybil L Crawford
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Denise G Jolicoeur
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Linda C Churchill
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Kolawole S Okuyemi
- Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Sean P David
- Center for Education & Research in Family and Community Medicine, Division of General Medical Disciplines, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Michael Adams
- Division of General Internal Medicine, Department of Medicine, Georgetown University Hospital, United States
| | - Jonathan Waugh
- Department of Clinical and Diagnostics Sciences/UAB Lung Health Center, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Sharon S Allen
- Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Frank T Leone
- Division of Pulmonary, Allergy and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Randy Fauver
- Center for Education & Research in Family and Community Medicine, Division of General Medical Disciplines, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Katherine Leung
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Qin Liu
- Wistar Institute, Philadelphia, PA, United States
| | - Judith K Ockene
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
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Sewali B, Okuyemi KS, Askhir A, Belinson J, Vogel RI, Joseph A, Ghebre RG. Cervical cancer screening with clinic-based Pap test versus home HPV test among Somali immigrant women in Minnesota: a pilot randomized controlled trial. Cancer Med 2015; 4:620-31. [PMID: 25653188 PMCID: PMC4402076 DOI: 10.1002/cam4.429] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 12/23/2014] [Accepted: 12/01/2014] [Indexed: 12/28/2022] Open
Abstract
Cervical cancer is more common in the Somali immigrant population than the general population in the United States (US). There are low rates of cervical cancer screening among Somali women. This study compares cervical cancer screening test completion rates for a home human papilloma virus (HPV) test and standard clinic Pap test. Sixty-three Somali immigrant women aged 30–70 years who had not undergone cervical cancer screening within the past 3 years were randomly assigned to a home HPV test group (intervention) or a clinic Pap test group (control). Test completion rates were measured at 3 months. Univariate and multivariate logistic regression models were used to explore factors associated with test completion (intention-to-treat analysis). Participants in the HPV test group were 14 times more likely to complete the test compared to those in the Pap test group (P = 0.0002). Women who reported having friends/family members to talk about cancer screening were approximately three times more likely to complete any screening test than those who did not (P = 0.127) and participants who reported residing in the US longer were more likely to complete a screening test (P = 0.011). Future research should explore the potential of using the home-based HPV test kits as an initial approach to cervical cancer screening. Impact: The use of a self-sampling HPV kit has the potential to increase cervical cancer screening in under-served communities in the US.
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Affiliation(s)
- Barrett Sewali
- Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, Minnesota; Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
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McClelland S, Ukwuoma OI, Lunos S, Okuyemi KS. The natural history of Dandy-Walker syndrome in the United States: A population-based analysis. J Neurosci Rural Pract 2015; 6:23-6. [PMID: 25552847 PMCID: PMC4244783 DOI: 10.4103/0976-3147.143185] [Citation(s) in RCA: 9] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Dandy-Walker syndrome (DWS) is a congenital disorder typically manifesting with hydrocephalus. The classic anatomic hallmarks of DWS are hypoplasia of the cerebellar vermis, anterior-posterior enlargement of the posterior fossa, upward displacement of the torcula and transverse sinuses, and cystic dilatation of the fourth ventricle. AIMS Although optimal treatment of DWS typically requires neurosurgical intervention to prevent intracranial pressure increases incompatible with life, the natural history of this disorder has yet to be evaluated on a nationwide level. SETTINGS AND DESIGN/MATERIALS AND METHODS The Kids' Inpatient Database covering 1997-2003 was used for analysis. Children younger than age 18 admitted for DWS (ICD-9-CM = 742.3) were analyzed with a matched control group. The primary procedure codes for operative CSF drainage were coded into the analysis. The incidence of DWS was 0.136%; 14,599 DWS patients were included. STATISTICAL ANALYSIS USED Multiple logistic regression models were used. Odds ratios (OR) were reported with 95% confidence intervals. RESULTS AND CONCLUSIONS Mortality (OR = 10.02; P < 0.0001) and adverse discharge disposition (OR = 4.59; P < 0.0001) were significantly greater in DWS patients compared with controls. 20.4% of DWS patients received operative cerebrospinal fluid (CSF) drainage, 81-times more than controls (P < 0.0001). CSF drainage reduced mortality by 44% among DWS patients (P < 0.0001). Although DWS is associated with a 10-fold increase in mortality, operative CSF drainage nearly halves the mortality rate. Based on these findings (Class IIB evidence), it is likely that the increased mortality associated with DWS is directly attributable to the nearly 80% of DWS patients who did not receive operative CSF drainage for hydrocephalus. Consequently, increased access to neurosurgical intervention could reduce the mortality rate of DWS towards that of the general population.
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Affiliation(s)
- Shearwood McClelland
- Program in Health Disparities Research, University of Minnesota Medical School, Minnesota, USA
| | - Onyinyechi I Ukwuoma
- Department of Pediatrics, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Scott Lunos
- Biostatistics Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minnesota, USA
| | - Kolawole S Okuyemi
- Program in Health Disparities Research, University of Minnesota Medical School, Minnesota, USA ; Department of Family Medicine, University of Minnesota Medical School, Minnesota, USA
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Felder TM, Braun KL, Brandt HM, Khan S, Tanjasiri S, Friedman DB, Armstead CA, Okuyemi KS, Hébert JR. Mentoring and Training of Cancer-Related Health Disparities Researchers Committed to Community-Based Participatory Research. Prog Community Health Partnersh 2015; 9 Suppl:97-108. [PMID: 26213409 PMCID: PMC4703034 DOI: 10.1353/cpr.2015.0020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND OBJECTIVE The National Cancer Institute's (NCI) Community Networks Program Centers (CNPCs) provide community-based participatory research (CBPR)-oriented mentoring and training to prepare early-stage/midcareer investigators and student trainees (trainees) in disparities reduction. This paper describes the academic, mentoring, training, and work-life balance experiences of CNPC-affiliated trainees. METHODS We used a collaborative and iterative process to develop a 57-item, web-based questionnaire completed by trainees from the 23 CNPCs between August 2012 and February 2013. Their CNPC mentors completed a 47-item questionnaire. Descriptive statistics were calculated. RESULTS The final analytic sample included 189 of 269 individuals (70%) identified as active participants in CNPC research or training/mentoring. Mentors (n=45) were mostly non-Hispanic White (77.8%) and 48.9% were male. Mentors published a median of 6 (interquartile range [IQR], 3-12) first-authored and 15 (IQR, 6-25) senior authored manuscripts, and secured 15 (IQR, 11-29) grants from the National Institutes of Health (NIH) and other sources in the previous 5 years. Most trainees (n=144) were female (79.2%), 43.7% were underrepresented racial/ethnic minorities, and 36.8% were first-generation college graduates. Over the previous 5 years, trainees reported a median of 4 (IQR, 1-6) publications as first author and 4 (IQR, 2-8) as co-author; 27.1% reported having one or more NIH R01s. Trainees reported satisfaction with their CNPC mentor (79.1%) and confidence in demonstrating most CBPR competencies. CONCLUSION The CNPC training program consists of a scientifically productive pool of mentors and trainees. Trainees reported rates of scholarly productivity comparable to other national training programs and provided insights into relationships with mentors, academic pressures, and professional-personal life balance.
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Reitzel LR, Nguyen N, Eischen S, Thomas J, Okuyemi KS. Is smoking cessation associated with worse comorbid substance use outcomes among homeless adults? Addiction 2014; 109:2098-104. [PMID: 25041459 PMCID: PMC4229393 DOI: 10.1111/add.12688] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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: 12/23/2013] [Revised: 03/20/2014] [Accepted: 07/10/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Smoking prevalence among homeless adults is exceedingly high, and high rates of comorbid substance use are among the barriers to abstinence experienced by this group. The extent to which smoking cessation might engender an escalation in comorbid substance use could be a concern prohibiting treatment provision and engagement. This study examined whether smoking abstinence status was associated with alcohol and substance use at 26 weeks post-randomization among homeless smokers in a smoking cessation trial. DESIGN The current study was a secondary analysis of randomized smoking cessation intervention trial data. SETTING The parent study was conducted in the Minneapolis/St Paul area of Minnesota, USA. PARTICIPANTS Participants were 427 homeless adult smokers interested in quitting smoking. MEASUREMENTS Covariates collected at baseline included alcohol, cocaine, marijuana/hashish, heroin and 'any' drug use, age, sex, race/ethnicity, education, tobacco dependence, length of time homeless and treatment group. Biochemically verified smoking abstinence and self-reported alcohol and substance use were collected at 26 weeks post-randomization. FINDINGS Smoking abstinence was associated with fewer drinking days (P = 0.03), fewer drinks consumed on drinking days (P = 0.01), and lower odds of heavy drinking (P = 0.05), but not with differences in the number of days of cocaine, marijuana/hashish, heroin or any drug use. CONCLUSIONS In homeless smokers, achieving smoking abstinence may be associated with a reduction in alcohol consumption but appears not to be associated with a substantial change in other drug use.
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Affiliation(s)
- Lorraine R. Reitzel
- College of Education, Department of Educational Psychology, University of Houston, Houston, TX, USA
| | - Nga Nguyen
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sara Eischen
- Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Janet Thomas
- General Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Kolawole S. Okuyemi
- Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
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Sewali BP, Pratt R, Abdiwahab E, Call KT, Okuyemi KS. Abstract B93: Understanding cancer screening service utilization by Somali men in Minnesota. Cancer Epidemiol Biomarkers Prev 2014. [DOI: 10.1158/1538-7755.disp13-b93] [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: 11/16/2022] Open
Abstract
Abstract
Background: There is a growing recognition of the role of men in reproductive health of women, and the benefits of including men in public health programs addressing women's health. Involvement of men has important implications especially within the context that men act as social gatekeepers and as powerful family members who enforce cultural practices, often to the detriment of women's health. However, there is a dearth of information about the role of men in promoting cancer prevention especially within immigrant communities. Objective(s): The main objective of this qualitative study was to explore the potential role of Somali immigrant men in healthcare decisions that may involve promoting breast and cervical cancer screening in their communities. The secondary objective was to explore knowledge, attitudes, and beliefs about cancer prevention while examining factors associated with barriers and proposed solutions to increase cancer screening in this underserved community.
Methods: We formed a community-academic partnership and used a community based participatory research (CBPR) approach to conduct 20 key informant Interviews and 10 focus groups with Somali men. The Key Informant Interviews were audio-taped, transcribed verbatim and analyzed QSR Nvivo 10. Data were coded to identify main themes.
Results: Three quarters of the participants were 45 years and older with 85% (17) of them were married, and 55% (12) having attained a high school education or higher; 35% (7) of the participants had no healthcare insurance; 55% (11) attained high school graduate or higher level of education; 75% (15) of the participants have lived in Minnesota for more than 5 years. We identified three major themes; (i) Faith influencing the attitudes and beliefs towards cancer screening. (ii) The changing roles of men in a society that is known to be patriarchal. (iii) The migration effect on screening.
Conclusions: Given the low utilization of cancer screening services and the widening cancer screening disparity gap in the minority communities, involvement of men and religious leaders in cancer screening efforts for Somali communities is worth exploring for future interventions. With the diverse cultural and health seeking behaviors in immigrant communities, cancer screening programs must adapt to increase cancer screening rates.
Citation Format: Barrett P. Sewali, Rebekah Pratt, Ekland Abdiwahab, Kathleen T. Call, Kolawole S. Okuyemi. Understanding cancer screening service utilization by Somali men in Minnesota. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B93. doi:10.1158/1538-7755.DISP13-B93
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Louwagie GMC, Okuyemi KS, Ayo-Yusuf OA. Efficacy of brief motivational interviewing on smoking cessation at tuberculosis clinics in Tshwane, South Africa: a randomized controlled trial. Addiction 2014; 109:1942-52. [PMID: 24962451 DOI: 10.1111/add.12671] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [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: 02/05/2014] [Revised: 03/10/2014] [Accepted: 06/16/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Tuberculosis (TB) patients who smoke risk adverse TB outcomes and other long-term health effects of smoking. This study aimed to determine the efficacy of brief motivational interviewing by lay health-care workers (LHCWs) in assisting TB patients to quit smoking. DESIGN Multi-centre two-group parallel individual randomized controlled trial. SETTING Six primary care tuberculosis clinics in a South African township. PARTICIPANTS Newly diagnosed adult TB patients identified as current smokers were randomized to brief motivational interviewing by a LHCW (intervention group, n = 205) or brief smoking cessation advice from a TB nurse (control group, n = 204). MEASUREMENTS The primary outcome was self-reported sustained 6-month smoking abstinence. Exhaled carbon monoxide (CO) testing was offered to about half the participants. Secondary outcomes were sustained abstinence at 3 months; 7-day point prevalence abstinence at 1, 3 and 6 months; and quit attempts. Allocation was concealed. Primary analysis relied on intention to treat. Multi-level analysis accounted for site heterogeneity of effect. FINDINGS Self-reported 6-month sustained abstinence was 21.5% for the intervention group versus 9.3% for the control group [relative risk (RR) = 2.29, 95% confidence interval (CI) = 1.34, 3.92]. Biochemically verified 6-month sustained abstinence was also higher in the intervention group (RR 2.21, 95% CI = 1.08, 4.51) for the 166 participants who were offered carbon monoxide testing. Self-reported 3-month sustained abstinence was 25.4% for the intervention group and 12.8% for the control group (RR = 1.98, 95% CI = 1.24, 3.18). CONCLUSIONS Motivational interviewing by lay counsellors to promote smoking cessation in tuberculosis patients in South Africa approximately doubled sustained smoking abstinence for at least 6 months compared with brief advice alone.
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Affiliation(s)
- Goedele M C Louwagie
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South Africa
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Businelle MS, Kendzor DE, Kesh A, Cuate EL, Poonawalla IB, Reitzel LR, Okuyemi KS, Wetter DW. Small financial incentives increase smoking cessation in homeless smokers: a pilot study. Addict Behav 2014; 39:717-20. [PMID: 24321696 DOI: 10.1016/j.addbeh.2013.11.017] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [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: 08/22/2013] [Revised: 11/05/2013] [Accepted: 11/18/2013] [Indexed: 11/30/2022]
Abstract
Although over 70% of homeless individuals smoke, few studies have examined the effectiveness of smoking cessation interventions in this vulnerable population. The purpose of this pilot study was to compare the effectiveness of shelter-based smoking cessation clinic usual care (UC) to an adjunctive contingency management (CM) treatment that offered UC plus small financial incentives for smoking abstinence. Sixty-eight homeless individuals in Dallas, Texas (recruited in 2012) were assigned to UC (n=58) or UC plus financial incentives (CM; n=10) groups and were followed for 5 consecutive weeks (1 week pre-quit through 4 weeks post-quit). A generalized linear mixed model regression analysis was conducted to compare biochemically-verified abstinence rates between groups. An additional model examined the interaction between time and treatment group. The participants were primarily male (61.8%) and African American (58.8%), and were 49 years of age on average. There was a significant effect of treatment group on abstinence overall, and effects varied over time. Follow-up logistic regression analyses indicated that CM participants were significantly more likely than UC participants to be abstinent on the quit date (50% vs. 19% abstinent) and at 4 weeks post-quit (30% vs. 1.7% abstinent). Offering small financial incentives for smoking abstinence may be an effective way to facilitate smoking cessation in homeless individuals.
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Affiliation(s)
- Michael S Businelle
- University of Texas Health Science Center School of Public Health, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA; University of Texas Southwestern Harold C. Simmons Comprehensive Cancer Center, Population Science and Cancer Control Program, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA.
| | - Darla E Kendzor
- University of Texas Health Science Center School of Public Health, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA; University of Texas Southwestern Harold C. Simmons Comprehensive Cancer Center, Population Science and Cancer Control Program, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
| | - Anshula Kesh
- University of Texas Health Science Center School of Public Health, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
| | - Erica L Cuate
- University of Texas Health Science Center School of Public Health, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
| | - Insiya B Poonawalla
- University of Texas Health Science Center School of Public Health, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
| | - Lorraine R Reitzel
- University of Houston, Department of Educational Psychology, 491 Farish Hall, Houston, TX, 77204-5029, USA
| | - Kolawole S Okuyemi
- University of Minnesota, Family Medicine and Community Health, 717 Delaware St SE, Ste 166, Minneapolis, MN, 55414, USA
| | - David W Wetter
- University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, PO Box 301402, Unit 1440, Houston, TX, 77230, USA
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Reitzel LR, Kendzor DE, Nguyen N, Regan SD, Okuyemi KS, Castro Y, Wetter DW, Businelle MS. Shelter proximity and affect among homeless smokers making a quit attempt. Am J Health Behav 2014; 38:161-9. [PMID: 24629545 DOI: 10.5993/ajhb.38.2.1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To explore the associations between shelter proximity and real-time affect during a specific smoking quit attempt among 22 homeless adults. METHODS Affect was measured via 485 smartphone-based Ecological Momentary Assessments randomly administered during the weeks immediately before and after the quit day, and proximity to the shelter was measured via GPS. Adjusted linear mixed model regressions examined associations between shelter proximity and affect. RESULTS Closer proximity to the shelter was associated with greater negative affect only during the post-quit attempt week (p = .008). All participants relapsed to smoking by one week post-quit attempt. CONCLUSIONS Among homeless smokers trying to quit, the shelter may be associated with unexpected negative affect/stress. Potential intervention applications are suggested.
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Affiliation(s)
- Lorraine R Reitzel
- Department of Educational Psychology, College of Education, University of Houston, Houston, Health Disparities Research at The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Darla E Kendzor
- Division of Health Promotion and Behavioral Sciences, University of Texas School of Public Health and The University of Texas Southwestern Harold C. Simmons Comprehensive Cancer, Dallas, TX, USA
| | - Nga Nguyen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Seann D Regan
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kolawole S Okuyemi
- Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Yessenia Castro
- School of Social Work, University of Texas at Austin, Austin, TX, USA
| | - David W Wetter
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael S Businelle
- Division of Health Promotion and Behavioral Sciences, University of Texas School of Public Health and The University of Texas Southwestern Harold C. Simmons Comprehensive Cancer, Dallas, TX, USA.
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Goldade K, Guo H, Jarlais DD, Connett JE, Whembolua GL, Owen G, Guy M, Okuyemi KS. Homeless former smokers' interest in helping homeless current smokers quit. Am J Health Promot 2013; 27:90-3. [PMID: 23113778 DOI: 10.4278/ajhp.110311-arb-112] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To describe the factors associated with interest of homeless former smokers in helping homeless smokers quit. METHODS A cross-sectional survey administered to an optimized convenience sample of homeless persons (n = 4570) at emergency shelters, transitional housing units, and open encampments in 80 cities across Minnesota. The in-person survey response rate was 90%. ANALYSIS Chi-square tests and t-tests for univariate analysis. RESULTS Of 4534 participants completing the smoking questions, 546 participants (12%) self-identified as former smokers, of which 59% expressed interest in helping homeless smokers quit. Significant predictors of reported interest in helping included racial/ethnic background (p < .05), number of people known who had quit smoking (p < .01), and receiving social services as an adult (p < .01). CONCLUSION Homeless former smokers are a potential resource for peer support programs to promote smoking cessation among homeless current smokers.
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Affiliation(s)
- Kate Goldade
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, 55414, USA.
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Warner C, Sewali B, Olayinka A, Eischen S, Wang Q, Guo H, Ahluwalia JS, Okuyemi KS. Smoking cessation in homeless populations: who participates and who does not. Nicotine Tob Res 2013; 16:369-72. [PMID: 24158227 DOI: 10.1093/ntr/ntt169] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Although homeless individuals smoke at an alarmingly high rate, few smoking cessation clinical trials have focused on this vulnerable population. Little is known about recruitment efforts and suitable eligibility criteria for tobacco control research in homeless populations. METHODS The aim of this article is to describe the recruitment, eligibility, and enrollment of homeless smokers who participated in the Power to Quit smoking study, a randomized smoking cessation clinical trial funded by the National Institutes of Health. The study compared motivational interviewing and standard counseling while participants received an 8-week treatment of the nicotine patch. RESULTS Working with local emergency shelters, a total of 839 adult smokers were screened for study eligibility, 580 of whom (69.1%) met eligibility criteria. Of those eligible, 430 (74.1%) returned for randomization. Those who returned for randomization were older and more likely to have a phone number compared with eligible participants not enrolled. The most common reasons for exclusion included exhaled carbon monoxide levels less than or equal to 5 parts per million (indicating nonsmoking status), use of smoking cessation aid during the past 30 days, and not meeting the study definition of homelessness. CONCLUSION Knowledge of these factors may help researchers tailor criteria that accurately identify and include homeless smokers in future research.
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Affiliation(s)
- Carolyn Warner
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
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Stahre MA, Toomey TL, Erickson DJ, Forster JL, Okuyemi KS, Ahluwalia JS. The Effects of a Tobacco Intervention on Binge Drinking Among African American Light Smokers. J Addict Dis 2013; 32:377-86. [DOI: 10.1080/10550887.2013.849972] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
OBJECTIVES To examine associations of menthol cigarette use with motivation and confidence to quit smoking, and potential moderation by race, among adult current smokers (N = 1067; 85% White, 15% Black). METHODS Regression analyses, adjusted for sociodemographics and tobacco dependence, examined associations of menthol use with motivation and confidence to quit smoking with and without an interaction term for race. RESULTS Main effects were not significant; however, there was a significant interaction for confidence to quit smoking (p = .02). Stratified analyses indicated that Black menthol users were more confident about quitting than Black non-menthol users (p = .01). CONCLUSIONS Given their relatively lower quit rates as cited in previous literature, Black menthol users appear overly confident about their ability to quit smoking.
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Affiliation(s)
- Lorraine R Reitzel
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Joseph A, Murphy S, Thomas J, Okuyemi KS, Hatsukami D, Wang Q, Briggs A, Doyle B, Winickoff JP. A pilot study of concurrent lead and cotinine screening for childhood tobacco smoke exposure: effect on parental smoking. Am J Health Promot 2013; 28:316-20. [PMID: 23971524 DOI: 10.4278/ajhp.120912-arb-445] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To investigate whether a biomarker screening approach for tobacco smoke exposure (TSE) conducted concurrently with lead screening at well-child visits would increase parental smoking cessation and implementation of home smoking restrictions. DESIGN Observational, quasi-experimental. SETTING Pediatric clinic in Minneapolis, Minnesota. SUBJECTS Eighty parents who smoked and their children presenting for well-child visits. INTERVENTION Children in the intervention group had serum cotinine measured with lead screening. Laboratory results were sent to providers and parents and a counselor proactively contacted parents to offer an eight-session telephone intervention to help parents stop smoking. The comparison group, a historical control, received usual care. MEASURES Parental smoking, engagement in tobacco treatment, and home and car smoking policies 8 weeks later. ANALYSIS Mean/standard deviation for continuous data or frequency/percentage for categorical data. RESULTS Eighty-four percent of eligible parents agreed to have their child tested for TSE along with lead testing. Measurable cotinine was identified in 93% of children. More parents in the intervention group received tobacco treatment than in the comparison group (74% vs. 0%) and more parents reported 7-day point-prevalent abstinence from smoking at 8 weeks (29% vs. 3%). CONCLUSION These data demonstrate the feasibility of adding cotinine measurement to routine well-child lead screening to document TSE in small children. Data suggest providing this information to parents increases engagement in tobacco treatment and prompts smoking cessation.
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Goldade K, Des Jarlais D, Everson-Rose SA, Guo H, Thomas J, Gelberg L, Joseph AM, Okuyemi KS. Knowing quitters predicts smoking cessation in a homeless population. Am J Health Behav 2013; 37:517-24. [PMID: 23985232 DOI: 10.5993/ajhb.37.4.9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To examine the impact of knowing quitters on cessation among homeless smokers. METHODS Secondary analysis of data derived from a community-based randomized controlled trial of 430 homeless smokers. We conducted multivariable logistic regression analysis to determine whether knowing quitters impacted the likelihood of cessation (salivary cotinine ≤ 20 ng/ml) at 26-week follow-up. RESULTS Multivariable logistic regression showed cessation was more likely for smokers who knew ≥ 5 quitters compared with those who knew no quitters (Odds Ratio = 3.79, CI = 1.17, 12.27, p = .008), adjusting for age, education, income, and time to first cigarette in morning. CONCLUSIONS Knowing former smokers was associated with increased likelihood of achieving smoking abstinence among homeless smokers.
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Affiliation(s)
- Kathryn Goldade
- Program in Health Disparities Research, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA.
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Okuyemi KS, Goldade K, Whembolua GL, Thomas JL, Eischen S, Sewali B, Guo H, Connett JE, Grant J, Ahluwalia JS, Resnicow K, Owen G, Gelberg L, Jarlais DD. Motivational interviewing to enhance nicotine patch treatment for smoking cessation among homeless smokers: a randomized controlled trial. Addiction 2013; 108:1136-44. [PMID: 23510102 PMCID: PMC3651796 DOI: 10.1111/add.12140] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Revised: 09/06/2012] [Accepted: 01/29/2013] [Indexed: 11/29/2022]
Abstract
AIMS To assess the effects of adding motivational interviewing (MI) counseling to nicotine patch for smoking cessation among homeless smokers. DESIGN Two-group randomized controlled trial with 26-week follow-up. PARTICIPANTS AND SETTING A total of 430 homeless smokers from emergency shelters and transitional housing units in Minneapolis/St Paul, Minnesota, USA. INTERVENTION AND MEASUREMENTS All participants received 8-week treatment of 21-mg nicotine patch. In addition, participants in the intervention group received six individual sessions of MI counseling which aimed to increase adherence to nicotine patches and to motivate cessation. Participants in the standard care control group received one session of brief advice to quit smoking. Primary outcome was 7-day abstinence from cigarette smoking at 26 weeks, as validated by exhaled carbon monoxide and salivary cotinine. FINDINGS Using intention-to-treat analysis, verified 7-day abstinence rate at week 26 for the intervention group was non-significantly higher than for the control group (9.3% versus 5.6%, P = 0.15). Among participants who did not quit smoking, reduction in number of cigarettes from baseline to week 26 was equally high in both study groups (-13.7 ± 11.9 for MI versus -13.5 ± 16.2 for standard care). CONCLUSIONS Adding motivational interviewing counseling to nicotine patch did not increase smoking rate significantly at 26-week follow-up for homeless smokers.
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Affiliation(s)
- Kolawole S. Okuyemi
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN,Program in Health Disparities Research, University Of Minnesota, Minneapolis, MN,Center for Health Equity, University Of Minnesota, Minneapolis, MN,Masonic Cancer Center, University Of Minnesota, Minneapolis, MN
| | - Kate Goldade
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN,Program in Health Disparities Research, University Of Minnesota, Minneapolis, MN
| | - Guy-Lucien Whembolua
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN,Program in Health Disparities Research, University Of Minnesota, Minneapolis, MN,Center for Health Equity, University Of Minnesota, Minneapolis, MN
| | - Janet L. Thomas
- Program in Health Disparities Research, University Of Minnesota, Minneapolis, MN,Center for Health Equity, University Of Minnesota, Minneapolis, MN,Masonic Cancer Center, University Of Minnesota, Minneapolis, MN,Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Sara Eischen
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN,Program in Health Disparities Research, University Of Minnesota, Minneapolis, MN
| | - Barrett Sewali
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN,Program in Health Disparities Research, University Of Minnesota, Minneapolis, MN
| | - Hongfei Guo
- Division of Biostatistics, School of Public Health, and Clinical and Translational Institute, University of Minnesota, Minneapolis, MN
| | - John E. Connett
- Division of Biostatistics, School of Public Health, and Clinical and Translational Institute, University of Minnesota, Minneapolis, MN
| | - Jon Grant
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | - Jasjit S. Ahluwalia
- Program in Health Disparities Research, University Of Minnesota, Minneapolis, MN,Center for Health Equity, University Of Minnesota, Minneapolis, MN,Masonic Cancer Center, University Of Minnesota, Minneapolis, MN,Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Ken Resnicow
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI
| | | | - Lillian Gelberg
- Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Don Des Jarlais
- Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, NY
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