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Rudd BN, Witzig J, Goff CN, Potter EN, Snyder SE, Ordorica C, Ivankova NV. A Statewide Evaluation of the Implementation of Evidence-Based Suicide Prevention Guidelines in Juvenile Detention Centers. Psychiatr Serv 2024:appips20220490. [PMID: 38369882 DOI: 10.1176/appi.ps.20220490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
This study aimed to explore suicide prevention in juvenile detention centers by conducting a case study of one state. Qualitative data from semistructured interviews were synthesized from 10 juvenile detention centers. Analytical techniques included thematic and content analysis and the integration of quantitative information and qualitative themes to illustrate key differences in suicide prevention practices and center characteristics among facilities with varying frequencies of crisis stabilization calls and critical incidents. Although the use of many suicide prevention practices was reported across the sample, the quality with which those practices were implemented was highly variable. The analysis suggests that facilities with higher-quality implementation of suicide prevention practices may have had leaders who acknowledged that their facility plays a role in suicide prevention. Moreover, preliminary evidence suggests that the quality of suicide prevention implementation may be associated with the number of crisis stabilization calls and critical incidents (i.e., variables related to suicidality) a facility experiences. Clear conceptualization of a juvenile detention center's role in suicide prevention may lead to better outcomes in suicide prevention implementation. High-quality implementation may reduce suicidality exhibited by youths in juvenile detention and save lives.
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Affiliation(s)
- Brittany N Rudd
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois Chicago, Chicago (Rudd, Witzig, Goff, Potter, Ordorica); Organizational Research Services Impact, Seattle (Goff); Department of Medicine, University of Pennsylvania, Philadelphia (Snyder); Department of Health Services Administration, University of Alabama at Birmingham School of Health Professions, Birmingham (Ivankova)
| | - Jax Witzig
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois Chicago, Chicago (Rudd, Witzig, Goff, Potter, Ordorica); Organizational Research Services Impact, Seattle (Goff); Department of Medicine, University of Pennsylvania, Philadelphia (Snyder); Department of Health Services Administration, University of Alabama at Birmingham School of Health Professions, Birmingham (Ivankova)
| | - Charlotte N Goff
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois Chicago, Chicago (Rudd, Witzig, Goff, Potter, Ordorica); Organizational Research Services Impact, Seattle (Goff); Department of Medicine, University of Pennsylvania, Philadelphia (Snyder); Department of Health Services Administration, University of Alabama at Birmingham School of Health Professions, Birmingham (Ivankova)
| | - Emily N Potter
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois Chicago, Chicago (Rudd, Witzig, Goff, Potter, Ordorica); Organizational Research Services Impact, Seattle (Goff); Department of Medicine, University of Pennsylvania, Philadelphia (Snyder); Department of Health Services Administration, University of Alabama at Birmingham School of Health Professions, Birmingham (Ivankova)
| | - Sean E Snyder
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois Chicago, Chicago (Rudd, Witzig, Goff, Potter, Ordorica); Organizational Research Services Impact, Seattle (Goff); Department of Medicine, University of Pennsylvania, Philadelphia (Snyder); Department of Health Services Administration, University of Alabama at Birmingham School of Health Professions, Birmingham (Ivankova)
| | - Catalina Ordorica
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois Chicago, Chicago (Rudd, Witzig, Goff, Potter, Ordorica); Organizational Research Services Impact, Seattle (Goff); Department of Medicine, University of Pennsylvania, Philadelphia (Snyder); Department of Health Services Administration, University of Alabama at Birmingham School of Health Professions, Birmingham (Ivankova)
| | - Nataliya V Ivankova
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois Chicago, Chicago (Rudd, Witzig, Goff, Potter, Ordorica); Organizational Research Services Impact, Seattle (Goff); Department of Medicine, University of Pennsylvania, Philadelphia (Snyder); Department of Health Services Administration, University of Alabama at Birmingham School of Health Professions, Birmingham (Ivankova)
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Davis SL, Jaser SS, Ivankova NV, Lemley T, Rice M. Using Mixed Methods Research in Children with Type 1 Diabetes: a Methodological Review. Curr Diab Rep 2023; 23:147-163. [PMID: 37097408 PMCID: PMC10651325 DOI: 10.1007/s11892-023-01509-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE OF REVIEW Many factors influence disease management and glycemic levels in children with type 1 diabetes (T1D). However, these concepts are hard to examine in children using only a qualitative or quantitative research paradigm. Mixed methods research (MMR) offers creative and unique ways to study complex research questions in children and their families. RECENT FINDINGS A focused, methodological literature review revealed 20 empirical mixed methods research (MMR) studies that included children with T1D and/or their parents/caregivers. These studies were examined and synthesized to elicit themes and trends in MMR. Main themes that emerged included disease management, evaluation of interventions, and support. There were multiple inconsistencies between studies when reporting MMR definitions, rationales, and design. Limited studies use MMR approaches to examine concepts related to children with T1D. Findings from future MMR studies, especially ones that use child-report, may illuminate ways to improve disease management and lead to better glycemic levels and health outcomes.
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Affiliation(s)
- Sara L. Davis
- Maternal Child Health Nursing, University of South Alabama, 5721 USA Dr N, Mobile, AL 36688, USA
| | - Sarah S. Jaser
- Division of Pediatric Endocrinology & Diabetes, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Nataliya V. Ivankova
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Trey Lemley
- Biomedical Library, University of South Alabama, Mobile, AL, USA
| | - Marti Rice
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
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Cherven B, Ivankova NV, Spencer JB, Fitzpatrick AM, Burns KC, Demedis J, Hoefgen HR, Mertens AC, Klosky JL. Examining decisional needs and contextual factors influencing fertility status assessment among young female survivors of childhood cancer: A sequential mixed methods study protocol. PLoS One 2023; 18:e0286511. [PMID: 37315007 DOI: 10.1371/journal.pone.0286511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/17/2023] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Female cancer survivors who received gonadotoxic cancer treatment are at risk for profound diminished ovarian reserve and/or primary ovarian insufficiency with resulting infertility, which can be associated with distress and decreased quality of life.. Despite prioritizing future parenthood, many survivors are unsure of the impact of their treatment on their future fertility, and little is known about the perceived reproductive health needs and factors associated with receipt of a fertility status assessment (FSA). There is a lack of developmentally appropriate reproductive health decisional support interventions available for emerging adult cancer survivors. This study will explore the perceived reproductive health needs of emerging adult female survivors of childhood cancer and to identify decisional and contextual factors that influence pursuit of FSA using an explanatory sequential quantitative to qualitative mixed methods design. METHODS AND ANALYSIS This study will enroll 325 female survivors (aged 18 to 29 years and >1-year post treatment; diagnosed with cancer < age 21 years) from four cancer centers in the United States. Sociodemographic and developmental factors, reproductive knowledge and values, decisional needs, and receipt of an FSA will be assessed through a web-based survey. Informed by survey findings, a subset of participants will be recruited for qualitative interviews to explore decisional factors associated with uptake of an FSA. Clinical data will be abstracted from the medical records. Multivariable logistic regression models will be developed to identify factors associated with FSA and qualitative descriptive analysis will be used to develop themes from the interviews. Quantitative and qualitative findings will be merged using a joint display to develop integrated study conclusions and direct future interventional research.
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Affiliation(s)
- Brooke Cherven
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, GA, United States of America
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Nataliya V Ivankova
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Jessica B Spencer
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Anne M Fitzpatrick
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Karen C Burns
- University of Cincinnati College of Medicine, Cincinnati, OH, United States of America
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States of America
| | - Jenna Demedis
- Center for Cancer and Blood Disorders at Children's Hospital Colorado, Aurora, CO, United States of America
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Holly R Hoefgen
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, GA, United States of America
- Washington University School of Medicine, St. Louis, MO, United States of America
| | - Ann C Mertens
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, GA, United States of America
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
| | - James L Klosky
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, GA, United States of America
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
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Edwards RL, Bakitas M, Li P, Spence D, Kahwa E, Stoltenberg M, Ivankova NV, Thomas K, Segree K, Kodilinye SM, Markaki A. Adaptation and psychometric testing of the end-of-life professional caregiver survey in Jamaica. BMC Health Serv Res 2023; 23:498. [PMID: 37193983 DOI: 10.1186/s12913-023-09497-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 05/03/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Using a validated instrument to measure palliative care (PC) educational needs of health professionals is an important step in understanding how best to educate a well-versed PC workforce within a national health system. The End-of-life Professional Caregiver Survey (EPCS) was developed to measure U.S. interprofessional PC educational needs and has been validated for use in Brazil and China. As part of a larger research project, this study aimed to culturally adapt and psychometrically test the EPCS among physicians, nurses, and social workers practicing in Jamaica. METHODS Face validation involved expert review of the EPCS with recommendations for linguistic item modifications. Content validation was carried out by six Jamaica-based experts who completed a formal content validity index (CVI) for each EPCS item to ascertain relevancy. Health professionals practicing in Jamaica (n = 180) were recruited using convenience and snowball sampling to complete the updated 25-item EPCS (EPCS-J). Internal consistency reliability was assessed using Cronbach's [Formula: see text] coefficient and McDonald's [Formula: see text]. Construct validity was examined through confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). RESULTS Content validation led to elimination of three EPCS items based on a CVI < 0.78. Cronbach's [Formula: see text] ranged from 0.83 to 0.91 and McDonald's [Formula: see text] ranged from 0.73 to 0.85 across EPCS-J subscales indicating good internal consistency reliability. The corrected item-total correlation for each EPCS-J item was > 0.30 suggesting good reliability. The CFA demonstrated a three-factor model with acceptable fit indices (RMSEA = 0.08, CFI = 0.88, SRMR = 0.06). The EFA determined a three-factor model had the best model fit, with four items moved into the effective patient care subscale from the other two EPCS-J subscales based on factor loading. CONCLUSIONS The psychometric properties of the EPCS-J resulted in acceptable levels of reliability and validity indicating that this instrument is suitable for use in measuring interprofessional PC educational needs in Jamaica.
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Affiliation(s)
- Rebecca L Edwards
- Department of Acute, Chronic, and Continuing Care, School of Nursing, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, US.
| | - Marie Bakitas
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, US
| | - Peng Li
- Department of Acute, Chronic, and Continuing Care, School of Nursing, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, US
| | - Dingle Spence
- Hope Institute Hospital, 7 Golding Ave, Kingston 7, Mona, Jamaica
- Department of Medicine, University of the West Indies, Mona Campus, Mona, Jamaica
- Jamaica Cancer Care and Research Institute, University of the West Indies, Mona Campus, Mona, Jamaica
| | - Eulalia Kahwa
- School of Health and Behavioral Sciences, University of the West Indies, Five Islands Campus, Antigua and Barbuda, Jamaica
| | - Mark Stoltenberg
- Global Palliative Care Program, Division of Palliative Care and Geriatrics, Massachusetts General Hospital, Boston, Massachusetts, US
- Harvard Medical School, Boston, Massachusetts, US
| | - Nataliya V Ivankova
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, US
| | - Kaesha Thomas
- Jamaica Cancer Care and Research Institute, University of the West Indies, Mona Campus, Mona, Jamaica
| | - Kammar Segree
- Jamaica Cancer Care and Research Institute, University of the West Indies, Mona Campus, Mona, Jamaica
| | - Syed Matthew Kodilinye
- Jamaica Cancer Care and Research Institute, University of the West Indies, Mona Campus, Mona, Jamaica
| | - Adelais Markaki
- PAHO/WHOCC for International Nursing, Family, Community and Health Systems Department, School of Nursing, University of Alabama at Birmingham, Birmingham, AL, US
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Barnes K, Zimmerman K, Herbey I, Arynchyna-Smith A, May B, Arata Wessinger C, Dreer LE, Thompson L, Ivankova NV, Rozzelle CJ, Johnston JM, Blount JP, Rocque BG. Understanding and identifying the needs of parent caregivers of children with hydrocephalus: a qualitative study. J Neurosurg Pediatr 2023; 31:433-443. [PMID: 36787132 DOI: 10.3171/2022.12.peds22425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 12/27/2022] [Indexed: 02/12/2023]
Abstract
OBJECTIVE Hydrocephalus is inherently unpredictable. Most parents whose child is diagnosed with hydrocephalus do not anticipate the diagnosis, nor can anyone predict if or when a child's shunt will fail and require emergency surgery. Previous research has shown that children with hydrocephalus and their caregivers experience significant posttraumatic stress symptoms secondary to the diagnosis. This study aims to understand caregiver experiences and needs, identify gaps in resources/support, and determine opportunities to improve care. METHODS Semistructured interviews were conducted with parent caregivers of children with hydrocephalus to learn about their experiences with the hydrocephalus diagnosis, hospitalizations, surgeries, coping and support, challenges of caring for a child with hydrocephalus, and logistics for a proposed support program. De-identified interviews were audio-recorded, transcribed, and analyzed for themes. RESULTS Thematic saturation was reached after 17 interviews. Five major themes emerged: 1) coping with the diagnosis, 2) received support, 3) hydrocephalus management, 4) implications for intervention, and 5) psychosocial stressors for caregivers. A top priority was balanced, trustworthy information delivered with compassion and updated throughout the child's life. Caregivers described a variety of coping strategies, but a majority reported a need for support in processing complex emotions and dealing with the uncertainty of their child's hydrocephalus. Most agreed that having a caregiver support network, medical professionals available for referrals and questions, and referrals to support services and therapies would facilitate feeling supported and providing the best care for their children. CONCLUSIONS Parent caregivers are critical to the health and well-being of children with hydrocephalus, and it is essential to understand their experiences to improve care. Providing well-defined information, psychosocial support, and resources will help to equip parent caregivers to be advocates for their children and to improve both the caregiver and the child's quality of life.
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Affiliation(s)
- Katherine Barnes
- 1Department of Pediatrics, Division of Neurology, University of Alabama at Birmingham.,2Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Alabama at Birmingham, Alabama
| | - Kathrin Zimmerman
- 2Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Alabama at Birmingham, Alabama.,3Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Ivan Herbey
- 4Department of Surgery, Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Alabama
| | - Anastasia Arynchyna-Smith
- 2Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Alabama at Birmingham, Alabama
| | - Bobby May
- 5Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina
| | | | | | - Lieu Thompson
- 8Health Services Administration, University of Alabama at Birmingham, Alabama
| | - Nataliya V Ivankova
- 8Health Services Administration, University of Alabama at Birmingham, Alabama
| | - Curtis J Rozzelle
- 2Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Alabama at Birmingham, Alabama
| | - James M Johnston
- 2Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Alabama at Birmingham, Alabama
| | - Jeffrey P Blount
- 2Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Alabama at Birmingham, Alabama
| | - Brandon G Rocque
- 2Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Alabama at Birmingham, Alabama
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Rogers LQ, Pekmezi D, Schoenberger-Godwin YM, Fontaine KR, Ivankova NV, Kinsey AW, Hoenemeyer T, Martin MY, Pisu M, Farrell D, Wall J, Waugaman K, Oster RA, Kenzik K, Winters-Stone K, Demark-Wahnefried W. Using the TIDieR checklist to describe development and integration of a web-based intervention promoting healthy eating and regular exercise among older cancer survivors. Digit Health 2023; 9:20552076231182805. [PMID: 37434730 PMCID: PMC10331096 DOI: 10.1177/20552076231182805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 06/01/2023] [Indexed: 07/13/2023] Open
Abstract
Objective To facilitate replication and future intervention design of web-based multibehavior lifestyle interventions, we describe the rationale, development, and content of the AiM, Plan, and act on LIFestYles (AMPLIFY) Survivor Health intervention which provides healthy eating and exercise behavior change support for older cancer survivors. The intervention promotes weight loss, improvements in diet quality, and meeting exercise recommendations. Methods The Template for Intervention Description and Replication (TIDieR) checklist was used to provide a comprehensive description of the AMPLIFY intervention, consistent with CONSORT recommendations. Results A social cognitive theory web-based intervention founded on the core components of efficacious print and in-person interventions was conceptualized and developed through an iterative collaboration involving cancer survivors, web design experts, and a multidisciplinary investigative team. The intervention includes the AMPLIFY website, text and/or email messaging, and a private Facebook group. The website consists of: (1) Sessions (weekly interactive e-learning tutorials); (2) My Progress (logging current behavior, receiving feedback, setting goals); (3) Tools (additional information and resources); (4) Support (social support resources, frequently asked questions); and (5) Home page. Algorithms were used to generate fresh content daily and weekly, tailor information, and personalize goal recommendations. An a priori rubric was used to facilitate intervention delivery as healthy eating only (24 weeks), exercise only (24 weeks), or both behaviors concurrently over 48 weeks. Conclusions Our TIDieR-guided AMPLIFY description provides pragmatic information helpful for researchers designing multibehavior web-based interventions and enhances potential opportunities to improve such interventions.
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Affiliation(s)
- Laura Q. Rogers
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
| | - Dori Pekmezi
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA, USA
| | - Yu-Mei Schoenberger-Godwin
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kevin R. Fontaine
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA, USA
| | - Nataliya V. Ivankova
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amber W. Kinsey
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Teri Hoenemeyer
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michelle Y. Martin
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Maria Pisu
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | - Kaitlyn Waugaman
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert A. Oster
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kelly Kenzik
- Department of Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Kerri Winters-Stone
- Division of Oncological Sciences, Oregon Health and Science University, Portland, OR, USA
| | - Wendy Demark-Wahnefried
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
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Anderson JL, Mugavero MJ, Ivankova NV, Reamey RA, Varley AL, Samuel SE, Cherrington AL. Adapting an Interdisciplinary Learning Health System Framework for Academic Health Centers: A Scoping Review. Acad Med 2022; 97:1564-1572. [PMID: 35675482 DOI: 10.1097/acm.0000000000004712] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Learning health systems (LHSs), defined as a systematic process for aligning science, informatics, and clinical practice to integrate providers, researchers, and patients as active participants in an evidence-based care continuum, can provide an ideal environment for academic health centers to rapidly adopt evidence-based guidelines and translate research into practice. However, few LHS frameworks are specifically adapted for academic health centers. The authors wanted to identify the definitions, components, and other features of LHSs to develop an interdisciplinary LHS framework for use within academic health centers. METHOD The authors conducted a scoping review of the literature to identify definitions, components, and other features of LHSs that are useful to academic health centers. In January 2021, they searched PubMed, Academic Search Premier, and Scopus databases and identified English-language, peer-reviewed articles pertaining to LHS, LHS frameworks, organization, components, and models. Since the phrase learning health system is relatively new terminology, they conducted a supplemental review with alternative phrases, including embedded research and coordinated or collaborative research network . They used the Knowledge to Action (KTA) Framework to integrate the generation and flow of research into practice. RESULTS The primary review retrieved 719 articles and the supplemental review retrieved 209; of these, 49 articles were retained to synthesize common definitions, components, and other features of LHS frameworks. Seven structural components of LHSs were identified: organization and collaborations, performance, ethics and security, scientific approaches, data, information technology, and patient outcomes. An adapted interdisciplinary LHS framework was developed that incorporated research and learning engines derived from the KTA and adaptations of common components and other features within the reviewed articles to fit the interests of providers, researchers, and patients within academic health centers. CONCLUSIONS The adapted LHS framework can be used as a dynamic foundation for development and organization of interdisciplinary LHSs within academic health centers.
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Affiliation(s)
- Jami L Anderson
- J.L. Anderson is a predoctoral trainee, Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama
| | - Michael J Mugavero
- M.J. Mugavero is professor, Division of Infectious Diseases, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Nataliya V Ivankova
- N.V. Ivankova is professor, Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama
| | - Rebecca A Reamey
- R.A. Reamey is assistant professor, Division of Infectious Diseases, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Allyson L Varley
- A.L. Varley is a researcher, Division of Preventive Medicine, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, and Health Services Research and Development, Birmingham VA Health System, Birmingham, Alabama
| | - Shekwonya E Samuel
- S.E. Samuel is a graduate research assistant, Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Andrea L Cherrington
- A.L. Cherrington is professor, Division of Preventive Medicine, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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Liang MI, Simons JL, Herbey II, Wall JA, Rucker LR, Ivankova NV, Huh WK, Pisu M. Navigating job and cancer demands during treatment: A qualitative study of ovarian cancer patients. Gynecol Oncol 2022; 166:481-486. [PMID: 35902296 PMCID: PMC10910482 DOI: 10.1016/j.ygyno.2022.07.021] [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: 04/03/2022] [Revised: 07/17/2022] [Accepted: 07/19/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Our objective was to obtain perspectives from ovarian cancer patients on job demands, cancer demands, and workplace or cancer resources and strategies to manage the cancer-work interface using the cancer-work management conceptual framework. METHODS We recruited ovarian cancer patients receiving systemic therapy who screened positive for financial distress using Comprehensive Score for Financial Toxicity <26. Interviews were conducted with participants about their costs of care, including employment concerns. Interviews were recorded, transcribed verbatim, and analyzed by three researchers using an inductive thematic analysis. RESULTS Of 22 participants, the average age was 57 years old, 36% were Black, 68% had income <$40,000, 41% had public insurance, and 68% were being treated for recurrent disease. Job demands included decreased productivity, inability to return to work, and worry about losing a job or employer-based health insurance coverage. Cancer demands included physical and cognitive limitations due to cancer treatment and reliance on caregivers, especially for transportation. Workplace resources/strategies including having a supportive employer, modifying job responsibilities, and utilizing family medical leave. Cancer care resources/strategies included planning appointments ahead of time and utilizing resources, such as disability. CONCLUSIONS Cancer care teams should consider screening patients for employment concerns; streamline care to minimize the side effects, time, and transportation demands of treatment on patients and caregivers; maximize utilization of available resources; and proactively communicate with employers to accommodate patients and caregivers who want or need to work.
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Affiliation(s)
- Margaret I Liang
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL, United States of America; Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, United States of America; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, United States of America.
| | - J Leahgrace Simons
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Ivan I Herbey
- Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Jaclyn A Wall
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Lindsay R Rucker
- Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Nataliya V Ivankova
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Warner K Huh
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL, United States of America; Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, United States of America; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Maria Pisu
- Division of Preventive Medicine, Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, AL, United States of America
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Pekmezi D, Fontaine K, Rogers LQ, Pisu M, Martin MY, Schoenberger-Godwin YM, Oster RA, Kenzik K, Ivankova NV, Demark-Wahnefried W. Adapting MultiPLe behavior Interventions that eFfectively Improve (AMPLIFI) cancer survivor health: program project protocols for remote lifestyle intervention and assessment in 3 inter-related randomized controlled trials among survivors of obesity-related cancers. BMC Cancer 2022; 22:471. [PMID: 35488238 PMCID: PMC9051494 DOI: 10.1186/s12885-022-09519-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/10/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Scalable, multiple behavior change interventions are needed to address poor diet, inactivity, and excess adiposity among the rising number of cancer survivors. Efficacy-tested diet (RENEW) and exercise (BEAT Cancer) programs were adapted for web delivery among middle-aged and older cancer survivors for the AMPLIFI study, a National Cancer Institute-funded, multi-site, program project. METHODS Throughout the continental U.S., survivors of several obesity-related cancers are being recruited for three interconnected randomized controlled trials (RCTs). Projects 1 and 2 test 6-month diet or exercise interventions versus a wait-list control condition. Upon completion of the 6-month study period, the intervention participants receive the next behavior change sequence (i.e., diet receives exercise, exercise receives diet) and the wait-list control arm initiates a 12-month combined diet and exercise intervention. Project 3 tests the efficacy of the sequential versus simultaneous interventions. Assessments occur at baseline and semi-annually for up to 2-years and include: body mass index, health behaviors (diet quality, accelerometry-assessed physical activity/sleep), waist circumference, D3 creatine-assessed muscle mass, physical performance, potential mediators/moderators of treatment efficacy, biomarkers of inflammation and metabolic regulation, health care utilization, cost, and overall health. Four shared resources support AMPLIFI RCTs: 1) Administrative; 2) Adaptation, Dissemination and Implementation; 3) Recruitment and Retention; and 4) Assessment and Analysis. DISCUSSION Representing a new generation of RCTs, AMPLIFI will exclusively use remote technologies to recruit, intervene and assess the efficacy of the newly-adapted, web-based diet and exercise interventions and determine whether sequential or combined delivery works best for at-risk (older, rural, racial minority) cancer survivors. TRIAL REGISTRATION ClinicalTrials.gov , NCT04000880 . Registered 27 June 2019.
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Affiliation(s)
- Dori Pekmezi
- Department of Health Behavior, University of Alabama at Birmingham (UAB), Birmingham, AL, USA.
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA.
| | - Kevin Fontaine
- Department of Health Behavior, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
| | - Laura Q Rogers
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
- Department of Medicine, UAB, Birmingham, AL, USA
| | - Maria Pisu
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
- Department of Medicine, UAB, Birmingham, AL, USA
| | - Michelle Y Martin
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Yu-Mei Schoenberger-Godwin
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
- Department of Medicine, UAB, Birmingham, AL, USA
| | - Robert A Oster
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
- Department of Medicine, UAB, Birmingham, AL, USA
| | - Kelly Kenzik
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
- Department of Medicine, UAB, Birmingham, AL, USA
| | | | - Wendy Demark-Wahnefried
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
- Department of Nutrition Sciences, UAB, Birmingham, AL, USA
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10
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Dionne-Odom JN, Azuero A, Taylor RA, Dosse C, Bechthold AC, Currie E, Reed RD, Harrell ER, Engler S, Ejem DB, Ivankova NV, Martin MY, Rocque GB, Williams GR, Bakitas MA. A lay navigator-led, early palliative care intervention for African American and rural family caregivers of individuals with advanced cancer (Project Cornerstone): Results of a pilot randomized trial. Cancer 2022; 128:1321-1330. [PMID: 34874061 PMCID: PMC8882155 DOI: 10.1002/cncr.34044] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/25/2021] [Accepted: 11/13/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND The objective of this study was to assess the feasibility, acceptability, and potential efficacy of ENABLE (Educate, Nurture, Advise, Before Life Ends) Cornerstone-a lay navigator-led, early palliative care telehealth intervention for African American/Black and/or rural-dwelling family caregivers of individuals with advanced cancer (ClinicalTrials.gov identifier NCT03464188). METHODS This was a pilot randomized trial (November 2019 to March 2021). Family caregivers of patients with newly diagnosed, stage III/IV, solid-tumor cancers were randomized to receive either an intervention or usual care. Intervention caregivers were paired with a specially trained lay navigator who delivered 6 weekly, 20-minute to 60-minute telehealth coaching sessions plus monthly follow-up for 24 weeks, reviewing skills in stress management, self-care, getting help, staying organized, and future planning. Feasibility was assessed according to the completion of sessions and questionnaires (predefined as a completion rate ≥80%). Acceptability was determined through intervention participants' ratings of their likelihood of recommending the intervention. Measures of caregiver distress and quality of life were collected at 8 and 24 weeks. RESULTS Sixty-three family caregivers were randomized (usual care, n = 32; intervention, n = 31). Caregivers completed 65% of intervention sessions and 87% of questionnaires. Average ratings for recommending the program were 9.4, from 1 (not at all likely) to 10 (extremely likely). Over 24 weeks, the mean ± SE Hospital Anxiety and Depression Scale score improved by 0.30 ± 1.44 points in the intervention group and worsened by 1.99 ± 1.39 points in the usual care group (difference, -2.29; Cohen d, -0.32). The mean between-group difference scores in caregiver quality of life was -1.56 (usual care - intervention; d, -0.07). Similar outcome results were observed for patient participants. CONCLUSIONS The authors piloted ENABLE Cornerstone, an intervention for African American and rural-dwelling advanced cancer family caregivers. The acceptability of the intervention and data collection rates were high, and the preliminary efficacy for caregiver distress was promising. LAY SUMMARY To date, very few programs have been developed to support under-resourced cancer family caregivers. To address this need, the authors successfully pilot tested an early palliative care program, called Educate, Nurture, Advise, Before Life Ends (ENABLE) Cornerstone, for African American and rural family caregivers of individuals with advanced cancer. Cornerstone is led by specially trained lay people and involves a series of weekly phone sessions focused on coaching caregivers to manage stress and provide effective support to patients with cancer. The authors are now testing Cornerstone in a larger trial. If the program demonstrates benefit, it may yield a model of caregiver support that could be widely implemented.
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Affiliation(s)
- J Nicholas Dionne-Odom
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama.,Division of Geriatrics, Gerontology, and Palliative Care, UAB Department of Medicine, Birmingham, Alabama.,UAB Center for Palliative and Supportive Care, Birmingham, Alabama
| | - Andres Azuero
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama
| | - Richard A Taylor
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama
| | - Chinara Dosse
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama
| | - Avery C Bechthold
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama
| | - Erin Currie
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama
| | - Rhiannon D Reed
- Comprehensive Transplant Institute, UAB, Birmingham, Alabama
| | - Erin R Harrell
- Department of Psychology, University of Alabama, Tuscaloosa, Alabama
| | - Sally Engler
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama
| | - Deborah B Ejem
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama
| | | | - Michelle Y Martin
- Department of Preventive Medicine, Center for Innovation in Health Equity Research, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Gabrielle B Rocque
- Division of Geriatrics, Gerontology, and Palliative Care, UAB Department of Medicine, Birmingham, Alabama.,UAB Center for Palliative and Supportive Care, Birmingham, Alabama.,Division of Hematology and Oncology, Department of Medicine, UAB, Birmingham, Alabama
| | - Grant R Williams
- Division of Hematology and Oncology, Department of Medicine, UAB, Birmingham, Alabama
| | - Marie A Bakitas
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama.,Division of Geriatrics, Gerontology, and Palliative Care, UAB Department of Medicine, Birmingham, Alabama.,UAB Center for Palliative and Supportive Care, Birmingham, Alabama
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11
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Barstow BA, Ivankova NV, Vogtle LK, Dreer L, Geiger B, Malone LA. Physical Activity Self-Efficacy in Older Adults with Vision Loss: A Grounded Theory Study. Occup Ther Health Care 2022:1-26. [PMID: 35019809 DOI: 10.1080/07380577.2021.2010158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The purpose of this study was to develop a model describing the process of how older adults with age-related macular degeneration develop physical activity self-efficacy. The primary aim of this research was to determine how adults with age-related macular degeneration living in a southeastern metropolitan area develop physical activity self-efficacy. Sixteen older adults with age-related macular degeneration participated in face-to-face interviews and observations of their regular physical activity. Grounded theory approach was used to identify emerging themes and a model describing the development of physical activity self-efficacy in this cohort. Five themes related to the development of physical activity self-efficacy emerged: 1) physical activity engagement, 2) self-management behaviors, 3) physical activity determinants, 4) strategies, and 5) self-perceived benefits. These themes were analyzed to produce a preliminary model describing the development of physical activity self-efficacy in older adults with age-related macular degeneration. Findings provide a preliminary model, which practitioners can use to facilitate self-efficacy and participation in physical activity in older adults with age-related macular degeneration.
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Affiliation(s)
- Beth A Barstow
- Department of Occupational Therapy, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nataliya V Ivankova
- Health Services Administration, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Laura K Vogtle
- Department of Occupational Therapy, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Laura Dreer
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Laurie A Malone
- School of Health Professions Research Collaborative, Lakeshore Foundation, Birmingham, AL, USA
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12
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Gropen TI, Ivankova NV, Beasley M, Hess EP, Mittman B, Gazi M, Minor M, Crawford W, Floyd AB, Varner GL, Lyerly MJ, Shoemaker CC, Owens J, Wilson K, Gray J, Kamal S. Trauma Communications Center Coordinated Severity-Based Stroke Triage: Protocol of a Hybrid Type 1 Effectiveness-Implementation Study. Front Neurol 2021; 12:788273. [PMID: 34938265 PMCID: PMC8686821 DOI: 10.3389/fneur.2021.788273] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Mechanical thrombectomy (MT) can improve the outcomes of patients with large vessel occlusion (LVO), but a minority of patients with LVO are treated and there are disparities in timely access to MT. In part, this is because in most regions, including Alabama, the emergency medical service (EMS) transports all patients with suspected stroke, regardless of severity, to the nearest stroke center. Consequently, patients with LVO may experience delayed arrival at stroke centers with MT capability and worse outcomes. Alabama's trauma communications center (TCC) coordinates EMS transport of trauma patients by trauma severity and regional hospital capability. Our aims are to develop a severity-based stroke triage (SBST) care model based on Alabama's trauma system, compare the effectiveness of this care pathway to current stroke triage in Alabama for improving broad, equitable, and timely access to MT, and explore stakeholder perceptions of the intervention's feasibility, appropriateness, and acceptability. Methods: This is a hybrid type 1 effectiveness-implementation study with a multi-phase mixed methods sequential design and an embedded observational stepped wedge cluster trial. We will extend TCC guided stroke severity assessment to all EMS regions in Alabama; conduct stakeholder interviews and focus groups to aid in development of region and hospital specific prehospital and inter-facility stroke triage plans for patients with suspected LVO; implement a phased rollout of TCC Coordinated SBST across Alabama's six EMS regions; and conduct stakeholder surveys and interviews to assess context-specific perceptions of the intervention. The primary outcome is the change in proportion of prehospital stroke system patients with suspected LVO who are treated with MT before and after implementation of TCC Coordinated SBST. Secondary outcomes include change in broad public health impact before and after implementation and stakeholder perceptions of the intervention's feasibility, appropriateness, and acceptability using a mixed methods approach. With 1200 to 1300 total observations over 36 months, we have 80% power to detect a 15% improvement in the primary endpoint. Discussion: This project, if successful, can demonstrate how the trauma system infrastructure can serve as the basis for a more integrated and effective system of emergency stroke care.
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Affiliation(s)
- Toby I Gropen
- Division of Cerebrovascular Disease, The University of Alabama at Birmingham, Birmingham, AL, United States
| | | | - Mark Beasley
- The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Erik P Hess
- Vanderbilt University Medical Center, Nashville, TN, United States
| | - Brian Mittman
- Kaiser Permanente Southern California, Pasadena, CA, United States
| | - Melissa Gazi
- The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Michael Minor
- The University of Alabama at Birmingham, Birmingham, AL, United States
| | - William Crawford
- The Office of Emergency Medical Services, Alabama Department of Public Health, Montgomery, AL, United States
| | - Alice B Floyd
- The Office of Emergency Medical Services, Alabama Department of Public Health, Prattville, AL, United States
| | - Gary L Varner
- The Office of Emergency Medical Services, Alabama Department of Public Health, Montgomery, AL, United States
| | - Michael J Lyerly
- The University of Alabama at Birmingham, Birmingham, AL, United States
| | | | - Jackie Owens
- Mobile Infirmary Medical Center, Mobile, AL, United States
| | - Kent Wilson
- The Office of Emergency Medical Services, Alabama Department of Public Health, Prattville, AL, United States
| | - Jamie Gray
- The Office of Emergency Medical Services, Alabama Department of Public Health, Montgomery, AL, United States
| | - Shaila Kamal
- The University of Alabama at Birmingham, Birmingham, AL, United States
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13
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Pisu M, Omairi I, Hoenemeyer T, Halilova KI, Schoenberger YMM, Rogers LQ, Kenzik KM, Oster RA, Ivankova NV, Pekmezi D, Fontaine K, Demark-Wahnefried W, Martin MY. Developing a virtual assessment protocol for the AMPLIFI Randomized Controlled Trial due to COVID-19: From assessing participants' preference to preparing the team. Contemp Clin Trials 2021; 111:106604. [PMID: 34757221 PMCID: PMC8555106 DOI: 10.1016/j.cct.2021.106604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/07/2021] [Accepted: 10/20/2021] [Indexed: 11/01/2022]
Abstract
Background During the COVID-19 pandemic, in-person research assessments needed to be adapted to ensure safety of participants and staff. Participants' willingness to participate in research activities, how to prepare assessors to ensure data integrity, and the feasibility of modified protocols, were unknown. Within the AMPLIFI randomized clinical trial (RCT) for cancer survivors, we elicited participants' preferences and willingness to participate in Clinic, Home, or Virtual assessments, prepared assessors for, and implemented virtual assessments. Methods 1) We conducted phone surveys of potential AMPLIFI participants; 2) Based on survey results, we modified assessments from in-person to virtual visits (VV) by videoconference. Assessors were trained and certified, i.e., assessors recorded 3 assessments that were reviewed and scored by 2 investigators. The modified protocol was proposed to 62 participants: we report numbers of those who agreed to attend VV. Results 1) Survey results: Among 74 survey respondents, 44.6% preferred, 75.7% were willing to attend Clinic Visits; 32.4% preferred, 83.8% were willing to do VV; 23% preferred, 77% were willing to do Home Visits. Survivors 70+ were less likely than 50-69 years old to be willing to do VV: no other differences were noted by gender, race, rural status or education. 2) Assessment uptake: 66.1% agreed to attend VV, and of them 75.6% completed them. Conclusion Diverse research participants adapted to protocols that prioritize their safety, although older participants may be reluctant to do virtual assessments. Virtual assessments are feasible and research teams can rigorously prepare to collect quality data through them.
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Affiliation(s)
- Maria Pisu
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Iman Omairi
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Teri Hoenemeyer
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA; School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Karina I Halilova
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yu-Mei M Schoenberger
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Laura Q Rogers
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kelly M Kenzik
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA; Division of Hematology & Oncology, University of Alabama at Birmingham, Birmingham, AL, USA; Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert A Oster
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nataliya V Ivankova
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Dori Pekmezi
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, AL, USA
| | - Kevin Fontaine
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, AL, USA
| | - Wendy Demark-Wahnefried
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA; School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michelle Y Martin
- Center for Innovation in Health Equity Research, Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
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14
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Ivankova NV, Rogers LQ, Herbey II, Martin MY, Pisu M, Pekmezi D, Thompson L, Schoenberger-Godwin YMM, Oster RA, Fontaine K, Anderson JL, Kenzik K, Farrell D, Demark-Wahnefried W. Features That Middle-aged and Older Cancer Survivors Want in Web-Based Healthy Lifestyle Interventions: Qualitative Descriptive Study. JMIR Cancer 2021; 7:e26226. [PMID: 34612832 PMCID: PMC8529475 DOI: 10.2196/26226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/05/2021] [Accepted: 08/10/2021] [Indexed: 01/11/2023] Open
Abstract
Background With the increasing number of older cancer survivors, it is imperative to optimize the reach of interventions that promote healthy lifestyles. Web-based delivery holds promise for increasing the reach of such interventions with the rapid increase in internet use among older adults. However, few studies have explored the views of middle-aged and older cancer survivors on this approach and potential variations in these views by gender or rural and urban residence. Objective The aim of this study was to explore the views of middle-aged and older cancer survivors regarding the features of web-based healthy lifestyle programs to inform the development of a web-based diet and exercise intervention. Methods Using a qualitative descriptive approach, we conducted 10 focus groups with 57 cancer survivors recruited from hospital cancer registries in 1 southeastern US state. Data were analyzed using inductive thematic and content analyses with NVivo (version 12.5, QSR International). Results A total of 29 male and 28 female urban and rural dwelling Black and White survivors, with a mean age of 65 (SD 8.27) years, shared their views about a web-based healthy lifestyle program for cancer survivors. Five themes emerged related to program content, design, delivery, participation, technology training, and receiving feedback. Cancer survivors felt that web-based healthy lifestyle programs for cancer survivors must deliver credible, high-quality, and individually tailored information, as recommended by health care professionals or content experts. Urban survivors were more concerned about information reliability, whereas women were more likely to trust physicians’ recommendations. Male and rural survivors wanted information to be tailored to the cancer type and age group. Privacy, usability, interaction frequency, and session length were important factors for engaging cancer survivors with a web-based program. Female and rural participants liked the interactive nature and visual appeal of the e-learning sessions. Learning from experts, an attractive design, flexible schedule, and opportunity to interact with other cancer survivors in Facebook closed groups emerged as factors promoting program participation. Low computer literacy, lack of experience with web program features, and concerns about Facebook group privacy were important concerns influencing cancer survivors’ potential participation. Participants noted the importance of technology training, preferring individualized help to standardized computer classes. More rural cancer survivors acknowledged the need to learn how to use computers. The receipt of regular feedback about progress was noted as encouragement toward goal achievement, whereas women were particularly interested in receiving immediate feedback to stay motivated. Conclusions Important considerations for designing web-based healthy lifestyle interventions for middle-aged and older cancer survivors include program quality, participants’ privacy, ease of use, attractive design, and the prominent role of health care providers and content experts. Cancer survivors’ preferences based on gender and residence should be considered to promote program participation.
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Affiliation(s)
- Nataliya V Ivankova
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Laura Q Rogers
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Ivan I Herbey
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Michelle Y Martin
- Health Science Center, University of Tennessee, Memphis, TN, United States
| | - Maria Pisu
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Dorothy Pekmezi
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Lieu Thompson
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States
| | | | - Robert A Oster
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Kevin Fontaine
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Jami L Anderson
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Kelly Kenzik
- Division of Hematology & Oncology, University of Alabama at Birmingham, Birmingham, AL, United States
| | | | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, United States
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Cochran RA, Feldman SS, Ivankova NV, Hall AG, Opoku-Agyeman W. Intention to Use Behavioral Health Data From a Health Information Exchange: Mixed Methods Study. JMIR Ment Health 2021; 8:e26746. [PMID: 34042606 PMCID: PMC8193493 DOI: 10.2196/26746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/31/2021] [Accepted: 04/13/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Patients with co-occurring behavioral health and chronic medical conditions frequently overuse inpatient hospital services. This pattern of overuse contributes to inefficient health care spending. These patients require coordinated care to achieve optimal health outcomes. However, the poor exchange of health-related information between various clinicians renders the delivery of coordinated care challenging. Health information exchanges (HIEs) facilitate health-related information sharing and have been shown to be effective in chronic disease management; however, their effectiveness in the delivery of integrated care is less clear. It is prudent to consider new approaches to sharing both general medical and behavioral health information. OBJECTIVE This study aims to identify and describe factors influencing the intention to use behavioral health information that is shared through HIEs. METHODS We used a mixed methods design consisting of two sequential phases. A validated survey instrument was emailed to clinical and nonclinical staff in Alabama and Oklahoma. The survey captured information about the impact of predictors on the intention to use behavioral health data in clinical decision making. Follow-up interviews were conducted with a subsample of participants to elaborate on the survey results. Partial least squares structural equation modeling was used to analyze survey data. Thematic analysis was used to identify themes from the interviews. RESULTS A total of 62 participants completed the survey. In total, 63% (n=39) of the participants were clinicians. Performance expectancy (β=.382; P=.01) and trust (β=.539; P<.001) predicted intention to use behavioral health information shared via HIEs. The interviewees (n=5) expressed that behavioral health information could be useful in clinical decision making. However, privacy and confidentiality concerns discourage sharing this information, which is generally missing from patient records altogether. The interviewees also stated that training for HIE use was not mandatory; the training that was provided did not focus specifically on the exchange of behavioral health information. CONCLUSIONS Despite barriers, individuals are willing to use behavioral health information from HIEs if they believe that it will enhance job performance and if the information being transmitted is trustworthy. The findings contribute to our understanding of the role HIEs can play in delivering integrated care, particularly to vulnerable patients.
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Affiliation(s)
- Randyl A Cochran
- Department of Health Sciences, College of Health Professions, Towson University, Towson, MD, United States
| | - Sue S Feldman
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Nataliya V Ivankova
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Allyson G Hall
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - William Opoku-Agyeman
- School of Health and Applied Human Sciences, College of Health and Human Services, University of North Carolina Wilmington, Wilmington, NC, United States
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Oner B, Zengul FD, Oner N, Ivankova NV, Karadag A, Patrician PA. Nursing-sensitive indicators for nursing care: A systematic review (1997-2017). Nurs Open 2021; 8:1005-1022. [PMID: 34482649 PMCID: PMC8046086 DOI: 10.1002/nop2.654] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 01/09/2023] Open
Abstract
AIM To provide a systematic review of the literature from 1997 to 2017 on nursing-sensitive indicators. DESIGN A qualitative design with a deductive approach was used. DATA SOURCES Original and Grey Literature references from Cochrane Library, Medline/PubMed, Embase, and CINAHL, Google Scholar Original and Grey Literature. REVIEW METHODS Quality assessment was performed using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. RESULTS A total of 3,633 articles were identified, and thirty-nine studies met the inclusion criteria. The quantitative assessment of investigated relationships in these studies suggests that nursing staffing, mortality, and nosocomial infections were the most frequently reported nursing-sensitive indicators. CONCLUSION This review provides a comprehensive list of nursing-sensitive indicators, their frequency of use, and the associations between these indicators and various outcome variables. Stakeholders of nursing research may use the findings to streamline the indicator development efforts and standardization of nursing-sensitive indicators. IMPACT This review provides evidence-based results that health organizations can benefit from nursing care quality.
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Affiliation(s)
- Beratiye Oner
- Department of Health Services AdministrationUniversity of Alabama at BirminghamBirminghamALUSA
| | - Ferhat D. Zengul
- Department of Health Services AdministrationUniversity of Alabama at BirminghamBirminghamALUSA
| | - Nurettin Oner
- Department of Health Services AdministrationUniversity of Alabama at BirminghamBirminghamALUSA
| | - Nataliya V. Ivankova
- Department of Health Services AdministrationUniversity of Alabama at BirminghamBirminghamALUSA
- School of NursingUniversity of Alabama at BirminghamBirminghamALUSA
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Anusiewicz CV, Ivankova NV, Swiger PA, Gillespie GL, Li P, Patrician PA. How does workplace bullying influence nurses' abilities to provide patient care? A nurse perspective. J Clin Nurs 2020; 29:4148-4160. [PMID: 32757394 PMCID: PMC8040339 DOI: 10.1111/jocn.15443] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 06/02/2020] [Revised: 07/14/2020] [Accepted: 07/25/2020] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore how workplace bullying influences nurses' abilities to provide patient care. BACKGROUND Nurses' experiences of workplace bullying undermine nursing work environments and potentially threaten patient care. Although there is a link between nurses' experiences of workplace bullying and poor patient care, additional exploration is necessary as current evidence remains underdeveloped and inconclusive. DESIGN Qualitative descriptive study. METHODS Fifteen inpatient staff nurses who have experienced workplace bullying while working in one hospital located in the southern region of the USA participated in individual, semi-structured interviews. Inductive thematic analysis was used to analyse interview transcripts in NVivo 12 software. The COREQ checklist for qualitative studies has been used in reporting this study. RESULTS Three themes, and respective subthemes, were generated from data analysis: (a) workplace bullying as part of the nursing work environment, (b) workplace bullying's influence on nurses and (c) workplace bullying's influence on patient care. Workplace bullying was perceived to be inherent in the nursing work environment; nurses felt that they were targets of workplace bullying because (a) they were new nurses, (b) there was an abuse of power, or (c) the nature of the work occasioned it. Nurses were mentally and emotionally influenced by the bullying. Some nurses perceived that workplace bullying did influence their ability to provide patient care; however, others did not. CONCLUSIONS Organisations must support new nurses and manage relational attributes of the nursing work environment to reduce workplace bullying. Nursing leaders should receive education on fostering and sustaining favourable nursing work environments and be held accountable for behavioural expectations of the organisation. RELEVANCE TO CLINICAL PRACTICE Understanding how nurses perceive the work environment to influence their experiences of workplace bullying informs the development of organisational interventions to reduce the behaviour. Furthermore, exploring how nurses' experiences of workplace bullying influences their abilities to provide patient care increases our understanding of workplace bullying implications.
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Affiliation(s)
| | - Nataliya V. Ivankova
- The University of Alabama at Birmingham School of Health Professions, Birmingham, AL, USA
| | - Pauline A. Swiger
- The University of Alabama at Birmingham School of Nursing, Birmingham, AL, USA
| | | | - Peng Li
- The University of Alabama at Birmingham School of Nursing, Birmingham, AL, USA
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Liang MI, Simons JL, Herbey II, Wall J, Rucker L, Ivankova NV, Pisu M, Huh WK. Ovarian cancer patients’ perspectives on facilitators and barriers to accessing financial assistance. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.29_suppl.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
64 Background: Our aim was to obtain ovarian cancer patients’ perspective on accessing financial assistance programs. Methods: We recruited ovarian cancer patients receiving systemic therapy who screened positive for financial distress using Comprehensive Score for Financial Toxicity <26. Two interviewers conducted 45-minute interviews on the costs of care, which were recorded and transcribed. Three coders used inductive thematic analysis to identify themes. Results: There were 18 of 22 interviews currently evaluable. Median age was 57 and 68% of participants reported income <$40,000. Facilitators and barriers to accessing financial assistance are shown in the table below. Conclusions: Patients’ reliance on existing support systems and cancer organizations highlight a need for health systems to leverage these relationships and improve organized efforts to provide information related to financial assistance. Proactively asking about financial needs and providing resources to all patients, regardless of income, may mitigate patient reported barriers to accessing financial assistance. [Table: see text]
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Affiliation(s)
| | | | | | - Jaclyn Wall
- University of Alabama at Birmingham, Birmingham, AL
| | | | | | - Maria Pisu
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
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Liang MI, Simons JL, Herbey II, Wall J, Rucker L, Ivankova NV, Huh WK, Pisu M. Exploring the three domains of financial hardship experienced by ovarian cancer patients. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.29_suppl.71] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
71 Background: We sought to obtain ovarian cancer patients’ perspective on the 3 domains of financial hardship (psychological response, material conditions, and coping behaviors). Methods: We recruited ovarian cancer patients on systemic therapy who screened positive for financial distress using Comprehensive Score for Financial Toxicity (COST) <26. Two interviewers conducted 45-minute interviews about patients’ experiences dealing with the costs of care. Interviews were recorded, transcribed, and coded by 3 analysts using inductive thematic analysis to identify common themes. Results: 22 patients completed interviews with 18 available for analysis. Median age was 57 years old, 36% were black, and participants had a median COST of 12 (range 0-23). We identified themes within each domain (Table). Conclusions: Ovarian cancer patients predominantly experienced financial hardship through psychological response and negative impact on their material conditions. These require increased provider awareness and targeted interventions. Patients did not report negative health-related coping behaviors as they prioritized their health care over immediate cost concerns. [Table: see text]
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Affiliation(s)
| | | | | | - Jaclyn Wall
- University of Alabama at Birmingham, Birmingham, AL
| | | | | | | | - Maria Pisu
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
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Liang MI, Simons JL, Herbey II, Wall J, Rucker L, Huh WK, Ivankova NV, Pisu M. Employment concerns experienced by ovarian cancer patients and caregivers. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.29_suppl.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
69 Background: Our aim was to obtain patient input on the impact of cancer treatment on employment. Methods: We recruited patients with ovarian cancer receiving systemic therapy who screened positive for financial distress using Comprehensive Score for Financial Toxicity <26. Participants completed a 45-minute interview with 2 interviewers on their costs of care, including employment concerns. Interviews were recorded, transcribed, and coded by 3 analysts using inductive thematic analysis. Results: Of 22 participants, 86% were <65 years old and 28% were on curative intent treatment. There were 18 with currently evaluable interviews. Themes are shown in the table. Conclusions: Cancer care has a negative impact on patient and caregiver work productivity, income, and employer benefits. Incorporating resources to navigate workplace factors, such as Family Medical Leave Act benefits and negotiating accommodations with an employer, could improve care delivery. [Table: see text]
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Affiliation(s)
| | | | | | - Jaclyn Wall
- University of Alabama at Birmingham, Birmingham, AL
| | | | | | | | - Maria Pisu
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
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Halilova KI, Ivankova NV, Rogers LQ, Pisu M, Kevin FR, Martin MY, Herbey II, Thompson L, Anusiewicz CV, Pekmezi D, Oster RA, Schoenberger-Godwin YMM, Demark-Wahnefried W. Perspectives on healthcare providers’ role in health promotion among cancer survivors. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e24037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e24037 Background: To further integrate health promotion into cancer survivorship care, we explored multilevel perspectives on potential roles healthcare providers could have in promoting uptake of web-based healthy lifestyle programs among cancer survivors. Methods: In developing the Aim, Plan, and Act on Lifestyles (AMPLIFY) Survivor Health diet and exercise web-based program, we conducted 10 focus groups with 57 cancer survivors and 27 individual semi-structured interviews with stakeholders representing advocacy groups (e.g., cancer survivorship support foundations; n = 8), cancer organizations (e.g., industry, health system; n = 11), and survivors’ supportive partners (n = 8). Verbatim transcripts were analyzed by multiple coders using inductive thematic analysis with NVivo 12. Results: Survivors (49% female; 40% African-American, mean age 63.7 years) and stakeholders (60% female) stated that healthcare provider and health system recommendation and support are vital for ensuring acceptance and use of web-based healthy lifestyle programs by cancer survivors. Survivors expressed that physician’s (e.g., oncologist, other physician) recommendation and support would motivate them to join and participate. Supportive partners also endorsed the importance of provider recommendations and the key role of health system support (e.g., reminders in doctor’s office, hospitals, web-based portal, and endorsement from cancer centers). Advocacy group representatives underscored the importance of data-driven support for the effects of such programs as critical for promotion. Moreover, technology supported continuous cancer care (e.g., physician communication and feedback) were seen as critical for sustained participation. Stakeholders from cancer organizations suggested survivors in need could be identified and referred during assessments in various cancer care clinics. This group also emphasized the need to integrate evidence-based healthy lifestyle recommendations into continuing medical education, medical board certifications, support and referrals into existing standard of cancer care, and to involve other key stakeholders and larger scale health systems in promotion. Conclusions: Healthcare providers and health systems have important roles in promoting and sustaining participation in web-based healthy lifestyle programs among cancer survivors. Further work developing, testing, and refining strategies to enhance their role in promoting the acceptability and uptake of healthy lifestyle programs by cancer survivors are needed.
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Affiliation(s)
- Karina I. Halilova
- University of Alabama at Birmingham, Cancer Prevention and Control Training Program, Birmingham, AL
| | | | - Laura Q. Rogers
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Maria Pisu
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Fontaine R. Kevin
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
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Zengul FD, Lee T, Delen D, Almehmi A, Ivankova NV, Mehta T, Topuz K. Research Themes and Trends in Ten Top-Ranked Nephrology Journals: A Text Mining Analysis. Am J Nephrol 2019; 51:147-159. [PMID: 31838480 DOI: 10.1159/000504871] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 11/14/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Nephrology research is expanding, and harnessing the much-needed information and data for the practice of evidence-based medicine is becoming more challenging. In this study, we used the natural language processing and text mining approach to mitigate some of these challenges. METHODS We analyzed 17,412 abstracts from the top-10 nephrology journals over 10 years (2007-2017) by using latent semantic analysis and topic analysis. RESULTS The analyses revealed 10 distinct topics (T) for nephrology research ranging from basic science studies, using animal modeling (T-1), to dialysis vascular access-related issues -(T-10). The trend analyses indicated that while the majority of topics stayed relatively stable, some of the research topics experienced increasing popularity over time such as studies focusing on mortality and survival (T-4) and Patient-related Outcomes and Perspectives of Clinicians (T-5). However, some research topics such as studies focusing on animal modeling (T-1), predictors of acute kidney injury, and dialysis access (T-10) exhibited a downward trend. CONCLUSION Stakeholders of nephrology research may use these trends further to develop priorities and enrich the research agenda for the future.
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Affiliation(s)
- Ferhat D Zengul
- Department of Health Services Administration, The University of Alabama at Birmingham, Birmingham, Alabama, USA,
- School of Engineering, Center for Integrated Systems, The University of Alabama at Birmingham, Birmingham, Alabama, USA,
| | - Timmy Lee
- Division of Nephrology and Hypertension, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Veterans Affairs Medical Center, Birmingham, Alabama, USA
| | - Dursun Delen
- Department of Management Science and Information Systems, Spears School of Business, Oklahoma State University, Stillwater, Oklahoma, USA
- Center for Health Systems Innovation, Department of Management Science and Information Systems, Spears School of Business, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Ammar Almehmi
- Division of Nephrology and Hypertension, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Nataliya V Ivankova
- Department of Health Services Administration, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Acute, Chronic, and Continuing Care, School of Nursing, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Tapan Mehta
- Department of Health Services Administration, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kazim Topuz
- School of Finance, Operations Management and International Business, Collins College of Business, The University of Tulsa, Tulsa, Oklahoma, USA
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Iyer AS, Dionne-Odom JN, Ford SM, Crump Tims SL, Sockwell ED, Ivankova NV, Brown CJ, Tucker RO, Dransfield MT, Bakitas MA. A Formative Evaluation of Patient and Family Caregiver Perspectives on Early Palliative Care in Chronic Obstructive Pulmonary Disease across Disease Severity. Ann Am Thorac Soc 2019; 16:1024-1033. [PMID: 31039003 PMCID: PMC6774751 DOI: 10.1513/annalsats.201902-112oc] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 02/04/2019] [Accepted: 04/29/2019] [Indexed: 12/20/2022] Open
Abstract
Rationale: Little direction exists on how to integrate early palliative care in chronic obstructive pulmonary disease (COPD).Objectives: We sought to identify patient and family caregiver early palliative care needs across stages of COPD severity.Methods: As part of the Medical Research Council Framework developmental phase for intervention development, we conducted a formative evaluation of patients with moderate to very severe COPD (forced expiratory volume in 1 s [FEV1]/FVC < 70% and FEV1 < 80%-predicted) and their family caregivers. Validated surveys on quality of life, anxiety and depressive symptoms, and social isolation quantified symptom severity. Semi-structured interviews were analyzed for major themes on early palliative care and needs in patients and family caregivers and across COPD severity stages.Results: Patients (n = 10) were a mean (±SD) age of 60.4 (±7.5) years, 50% African American, and 70% male, with 30% having moderate COPD, 30% severe COPD, and 40% very severe COPD. Family caregivers (n = 10) were a mean age of 58.3 (±8.7) years, 40% African American, and 10% male. Overall, 30% (n = 6) of participants had poor quality of life, 45% (n = 9) had moderate-severe anxiety symptoms, 25% (n = 5) had moderate-severe depressive symptoms, and 40% (n = 8) reported social isolation. Only 30% had heard of palliative care, and most participants had misconceptions that palliative care was end-of-life care. All participants responded positively to a standardized description of early palliative care and were receptive to its integration as early as moderate stage. Five broad themes of early palliative care needs emerged: 1) coping with COPD; 2) emotional symptoms; 3) respiratory symptoms; 4) illness understanding; and 5) prognostic awareness. Coping with COPD and emotional symptoms were commonly shared early palliative care needs. Patients with very severe COPD and their family caregivers prioritized illness understanding and prognostic awareness compared with those with moderate-severe COPD.Conclusions: Patients with moderate to very severe COPD and their family caregivers found early palliative care acceptable and felt it should be integrated before end-stage. Of the five broad themes of early palliative care needs, coping with COPD and emotional symptoms were the highest priority, followed by respiratory symptoms, illness understanding, and prognostic awareness.
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Affiliation(s)
- Anand S. Iyer
- Division of Pulmonary, Allergy, and Critical Care Medicine
- Health Services, Outcomes, and Effectiveness Research Training Program
- Lung Health Center
| | - J. Nicholas Dionne-Odom
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine
- School of Nursing, and
| | - Stephanie M. Ford
- Lung Health Center
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine
| | - Sheri L. Crump Tims
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine
- School of Nursing, and
| | - Elizabeth D. Sockwell
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine
- School of Nursing, and
| | - Nataliya V. Ivankova
- School of Nursing, and
- School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama; and
| | - Cynthia J. Brown
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine
- Birmingham Veterans Affairs Medical Center, Birmingham, Alabama
| | - Rodney O. Tucker
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine
| | - Mark T. Dransfield
- Division of Pulmonary, Allergy, and Critical Care Medicine
- Lung Health Center
- Birmingham Veterans Affairs Medical Center, Birmingham, Alabama
| | - Marie A. Bakitas
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine
- School of Nursing, and
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Torres-Alzate HM, Wilson LL, Harper DC, Ivankova NV, Heaton K, Shirey MR. Essential global health competencies for baccalaureate nursing students in the United States: A mixed methods Delphi study. J Adv Nurs 2019; 76:725-740. [PMID: 31012146 DOI: 10.1111/jan.14030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 09/30/2018] [Revised: 02/06/2019] [Accepted: 02/27/2019] [Indexed: 11/27/2022]
Abstract
AIMS To reach consensus among experts on global health competencies for baccalaureate nursing students in the USA. DESIGN A three-round modified Delphi study using a mixed methods research approach. METHODS In the first round, the original list of competencies (Wilson et al., 2012, Journal of Professional Nursing, 28, 213-222) was revised based on prior research, a review of literature and the Nursing Global Health Competencies Framework developed by the fist author. Nine global health domains and 52 competencies were identified in Round One. In Round Two, two surveys were conducted for validation of the revised list of global health competencies using a group of six nurses with expertise in global health and baccalaureate nursing education, which produced modifications in the competencies used for the third phase of the study. In Round Three, 41 participants completed a survey to rate the extent to which they thought the competencies obtained in Round Two were essential for baccalaureate nursing education in the United States. Data collection took place from May 2017 - January 2018. RESULTS A group of experts in global health and baccalaureate nursing education from the United States achieved consensus that 40 global health competencies were essential for baccalaureate nursing education in the United States. CONCLUSION AND IMPACT The domains and competencies derived in this study can be used to guide undergraduate nursing curriculum development in global health and provide a framework for both clinical instruction and evaluation of global health student experiences.
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Affiliation(s)
| | - Lynda Law Wilson
- University of Alabama at Birmingham School of Nursing, Birmingham, Alabama
| | - Doreen C Harper
- University of Alabama at Birmingham School of Nursing, Birmingham, Alabama
| | - Nataliya V Ivankova
- Schools of Health Professions and Nursing, University of Alabama at Birmingham, Birmingham, Alabama
| | - Karen Heaton
- University of Alabama at Birmingham School of Nursing, Birmingham, Alabama
| | - Maria R Shirey
- University of Alabama at Birmingham School of Nursing, Birmingham, Alabama
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Dionne-Odom JN, Ejem D, Wells R, Barnato AE, Taylor RA, Rocque GB, Turkman YE, Kenny M, Ivankova NV, Bakitas MA, Martin MY. How family caregivers of persons with advanced cancer assist with upstream healthcare decision-making: A qualitative study. PLoS One 2019; 14:e0212967. [PMID: 30865681 PMCID: PMC6415885 DOI: 10.1371/journal.pone.0212967] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [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: 11/06/2018] [Accepted: 02/12/2019] [Indexed: 12/27/2022] Open
Abstract
Aims Numerous healthcare decisions are faced by persons with advanced cancer from diagnosis to end-of-life. The family caregiver role in these decisions has focused on being a surrogate decision-maker, however, little is known about the caregiver’s role in supporting upstream patient decision-making. We aimed to describe the roles of family caregivers in assisting community-dwelling advanced cancer patients with healthcare decision-making across settings and contexts. Methods Qualitative study using one-on-one, semi-structured interviews with community-dwelling persons with metastatic cancer (n = 18) and their family caregivers (n = 20) recruited from outpatient oncology clinics of a large tertiary care academic medical center, between October 2016 and October 2017. Transcribed interviews were analyzed using a thematic analysis approach. Findings Caregivers averaged 56 years and were mostly female (95%), white (85%), and the patient’s partner/spouse (70%). Patients averaged 58 years and were mostly male (67%) in self-reported “fair” or “poor” health (50%) with genitourinary (33%), lung (17%), and hematologic (17%) cancers. Themes describing family member roles in supporting patients’ upstream healthcare decision-making were: 1) seeking information about the cancer, its trajectory, and treatments options; 2) ensuring family and healthcare clinicians have a common understanding of the patient’s treatment plan and condition; 3) facilitating discussions with patients about their values and the framing of their illness; 5) posing “what if” scenarios about current and potential future health states and treatments; 6) addressing collateral decisions (e.g., work arrangements) resulting from medical treatment choices; 6) originating healthcare-related decision points, including decisions about seeking emergency care; and 7) making healthcare decisions for patients who preferred to delegate healthcare decisions to their family caregivers. Conclusions These findings highlight a previously unreported and understudied set of critical decision partnering roles that cancer family caregivers play in patient healthcare decision-making. Optimizing these roles may represent novel targets for early decision support interventions for family caregivers.
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Affiliation(s)
- J. Nicholas Dionne-Odom
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- * E-mail:
| | - Deborah Ejem
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Rachel Wells
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Amber E. Barnato
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, United States of America
| | - Richard A. Taylor
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Gabrielle B. Rocque
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Yasemin E. Turkman
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Matthew Kenny
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Nataliya V. Ivankova
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Marie A. Bakitas
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Michelle Y. Martin
- Center for Innovation in Health Equity Research, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
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DuBay DA, Ivankova NV, Herbey I, Redden DT, Holt C, Siminoff L, Fouad MN, Morinelli TA, Martin MY. An African American Perspective on Familial Notification of Becoming a Registered Organ Donor. Prog Transplant 2019; 29:164-172. [PMID: 30845889 DOI: 10.1177/1526924819835837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Studies demonstrate that family notification is much less frequent in African Americans than in Caucasians. Familial notification of one's decision to become a registered organ donor (ROD) is important to ensure adherence to the decedent's donation decision and to disseminate prodonation attitudes. The purpose of this study was to explore the experiences of familial notification among recent African American RODs and to identify intervention strategies to overcome potential barriers to the notification process. METHODS/APPROACH The study used a qualitative focus group approach. An inductive thematic analysis identified common categories and themes in the recorded and transcribed discussions. FINDINGS The focus groups consisted of 50 African American participants who had recently visited Alabama Department of Motorized Vehicles and made the voluntary decision (yes or no) about becoming an organ donor. Three major themes describing the African American experiences with notifying their family members about their decision to become a ROD emerged. These themes were as follows: motivation for the notification, notification conversation, and promoting familial notification. Specific discussions centered upon the importance of and barriers to familial notification, information, and strategies needed for successful notification. Strategies identified were use of media and social networks to provide enhanced knowledge on the notification process and the importance of health-care, community-provided knowledge about the donation process. DISCUSSION Findings from this study provide a framework for future interventions designed to assist African American RODs in notifying family members of their status.
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Affiliation(s)
- Derek A DuBay
- 1 Department of Surgery, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Nataliya V Ivankova
- 2 Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA.,3 Department of Acute, Chronic and Continuing Care, School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ivan Herbey
- 4 Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David T Redden
- 5 Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Cheryl Holt
- 6 Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - Laura Siminoff
- 7 College of Public Health, Temple University, Philadelphia, PA, USA
| | - Mona N Fouad
- 4 Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Thomas A Morinelli
- 1 Department of Surgery, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Michelle Y Martin
- 8 Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA
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DuBay DA, Ivankova NV, Herbey I, Redden DT, Holt C, Siminoff L, Fouad MN, Su Z, Morinelli TA, Martin MY. A quantitative appraisal of African Americans' decisions to become registered organ donors at the driver's license office. Clin Transplant 2018; 32:e13402. [PMID: 30179271 DOI: 10.1111/ctr.13402] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 08/28/2018] [Accepted: 08/30/2018] [Indexed: 11/27/2022]
Abstract
African American (AA) organ donation registration rates fall short of national objectives. The goal of the present study was to utilize data acquired from a quantitative telephone survey to provide information for a future Department of Motorized Vehicles (DMV) intervention to increase AA organ donor registration at the DMV. AAs (n = 20 177) that had visited an Alabama DMV office within a 3-month period were recruited via direct mailing to participate in a quantitative phone survey. Data from 155 respondents that participated in the survey were analyzed. Of those respondents deciding to become a registered organ donor (ROD; n = 122), one-third made that decision at the time of visiting the DMV. Of those who chose not to become a ROD (n = 33), one-third made the decision during the DMV visit. Almost 85% of all participants wanted to learn more about organ donation while waiting at the DMV, preferably via TV messaging (digital signage), with the messaging delivered from organ donors, transplant recipients, and healthcare experts. Altruism, accurate organ donation information, and encouragement from family and friends were the most important educational topics to support AAs becoming a ROD. These data provide a platform to inform future interventions designed to increase AAs becoming a ROD at the DMV.
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Affiliation(s)
- Derek A DuBay
- Department of Surgery, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Nataliya V Ivankova
- Department of Health Services Administration, School of Health Professions and Department of Acute, Chronic and Continuing Care, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ivan Herbey
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama
| | - David T Redden
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Cheryl Holt
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, Maryland
| | - Laura Siminoff
- College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Mona N Fouad
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama
| | - Zemin Su
- Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Thomas A Morinelli
- Department of Surgery, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Michelle Y Martin
- Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee
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Ivankova NV. Applying mixed methods in community-based participatory action research: a framework for engaging stakeholders with research as a means for promoting patient-centredness. J Res Nurs 2017. [DOI: 10.1177/1744987117699655] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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] Open
Abstract
An increased focus on patient-centred care in response to national efforts of improving the quality of health care calls for effective approaches to engaging patients and other stakeholders with research and its outcomes. Mixed methods research can provide a rigorous methodological foundation for community-based participatory action research (CBPAR) by synergistically combining qualitative stakeholder engagement methods with quantitative outcome-based oriented approaches for developing evidence-based, scientifically sound and patient-centred plans for improvement. CBPAR has long been applied in nursing research as a tool to engage patients and other stakeholders as co-researchers. When combined with mixed methods, CBPAR can assist stakeholders in developing better appreciation for a data-driven decision-making process by capitalising on the advantages of integrating quantitative and qualitative methods. This paper describes a mixed methods methodological framework for CBPAR as a means for promoting patient-centredness and enhancing stakeholder engagement with research outcomes. It follows the action research methodological steps and captures the synergetic combination of the two approaches by integrating mixed methods into each step in the CBPAR process. This framework is one illustration of using mixed methods to facilitate patient-centred research. It can provide a framework for developing stakeholder engagement plans and facilitating the process of translation of generated evidence into nursing practice.
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Affiliation(s)
- Nataliya V Ivankova
- Professor, Health Services Administration, School of Health Professions, Acute, Chronic and Continuing Care, School of Nursing, The University of Alabama at Birmingham, USA
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Cunningham-Erves J, Talbott LL, O'Neal MR, Ivankova NV, Wallston KA. Development of a Theory-based, Sociocultural Instrument to Assess Black Maternal Intentions to Vaccinate Their Daughters Aged 9 to 12 Against HPV. J Cancer Educ 2016; 31:514-521. [PMID: 26081311 DOI: 10.1007/s13187-015-0867-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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] [Indexed: 06/04/2023]
Abstract
The human papillomavirus (HPV) vaccine could assist in reducing the cervical cancer disparity existing between Black and White women. Understanding factors influencing Black maternal intentions to vaccinate their daughter is essential in improving vaccination uptake. However, existing instruments do not comprehensively assess factors (e.g., culture) influencing maternal intentions. This paper describes the development of the Human Papillomavirus Vaccination Survey for Black Mothers with Girls Aged 9 to 12 (HPVS-BM), the first instrument to measure knowledge, attitudes, subjective norms, and cultural beliefs relating to Black maternal intentions to vaccinate their daughters aged 9 to 12 years against HPV. The items and scales were refined using content review by experts, as well as cognitive interviews and pilot testing with target audience participants. The final version of the HPVS-BM was administered to 242 Black mothers with adolescent daughters. Internal reliability was determined using Cronbach's alpha. An a priori hypothetical model was developed to determine convergent and discriminant validity. All scales of the HPVS-BM had an acceptable internal reliability of 0.70 or higher. The intention scale of HPVS-BM was significantly correlated (p < .05) with perceived benefits, perceived barriers, and subjective norms, supporting strong convergent validity. Moderate discriminant construct validity was also demonstrated. Exhibiting good psychometrics, this instrument could be used by healthcare researchers and professionals to develop programs to increase HPV vaccination among Black adolescent females aimed at reducing the racial disparities in cervical cancer. Further psychometric testing of this survey tool for understanding factors influencing maternal intentions is warranted.
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Affiliation(s)
- Jennifer Cunningham-Erves
- Department of Surgery and Office of Research, Meharry Medical College, 1005 Dr. D. B. Todd Jr. Blvd., Nashville, TN, 37208-3599, USA.
| | - Laura L Talbott
- Department of Human Studies, School of Education, The University of Alabama at Birmingham, EB 255, 901 13th Street South Room 255, Birmingham, AL, 35294-1250, USA
| | - Marcia R O'Neal
- Department of Human Studies, School of Education, The University of Alabama at Birmingham, EB 233, 1720 2nd Ave. S, Birmingham, AL, 35294-1250, USA
| | - Nataliya V Ivankova
- School of Health Professions, The University of Alabama at Birmingham, SHPB 560, 1720 2nd Ave. S, Birmingham, AL, 35294-1212, USA
| | - Kenneth A Wallston
- School of Nursing, Vanderbilt University, 461 21st Ave. S, Nashville, TN, 37240, USA
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Wingo NP, Peters GB, Ivankova NV, Gurley DK. Benefits and Challenges of Teaching Nursing Online: Exploring Perspectives of Different Stakeholders. J Nurs Educ 2016; 55:433-40. [DOI: 10.3928/01484834-20160715-03] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 05/18/2016] [Indexed: 11/20/2022]
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Ivankova NV. Teaching and learning mixed methods research in computer-mediated environment: Educational gains and challenges. ACTA ACUST UNITED AC 2014. [DOI: 10.5172/mra.2010.4.1.049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Wilbanks SR, Ivankova NV. Exploring factors facilitating adults with spinal cord injury rejoining the workforce: a pilot study. Disabil Rehabil 2014; 37:739-49. [DOI: 10.3109/09638288.2014.938177] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Palcanis KG, Geiger BF, O'Neal MR, Ivankova NV, Evans RR, Kennedy LB, Carera KW. Preparing students to practice evidence-based dentistry: a mixed methods conceptual framework for curriculum enhancement. J Dent Educ 2012; 76:1600-1614. [PMID: 23225679] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This article describes a mixed methods conceptual framework for evidence-based dentistry to enhance the curriculum at the University of Alabama at Birmingham School of Dentistry. A focus of recent curriculum reform has been to prepare students to integrate evidence-based dentistry into clinical practice. The authors developed a framework consisting of four conceptual phases to introduce curriculum innovation: 1) exploration of the phenomenon; 2) development of two new instruments; 3) data collection, analysis, outcomes, and evaluation; and 4) application to curricular reform. Eight sequential procedural steps (literature review; focus group discussions; development of themes; survey design; internal review; data collection, analysis, and evaluation; development of recommendations with external review; and implementation of recommendations for curricular enhancement) guided the curricular enhancement. Faculty members supported the concept of teaching evidence-based dentistry to facilitate major curriculum reform, and course directors incorporated evidence-based teaching to prepare scientist-practitioners who meet dental performance standards. The new curriculum implemented following completion of the study is in its third year. Much of its structure is based on evidence-based teaching methodologies, and approximately one-third of the content consists of small groups researching clinical problems with applied science and discussing the findings. The framework described in this article proved useful to guide revision of predoctoral clinical education at one dental school and may be useful in other settings.
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Affiliation(s)
- Kent G Palcanis
- Birmingham, Room EB 233, 1720 2nd Ave. South, Birmingham, AL 35294-1250, USA.
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Palcanis KG, Geiger BF, O'Neal MR, Ivankova NV, Evans RR, Kennedy LB, Carera KW. Preparing Students to Practice Evidence-Based Dentistry: A Mixed Methods Conceptual Framework for Curriculum Enhancement. J Dent Educ 2012. [DOI: 10.1002/j.0022-0337.2012.76.12.tb05423.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kent G. Palcanis
- Department of Periodontology; School of Dentistry; University of Alabama at Birmingham
| | - Brian F. Geiger
- School of Education; Center for Educational Accountability; University of Alabama at Birmingham
| | - Marcia R. O'Neal
- Department of Human Studies; University of Alabama at Birmingham
| | | | - Retta R. Evans
- Department of Human Studies; University of Alabama at Birmingham
| | - Lasonja B. Kennedy
- Health Education and Health Promotion; University of Alabama at Birmingham
| | - Karen W. Carera
- Health Communication and Technical Training Programs; Oak Ridge Associated Universities
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Herbey II, Ivankova NV, Katkoori VR, Mamaeva OA. Colorectal cancer and hypercholesterolemia: review of current research. Exp Oncol 2005; 27:166-78. [PMID: 16244576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
AIM In spite of ample research about a high level of cholesterol in the blood of patients with colorectal cancer (CRC), the relationship between factors causing hypercholesterolemia and factors leading to CRC development is not fully investigated. The purpose of this article is to provide a review of the current research about the risk factors leading to the development of hypercholesterolemia and CRC, and to show the relationship between these factors, hypercholesterolemia and CRC with the implication for CRC preventive and treatment practices. METHODS A systematic search of MEDLINE and PUBMED databases between 1990 and 2005 was conducted to locate the studies that investigated the risk factors causing CRC and hypercholesterolemia. From among 255 studies found, 66 were selected that matched the following criteria for selection: (1) reported original research; (2) discussed at least one of the listed eight factors; (3) discussed hypercholesterolemia; and/or (4) discussed colon or rectum cancer. RESULTS The studies were grouped according to four areas of research: (1) studies that explored the relationship between different factors and CRC incidences; (2) studies that investigated the relationship between different factors and CRC incidences and the role of mutations in causing CRC; (3) studies that looked at the factors causing hypercholesterolemia; and (4) studies that explored the relationship among the factors, hypercholesterolemia, and CRC development. A discussion of the studies is presented and the details related to the studies major aspects are summarized in 4 tables. CONCLUSION The review has revealed a relationship between factors that can lead to the development of CRC and those that lead to hypercholesterolemia. Although the role of many individual risk factors is still controversial the analysis of their significance in combination might be important for diagnostic and development of the models for prediction of cancer occurrence.
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Affiliation(s)
- I I Herbey
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35294-1250, USA.
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Fetters MD, Ivankova NV, Ruffin MT, Creswell JW, Power D. Developing a Web site in primary care. Fam Med 2004; 36:651-9. [PMID: 15467943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
BACKGROUND AND OBJECTIVES While content, navigability, and usability are essential qualities of effective Web sites, the health care literature contains limited discussion of these issues. This article describes how knowledge gained through focus groups, Web site searches, and individual interviews were used to develop and improve a health-related Web site. METHODS We conducted 10 focus groups and searches of existing Web sites in preparation for developing a Web site about colorectal cancer (CRC) screening. We conducted 30 in-depth interviews to assess content, navigation, and usability of a new CRC Web site, using participants recruited from Michigan communities with a low incidence of CRC testing. Targeted participants were 50-70 years of age, had no prior experience with CRC testing, and had variable comfort levels with Internet use. RESULTS Existing CRC screening Web sites uniformly use user-directed navigation and have little variation in content. Our study participants stimulated revisions in content, navigation, and usability. Revised content factors included comprehension, utility, and appeal. Navigation changes focused on logical transition between sections. Usability changes included user focus and clarity of graphics/ text. CONCLUSIONS We found focus groups, Web site searches, and individual interviews useful in developing and testing content, navigation, and usability of a CRC screening Web site. These steps provide methodological procedures for developing and revising health-related Web sites.
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Affiliation(s)
- Michael D Fetters
- Department of Family Medicine, University of Michigan, Ann Arbor, MI 48109-0708, USA.
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Abstract
BACKGROUND Mixed methods or multimethod research holds potential for rigorous, methodologically sound investigations in primary care. The objective of this study was to use criteria from the literature to evaluate 5 mixed methods studies in primary care and to advance 3 models useful for designing such investigations. METHODS We first identified criteria from the social and behavioral sciences to analyze mixed methods studies in primary care research. We then used the criteria to evaluate 5 mixed methods investigations published in primary care research journals. RESULTS Of the 5 studies analyzed, 3 included a rationale for mixing based on the need to develop a quantitative instrument from qualitative data or to converge information to best understand the research topic. Quantitative data collection involved structured interviews, observational checklists, and chart audits that were analyzed using descriptive and inferential statistical procedures. Qualitative data consisted of semistructured interviews and field observations that were analyzed using coding to develop themes and categories. The studies showed diverse forms of priority: equal priority, qualitative priority, and quantitative priority. Data collection involved quantitative and qualitative data gathered both concurrently and sequentially. The integration of the quantitative and qualitative data in these studies occurred between data analysis from one phase and data collection from a subsequent phase, while analyzing the data, and when reporting the results. DISCUSSION We recommend instrument-building, triangulation, and data transformation models for mixed methods designs as useful frameworks to add rigor to investigations in primary care. We also discuss the limitations of our study and the need for future research.
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Affiliation(s)
- John W Creswell
- Department of Educational Psychology, University of Nebraska-Lincoln, Lincoln, Neb 68588, USA.
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