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Fennell BS, Jones SR, Sutton SK, Hoogland CE, Cottrell-Daniels C, Wetter DW, Shih YCT, Simmons VN, Stephens YP, Vidrine DJ, Vidrine JI. In-Clinic vs. Online Recruitment of Women with a History of Cervical Intraepithelial Neoplasia or Cervical Cancer to a Smoking Cessation Trial: A Post-hoc Comparison of Participant Characteristics, Study Retention, and Cessation Outcomes. Nicotine Tob Res 2024:ntae049. [PMID: 38452212 DOI: 10.1093/ntr/ntae049] [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: 08/18/2023] [Indexed: 03/09/2024]
Abstract
INTRODUCTION Recruiting special populations to smoking cessation trials is challenging and approaches beyond in-clinic recruitment may be beneficial. This secondary analysis of data from a smoking cessation RCT for individuals with a history of cervical cancer or cervical intraepithelial neoplasia (CIN) explored differences associated with in-clinic vs. online recruitment. METHODS Participants were recruited from clinics within a university-based NCI-designated cancer center (n=87) and online nationally via Facebook (n=115). Baseline measures included sociodemographics, smoking history, and cancer or CIN history. Study retention and smoking abstinence were assessed 12 months post-baseline. Group differences in baseline characteristics were evaluated. Retention and abstinence were evaluated while controlling for group differences and predictors. RESULTS Participants recruited online (vs. in-clinic) had higher educational attainment (p=.01) and health literacy (p=.003). They were more likely to have CIN vs. cancer, to be further from the time of diagnosis, and to have completed active treatment (p values<.001). While controlling for these group differences and independent predictors, retention was higher among participants recruited online (log-likelihood χ2(1)=11.41, p<.001). There were no recruitment differences in self-reported (p=.90) or biochemically confirmed smoking abstinence (p=.18). CONCLUSIONS Compared to individuals recruited in-person, individuals recruited online were more educated, had higher health literacy, and presented with a different clinical profile (i.e., more likely to have CIN vs. cancer and to have completed active treatment). There were few differences in participant characteristics between recruitment approaches, and no differences on any smoking-related variables. Online recruitment has the potential to improve enrollment of cancer survivors to smoking cessation trials. IMPLICATIONS People with a history of CIN or cervical cancer recruited to a smoking cessation RCT online (vs. in-clinic) were more likely to have a diagnosis of CIN vs. cancer and were more educated and health literate. Participants recruited online were more likely to be retained in the study and there were no differences in smoking abstinence rates at 12-months. Incorporating online recruitment increased the reach of tobacco treatment efforts to a larger and more diverse sample. This could reduce the burden of tobacco-related disease, improve CIN and cancer treatment outcomes, and reduce secondary malignancies and morbidity among this underserved group.
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Affiliation(s)
- Bethany Shorey Fennell
- Department of Family and Community Medicine and Markey Cancer Center, University of Kentucky, Lexington, KY, United States
| | - Sarah R Jones
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Steven K Sutton
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Charles E Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | | | - David W Wetter
- Department of Population Health Sciences and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Ya-Chen Tina Shih
- Program in Cancer Health Economics Research, Jonsson Comprehensive Cancer Center, and Department of Radiation Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Yesenia P Stephens
- Philadelphia College of Osteopathic Medicine South Georgia, Moultrie, GA, USA
| | - Damon J Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Jennifer I Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
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Cottrell-Daniels C, Hoogland CE, Fennell BS, Simmons VN, Vidrine DJ, Vidrine JI. Smoking Cessation by Cancer Treatment Status Among Cervical Cancer Survivors. Am J Prev Med 2024:S0749-3797(24)00043-6. [PMID: 38342477 DOI: 10.1016/j.amepre.2024.02.004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 02/13/2024]
Abstract
INTRODUCTION Continued smoking following a cancer diagnosis is associated with poorer cancer treatment outcomes and survival times. Little is known about how cancer treatment status at the time of tobacco treatment enrollment impacts long-term smoking cessation outcomes. Using data from a smoking cessation RCT, this study compared long-term cessation outcomes of women undergoing active treatment for cervical cancer at trial enrollment (n=40) to outcomes of women with a history of cervical cancer or cervical intraepithelial neoplasia (CIN) who were not undergoing active cancer treatment at enrollment (n=154). METHODS Participants (n=194) were randomized to Standard Treatment (ST) or ST plus a 6-session Motivation And Problem Solving (MAPS) telephone counseling protocol (data collected: 2017-2021; analyzed: 2023). Sociodemographic differences between participants undergoing (versus not undergoing) active cancer treatment at enrollment were examined. Significant covariates were included in a logistic regression analysis comparing the 2 groups' smoking cessation outcomes at 12 months, the end of the tobacco treatment period. RESULTS Participants in active cancer treatment at enrollment were significantly younger and less educated than those not in active cancer treatment. Race/ethnicity, relationship status, household income, nicotine dependence, and tobacco treatment condition did not vary by cancer treatment status. After adjusting for tobacco treatment condition, age, and education, being in active cancer treatment at the time of enrollment was associated with lower odds of abstinence at 12 months (5% vs 20%, aOR=0.22, 95% CI [0.05-0.998]). CONCLUSIONS Further research is necessary to identify and overcome barriers to abstinence among cancer survivors undergoing active treatment.
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Affiliation(s)
| | - Charles E Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
| | - Bethany Shorey Fennell
- Department of Family and Community Medicine and Markey Cancer Center, University of Kentucky, Lexington, Kentucky
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida; Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida; Department of Psychology, University of South Florida, Tampa, Florida
| | - Damon J Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida; Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Jennifer I Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida; Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida; Department of Psychology, University of South Florida, Tampa, Florida.
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Vidrine JI, Simmons VN, Vidrine DJ. Improving Smoking Cessation Support for Patients With Cancer. JCO Oncol Pract 2024; 20:161-163. [PMID: 38181304 PMCID: PMC10911543 DOI: 10.1200/op.23.00708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/16/2023] [Indexed: 01/07/2024] Open
Affiliation(s)
- Jennifer I. Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Psychology, College of Arts and Sciences, University of South Florida, Tampa, FL
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Vani N. Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Psychology, College of Arts and Sciences, University of South Florida, Tampa, FL
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Damon J. Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL
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Martinez U, Simmons VN, Brandon KO, Quinn GP, Brandon TH. Examining smoking and vaping behaviors, expectancies, and cessation outcomes between bisexual and heterosexual individuals. Behav Med 2023; 49:392-401. [PMID: 35614523 PMCID: PMC9691792 DOI: 10.1080/08964289.2022.2077295] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 05/05/2022] [Accepted: 05/08/2022] [Indexed: 11/02/2022]
Abstract
Prior research indicates bisexual individuals have higher smoking and vaping rates and heightened vulnerability to negative health outcomes. Thus, we compared adult bisexual (n = 294) and heterosexual (n = 2412) participants enrolled in a smoking cessation trial on baseline smoking and vaping use behaviors, motivations, and expectancies/beliefs as well as follow-up smoking and vaping status. This is a secondary analysis of a large randomized controlled trial testing a smoking cessation intervention for dual users of combustible and electronic cigarettes (e-cigarettes) in the United States. Self-reported 7-day point prevalence smoking and vaping abstinence were collected at 3-, 12-, and 24-month assessments. Bisexual and heterosexual participants did not differ in sociodemographic variables or baseline smoking and vaping history and behavior. We found significant differences among bisexual and heterosexual individuals in smoking and vaping beliefs/expectancies. Specifically, bisexual participants expressed overall greater positive expectancies regarding smoking and vaping, such as smoking and vaping to reduce negative affect and stress. There were no differences in smoking at any follow-up assessment. Only at 3 months were bisexual individuals more likely to be abstinent from vaping and less likely to be dual users than heterosexual individuals. Despite similar smoking and vaping status over time, bisexual individuals reported greater positive expectancies regarding smoking and vaping. Our findings revealed few targets for tailoring cessation interventions to bisexual individuals; thus, it is possible that there may be greater utility in targeting the disparities in prevalence (i.e., via prevention efforts).
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Affiliation(s)
- Ursula Martinez
- Department of Health Outcomes and Behavior, H. Lee Moffitt
Cancer Center, Tampa, FL, USA
- Department of Oncologic Sciences, University of South
Florida, Tampa, FL, USA
| | - Vani N. Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt
Cancer Center, Tampa, FL, USA
- Department of Oncologic Sciences, University of South
Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida,
Tampa, FL, USA
| | - Karen O. Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt
Cancer Center, Tampa, FL, USA
| | - Gwendolyn P. Quinn
- Deparment of Obstetrics and Gynecology, New York University
Grossman School of Medicine, New York, NY, USA
| | - Thomas H. Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt
Cancer Center, Tampa, FL, USA
- Department of Oncologic Sciences, University of South
Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida,
Tampa, FL, USA
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Rollison DE, Gonzalez BD, Turner K, Jim HSL, Zhao Y, Amorrortu RP, Howard R, Ghia KM, Ngo B, Reisman P, Moore C, Perkins R, Keenan RJ, Sallman DA, Naso CM, Robinson EJ, Vadaparampil ST, Simmons VN, Schabath MB, Gilbert SM. Examining disparities in large-scale patient-reported data capture using digital tools among cancer patients at clinical intake. Cancer Med 2023; 12:19033-19046. [PMID: 37596773 PMCID: PMC10557830 DOI: 10.1002/cam4.6459] [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: 06/05/2023] [Revised: 07/19/2023] [Accepted: 08/06/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Patient-reported data can improve quality of healthcare delivery and patient outcomes. Moffitt Cancer Center ("Moffitt") administers the Electronic Patient Questionnaire (EPQ) to collect data on demographics, including sexual orientation and gender identity (SOGI), medical history, cancer risk factors, and quality of life. Here we investigated differences in EPQ completion by demographic and cancer characteristics. METHODS An analysis including 146,142 new adult patients at Moffitt in 2009-2020 was conducted using scheduling, EPQ and cancer registry data. EPQ completion was described by calendar year and demographics. Logistic regression was used to estimate associations between demographic/cancer characteristics and EPQ completion. More recently collected information on SOGI were described. RESULTS Patient portal usage (81%) and EPQ completion rates (79%) were consistently high since 2014. Among patients in the cancer registry, females were more likely to complete the EPQ than males (odds ratio [OR] = 1.17, 95% confidence interval [CI] = 1.14-1.20). Patients ages 18-64 years were more likely to complete the EPQ than patients aged ≥65. Lower EPQ completion rates were observed among Black or African American patients (OR = 0.59, 95% CI = 0.56-0.63) as compared to Whites and among patients whose preferred language was Spanish (OR = 0.40, 95% CI = 0.36-0.44) or another language as compared to English. Furthermore, patients with localized (OR = 1.16, 95% CI = 1.12-1.19) or regional (OR = 1.16, 95% CI = 1.12-1.20) cancer were more likely to complete the EPQ compared to those with metastatic disease. Less than 3% of patients self-identified as being lesbian, gay, or bisexual and <0.1% self-identified as transgender, genderqueer, or other. CONCLUSIONS EPQ completion rates differed across demographics highlighting opportunities for targeted process improvement. Healthcare organizations should evaluate data acquisition methods to identify potential disparities in data completeness that can impact quality of clinical care and generalizability of self-reported data.
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Affiliation(s)
- Dana E. Rollison
- Department of Cancer EpidemiologyMoffitt Cancer CenterTampaFloridaUSA
| | - Brian D. Gonzalez
- Department of Health Outcomes and BehaviorMoffitt Cancer CenterTampaFloridaUSA
| | - Kea Turner
- Department of Health Outcomes and BehaviorMoffitt Cancer CenterTampaFloridaUSA
| | - Heather S. L. Jim
- Department of Health Outcomes and BehaviorMoffitt Cancer CenterTampaFloridaUSA
| | - Yayi Zhao
- Department of Cancer EpidemiologyMoffitt Cancer CenterTampaFloridaUSA
| | | | - Rachel Howard
- Department of Health InformaticsMoffitt Cancer CenterTampaFloridaUSA
| | - Kavita M. Ghia
- Collaborative Data Services Core, Moffitt Cancer CenterTampaFloridaUSA
| | - Bryan Ngo
- Department of Business Intelligence and AnalyticsMoffitt Cancer CenterTampaFloridaUSA
| | - Phillip Reisman
- Department of Health InformaticsMoffitt Cancer CenterTampaFloridaUSA
| | - Colin Moore
- Department of Clinical InformaticsMoffitt Cancer CenterTampaFloridaUSA
| | - Randa Perkins
- Department of Clinical InformaticsMoffitt Cancer CenterTampaFloridaUSA
| | - Robert J. Keenan
- Department of Thoracic OncologyMoffitt Cancer CenterTampaFloridaUSA
| | - David A. Sallman
- Department of Malignant HematologyMoffitt Cancer CenterTampaFloridaUSA
| | - Cristina M. Naso
- Department of Virtual HealthMoffitt Cancer CenterTampaFloridaUSA
| | - Edmondo J. Robinson
- Center for Digital HealthMoffitt Cancer CenterTampaFloridaUSA
- Department of Internal and Hospital MedicineMoffitt Cancer CenterTampaFloridaUSA
| | | | - Vani N. Simmons
- Department of Health Outcomes and BehaviorMoffitt Cancer CenterTampaFloridaUSA
| | | | - Scott M. Gilbert
- Department of Health Outcomes and BehaviorMoffitt Cancer CenterTampaFloridaUSA
- Department of Genitourinary OncologyMoffitt Cancer CenterTampaFloridaUSA
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Yang MJ, Pérez-Morales J, Quinn GP, Miller JD, Simmons VN, Schabath MB. Psychosocial characteristics and quality of life among sexual and gender minority patients with cancer. JNCI Cancer Spectr 2023; 7:pkad061. [PMID: 37572311 PMCID: PMC10587999 DOI: 10.1093/jncics/pkad061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/17/2023] [Accepted: 08/07/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND Underserved and minoritized patients with cancer often experience more psychosocial concerns and inferior quality of life (QOL) compared with majority populations. This study compared patient-reported psychosocial characteristics and QOL among self-identified sexual and gender minority patients with cancer vs cisgender-heterosexual patients with cancer treated at a National Cancer Institute-designated comprehensive cancer center in the United States. METHODS Self-report data from 51 503 patients were obtained from an institutional standard-of-care electronic patient questionnaire that was completed prior to, or on the day of, the patient's initial visit. The electronic patient questionnaire collects demographic information, including sexual orientation and gender identity, psychosocial variables, and QOL using the validated Short Form Health Survey-12. Sexual orientation and gender identity information was used to identify self-identified sexual and gender minority and cisgender-heterosexual persons (ie, non-self-identified sexual and gender minority). Using parametric analyses, psychosocial variables and QOL measures were compared for self-identified sexual and gender minority vs non-self-identified sexual and gender minority patients with cancer. RESULTS Compared with non-self-identified sexual and gender minority patients (n = 50 116), self-identified sexual and gender minority patients (n = 1387, 2.7%) reported statistically significantly greater concerns regarding getting help during treatment (2.6% vs 4.3%, respectively; P = .001) and concerns with ability to seek care (16.7% vs 21.6%, respectively, P < .001). Self-identified sexual and gender minority patients reported statistically significantly elevated mental health concerns and daily emotional and pain interference (all P < .001), whereas there was no statistically significant difference in daily interference due to physical functioning. CONCLUSION These data reveal real-world disparities among self-identified sexual and gender minority patients with cancer, which can be used to develop psychosocial interventions tailored to address the unique psychosocial and QOL needs of this underserved and minoritized population and to ultimately improve cancer care.
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Affiliation(s)
- Min-Jeong Yang
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jaileene Pérez-Morales
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Gwendolyn P Quinn
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Jarred D Miller
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Vani N Simmons
- Department of Oncologic Sciences, College of Medicine, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Matthew B Schabath
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Oncologic Sciences, College of Medicine, University of South Florida, Tampa, FL, USA
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Yang MJ, Martínez Ú, Fulton HJ, Maconi ML, Turner K, Powell ST, Chern JY, Brandon TH, Vidrine JI, Simmons VN. Qualitative evaluation of the implementation and future sustainability of an e-referral system for smoking cessation at a US NCI-designated comprehensive cancer center: lessons learned. Support Care Cancer 2023; 31:483. [PMID: 37480364 PMCID: PMC10577649 DOI: 10.1007/s00520-023-07956-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/18/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Promoting smoking cessation is recognized as an essential part of cancer care. Moffitt Cancer Center, supported by the National Cancer Institute Cancer Moonshot Cancer Center Cessation Initiative, developed and implemented an opt-out-based automatic electronic health record (EHR)-mediated referral (e-referral) system for Tobacco Quitline services along with options for local group cessation support and an in-house tobacco treatment specialist. This study evaluated barriers and facilitators for implementation of the e-referral system. METHOD Steering committee members (N=12) responsible for developing and implementing the new clinical workflow and nurses (N=12) who were expected to use the new e-referral system completed semi-structured interviews. Qualitative thematic content analyses were conducted. RESULTS Interviewees perceived the e-referral system as an effective strategy for identifying and referring smokers to cessation services. However, barriers were noted including competing demands and perceptions that smoking cessation was a low priority and that some patients were likely to have low motivation to quit smoking. Suggestions to improve future implementation and sustainability included providing regular trainings and e-referral outcome reports and increasing the visibility of the e-referral system within the EHR. CONCLUSION Initial implementation of the e-referral system was perceived as successful; however, additional implementation strategies are needed to ensure sustainability at both the clinician and system levels. Recommendations for future modifications include providing regular clinician trainings and developing a fully closed-loop system. Implications for cancer survivors Initial implementation of an e-referral system for smoking cessation for cancer patients revealed opportunities to improve the smoking cessation referral process at cancer centers.
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Affiliation(s)
- Min-Jeong Yang
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
| | - Úrsula Martínez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Hayden J Fulton
- Participant Research, Intervention, and Measurements Core, Moffitt Cancer Center, Tampa, FL, USA
| | - Melinda Leigh Maconi
- Participant Research, Intervention, and Measurements Core, Moffitt Cancer Center, Tampa, FL, USA
| | - Kea Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Sean T Powell
- Social Work and Patient Support Services, Moffitt Cancer Center, Tampa, FL, USA
| | - Jing-Yi Chern
- Gynecologic Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Jennifer I Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
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Vidrine JI, Fennell BS, Simmons VN, Sutton SK, Jones SR, Woodward HW, Hoogland CE, Vidrine DJ. Enhancing long-term smoking abstinence among individuals with a history of cervical intraepithelial neoplasia or cervical cancer (Project ACCESS): protocol for a randomized clinical trial. BMC Public Health 2023; 23:1284. [PMID: 37403057 DOI: 10.1186/s12889-023-16189-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 06/25/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND The prevalence of smoking among cervical cancer survivors is high and evidence-based smoking cessation interventions are critically needed. This paper describes the study design, methods, and data analysis plans for a randomized clinical trial (RCT) designed to evaluate the efficacy of a novel, personally tailored SMS-delivered text-based digital treatment adjuvant designed to enhance the long-term efficacy of a "Motivation And Problem-Solving" (MAPS) approach for smoking cessation among individuals with a history of cervical intraepithelial neoplasia (CIN) or cervical cancer. MAPS is a phone counseling approach designed to facilitate long-term abstinence that comprises 6 counseling calls over 12 months. The current trial is evaluating the efficacy of MAPS+, which comprises all MAPS components plus a 24-month digital treatment adjuvant. This trial represents a logical extension of our previous RCT, which compared the efficacy of MAPS to a quitline control condition and found that MAPS resulted in greater than a 2-fold increase in smoking abstinence at 12 months (i.e., 26.4% vs. 11.9%). This treatment effect was no longer significant at 18 months, suggesting that efficacy dissipated as time from the end of treatment increased. The primary aim of the current trial is to compare the efficacy of MAPS + and ST in facilitating long-term abstinence. METHODS Individuals who smoke and have a history of cervical cancer or CIN (N = 340) are recruited throughout Florida and randomly assigned to Standard Treatment [ST] or MAPS+. ST participants are electronically connected with the Florida Quitline. MAPS + consists of 6 proactive MAPS-based counseling calls over 12 months plus the novel, personally tailored, text message-based treatment adjuvant delivered over 24 months. All participants receive 12 weeks of combination nicotine replacement therapy (patch and lozenge) and are followed for 24 months. Participant recruitment commenced in December 2022 and is ongoing. DISCUSSION This study builds on promising results from our recent trial which found that MAPS was associated with substantially higher abstinence from smoking at the end of the 12-month treatment period. Finding that this low-burden, personally tailored digital treatment adjuvant improves the long-term efficacy of MAPS would have important clinical and public health implications. TRIAL REGISTRATION Clinical Trials Registry NCT05645146; https://clinicaltrials.gov/ct2/show/NCT05645146 ; Registered on December 9, 2022.
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Grants
- 22K02, Principal Investigator JIV James and Esther King Florida Biomedical Research Program
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- T32CA090314-18, MPIs: Vadaparampil, Simmons National Institutes of Health Training Grant in Behavioral Oncology
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Affiliation(s)
- Jennifer I Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA.
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
- Department of Psychology, University of South Florida, Tampa, FL, USA.
| | - Bethany Shorey Fennell
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Steven K Sutton
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Sarah R Jones
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Honor W Woodward
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Charles E Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Damon J Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
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Casas L, Medina-Ramirez P, Carreno V, Calixte-Civil P, Martinez U, Brandon TH, Simmons VN. Hispanic/Latinx individuals' attributions for abstinence and smoking: A content analysis of open-ended responses from a randomized cessation trial. Addict Behav Rep 2023; 17:100478. [PMID: 36619608 PMCID: PMC9816900 DOI: 10.1016/j.abrep.2022.100478] [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: 09/13/2022] [Revised: 11/18/2022] [Accepted: 12/23/2022] [Indexed: 12/26/2022] Open
Abstract
Introduction Little is known about facilitators and barriers to smoking cessation among Hispanics seeking treatment. This secondary analysis examined attributions for abstinence or smoking among participants in a nationwide randomized controlled trial testing a self-help smoking cessation intervention among Spanish-speaking Hispanics in the United States (US). Methods At each follow-up assessment (6, 12, 18, and 24 months), participants (N = 1,417) responded to open-ended items regarding reasons for either abstinence or smoking. A content analysis was conducted using NVivo on the responses from 1,035 participants. Results Mood Management (e.g., stress and anxiety) was the most frequent reason for smoking across all timepoints. Concern for personal health and wellbeing was the most frequent reason cited for abstinence across all timepoints. Important barriers (e.g., financial stressors, environmental disasters) and facilitators (e.g., family, faith) were also identified. Quantitative subgroup analyses revealed differences in the frequency of abstinence and smoking attributions by sex, marital status, and annual household income. Conclusion The identified facilitators and barriers to abstinence support and expand findings from previous studies by using a geographically and ethnically diverse sample of treatment seeking, Spanish-preferring smokers. They also provide specific targets for tailoring cessation and relapse prevention interventions designed to improve cessation outcomes and reduce tobacco-related health disparities among Hispanics in the US.
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Affiliation(s)
- Laura Casas
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Vanesa Carreno
- St. George’s University School of Medicine, West Indies, Grenada
| | | | - Ursula Martinez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Thomas H. Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Vani N. Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
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Yang MJ, Martínez Ú, Simmons VN, Schabath MB, Vinci C. Considerations and recommendations for mHealth interventions for substance use among Sexual and Gender Minority (SGM) individuals: A narrative review of the past 5 years. Curr Addict Rep 2023; 10:1-13. [PMID: 37359146 PMCID: PMC10214315 DOI: 10.1007/s40429-023-00497-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 06/28/2023]
Abstract
Purposeof Review The prevalence of problematic substance use is disproportionately higher among sexual and gender minority (SGM) adults compared to adults in the general population. mHealth as a treatment modality could reduce barriers to accessing substance use treatments among SGM populations. Through a qualitative literature search, the current narrative review aimed to understand the lived experiences of SGM individuals who use substances and to synthesize recommendations made in the literature to inform future mHealth interventions. Recent Findings Positive and negative reinforcement motives were prominent reasons for substance use, which included SGM identity expression and conformity motives. Individual- and system-level treatment barriers included a lack of safe and nonjudgmental environment, shame and stigma, and limited knowledge about treatment options. Barriers were directly linked to the reported substance use treatment needs in this population. Summary On-demand app features, real-time intervention and assessment, and anonymity should be considered in future mHealth trials. Supplementary Information The online version contains supplementary material available at 10.1007/s40429-023-00497-0.
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Affiliation(s)
- Min-Jeong Yang
- Department of Health Outcomes and Behavior, Tobacco Research and Intervention Program, H. Lee Moffitt Cancer Center & Research Institute, MRC-TRIP, 12902 Magnolia Drive, Tampa, FL 33612 USA
| | - Úrsula Martínez
- Department of Health Outcomes and Behavior, Tobacco Research and Intervention Program, H. Lee Moffitt Cancer Center & Research Institute, MRC-TRIP, 12902 Magnolia Drive, Tampa, FL 33612 USA
- Department of Oncologic Sciences, College of Medicine, University of South Florida, Tampa, FL USA
| | - Vani N. Simmons
- Department of Health Outcomes and Behavior, Tobacco Research and Intervention Program, H. Lee Moffitt Cancer Center & Research Institute, MRC-TRIP, 12902 Magnolia Drive, Tampa, FL 33612 USA
- Department of Oncologic Sciences, College of Medicine, University of South Florida, Tampa, FL USA
- Department of Psychology, University of South Florida, Tampa, FL USA
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL USA
| | - Matthew B. Schabath
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL USA
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL USA
| | - Christine Vinci
- Department of Health Outcomes and Behavior, Tobacco Research and Intervention Program, H. Lee Moffitt Cancer Center & Research Institute, MRC-TRIP, 12902 Magnolia Drive, Tampa, FL 33612 USA
- Department of Oncologic Sciences, College of Medicine, University of South Florida, Tampa, FL USA
- Department of Psychology, University of South Florida, Tampa, FL USA
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11
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Vidrine JI, Sutton SK, Wetter DW, Shih YCT, Ramondetta LM, Elting LS, Walker JL, Smith KM, Frank-Pearce SG, Li Y, Jones SR, Kendzor DE, Simmons VN, Vidrine DJ. Efficacy of a Smoking Cessation Intervention for Survivors of Cervical Intraepithelial Neoplasia or Cervical Cancer: A Randomized Controlled Trial. J Clin Oncol 2023; 41:2779-2788. [PMID: 36921237 PMCID: PMC10414739 DOI: 10.1200/jco.22.01228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 02/06/2023] [Indexed: 03/17/2023] Open
Abstract
PURPOSE Women who smoke and have a history of cervical intraepithelial neoplasia (CIN) or cervical cancer represent a vulnerable subgroup at elevated risk for recurrence, poorer cancer treatment outcomes, and decreased quality of life. The purpose of this study was to evaluate the long-term efficacy of Motivation And Problem Solving (MAPS), a novel treatment well-suited to meeting the smoking cessation needs of this population. METHODS Women who were with a history of CIN or cervical cancer, age 18 years and older, spoke English or Spanish, and reported current smoking (≥100 lifetime cigarettes plus any smoking in the past 30 days) were eligible. Participants (N = 202) were recruited in clinic in Oklahoma City and online nationally and randomly assigned to (1) standard treatment (ST) or (2) MAPS. ST consisted of repeated referrals to a tobacco cessation quitline, self-help materials, and combination nicotine replacement therapy (patch plus lozenge). MAPS comprised all ST components plus up to six proactive telephone counseling sessions over 12 months. Logistic regression and generalized estimating equations evaluated the intervention. The primary outcome was self-reported 7-day point prevalence abstinence from tobacco at 18 months, with abstinence at 3, 6, and 12 months and biochemically confirmed abstinence as secondary outcomes. RESULTS There was no significant effect for MAPS over ST at 18 months (14.2% v 12.9%, P = .79). However, there was a significant condition × assessment interaction (P = .015). Follow-up analyses found that MAPS (v ST) abstinence rates were significantly greater at 12 months (26.4% v 11.9%, P = .017; estimated OR, 2.60; 95% CI, 1.19 to 5.89). CONCLUSION MAPS led to a greater than two-fold increase in smoking abstinence among survivors of CIN and cervical cancer at 12 months. At 18 months, abstinence in MAPS declined to match the control condition and the treatment effect was no longer significant.
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Affiliation(s)
- Jennifer I. Vidrine
- Tobacco Research and Intervention Program and Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Psychology, College of Arts and Sciences, University of South Florida, Tampa, FL
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Steven K. Sutton
- Department of Psychology, College of Arts and Sciences, University of South Florida, Tampa, FL
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL
| | - David W. Wetter
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and the Department of Population Health Sciences, University of Utah, Salt Lake City, UT
| | - Ya-Chen Tina Shih
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lois M. Ramondetta
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Linda S. Elting
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Joan L. Walker
- Department of Obstetrics and Gynecology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Katie M. Smith
- Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Summer G. Frank-Pearce
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK
- University of Oklahoma Health Sciences Center, Oklahoma City, OK
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Yisheng Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sarah R. Jones
- Tobacco Research and Intervention Program and Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Darla E. Kendzor
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK
- University of Oklahoma Health Sciences Center, Oklahoma City, OK
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Vani N. Simmons
- Tobacco Research and Intervention Program and Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Psychology, College of Arts and Sciences, University of South Florida, Tampa, FL
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Damon J. Vidrine
- Tobacco Research and Intervention Program and Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL
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12
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Harrell PT, Brandon TH, Stark SE, Simmons VN, Barnett TE, Quinn GP, Chun S. Measuring vaping-related expectancies in young adults: Psychometric evaluation of the Electronic Nicotine Vaping Outcomes (ENVO) scale. Drug Alcohol Depend 2023; 246:109861. [PMID: 37028105 PMCID: PMC10187827 DOI: 10.1016/j.drugalcdep.2023.109861] [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: 01/20/2023] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 04/09/2023]
Abstract
OBJECTIVE Electronic cigarettes are the most commonly used tobacco products by young adults. Measures of beliefs about outcomes of use (i.e., expectancies) can be helpful in predicting use, as well as informing and evaluating interventions to impact use. METHODS We surveyed young adult students (N = 2296, Mean age=20.0, SD=1.8, 64 % female, 34 % White) from a community college, a historically black university, and a state university. Students answered ENDS expectancy items derived from focus groups and expert panel refinement using Delphi methods. Factor Analysis and Item Response Theory (IRT) methods were used to understand relevant factors and identify useful items. RESULTS A 5-factor solution [Positive Reinforcement (consists of Stimulation, Sensorimotor, and Taste subthemes, α = .92), Negative Consequences (Health Risks and Stigma, α = .94), Negative Affect Reduction (α = .95), Weight Control (α = .92), and Addiction (α = .87)] fit the data well (CFI=0.95; TLI=0.94; RMSEA=0.05) and was invariant across subgroups. Factors were significantly correlated with relevant vaping measures, including vaping susceptibility and lifetime vaping. Hierarchical linear regression demonstrated factors were significant predictors of lifetime vaping after controlling for demographics, vaping ad exposure, and peer/family vaping. IRT analyses indicated that individual items tended to be related to their underlying constructs (a parameters ranged from 1.26 to 3.18) and covered a relatively wide range of the expectancies continuum (b parameters ranged from -0.72 to 2.47). CONCLUSIONS A novel ENDS expectancy measure appears to be a reliable measure for young adults with promising results in the domains of concurrent validity, incremental validity, and IRT characteristics. This tool may be helpful in predicting use and informing future interventions. IMPLICATIONS Findings provide support for the future development of computerized adaptive testing of vaping beliefs. Expectancies appear to play a role in vaping similar to smoking and other substance use. Public health messaging should target expectancies to modify young adult vaping behavior.
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Affiliation(s)
- Paul T Harrell
- Department of Pediatrics, Division of Community Health & Research, Eastern Virginia Medical School (EVMS), Norfolk, VA, USA; Department of Psychiatry & Behavioral Sciences, EVMS, Norfolk, VA, USA.
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA; Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Stephen E Stark
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA; Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Tracey E Barnett
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Gwendolyn P Quinn
- Department of Obstetrics & Gynecology, Grossman School of Medicine, New York University, New York, NY, USA
| | - Seokjoon Chun
- Department of Psychology, University of South Florida, Tampa, FL, USA
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Hohl SD, Shoenbill KA, Taylor KL, Minion M, Bates-Pappas GE, Hayes RB, Nolan MB, Simmons VN, Steinberg MB, Park ER, Ashing K, Beneventi D, Sanderson Cox L, Goldstein AO, King A, Kotsen C, Presant CA, Sherman SE, Sheffer CE, Warren GW, Adsit RT, Bird JE, D’Angelo H, Fiore MC, Van Thanh Nguyen C, Pauk D, Rolland B, Rigotti NA. The Impact of the COVID-19 Pandemic on Tobacco Treatment Program Implementation at National Cancer Institute-Designated Cancer Centers. Nicotine Tob Res 2023; 25:345-349. [PMID: 35778237 PMCID: PMC9384385 DOI: 10.1093/ntr/ntac160] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 05/17/2022] [Accepted: 06/27/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION The COVID-19 pandemic disrupted cancer screening and treatment delivery, but COVID-19's impact on tobacco cessation treatment for cancer patients who smoke has not been widely explored. AIMS AND METHODS We conducted a sequential cross-sectional analysis of data collected from 34 National Cancer Institute (NCI)-designated cancer centers participating in NCI's Cancer Center Cessation Initiative (C3I), across three reporting periods: one prior to COVID-19 (January-June 2019) and two during the pandemic (January-June 2020, January-June 2021). Using McNemar's Test of Homogeneity, we assessed changes in services offered and implementation activities over time. RESULTS The proportion of centers offering remote treatment services increased each year for Quitline referrals (56%, 68%, and 91%; p = .000), telephone counseling (59%, 79%, and 94%; p = .002), and referrals to Smokefree TXT (27%, 47%, and 56%; p = .006). Centers offering video-based counseling increased from 2020 to 2021 (18% to 59%; p = .006), Fewer than 10% of centers reported laying off tobacco treatment staff. Compared to early 2020, in 2021 C3I centers reported improvements in their ability to maintain staff and clinician morale, refer to external treatment services, train providers to deliver tobacco treatment, and modify clinical workflows. CONCLUSIONS The COVID-19 pandemic necessitated a rapid transition to new telehealth program delivery of tobacco treatment for patients with cancer. C3I cancer centers adjusted rapidly to challenges presented by the pandemic, with improvements reported in staff morale and ability to train providers, refer patients to tobacco treatment, and modify clinical workflows. These factors enabled C3I centers to sustain evidence-based tobacco treatment implementation during and beyond the COVID-19 pandemic. IMPLICATIONS This work describes how NCI-designated cancer centers participating in the Cancer Center Cessation Initiative (C3I) adapted to challenges to sustain evidence-based tobacco use treatment programs during the COVID-19 pandemic. This work offers a model for resilience and rapid transition to remote tobacco treatment services delivery and proposes a policy and research agenda for telehealth services as an approach to sustaining evidence-based tobacco treatment programs.
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Affiliation(s)
- Sarah D Hohl
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Kimberly A Shoenbill
- Department of Family Medicine, Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Kathryn L Taylor
- Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, Washington, DC, USA
| | - Mara Minion
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Gleneara E Bates-Pappas
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rashelle B Hayes
- Department of Psychiatry, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Margaret B Nolan
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Michael B Steinberg
- Center for Tobacco Studies, Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Elyse R Park
- Department of Psychiatry, Massachusetts General Hospital (MGH), Boston, MA, USA
| | - Kimlin Ashing
- Department of Population Sciences, Center of Community Alliance for Research & Education, City of Hope National Medical Center, Duarte, CA, USA
| | - Diane Beneventi
- Tobacco Research and Treatment Program, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Lisa Sanderson Cox
- Cancer Prevention and Control, University of Kansas School of Medicine, University of Kansas Cancer Center, Kansas City, KS, USA
| | - Adam O Goldstein
- Department of Family Medicine, Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Andrea King
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Chris Kotsen
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Cary A Presant
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA, USA
| | - Scott E Sherman
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Christine E Sheffer
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Graham W Warren
- Department of Radiation Oncology, Medical University of South Carolina, Hollings Cancer Center, Charleston, SC, USA
- Department of Cell and Molecular Pharmacology and Experimental Therapeutics, Medical University of South Carolina, Hollings Cancer Center, Charleston, SC, USA
| | - Robert T Adsit
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Jennifer E Bird
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Heather D’Angelo
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Michael C Fiore
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - Danielle Pauk
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Betsy Rolland
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
- Institute for Clinical and Translational Research, University of Wisconsin-Madison, Madison, WI, USA
| | - Nancy A Rigotti
- Department of Medicine, Division of General Internal Medicine and Mongan Institute, Tobacco Research and Treatment Center, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
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Pérez-Morales J, Pathak R, Reyes M, Tolbert H, Tirbene R, Gray JE, Simmons VN, Schabath MB, Quinn GP. Qualitative Findings From a Survey on Patient Experiences and Satisfaction with Lung Cancer Screening. Cancer Control 2023; 30:10732748231167963. [PMID: 36971270 PMCID: PMC10052477 DOI: 10.1177/10732748231167963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND To reveal successes and potential limitations of the lung cancer screening program, we conducted a survey that included both quantitative and open-ended questions to measure patient experiences and satisfaction with screening. METHODS We report on the five open-ended items related to barriers to returning for screening, experience with other cancer prevention screenings, positive and negative experiences, and suggestions for improving future appointments. The open-ended responses were analyzed using constant comparison method and inductive content analysis. RESULTS Respondents (182 patients, 86% response rate for open-ended questions) provided generally positive comments about their lung cancer screening experience. Negative comments were related to desire for more information about results, long wait times for results, and billing issues. Suggestions for improvements included: scheduling on-line appointments and text or email reminders, lower costs, and responding to uncertainty about eligibility criteria. CONCLUSION Findings provide insights about patient experiences and satisfaction with lung cancer screening which is important given low uptake. Ongoing patient-centered feedback may improve the lung cancer screening experience and increase follow-up screening rates.
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Affiliation(s)
- Jaileene Pérez-Morales
- Department of Cancer Epidemiology, 25301H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Rashmi Pathak
- Department of Cancer Epidemiology, 25301H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Monica Reyes
- Department of Cancer Epidemiology, 25301H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Haley Tolbert
- Department of Thoracic Oncology, 25301H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Rajwantee Tirbene
- Department of Cancer Epidemiology, 25301H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Jhanelle E Gray
- Department of Thoracic Oncology, 25301H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, 25301H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Matthew B Schabath
- Department of Cancer Epidemiology, 25301H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
- Department of Thoracic Oncology, 25301H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Gwendolyn P Quinn
- Departments of Obstetrics and Gynecology and Population Health, 12296New York University Grossman School of Medicine, New York, NY, USA
- Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA
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Medina-Ramirez P, Casas L, Haver MK, Calixte-Civil P, Kim Y, Woodward H, Martinez U, Brandon TH, Simmons VN. Smoking cessation interventions for Hispanic/Latino(a) adults in the USA: protocol for a systematic review and planned meta-analysis. BMJ Open 2022; 12:e065634. [PMID: 36521902 PMCID: PMC9756193 DOI: 10.1136/bmjopen-2022-065634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 11/20/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Hispanic smokers face multiple cultural and socioeconomic barriers to cessation that lead to prominent health disparities, including a lack of language-appropriate, culturally relevant, evidence-based smoking cessation interventions. This systematic review will examine the literature on smoking cessation interventions for Hispanic adults in the USA to assess (1) the availability of interventions, (2) the methodological quality of the studies evaluating the interventions and (3) the efficacy of the interventions. METHODS AND ANALYSIS A systematic literature search will be conducted, in English with no date limits, through the following databases starting at year of inception: Medical Allied Health Literature, Embase, American Psychology Association Psychology Articles, Cumulative Index to Nursing and Allied Health Literature Complete, ScienceDirect, Health & Medicine Collection and Web of Science Core Collection. Trial registries and grey literature sources will be searched to identify ongoing or unpublished studies. Literature search will be rerun prior to eventual submission of the review to ensure the inclusion of relevant studies. Quantitative studies evaluating the efficacy of a smoking cessation intervention (ie, smoking cessation as a measured outcome) for Hispanic adult smokers in the USA will be included in the systematic review. Two authors will independently identify relevant studies, extract data and conduct quality and risk of bias assessments. Discrepancies in coding will be discussed between the two reviewers and pending disagreements will be resolved by a third reviewer. First, the quality of all studies will be assessed, then randomised controlled trials (RCTs) will be further evaluated for risk of bias using Cochrane's Risk of Bias Tool. All eligible studies will be summarised descriptively. If data allow, the efficacy of smoking cessation interventions tested in RCTs, with a minimum follow-up of 6 months, will be quantitatively estimated using ORs and 95% CIs. The association between intervention type/modality and efficacy will be assessed via subgroup analyses. PROSPERO REGISTRATION NUMBER CRD42022291068.
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Affiliation(s)
| | - Laura Casas
- Clinical Trials Office, Moffitt Cancer Center, Tampa, Florida, USA
| | | | - Patricia Calixte-Civil
- Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Youngchul Kim
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida, USA
| | - Honor Woodward
- Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Ursula Martinez
- Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Thomas H Brandon
- Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
- Department of Psychology, University of South Florida, Tampa, Florida, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Vani N Simmons
- Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
- Department of Psychology, University of South Florida, Tampa, Florida, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
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Fennell BS, Piñeiro B, Vidrine DJ, Frank-Pearce SG, Wetter DW, Simmons VN, Vidrine JI. Ask-Advise-Connect: Differential Enrollment and Smoking Cessation Outcomes Between Primary Care Patients Who Received Quitline-Delivered Treatment in Spanish vs English. Ann Fam Med 2022; 20:519-525. [PMID: 36443074 PMCID: PMC9705036 DOI: 10.1370/afm.2878] [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: 12/03/2021] [Revised: 05/19/2022] [Accepted: 06/30/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE This study examined differences in Quitline treatment enrollment, engagement, and smoking cessation outcomes among primary care patients preferring Spanish and English using the evidence-based tobacco treatment Ask-Advise-Connect. METHODS Ask-Advise-Connect was implemented April 2013 through February 2016 in a large safety-net health system to connect smokers with treatment via a link in the electronic health record. Rates of treatment enrollment, engagement, acceptance of nicotine replacement therapy, and smoking abstinence (self-reported and biochemically confirmed) were compared at 6 months among patients who received treatment in Spanish and English using χ 2 tests. Logistic regression examined language and nicotine replacement therapy and their interaction as predictors of abstinence. RESULTS The smoking status of 218,915 patients was assessed and recorded in the electronic health record. Smoking prevalence was 8.4% among patients preferring Spanish and 27.0% among those preferring English. Spanish-preferring patients were less likely to enroll in treatment (10.7% vs 12.0%, χ 2 = 12.06, P = .001) yet completed more counseling calls when enrolled (median = 2 vs 1, P <.001). Patients who received treatment in Spanish (vs English) were twice as likely to be abstinent at 6 months (self-reported: 25.1% vs 14.5%, odds ratio [OR] = 1.98, 95% CI, 1.62-2.40; biochemically confirmed: 7.6% vs 3.7%, OR = 2.13, 95% CI, 1.52-2.97). Receipt of nicotine replacement therapy increased abstinence for all patients and language did not interact with nicotine replacement therapy to predict abstinence. CONCLUSIONS Automated point-of-care approaches such as Ask-Advise-Connect have great potential to reach Spanish-preferring smokers. Those who received tobacco treatment in Spanish (vs English) demonstrated better engagement and cessation outcomes.
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Affiliation(s)
| | - Bárbara Piñeiro
- Centre d'Estudis Demogràfics, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Damon J Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
| | - Summer G Frank-Pearce
- Stephenson Cancer Center and Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - David W Wetter
- Huntsman Cancer Institute and the Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
| | - Jennifer I Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
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17
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Sims Z, Cousin L, Suppiah V, Stanley N, Li J, Quinn G, Martinez U, Zea AH, Simmons VN, Meade CD, Tsien F, Gwede CK. Improving Multi-site Interaction Through Remote Learning Technology: Report from a Training Program to Increase Underrepresented Undergraduate and Medical Students in Health Disparities Research. J Cancer Educ 2022; 37:1466-1471. [PMID: 33860443 PMCID: PMC9157396 DOI: 10.1007/s13187-021-01985-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/26/2021] [Indexed: 06/12/2023]
Abstract
Since 2018, we have evaluated the effectiveness of various teaching technologies for training young investigators on translational research in cancer health disparities. The Southeast Partnership for Improving Research and Training in Cancer Health Disparities (SPIRIT-CHD) unites Moffitt Cancer Center and the Louisiana State University Health Sciences Center. One of the main components of the SPIRIT-CHD is the Cancer Research Education Program (CREP) for training undergraduate and medical students from underrepresented backgrounds. The CREP utilizes a web-based didactic curriculum to engage students at both institutions in biobanking, precision medicine, and cancer health disparities topics. We report experiences from our cross-institutional cancer education program, specifically evaluating the cohorts' satisfaction and learning gains using various communication technologies and instructional approaches. Trainees completed a survey with questions evaluating the curriculum and technology. Trainees reported satisfaction with the flipped classroom model (FCM) content and overall program (mean score = 3.2, SD = 0.79), and would recommend the program to peers. Yet, despite improved program delivery, trainees felt interaction between the two sites (mean score = 1.5, SD = 0.85) and engagement with faculty (mean score = 2.80, SD = 1.14) could be improved. The technology with the highest reported use was e-mail, with a mean score of 4.6 (SD = 0.52). LinkedIn and Twitter had the lowest frequency of use with mean scores at 1.90 (SD = 0.99) and 1.30 (SD = 1.34). Our study highlights the successes and challenges of remote learning using technology to increase interaction and engagement among trainees and faculty in a multi-site cancer research training program.
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Affiliation(s)
- Z'Kera Sims
- H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr., MFC-EDU, Tampa, FL, 33612, USA.
| | - Lakeshia Cousin
- H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr., MFC-EDU, Tampa, FL, 33612, USA
| | - Vivekka Suppiah
- H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr., MFC-EDU, Tampa, FL, 33612, USA
| | - Nathanael Stanley
- H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr., MFC-EDU, Tampa, FL, 33612, USA
| | - Jiannong Li
- H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr., MFC-EDU, Tampa, FL, 33612, USA
| | - Gwendolyn Quinn
- Grossman School of Medicine, New York University, New York, NY, USA
| | - Ursula Martinez
- H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr., MFC-EDU, Tampa, FL, 33612, USA
- University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Arnold H Zea
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Vani N Simmons
- H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr., MFC-EDU, Tampa, FL, 33612, USA
- University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Cathy D Meade
- H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr., MFC-EDU, Tampa, FL, 33612, USA
- University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Fern Tsien
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Clement K Gwede
- H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr., MFC-EDU, Tampa, FL, 33612, USA
- University of South Florida, Morsani College of Medicine, Tampa, FL, USA
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18
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Sutton SK, Brandon KO, Harrell PT, Martínez Ú, Simmons VN, Gore LR, Bullen CR, Brandon TH. Identifying prospective subpopulations of combustible and electronic cigarette dual users in the United States via finite mixture modeling. Addiction 2022; 117:2493-2503. [PMID: 35491736 PMCID: PMC9795793 DOI: 10.1111/add.15906] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 04/01/2022] [Indexed: 12/30/2022]
Abstract
AIMS To identify subpopulations of dual users of combustible and electronic cigarettes using current smoking and vaping behaviors. DESIGN Secondary analysis of baseline data from a randomized controlled trial testing a smoking cessation intervention for dual users. Finite mixture modeling of frequency, quantity, and dependence on combustible and electronic cigarettes was used to identify classes. Demographics and additional smoking and vaping variables were used to further characterize the classes. SETTING United States. PARTICIPANTS A total of 2896 adults who smoked weekly for the past year and vaped weekly for the past month. MEASUREMENTS Self-report baseline measures assessed demographics and smoking and vaping behaviors and characteristics including days of use per week, frequency of use within a day, time to first use after waking, urges to smoke, smoking cessation motivation, self-efficacy to abstain from smoking, months since vaping initiation, reasons for initiating and maintaining vaping, and future plans to stop vaping. FINDINGS Eight probabilistic classes were identified and well-defined (relative entropy = 0.95, Lo-Mendell-Rubin adjusted likelihood ratio test P < 0.0001; class probabilities 0.89-0.97). In general, classes crossed two levels of smoking with four levels of vaping. The largest class (31%) had relatively high levels of smoking (72% daily, 56% 11+ cigarettes per day [CPD], 96% within 30 minutes of waking) and vaping (74% daily, 100% 20+ electronic-CPD, 74% <30 minutes). The next largest class (27%) had relatively high levels of vaping (93% daily, 100% 20+ electronic-CPD, 82% <30 minutes) and very low levels of smoking (28% daily, 12% 11+ CPD, 0% <30 minutes). The six smaller classes (3%-13%) also had distinct smoking and vaping behaviors. All eight classes exhibited distinguishing characteristics beyond current smoking and vaping behaviors. CONCLUSIONS Dual users of combustible and electronic cigarettes are not a homogeneous population, having eight well-defined prospective subpopulations.
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Affiliation(s)
- Steven K. Sutton
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, FL, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Karen O. Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Paul T. Harrell
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Úrsula Martínez
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Vani N. Simmons
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - L. Robert Gore
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Christopher R. Bullen
- School of Population Health, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Thomas H. Brandon
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA
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19
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Yang MJ, Pérez-Morales J, Miller JD, Simmons VN, Schabath MB. Abstract 22: Sexual and gender minority patients report psychosocial concerns and low quality of life entering cancer treatment. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Prior studies have suggested that underserved and minority populations experience psychosocial concerns and low quality of life (QoL) regarding their cancer care experience; however, presently there are limited data regarding psychosocial concerns and QoL among sexual and gender minority (SGM) populations (i.e., LGBTQ). Given the significantly higher emotional difficulties among SGM cancer patients and adverse impact of psychosocial vulnerabilities on patient outcomes, understanding of unique concerns related to physical/emotional health and QoL among SGM cancer patients is an unmet need. The current study analyzed the association between psychosocial concerns and QoL by SGM status.
Methods: Participants (N=70,312) were cancer patients who completed a standard-of-care electronic patient questionnaire (EPQ) during their initial visits at the Moffitt Cancer Center. The EPQ captures patient-reported information on demographics (including sexual orientation and gender identity [SOGI]), medical history, family cancer history, lifestyle factors, use of complementary and alternative medicine, and QoL. The SOGI questions were used to identify SGM and non-SGM patients. The outcome variables were concerns in (1) having someone who can help the patient during treatment, (2) interference with ability to seek care (e.g., transportation, financial), (3) problems with work or other regular activities due to physical/emotional health and pain over the past 4 weeks, and (4) perceived general health. Pearson’s Chi-Square test and ANOVA were utilized; significance was determined by p<0.05.
Results: Approximately 2.3% of the population self-identified as an SGM. SGM vs. non-SGM patients reported significantly greater concerns in having someone who can help the patient (4.4% vs 2.7%; p<.001), interference with ability to seek care (21.8% vs 16.6%; p<.001), and reported having accomplished less than one would like (36.6% vs 27.8%; p<.001), and engaged in activities less carefully than usual (23.1% vs 18.2%; p<.001) as a result of emotional problems. Further, SGM vs. non-SGM patients reported significantly greater interference due to pain and overall physical/emotional problems (p<.001) and marginally significant worse perceived general health (p=.060). Daily interference due to physical health did not differ between SGM and non-SGM patients.
Discussion: These data suggest that SGM cancer patients compared to non-SGM cancer patients are reporting less psychosocial resources and lower QoL. These results add to the existing literature by elucidating potential difficulties in cancer treatment and preexisting interference due to emotional difficulties and pain among SGM cancer patients with heterogeneous cancer types. Further research is warranted in the short- and long-term impact of such concerns on cancer outcomes and potential need for early intervention.
Citation Format: Min-Jeong Yang, Jaileene Pérez-Morales, Jarred D. Miller, Vani N. Simmons, Matthew B. Schabath. Sexual and gender minority patients report psychosocial concerns and low quality of life entering cancer treatment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 22.
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20
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Medina-Ramirez P, Casas L, Sutton SK, Calixte-Civil P, Brandon KO, Martinez U, Meade CD, Byrne MM, Brandon TH, Simmons VN. Hispanic/Latinx ethnic subgroup differences in sociodemographic, sociocultural, and smoking characteristics in a cessation trial: An exploratory study. Nicotine Tob Res 2022; 24:1589-1596. [PMID: 35366328 PMCID: PMC9575968 DOI: 10.1093/ntr/ntac081] [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] [Received: 09/30/2021] [Revised: 01/10/2022] [Accepted: 03/30/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Hispanic/Latinx smokers in the United States are often treated as a homogeneous group. However, population-based studies suggest cigarette use differs among Hispanic/Latinx subgroups by sociodemographic or sociocultural characteristics. This secondary analysis aimed to advance the limited literature by examining differences in smoking-related variables. METHODS We used baseline data from a randomized controlled trial testing a self-help Spanish-language smoking cessation intervention. Puerto Rican (PR), Mexican, and Cuban, the three largest Hispanic/Latinx subgroups in the sample (N=1028), were first compared on sociodemographic and sociocultural variables (acculturation and familism). Primary analyses assessed subgroup differences in cigarette use variables [e.g., cigarettes per day (CPD), nicotine dependence (Fagerström Test for Nicotine Dependence), daily smoking] and smoking-related cognitive constructs (motivation to quit, smoking outcome expectancies and abstinence self-efficacy) controlling for sociodemographic and sociocultural variables. Additional analyses explored differences between men and women within subgroups. RESULTS Mexicans exhibited the lowest levels of daily smoking (90% vs. 95% Cubans and 96% PR; p=.001), CPD (M=13.5, SD=9.5 vs. M=20.1, SD=9.9 Cubans and M=16.7, SD=10.1 PR; p=.016), and nicotine dependence (M=4.2, SD=2.3 vs. M=6.0, SD=2.1 Cubans and M=5.7, SD=2.2 PR; p< .001), with no differences between PRs and Cubans. Within-subgroup comparisons between men and women showed the most differences among PRs [e.g., men were more nicotine dependent (M=6.0, SD=1.9) than women (M=5.4, SD=2.3; p=.041)] and Cubans [e.g., men smoked more CPD (M=22.2, SD=12.2) than women (M=19.3, SD=12.0; p=.042)], and the fewest among Mexicans. CONCLUSIONS Findings support heterogeneity within Hispanic/Latinx smokers and highlight the potential utility of examining sociodemographic, sociocultural, and smoking characteristics important for developing salient cessation interventions. IMPLICATIONS Findings demonstrate that treatment-seeking Hispanic/Latinx smokers in the US differ in sociodemographic, sociocultural, and smoking-related variables (cigarette use and smoking-related cognitive constructs) by subgroup (i.e., Puerto Rican, Mexican, Cuban) and within subgroups by sex. These differences suggest that heterogeneity among subgroups should be considered when developing cessation interventions for Hispanics/Latinxs. Future research should examine how differences in sociodemographic and smoking-related variables impact intervention outcomes and explore the role of sociocultural factors (e.g., acculturation and familism) as determinants of cessation.
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Affiliation(s)
| | - Laura Casas
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL. USA
| | - Steven K Sutton
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL. USA.,Department of Psychology, University of South Florida, Tampa, FL. USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL. USA
| | - Patricia Calixte-Civil
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL. USA.,Department of Psychology, University of South Florida, Tampa, FL. USA
| | - Karen O Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL. USA
| | - Ursula Martinez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL. USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL. USA
| | - Cathy D Meade
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL. USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL. USA
| | - Margaret M Byrne
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL. USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL. USA
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL. USA.,Department of Psychology, University of South Florida, Tampa, FL. USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL. USA
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL. USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL. USA
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21
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Jones SR, Vidrine DJ, Wetter DW, Shih YCT, Sutton SK, Ramondetta LM, Elting LS, Walker JL, Smith KM, Frank-Pearce SG, Li Y, Simmons VN, Vidrine JI. Evaluation of the Efficacy of a Smoking Cessation Intervention for Cervical Cancer Survivors and Women With High-Grade Cervical Dysplasia: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e34502. [PMID: 34967755 PMCID: PMC8765796 DOI: 10.2196/34502] [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] [Received: 10/26/2021] [Accepted: 11/04/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The prevalence of smoking among cervical cancer survivors is strikingly high, yet no smoking cessation interventions to date have specifically targeted this population. This paper describes the study design, methods, and data analysis plans for a randomized clinical trial designed to evaluate the efficacy of a theoretically and empirically based Motivation And Problem Solving (MAPS) approach for promoting and facilitating smoking cessation among cervical cancer survivors. MAPS is a comprehensive, dynamic, and holistic intervention that incorporates empirically supported cognitive behavioral and social cognitive theory-based treatment strategies within an overarching motivational framework. MAPS is designed to be appropriate for all smokers regardless of their motivation to change and views motivation as dynamically fluctuating from moment to moment throughout the behavior change process. OBJECTIVE This 2-group randomized controlled trial compares the efficacy of standard treatment to MAPS in facilitating smoking cessation among women with a history of high-grade cervical dysplasia or cervical cancer. METHODS Participants (N=202) are current smokers with a history of high-grade cervical dysplasia or cervical cancer recruited nationally and randomly assigned to one of two treatment conditions: (1) standard treatment (ST) or (2) MAPS. ST consists of repeated letters referring participants to their state's tobacco cessation quitline, standard self-help materials, and free nicotine replacement therapy when ready to quit. MAPS has all ST components along with 6 proactive telephone counseling sessions delivered over 12 months. The primary outcome is abstinence from tobacco at 18 months. Secondary outcomes include abstinence over time across all assessment points, abstinence at other individual assessment time points, quit attempts, cigarettes per day, and use of state quitlines. Hypothesized treatment mechanisms and cost-effectiveness will also be evaluated. RESULTS This study was approved by the institutional review boards at the University of Texas MD Anderson Cancer Center, the University of Oklahoma Health Sciences Center, and Moffitt Cancer Center. Participant enrollment concluded at Moffitt Cancer Center in January 2020, and follow-up data collection was completed in July 2021. Data analysis is ongoing. CONCLUSIONS This study will yield crucial information regarding the efficacy and cost-effectiveness of a MAPS approach for smoking cessation tailored to the specific needs of women with a history of high-grade cervical dysplasia or cervical cancer. Findings indicating that MAPS has substantially greater efficacy than existing evidence-based tobacco cessation treatments would have tremendous public health significance. TRIAL REGISTRATION ClinicalTrials.gov NCT02157610; https://clinicaltrials.gov/ct2/show/NCT02157610. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/34502.
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Affiliation(s)
- Sarah R Jones
- Tobacco Research & Intervention Program, Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Damon J Vidrine
- Tobacco Research & Intervention Program, Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - David W Wetter
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States
| | - Ya-Chen Tina Shih
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Steven K Sutton
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, United States
| | - Lois M Ramondetta
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Linda S Elting
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Joan L Walker
- Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.,Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Katie M Smith
- Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Summer G Frank-Pearce
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.,TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Yisheng Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Vani N Simmons
- Tobacco Research & Intervention Program, Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Jennifer I Vidrine
- Tobacco Research & Intervention Program, Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
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Simmons VN, Sutton SK, Medina-Ramirez P, Martinez U, Brandon KO, Byrne MM, Meade CD, Meltzer LR, Brandon TH. Self-help smoking cessation intervention for Spanish-speaking Hispanics/Latinxs in the United States: A randomized controlled trial. Cancer 2021; 128:984-994. [PMID: 34679188 DOI: 10.1002/cncr.33986] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/23/2021] [Accepted: 10/04/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Hispanic/Latinx smokers living in the United States face unique challenges in quitting smoking. This study evaluated the efficacy of a culturally relevant, Spanish-language, extended self-help smoking cessation intervention among Hispanic smokers. METHODS A 2-arm parallel randomized controlled trial was conducted with Hispanic/Latinx smokers living in the United States who preferred health information in Spanish and smoked 5 or more cigarettes per week. Participants were randomly allocated to receive Libre del Cigarrillo (LDC), which consisted of 11 booklets and 9 pamphlets mailed monthly over 18 months, or the usual care (UC), which was a single Spanish-language self-help booklet from the National Cancer Institute. The primary outcome was self-reported 7-day point prevalence smoking abstinence assessed 6, 12, 18, and 24 months after the baseline. Eight prespecified moderators of the intervention were evaluated. Cost-effectiveness was also evaluated. All statistical tests were 2-sided. RESULTS Data from all participants randomized to LDC (n = 714) or UC (n = 703) were used for analyses after multiple imputation to manage missing data. Generalized estimating equation analyses indicated that LDC abstinence rates were higher (P < .001) across all assessments. Logistic regression analyses revealed that at 24 months, the abstinence rate was greater for LDC (33.1%) than UC (24.3%; odds ratio, 1.54; 95% confidence interval, 1.18-2.02; P = .002). Men exhibited a strong intervention effect at all assessments (P values < .001), whereas the intervention effect for women was observed only at 6 and 12 months (P values < .018). In comparison with UC, the incremental cost per quitter in the LDC arm was $648.43 at 18 months and $683.93 at 24 months. CONCLUSIONS A culturally relevant, Spanish-language intervention was efficacious and cost-effective for smoking cessation. LAY SUMMARY Research is needed to develop interventions for ethnic minority smokers. The aim of the current study was to test a Spanish-language adaptation of a validated and easily implemented self-help smoking cessation intervention in a nationwide randomized controlled trial. The findings demonstrated that the intervention produced greater smoking abstinence in comparison with a standard self-help booklet. Participants also were more satisfied with the intervention, and it was cost-effective. Efforts aimed at promoting tobacco abstinence in this underserved population could have significant public health implications, including potential reductions in cancer health disparities associated with tobacco smoking.
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Affiliation(s)
- Vani N Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida
| | - Steven K Sutton
- Department of Oncologic Sciences, University of South Florida, Tampa, Florida.,Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida
| | | | - Ursula Martinez
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida
| | - Karen O Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Margaret M Byrne
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida
| | - Cathy D Meade
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida
| | - Lauren R Meltzer
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida
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23
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Martinez U, Simmons VN, Sutton SK, Drobes DJ, Meltzer LR, Brandon KO, Byrne MM, Harrell PT, Eissenberg T, Bullen CR, Brandon TH. Targeted smoking cessation for dual users of combustible and electronic cigarettes: a randomised controlled trial. Lancet Public Health 2021; 6:e500-e509. [PMID: 34175001 PMCID: PMC8281505 DOI: 10.1016/s2468-2667(20)30307-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/10/2020] [Accepted: 12/18/2020] [Indexed: 12/31/2022]
Abstract
Background Although many smokers use electronic cigarettes (e-cigarettes) to
quit smoking, most continue to smoke while vaping. This dual use might delay
cessation and increase toxicant exposure. We aimed to test the efficacy of a
self-help intervention designed to help dual users to quit smoking. Methods In this three-arm randomised controlled trial we recruited
individuals in the USA using Facebook and multimedia advertisements.
Included participants were 18 years or older, smoked at least weekly in the
preceding year, and vaped at least weekly in the preceding month. We used
computer generated randomisation with balanced-permuted blocks (block size
10, with 2–4-4 ratio) to allocate participants to assessment only
(ASSESS group), generic smoking cessation self-help booklets (GENERIC
group), or booklets targeting dual users (eTARGET group). Individuals in the
generic or targeted intervention groups received monthly cessation materials
for 18 months, with assessments every 3 months for 24 months. The main
outcome was self-reported 7-day point-prevalence smoking abstinence at each
assessment point. All randomly allocated participants were included in
primary analyses using generalised estimating equations for each of 20
datasets created by multiple imputation. Analysis of the
χ2s produced an F test. The trial is registered with
ClinicalTrials.gov, NCT02416011, and is now closed. Findings Between July 12, 2016, and June 30, 2017, we randomly assigned 2896
dual users (575 to assessment, 1154 to generic intervention, and 1167 to
targeted self-help). 7-day point-prevalence smoking abstinence increased
from 14% at 3 months to 42% at 24 months
(F7,541·7=67·1,
p<0·0001) in the overall sample. Targeted self-help resulted
in higher smoking abstinence than did assessment alone throughout the
treatment period (F1,973·8=10·20,
p=0·0014 [α=0·017]). The generic intervention group had
abstinence rates between those of the assessment and targeted groups, but
did not significantly differ from either when adjusted for multiple
comparisons (GENERIC vs eTARGET
F1,1102·5=1·79, p=0·18
[α=0·05]; GENERIC vs ASSESS
F1,676·7=4·29, p=0·039
[α=0·025]). Differences between study groups attenuated after
the interventions ended. Interpretation A targeted self-help intervention with high potential for
dissemination could be efficacious in promoting smoking cessation among dual
users of combustible cigarettes and e-cigarettes.
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Affiliation(s)
- Ursula Martinez
- Department of Health Outcomes and Behavior, H Lee Moffitt Cancer Center, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, H Lee Moffitt Cancer Center, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA; Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Steven K Sutton
- Department of Biostatistics and Bioinformatics, H Lee Moffitt Cancer Center, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA; Department of Psychology, University of South Florida, Tampa, FL, USA
| | - David J Drobes
- Department of Health Outcomes and Behavior, H Lee Moffitt Cancer Center, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA; Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Lauren R Meltzer
- Department of Health Outcomes and Behavior, H Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Karen O Brandon
- Department of Health Outcomes and Behavior, H Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Margaret M Byrne
- Department of Health Outcomes and Behavior, H Lee Moffitt Cancer Center, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Paul T Harrell
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Christopher R Bullen
- School of Population Health, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, H Lee Moffitt Cancer Center, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA; Department of Psychology, University of South Florida, Tampa, FL, USA.
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Reyes ME, Perez-Morales J, Pathak R, Sulbaran A, Gillard TJ, Tolbert H, Tirbene R, Gray J, Simmons VN, Quinn GP, Schabath MB. Abstract 890: Survey results of lung cancer screening patient experiences and satisfaction. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: In 2014, Moffitt Cancer Center (MCC) in Tampa, Florida launched a lung cancer screening program for high-risk individuals meeting USPSTF inclusion criteria. To reveal successes and potential limitations of this program, we conducted a survey to measure lung cancer screening patient experiences and satisfaction.
Methods: In August 2020, a survey was mailed to 576 patients who completed one or more lung cancer screenings at MCC. The survey collected demographics and smoking history and measured patient satisfaction and experiences in 6 domains: the appointment process, clinical staff interactions, communication, visit with the provider, screening results and cost, and the clinic facility/overall satisfaction. There were also questions on the impact of the COVID-19 pandemic. A 5-point Likert scale was used to measure satisfaction with clinical staff and clinic facility/overall satisfaction (1= excellent to 5= poor) and other domains (1=strongly agree to 5=strongly disagree). Results were quantified using descriptive statistics.
Results: Among the 160 patients that completed the survey, 96.3% were White, 93.1% were non-Hispanic, 46.9% were female, 78.1% were former smokers, and the mean age was 69 years. For the appointment process, 91.2% “strongly agreed/agreed” it was easy to make an appointment and 92.5% “strongly agreed/agreed” the clinic check-in process was efficient. Next, nearly 93% reported the courtesy of the clinical staff was “excellent/very good”. For communication, while 90% “strongly agreed/agreed” that the lung cancer screening process was clearly explained, 63.2% “strongly agreed/agreed” that the potential harms and limitations were clearly explained and 71.2% “strongly agreed/agreed” that the process for follow-up screening was clearly explained. For the provider questions, 71.3% “strongly agreed/agreed” that the provider was willing to listen carefully and 66.3% “strongly agreed/agreed” that the instructions regarding follow-up were easy to understand. For results and costs, 79.4% “strongly agreed/agreed” the screening results were clearly explained and 70% “strongly agreed/agreed” that the cost of the screening was justified. Regarding overall satisfaction, 87.6% “strongly agreed/agreed” they would recommend lung cancer screening at MCC. Finally, 10.6% of patients were concerned about getting a lung cancer screening during the COVID-19 pandemic and only 8.1% reported that the COVID-19 pandemic prevented them from getting a lung cancer screening.
Conclusion: Generally, for all 6 domains, patients reported favorable satisfaction and experience with lung cancer screening at MCC. However, higher rates of “neither agree/disagree” and “prefer not to answer” were observed for items related to communication and visit with the provider items suggesting improvements may be warranted, particularly related to future visits.
Citation Format: Monica E. Reyes, Jaileene Perez-Morales, Rashmi Pathak, Ada Sulbaran, Tiffany J. Gillard, Haley Tolbert, Rajwantee Tirbene, Jhanelle Gray, Vani N. Simmons, Gwendolyn P. Quinn, Matthew B. Schabath. Survey results of lung cancer screening patient experiences and satisfaction [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 890.
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Affiliation(s)
- Monica E. Reyes
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | | | - Rashmi Pathak
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Ada Sulbaran
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | | | - Haley Tolbert
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | | | - Jhanelle Gray
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Vani N. Simmons
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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25
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Perez-Morales J, Pathak R, Reyes M, Sulbaran A, Gilliard T, Tolbert H, Tirbene R, Gray J, Simmons VN, Schabath MB, Quinn GP. Abstract 889: Qualitative findings from a survey on patient experiences and satisfaction with lung cancer screening. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: In 2014, Moffitt Cancer Center initiated a lung cancer screening program for high-risk individuals who meet USPSTF inclusion criteria. As of January 2020, 576 patients have completed one or more lung cancer screenings. However, approximately 40% of lung cancer screening patients were noncompliant with their recommended follow-up. To understand reasons for lack of follow-up screening and to determine patient satisfaction and experiences, we conducted a survey with open-ended items to assess patient experiences and satisfaction among lung cancer screening patients.
Methods: In this analysis, we report on findings from the qualitative portion of the survey. Six open-ended items elicited barriers related to returning for screening, experience with other cancer screenings, positive and negative experiences with the LDCT visit, as well as suggestions for improving the process of LDCT screening visits. Content analysis using the constant comparison method was applied to the text and coded based on the a priori codes of the open-ended questions.
Results: As of November 2020, 190 people responded to the quantitative survey and 77 provided responses to one or more open-ended questions. Thirty-five respondents provided general positive comments about their lung cancer screening experience with typical responses of “positive” and “good experience”. Twenty respondents mentioned that the staff was “caring”, “knowledgeable”, and “great staff”. Ten respondents mentioned that they were “always treated well”, “treated with respect”, “high quality care”.. Negative comments were provided by 32 respondents in the areas of: “wanting more information on results” or “waiting too long for results” (N=7), “inefficient scheduling issues” (N=6), and billing issues (N=5). Additionally, six patients reported COVID-related issues impacted their lung cancer screening experience. Suggestion for improvements included: on-line appointments or text or email reminders (N = 10), lower costs (N=6), and uncertainty about remaining qualified for lung cancer screening due to age or current/prior medical conditions (N=5).
Conclusion: Overall, findings provide insights about patient experiences and satisfaction for lung cancer screening. Suggestions for improvement centered on better scheduling systems and appointment reminders as well as the ability to speak to a clinician to better understand results and future eligibility. Ongoing patient-centered feedback may improve the lung cancer screening experience and increase follow-up screening rates.
Citation Format: Jaileene Perez-Morales, Rashmi Pathak, Monica Reyes, Ada Sulbaran, Tiffany Gilliard, Haley Tolbert, Rajwantee Tirbene, Jhanelle Gray, Vani N. Simmons, Matthew B. Schabath, Gwendolyn P. Quinn. Qualitative findings from a survey on patient experiences and satisfaction with lung cancer screening [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 889.
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26
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Sutter ME, Simmons VN, Sutton SK, Vadaparampil ST, Sanchez JA, Bowman-Curci M, Duarte L, Schabath MB, Quinn GP. Oncologists' experiences caring for LGBTQ patients with cancer: Qualitative analysis of items on a national survey. Patient Educ Couns 2021; 104:871-876. [PMID: 32981814 PMCID: PMC7982350 DOI: 10.1016/j.pec.2020.09.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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] [Received: 01/31/2020] [Revised: 09/06/2020] [Accepted: 09/15/2020] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Sexual and gender minority (SGM) individuals experience cancer-related health disparities and reduced quality of cancer care compared to the general population in part due to a lack of knowledgeable providers. This study explored oncologists' experiences and perspectives in providing patient-centered care for SGM individuals with cancer. METHODS We conducted a qualitative analysis of oncologists' responses to four open-ended items on a national survey eliciting their experiences, reservations, and suggestions in treating SGM patients. RESULTS Over 50 % of the 149 respondents of the national survey responded to at least one open-ended item. Many oncologists reported positive experiences reflecting personal growth and affirmative care practices, such as open, non-judgmental communication, compassion, competence, and supporting patients' identity. There was a notable lack of experience with transgender patients in particular. Lack of knowledge, interpersonal communication concerns (e.g., fear of offending patients), and microaggressions ("don't ask, don't tell") were identified as barriers to providing affirming care. CONCLUSIONS Oncologists recognize their knowledge deficits and need strategies to overcome communication barriers and microaggressions among the cancer care team to provide SGM-affirming care. PRACTICE IMPLICATIONS Curricula are needed to train oncologists in SGM healthcare needs and affirming communication skills to facilitate patient-centered care for SGM individuals with cancer.
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Affiliation(s)
- Megan E Sutter
- Departments of Obstetrics and Gynecology and Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA; Morsani School of Medicine, University of South Florida, Tampa, FL, USA
| | - Steven K Sutton
- Morsani School of Medicine, University of South Florida, Tampa, FL, USA; Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Susan T Vadaparampil
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA; Morsani School of Medicine, University of South Florida, Tampa, FL, USA
| | - Julian A Sanchez
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Meghan Bowman-Curci
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Luisa Duarte
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Matthew B Schabath
- Morsani School of Medicine, University of South Florida, Tampa, FL, USA; Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Gwendolyn P Quinn
- Departments of Obstetrics and Gynecology and Population Health, New York University Grossman School of Medicine, New York, NY, USA; Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA.
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27
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Palmer AM, Sutton SK, Correa JB, Simmons VN, Brandon TH. Abstinence-related motivational engagement for smoking cessation: Longitudinal patterns and predictive validity. PLoS One 2021; 16:e0247867. [PMID: 33661996 PMCID: PMC7932153 DOI: 10.1371/journal.pone.0247867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 02/15/2021] [Indexed: 11/18/2022] Open
Abstract
The Abstinence-Related Motivational Engagement (ARME) scale was developed to assess motivation to remain abstinent after a smoking cessation attempt. The ARME demonstrated reliability and validity among a small sample of ex-smokers. This study expands the psychometric evaluation of the ARME and tests the ARME as a predictor of smoking status among a sample of participants quitting smoking. The parent trial tested the efficacy of a self-help smoking cessation intervention (N = 1874), with assessments every 6 months. Internal consistency and factor structure of the ARME was evaluated at each assessment to confirm use of the measure as designed. Discriminant validity was assessed by comparing the ARME to the Situation-specific Abstinence Self-Efficacy (SSE) scale via inter-correlations and prediction of future smoking status. Finally, the trajectories of both the ARME and SSE were compared among continuous abstainers and continuous smokers. A single-factor structure was observed at each assessment. Cronbach's alphas ranged from 0.88-0.91 for the total sample. Correlations between the ARME and the SSE ranged from 0.38-0.47 (ps <0.001) among smokers; and from 0.09-0.15 (most ps > 0.05) among abstainers. Among current smokers, the ARME and SSE were independent positive predictors of subsequent abstinence (AORs 1.28-2.29, ps <0.001). For those currently abstinent, only the SSE predicted subsequent abstinence (AORs 1.69-2.60, ps <0.05). GEE analyses showed different trajectories for the two measures, as well as between abstainers and smokers. In conclusion, the ARME is a reliable, valid measure with unique predictive utility for current smokers and a distinct trajectory among those who have successfully quit.
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Affiliation(s)
- Amanda M. Palmer
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, United States of America
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, United States of America
- Department of Psychology, University of South Florida, Tampa, Florida, United States of America
| | - Steven K. Sutton
- Department of Psychology, University of South Florida, Tampa, Florida, United States of America
- Department of Oncologic Sciences, University of South Florida, Tampa, Florida, United States of America
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida, United States of America
| | - John B. Correa
- Mental Health Service, VA San Diego Healthcare System, San Diego, California, United States of America
- Department of Psychiatry, University of California, San Diego, California, United States of America
| | - Vani N. Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, United States of America
- Department of Psychology, University of South Florida, Tampa, Florida, United States of America
- Department of Oncologic Sciences, University of South Florida, Tampa, Florida, United States of America
| | - Thomas H. Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, United States of America
- Department of Psychology, University of South Florida, Tampa, Florida, United States of America
- Department of Oncologic Sciences, University of South Florida, Tampa, Florida, United States of America
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Meltzer LR, Simmons VN, Piñeiro B, Drobes DJ, Quinn GP, Meade CD, Brandon KO, Palmer A, Unrod M, Harrell PT, Bullen CR, Eissenberg T, Brandon TH. Development of a Self-Help Smoking Cessation Intervention for Dual Users of Tobacco Cigarettes and E-Cigarettes. Int J Environ Res Public Health 2021; 18:2328. [PMID: 33673413 PMCID: PMC7956571 DOI: 10.3390/ijerph18052328] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/23/2021] [Accepted: 02/23/2021] [Indexed: 12/04/2022]
Abstract
Most users of electronic cigarettes (e-cigarettes) report initiating use to quit combustible cigarettes. Nevertheless, high levels of dual use (i.e., using both combustible cigarettes and e-cigarettes) occur among adults. Using formative data from in-depth interviews and employing learner verification, we adapted an existing, validated self-help smoking-cessation intervention (Stop Smoking for Good; SSFG) to create a targeted intervention for dual users, If You Vape: A Guide to Quitting Smoking (IYV). In Phase I, in-depth interviews (n = 28) were conducted to assess relevance of the existing SSFG materials (10 booklets, nine pamphlets) and identify new content for the booklets. Next, for Phase II, learner verification interviews (n = 20 dual users) were conducted to assess their appeal and acceptability. Several key themes emerged from the Phase I in-depth interviews. Findings led to the inclusion of e-cigarette-specific strategies used by successful quitters such as gradually reducing nicotine levels, switching from tobacco flavor to alternative flavors, and limiting e-cigarette use to places one would normally smoke (i.e., not expanding use). Suggestions from Phase II learner verification included broadening the visual appeal for a younger, more diverse demographic, expanding tips for quitting smoking via e-cigarettes, and expanding terminology for e-cigarette devices. Beginning with an efficacious self-help intervention, we used a systematic process to develop a version specifically for dual users.
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Affiliation(s)
- Lauren R. Meltzer
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (L.R.M.); (V.N.S.); (B.P.); (D.J.D.); (C.D.M.); (K.O.B.); (A.P.); (M.U.)
| | - Vani N. Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (L.R.M.); (V.N.S.); (B.P.); (D.J.D.); (C.D.M.); (K.O.B.); (A.P.); (M.U.)
- Department of Psychology, University of South Florida, Tampa, FL 33612, USA
| | - Bárbara Piñeiro
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (L.R.M.); (V.N.S.); (B.P.); (D.J.D.); (C.D.M.); (K.O.B.); (A.P.); (M.U.)
| | - David J. Drobes
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (L.R.M.); (V.N.S.); (B.P.); (D.J.D.); (C.D.M.); (K.O.B.); (A.P.); (M.U.)
- Department of Psychology, University of South Florida, Tampa, FL 33612, USA
| | - Gwendolyn P. Quinn
- Department of Obstetrics and Gynecology and Population Health, School of Medicine, New York University, New York, NY 10016, USA;
| | - Cathy D. Meade
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (L.R.M.); (V.N.S.); (B.P.); (D.J.D.); (C.D.M.); (K.O.B.); (A.P.); (M.U.)
| | - Karen O. Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (L.R.M.); (V.N.S.); (B.P.); (D.J.D.); (C.D.M.); (K.O.B.); (A.P.); (M.U.)
| | - Amanda Palmer
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (L.R.M.); (V.N.S.); (B.P.); (D.J.D.); (C.D.M.); (K.O.B.); (A.P.); (M.U.)
- Department of Psychology, University of South Florida, Tampa, FL 33612, USA
| | - Marina Unrod
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (L.R.M.); (V.N.S.); (B.P.); (D.J.D.); (C.D.M.); (K.O.B.); (A.P.); (M.U.)
| | - Paul T. Harrell
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA 23501, USA;
| | - Christopher R. Bullen
- Department of Population Health, University of Auckland, Auckland 1142, New Zealand;
| | - Thomas Eissenberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23220, USA;
| | - Thomas H. Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (L.R.M.); (V.N.S.); (B.P.); (D.J.D.); (C.D.M.); (K.O.B.); (A.P.); (M.U.)
- Department of Psychology, University of South Florida, Tampa, FL 33612, USA
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29
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Permuth JB, Dezsi KB, Vyas S, Ali KN, Basinski TL, Utuama OA, Denbo JW, Klapman J, Dam A, Carballido E, Kim DW, Pimiento JM, Powers BD, Otto AK, Choi JW, Chen DT, Teer JK, Beato F, Ward A, Cortizas EM, Whisner SY, Williams IE, Riner AN, Tardif K, Velanovich V, Karachristos A, Douglas WG, Legaspi A, Allan BJ, Meredith K, Molina-Vega MA, Bao P, St. Julien J, Huguet KL, Green L, Odedina FT, Kumar NB, Simmons VN, George TJ, Vadaparampil ST, Hodul PJ, Arnoletti JP, Awad ZT, Bose D, Jiang K, Centeno BA, Gwede CK, Malafa M, Judge SM, Judge AR, Jeong D, Bloomston M, Merchant NB, Fleming JB, Trevino JG. The Florida Pancreas Collaborative Next-Generation Biobank: Infrastructure to Reduce Disparities and Improve Survival for a Diverse Cohort of Patients with Pancreatic Cancer. Cancers (Basel) 2021; 13:809. [PMID: 33671939 PMCID: PMC7919015 DOI: 10.3390/cancers13040809] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Well-annotated, high-quality biorepositories provide a valuable platform to support translational research. However, most biorepositories have poor representation of minority groups, limiting the ability to address health disparities. Methods: We describe the establishment of the Florida Pancreas Collaborative (FPC), the first state-wide prospective cohort study and biorepository designed to address the higher burden of pancreatic cancer (PaCa) in African Americans (AA) compared to Non-Hispanic Whites (NHW) and Hispanic/Latinx (H/L). We provide an overview of stakeholders; study eligibility and design; recruitment strategies; standard operating procedures to collect, process, store, and transfer biospecimens, medical images, and data; our cloud-based data management platform; and progress regarding recruitment and biobanking. Results: The FPC consists of multidisciplinary teams from fifteen Florida medical institutions. From March 2019 through August 2020, 350 patients were assessed for eligibility, 323 met inclusion/exclusion criteria, and 305 (94%) enrolled, including 228 NHW, 30 AA, and 47 H/L, with 94%, 100%, and 94% participation rates, respectively. A high percentage of participants have donated blood (87%), pancreatic tumor tissue (41%), computed tomography scans (76%), and questionnaires (62%). Conclusions: This biorepository addresses a critical gap in PaCa research and has potential to advance translational studies intended to minimize disparities and reduce PaCa-related morbidity and mortality.
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Affiliation(s)
- Jennifer B. Permuth
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Kaleena B. Dezsi
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Shraddha Vyas
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Karla N. Ali
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Toni L. Basinski
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Ovie A. Utuama
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Jason W. Denbo
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Jason Klapman
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Aamir Dam
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Estrella Carballido
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Dae Won Kim
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Jose M. Pimiento
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Benjamin D. Powers
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Amy K. Otto
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33612, USA;
| | - Jung W. Choi
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.C.); (D.J.)
| | - Dung-Tsa Chen
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (D.-T.C.); (J.K.T.)
| | - Jamie K. Teer
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (D.-T.C.); (J.K.T.)
| | - Francisca Beato
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Alina Ward
- Lee Health Regional Cancer Center, Fort Myers, FL 33905, USA; (A.W.); (B.J.A.); (M.B.)
| | - Elena M. Cortizas
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA;
| | | | - Iverson E. Williams
- College of Medicine, University of Florida, Gainesville, FL 32610, USA; (I.E.W.); (A.N.R.); (J.G.T.)
| | - Andrea N. Riner
- College of Medicine, University of Florida, Gainesville, FL 32610, USA; (I.E.W.); (A.N.R.); (J.G.T.)
| | - Kenneth Tardif
- Department of Surgery, St. Anthony’s Hospital, St. Petersburg, FL 33705, USA; (K.T.); (J.S.J.); (K.L.H.)
| | - Vic Velanovich
- Tampa General Hospital, University of South Florida, Tampa, FL 33606, USA; (V.V.); (A.K.)
| | - Andreas Karachristos
- Tampa General Hospital, University of South Florida, Tampa, FL 33606, USA; (V.V.); (A.K.)
| | - Wade G. Douglas
- Division of Surgery, Tallahassee Memorial Healthcare, Department of Clinical Sciences, College of Medicine, Florida State University, Tallahassee, FL 32308, USA;
| | - Adrian Legaspi
- Center for Advanced Surgical Oncology at Palmetto General Hospital, Tenet Healthcare Palmetto General, Hialeah, FL 33016, USA;
| | - Bassan J. Allan
- Lee Health Regional Cancer Center, Fort Myers, FL 33905, USA; (A.W.); (B.J.A.); (M.B.)
| | - Kenneth Meredith
- Department of Gastrointestinal Oncology, Brian Jellison Cancer Institute, Sarasota Memorial Hospital, Sarasota, FL 34239, USA;
| | | | - Philip Bao
- Department of Surgical Oncology, Mount Sinai Medical Center, Miami Beach, FL 33140, USA;
| | - Jamii St. Julien
- Department of Surgery, St. Anthony’s Hospital, St. Petersburg, FL 33705, USA; (K.T.); (J.S.J.); (K.L.H.)
| | - Kevin L. Huguet
- Department of Surgery, St. Anthony’s Hospital, St. Petersburg, FL 33705, USA; (K.T.); (J.S.J.); (K.L.H.)
| | - Lee Green
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (L.G.); (V.N.S.); (S.T.V.); (C.K.G.)
| | - Folakemi T. Odedina
- Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, FL 32610, USA;
| | - Nagi B. Kumar
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Vani N. Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (L.G.); (V.N.S.); (S.T.V.); (C.K.G.)
| | - Thomas J. George
- Division of Oncology, Department of Medicine, University of Florida, Gainesville, FL 32610, USA;
| | - Susan T. Vadaparampil
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (L.G.); (V.N.S.); (S.T.V.); (C.K.G.)
- Office of Community Outreach, Engagement, and Equity, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Pamela J. Hodul
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - J. Pablo Arnoletti
- Center for Surgical Oncology, Advent Health Orlando, Orlando, FL 32804, USA;
| | - Ziad T. Awad
- Surgery, University of Florida-Jacksonville, Jacksonville, FL 32209, USA;
| | - Debashish Bose
- Surgical Oncology, University of Florida-Orlando, Orlando, FL 32806, USA;
| | - Kun Jiang
- Department of Pathology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.J.); (B.A.C.)
| | - Barbara A. Centeno
- Department of Pathology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.J.); (B.A.C.)
| | - Clement K. Gwede
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (L.G.); (V.N.S.); (S.T.V.); (C.K.G.)
| | - Mokenge Malafa
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Sarah M. Judge
- Department of Physical Therapy, University of Florida, Gainesville, FL 32610, USA; (S.M.J.); (A.R.J.)
| | - Andrew R. Judge
- Department of Physical Therapy, University of Florida, Gainesville, FL 32610, USA; (S.M.J.); (A.R.J.)
| | - Daniel Jeong
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.C.); (D.J.)
| | - Mark Bloomston
- Lee Health Regional Cancer Center, Fort Myers, FL 33905, USA; (A.W.); (B.J.A.); (M.B.)
| | - Nipun B. Merchant
- Department of Surgical Oncology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA;
| | - Jason B. Fleming
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Jose G. Trevino
- College of Medicine, University of Florida, Gainesville, FL 32610, USA; (I.E.W.); (A.N.R.); (J.G.T.)
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Virginia Commonwealth University, Richmond, VA 23219, USA
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Brandon TH, Simmons VN, Martínez Ú, Calixte-Civil P. Tobacco Use and Cessation. Psychooncology 2021. [DOI: 10.1093/med/9780190097653.003.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Tobacco use, particularly cigarette smoking, continues to be the leading preventable cause of cancer. Moreover, smoking by cancer patients is detrimental to their treatment outcomes and prognosis. Therefore, tobacco control remains a key element of comprehensive cancer prevention and control. The tobacco landscape continues to evolve, with demographic shifts in tobacco use exacerbating existing health disparities, while the emergence of electronic cigarettes presents both opportunities and challenges. This chapter summarizes these ongoing changes and then provides an overview of both pharmacological and behavioral smoking cessation strategies. With respect to cancer patients, as the benefits of smoking cessation have been identified, there have been accumulating recommendations and guidelines for the systematic assessment and treatment of tobacco use.
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Chavarria EA, Christy SM, Simmons VN, Vadaparampil ST, Gwede CK, Meade CD. Learner Verification: A Methodology to Create Suitable Education Materials. Health Lit Res Pract 2021; 5:e49-e59. [PMID: 34251862 PMCID: PMC8075101 DOI: 10.3928/24748307-20210201-02] [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] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Learner verification and revision (LV&R) is a research methodological approach to inform educational message design with the aim of producing suitable, actionable, and literacy appropriate messages to aid in awareness, adoption of healthy behaviors, and decision-making. It consists of a series of participatory steps that engage users throughout materials development, revision, and refinement. This approach is congruent with Healthy People 2030 communication objectives to improve access to information among diverse, multicultural, multilingual populations, and enhance health care quality toward health equity. Brief description of activity: To illustrate LV&R, we describe its use in three cancer education projects that produced targeted information about (1) inherited breast cancer among African Americans (brochure); (2) colorectal cancer screening among Latinos (photo novella and DVD); and (3) smoking-relapse prevention among patients receiving cancer treatment (video). We discuss rationale for its application in the three exemplars and extrapolate lessons learned from our experiences when using this approach. Implementation: A qualitative approach entailing individual or group-based discussions helped to examine the elements of learner verification (i.e., attraction, comprehension, self-efficacy, cultural acceptability, persuasion). The following steps are reported: (1) preparation of materials, interview guide, and recruitment; (2) interviewing of participants; and (3) evaluation of responses. Data were analyzed by use of a coding system that placed participant responses from each of the elements into data summary matrices. Findings informed revisions and refinement of materials. Results: LV&R was effectively applied across the three cancer education projects to enhance the suitability of the materials. As a result, the materials were improved by using clearer, more salient language to enhance comprehension and cultural acceptability, by integrating design elements such as prompts, headers, and stylistic edits to reduce text density, incorporating preferred colors and graphics to improve aesthetic appeal, and including actionable terms and words to bolster motivation and self-efficacy. Lessons learned: Results suggest that LV&R methodology can improve suitability of education materials through systematic, iterative steps that engage diverse, multicultural, multilingual populations. This approach is a critical participa-tory strategy toward health equity, and is appropriate in a variety of education, research, and clinical practice settings to improve health communications. [HLRP: Health Literacy Research and Practice. 2021;5(1):e49–e59.] Plain Language Summary: This article describes the use of a systematic approach called “learner verification” used for developing educational materials. This approach involves obtaining feedback from audience members to ensure that the information is understandable, attractive in design, motivating, and culturally relevant.
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Affiliation(s)
| | | | | | | | | | - Cathy D. Meade
- Address correspondence to Cathy D. Meade, PhD, RN, FAAN, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, MFC-EDU, Tampa, FL 33612;
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Rodríguez-Rabassa MS, Simmons VN, Vega A, Moreno D, Irizarry-Ramos J, Quinn GP. Perceptions of and Barriers to Lung Cancer Screening Among Physicians in Puerto Rico: A Qualitative Study. J Health Care Poor Underserved 2021; 31:973-991. [PMID: 33410819 DOI: 10.1353/hpu.2020.0072] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Low-dose computed tomography (LDCT), an accepted U.S. screening tool for early lung cancer detection, is not widely-used in Puerto Rico. We investigated knowledge and attitudes about LDCT in focus groups of primary care physicians (PCP) and individuals at high risk for lung cancer (HRI) in Puerto Rico. Transcribed/translated audio-recorded discussions were analyzed with the constant comparison method. Both groups had limited knowledge about LDCT and concerns regarding insurance coverage. Most HRIs had never had a provider recommend LDCT and believed that having symptoms was necessary to obtain LDCT screening. Perceived barriers included fears about results and the procedure; a perceived benefit was having early detection and possibly being cured. Few PCPs had ever recommended LDCT to a patient, with those who had basing their decision on symptoms/smoking history but having challenges with insurance. More education on LDCT is needed among HRIs, and U.S. Preventive Services Task Force guidelines should be widely distributed to encourage physician recommendations.
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Maller B, Simmons VN, Byrne MM, Tanvetyanon T. Characteristics and Outcomes of Lung Cancer Screening Among Individuals With or Without Cancer History. Clin Lung Cancer 2020; 22:e629-e636. [PMID: 33441268 DOI: 10.1016/j.cllc.2020.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/29/2020] [Accepted: 12/10/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lung cancer screening with low-dose computed tomography (LDCT) can reduce mortality from lung cancer. Individuals with previous malignancy are at an increased risk of lung cancer but are often underrepresented in clinical trials. This study compares the outcomes of LDCT screening among individuals with and without cancer history. MATERIALS AND METHODS The study cohort included consecutive participants undergoing LDCT screening at a tertiary care cancer institution. Abnormal screening result was defined as having Lung-RADS 3 or 4 at baseline (T0). Participant information was prospectively collected and predicted risk of lung cancer was calculated per the PLCOm2012 model. RESULTS A total of 454 participants underwent LDCT screening. Abnormal screening result occurred in 57 (13.2%) participants at T0, and lung cancer was diagnosed in 11 (2.4%) participants. Among 153 individuals with cancer history, abnormal result occurred in 9.8%, compared with 15.4% among those without cancer history (P = .11). Lung cancer was diagnosed in 1.3%, compared with 3.5% (P = .22). The predicted risk of lung cancer at 6 years was higher among individuals with cancer history than those without: 4.8% versus 2.2% (P < .001). In a multivariable analysis, cancer history significantly reduced the likelihood of abnormal screening (odds ratio, 0.49; 95% confidence interval, 0.26-0.94; P = .03). We observed a higher proportion of participants who had a previous CT scan available for comparison at T0 among individuals with cancer history than those without: 43.1% versus 9.1% (P < .001). CONCLUSIONS In this single-institutional study, individuals with cancer history were significantly less likely to have abnormal screening results than those without cancer history.
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Affiliation(s)
- Bradley Maller
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Vani N Simmons
- Tobacco Research and Intervention Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Margaret M Byrne
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Tawee Tanvetyanon
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.
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Conn MR, Brandon TH, Lorenzo YL, Sawyer LE, Simmons VN, Sutton SK, Donny EC, Hatsukami D, Drobes DJ. Facilitating smoking cessation using reduced nicotine cigarettes: Intervention development and RCT study design. Contemp Clin Trials 2020; 98:106172. [PMID: 33038504 DOI: 10.1016/j.cct.2020.106172] [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] [Received: 06/18/2020] [Revised: 08/25/2020] [Accepted: 09/07/2020] [Indexed: 11/27/2022]
Abstract
Smoking cigarettes with substantially lower nicotine than conventional cigarettes prior to a quit attempt may reduce the reinforcing effects of smoking, which could facilitate smoking cessation through extinction learning. This paper describes the development of a smoking cessation intervention designed to optimize extinction processes using reduced nicotine cigarettes, as well as the design and methods for an ongoing randomized controlled trial (RCT) to evaluate this intervention. Qualitative methods and pilot testing were conducted to develop the novel facilitated extinction (FE) intervention, with a key focus on maximizing opportunities for extinction learning during a five-week pre-quit period. The primary aims of the RCT are to test the effects of the FE intervention versus a standard (cognitive-behavioral) intervention, while also comparing two nicotine reduction schedules for providing very low nicotine content (VLNC) cigarettes. The efficacy of the intervention is currently being evaluated with treatment-seeking smokers (n = 208) randomly assigned to one of four conditions crossing FE versus standard intervention with immediate versus gradual transition to VLNC cigarettes.
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Affiliation(s)
- Melissa R Conn
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States of America
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States of America; Department of Psychology, University of South Florida, Tampa, FL, United States of America
| | - Yenis L Lorenzo
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States of America
| | - Leslie E Sawyer
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States of America; Department of Psychology, University of South Florida, Tampa, FL, United States of America
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States of America; Department of Psychology, University of South Florida, Tampa, FL, United States of America
| | - Steven K Sutton
- Department of Psychology, University of South Florida, Tampa, FL, United States of America; Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States of America
| | - Eric C Donny
- Wake Forest School of Medicine, Wake Forest University, Winston-Salem, NC, United States of America
| | - Dorothy Hatsukami
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States of America
| | - David J Drobes
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States of America; Department of Psychology, University of South Florida, Tampa, FL, United States of America.
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Simmons VN, Sutton SK, Meltzer LR, Martinez U, Palmer AM, Meade CD, Jacobsen PB, McCaffrey JC, Haura EB, Brandon TH. Preventing smoking relapse in patients with cancer: A randomized controlled trial. Cancer 2020; 126:5165-5172. [PMID: 32902856 DOI: 10.1002/cncr.33162] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND Abstaining from smoking after a cancer diagnosis is critical to mitigating the risk of multiple adverse health outcomes. Although many patients with cancer attempt to quit smoking, the majority relapse. The current randomized controlled trial evaluated the efficacy of adapting an evidence-based smoking relapse prevention (SRP) intervention for patients with cancer. METHODS The trial enrolled 412 patients newly diagnosed with cancer who had recently quit smoking. Participants were randomized to usual care (UC) or SRP. Participants in the UC group received the institution's standard of care for treating tobacco use. Participants in the SRP group in addition received a targeted educational DVD plus a validated self-help intervention for preventing smoking relapse. The primary outcome was smoking abstinence at 2 months, 6 months, and 12 months. RESULTS Abstinence rates for participants in the SRP and UC groups were 75% versus 71% at 2 months and 69% versus 64% at 6 months (Ps > .20). At 12 months, abstinence rates among survivors were 68% for those in the SRP group and 63% for those in the UC group (P = .38). Post hoc analyses revealed that across 2 months and 6 months, patients who were married/partnered were more likely to be abstinent after SRP than UC (P = .03). CONCLUSIONS A smoking relapse prevention intervention did not reduce relapse rates overall, but did appear to have benefited those participants who had the social support of a partner. Future work is needed to extend this effect to the larger population of patients.
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Affiliation(s)
- Vani N Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida.,Department of Thoracic Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Steven K Sutton
- Department of Oncologic Sciences, University of South Florida, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida.,Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Lauren R Meltzer
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Ursula Martinez
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida
| | - Amanda M Palmer
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida
| | - Cathy D Meade
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida.,Department of Nursing, University of South Florida, Tampa, Florida
| | - Paul B Jacobsen
- Healthcare Delivery Research Program, National Cancer Institute, Bethesda, Maryland
| | - Judith C McCaffrey
- Department of Otolaryngology, University of South Florida, Tampa, Florida.,Department of Otolaryngology-Head and Neck Surgery, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Eric B Haura
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida.,Department of Thoracic Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida
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Medina-Ramirez P, Calixte-Civil P, Meltzer LR, Brandon KO, Martinez U, Sutton SK, Meade CD, Byrne MM, Brandon TH, Simmons VN. Comparing Methods of Recruiting Spanish-Preferring Smokers in the United States: Findings from a Randomized Controlled Trial. J Med Internet Res 2020; 22:e19389. [PMID: 32795986 PMCID: PMC7455877 DOI: 10.2196/19389] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 04/17/2020] [Revised: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 12/14/2022] Open
Abstract
Background There is a pressing need to address the unacceptable disparities and underrepresentation of racial and ethnic minority groups, including Hispanics or Latinxs, in smoking cessation trials. Objective Given the lack of research on recruitment strategies for this population, this study aims to assess effective recruitment methods based on enrollment and cost. Methods Recruitment and enrollment data were collected from a nationwide randomized controlled trial (RCT) of a Spanish-language smoking cessation intervention (N=1417). The effectiveness of each recruitment strategy was evaluated by computing the cost per participant (CPP), which is the ratio of direct cost over the number enrolled. More effective strategies yielded lower CPPs. Demographic and smoking-related characteristics of participants recruited via the two most effective strategies were also compared (n=1307). Results Facebook was the most effective method (CPP=US $74.12), followed by TV advertisements (CPP=US $191.31), whereas public bus interior card advertising was the least effective method (CPP=US $642.50). Participants recruited via Facebook had lower average age (P=.008) and had spent fewer years in the United States (P<.001). Among the participants recruited via Facebook, a greater percentage of individuals had at least a high school education (P<.001) and an annual income above US $10,000 (P<.001). In addition, a greater percentage of individuals were employed (P<.001) and foreign born (P=.003). In terms of subethnicity, among the subjects recruited via Facebook, a lower percentage of individuals were of Mexican origin (P<.001) and a greater percentage of individuals were of Central American (P=.02), South American (P=.01), and Cuban (P<.001) origin. Conclusions Facebook was the most effective method for recruiting Hispanic or Latinx smokers in the United States for this RCT. However, using multiple methods was necessary to recruit a more diverse sample of Spanish-preferring Hispanic or Latinx smokers.
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Affiliation(s)
- Patricia Medina-Ramirez
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Patricia Calixte-Civil
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States.,Department of Psychology, University of South Florida, Tampa, FL, United States
| | - Lauren R Meltzer
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Karen O Brandon
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Ursula Martinez
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Steven K Sutton
- Department of Psychology, University of South Florida, Tampa, FL, United States.,Biostatistics and Bioinformatics Department, Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Cathy D Meade
- Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States.,College of Nursing, University of South Florida, Tampa, FL, United States
| | - Margaret M Byrne
- Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States.,Department of Oncologic Sciences, University of South Florida, Tampa, FL, United States
| | - Thomas H Brandon
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States.,Department of Psychology, University of South Florida, Tampa, FL, United States
| | - Vani N Simmons
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States.,Department of Psychology, University of South Florida, Tampa, FL, United States
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Webb Hooper M, Calixte-Civil P, Verzijl C, Brandon KO, Asfar T, Koru-Sengul T, Antoni MH, Lee DJ, Simmons VN, Brandon TH. Associations between Perceived Racial Discrimination and Tobacco Cessation among Diverse Treatment Seekers. Ethn Dis 2020; 30:411-420. [PMID: 32742143 PMCID: PMC7360180 DOI: 10.18865/ed.30.3.411] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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] [Indexed: 01/05/2023] Open
Abstract
Objectives This study investigated a) racial/ethnic differences in past-year discrimination experiences and b) associations between discrimination and smoking abstinence. Design Prospective, longitudinal analysis of smoking status. Perceived past-year discrimination was assessed at baseline. ANCOVAs and intent-to-treat hierarchical logistic regressions were conducted. Setting Dual-site (Tampa, FL and Miami, FL) randomized controlled trial testing the effects of a group cessation intervention plus pharmacotherapy. Participants Treatment-seeking adult smokers (N=347; non-Hispanic White, non-Hispanic African American/Black, or Hispanic). Main Outcome Measures Biochemically verified 7-day point prevalence abstinence (7-day ppa) was assessed immediately post-intervention and at 6-month follow-up. Results After controlling for covariates, African Americans/Blacks reported greater perceived discrimination compared with non-Hispanic Whites (P=.02), and Hispanics (P=.06). Non-Hispanic Whites and Hispanics did not differ in perceived racial/ethnic discrimination experiences over the past year. Irrespective of race/ethnicity, past-year perceived discrimination was inversely associated with 7-day ppa, both post-intervention (AOR=.97, CI: .95-.99) and at 6-months (AOR=.98, CI: .96-.99). Among African Americans/Blacks, past-year perceived discrimination was inversely associated with 7-day ppa, both post-intervention (AOR=.95, CI: .92-.97) and at 6-months (AOR=.97, CI: .94-.99). Perceived discrimination was unrelated to 7-day ppa among Hispanics. Among non-Hispanic Whites, past-year perceived discrimination was inversely associated with post-intervention 7-day ppa (AOR=.95, CI: .91-.99), but not 6-months. Conclusions Perceived racial/ethnic discrimination was greater among African American/Black smokers compared with non-Hispanic Whites. Perceived discrimination was negatively associated with tobacco cessation in the full sample, and for African Americans at 6-months post-intervention. These data have implications for intervention delivery and health disparities.
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Affiliation(s)
- Monica Webb Hooper
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD (former affiliation when study was conducted: Case Western Reserve University School of Medicine, Case Comprehensive Cancer Center, Cleveland, OH)
| | | | | | | | - Taghrid Asfar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | | | - David J. Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Vani N. Simmons
- Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
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Martínez Ú, Martínez-Loredo V, Simmons VN, Meltzer LR, Drobes DJ, Brandon KO, Palmer AM, Eissenberg T, Bullen CR, Harrell PT, Brandon TH. How Does Smoking and Nicotine Dependence Change After Onset of Vaping? A Retrospective Analysis of Dual Users. Nicotine Tob Res 2020; 22:764-770. [PMID: 30883640 PMCID: PMC7171272 DOI: 10.1093/ntr/ntz043] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 03/14/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Although some smokers switch to exclusive use of electronic cigarettes (e-cigarettes), others become dual users of combustible cigarettes and e-cigarettes. Little is known about how the onset of vaping affects the use of and dependence on combustible cigarettes or total nicotine use and dependence, which may influence health-related and cessation outcomes. Using self-report data of current combustible and e-cigarette use and retrospective recall of pre-vaping smoking in a sample of dual users, the aims of this study were (1) to compare pre- and post-vaping number of cigarettes per day and combustible cigarette dependence; (2) to compare pre- and post-vaping total nicotine use frequency (number of vaping sessions and cigarettes smoked per day), and total nicotine dependence; and (3) to examine predictors of nicotine dependence. METHODS We used baseline data from a smoking cessation trial with 2896 dual users. Nicotine use frequency and the Heaviness of Smoking Index were used as measures of nicotine use and dependence, respectively. RESULTS Participants decreased cigarettes/day from pre- (M = 19.24, SD = 9.01) to post-vaping (M = 11.15, SD = 8.02, p < .0001) and combustible cigarette dependence declined from pre- (M = 3.55, SD = 1.51) to post-vaping (M = 2.11, SD = 1.60, p < .0001). Total daily nicotine use frequency increased after initiating vaping (M = 19.25, SD = 9.01 vs. M = 29.46, SD = 8.61; p < .0001), as did total nicotine dependence (M = 3.55, SD = 1.51 vs. M = 4.68, SD = 1.38; p < .0001). Hierarchical regression analyses indicated that variables associated with greater overall nicotine dependence included: younger age, lower education, more years smoking, higher pre-vaping nicotine dependence, using e-cigarettes more days per month, more puffs per vaping session, higher e-liquid nicotine concentration, and longer vaping history. CONCLUSIONS Dual use leads to a reduction in the number of combustible cigarettes, but total nicotine use and dependence increases. IMPLICATIONS In dual users, a reduction in smoking following onset of vaping may offer some harm reduction via reduction in cigarette intake. However, the increase in total nicotine use and dependence could affect the ability to quit either or both products.
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Affiliation(s)
- Úrsula Martínez
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL
| | - Víctor Martínez-Loredo
- Clinical Unit of Addictive Behaviors, Department of Psychology, University of Oviedo, Spain
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL
- Department of Psychology, University of South Florida, Tampa, FL
- Department of Oncologic Sciences, University of South Florida, Tampa, FL
| | - Lauren R Meltzer
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL
| | - David J Drobes
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL
- Department of Psychology, University of South Florida, Tampa, FL
- Department of Oncologic Sciences, University of South Florida, Tampa, FL
| | - Karen O Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL
| | - Amanda M Palmer
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL
- Department of Psychology, University of South Florida, Tampa, FL
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Christopher R Bullen
- School of Population Health, Faculty of Medical and Health Science, University of Auckland, New Zealand
| | - Paul T Harrell
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL
- Department of Psychology, University of South Florida, Tampa, FL
- Department of Oncologic Sciences, University of South Florida, Tampa, FL
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Vinci C, Malkhasyan L, Simmons VN, Correa-Fernandez V. The relationship of mindfulness and mindfulness-related practices with alcohol use among Hispanics/Latinx. Psychiatry Res 2020; 285:112774. [PMID: 32035378 DOI: 10.1016/j.psychres.2020.112774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/03/2019] [Accepted: 01/05/2020] [Indexed: 10/25/2022]
Abstract
Hispanics/Latinx (H/Ls) are the largest ethnic minority group in the U.S., and three of the four leading causes of death are associated with problematic alcohol use. This study examined the relationship between mindfulness and alcohol use among H/Ls and whether differences emerged by sub-ethnicity. Participants (N = 341; 49.7% female; average age=28.57) were H/Ls currently living in the U.S. Survey questions were answered online in English or Spanish. Participants primarily endorsed engaging in informal mindfulness practices (47.5%), spiritual practices (25.2%), and mindfulness meditation (24.6%). No significant differences emerged among H/L sub-ethnicities. Spiritual practices and higher mindfulness were associated with less problematic alcohol use among the entire sample. Similar results were found among drinkers-only. Findings shed light on commonly used mindfulness practices and indicate that very few differences emerge among H/L sub-ethnicities on mindfulness practices and general mindfulness. The delivery/tailoring of mindfulness-based interventions (MBIs) may not need to differ amongst H/L sub-ethnicities in the U.S. Aspects of mindfulness appear protective regarding problematic alcohol use, suggesting that future MBIs that increase mindfulness should be explored for this population.
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Affiliation(s)
- Christine Vinci
- Moffitt Cancer Center, Health Outcomes and Behavior, 4115 E Fowler Ave., Tampa, FL 33617, United States; University of South Florida, Departments of Psychology and Interdisciplinary Oncology, United States.
| | - Lauren Malkhasyan
- Moffitt Cancer Center, Health Outcomes and Behavior, 4115 E Fowler Ave., Tampa, FL 33617, United States
| | - Vani N Simmons
- Moffitt Cancer Center, Health Outcomes and Behavior, 4115 E Fowler Ave., Tampa, FL 33617, United States
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Muñoz-Antonia T, Simmons VN, Sutton SK, Schabath MB, Alam I, Chiappori A, Quinn GP. Use of biomarker testing in lung cancer among Puerto Rico and Florida Physicians: Results of a comparative study. J Clin Pathw 2019; 5:33-40. [PMID: 31930172 PMCID: PMC6953751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Lung cancer biomarker-driven therapies are the gold standard of treatment and recent studies suggest a higher prevalence of specific targetable biomarkers among Hispanic/Latinos (H/L) than Non-Hispanic Whites (NHW). The study aimed (1) to identify Florida (FL) and Puerto Rico (PR) physicians' knowledge and perceived value of newer genomic data regarding race/ethnicity in relation to optimal lung cancer treatment and survival; and (2) to identify modifiable practice barriers both across and within each location regarding biomarker testing in lung cancer. METHODS A 25-item survey was administered to a stratified random sample of physicians in FL and PR (medical oncologists, radiation oncologists, pulmonologists, and pathologists). Questions targeted domains of biomarker knowledge, attitudes toward testing, barriers, and practice behaviors regarding lung cancer biomarker testing. RESULTS The response rate was 45%. Participants identified guiding treatment decisions (82%) and personalizing treatments for patients (78%) as key benefits to mutation testing. PR physicians were more likely (p=0.022) to believe H/L had an elevated incidence of targetable epidermal growth factor receptor (EGFR) mutations compared to NHW. They also perceived lack of appropriate testing resources as a primary barrier compared to FL physicians (43.6% vs. 20.6%, p<0.001), whereas FL physicians identified mutation tests not conducted routinely as part of patient diagnosis as a primary barrier (43.1% vs 24.2%, p= 0.008). CONCLUSIONS Practice behaviors differed by specialty and between locations, and differences were noted concerning physician's preferences for ordering mutation testing, indicating a clear need for education among physicians in both locations. IMPACT Educating physicians regarding biomarker testing is imperative to improve patient care.
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Affiliation(s)
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
- Thoracic Oncology Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Steven K Sutton
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Matthew B Schabath
- Thoracic Oncology Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Iffat Alam
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Alberto Chiappori
- Thoracic Oncology Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Gwendolyn P Quinn
- Departments of OB-GYN, Population Health and Center for Medical Ethics, New York University School of Medicine, New York, NY
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Brandon TH, Unrod M, Drobes DJ, Sutton SK, Hawk LW, Simmons VN, Brandon KO, Roetzheim RG, Meltzer LR, Miller RR, Cahill SP. Facilitated Extinction Training to Improve Pharmacotherapy for Smoking Cessation: A Pilot Feasibility Trial. Nicotine Tob Res 2019; 20:1189-1197. [PMID: 29059409 DOI: 10.1093/ntr/ntx203] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 09/11/2017] [Indexed: 11/13/2022]
Abstract
Introduction Varenicline reduces smoking satisfaction during the pre-cessation run-in period, which may contribute to extinction of cravings and smoking behavior. Research indicates that efficacy is enhanced when the run-in period is increased from 1 to 4 weeks, providing a longer extinction opportunity. We hypothesized that efficacy could be further enhanced by harnessing basic and applied research on extinction. We developed a pre-cessation extinction-facilitating intervention and tested its feasibility in a pilot trial. Methods The facilitated extinction (FE) intervention comprised brief counseling and workbook-recommending strategies to maximize extinction processes during the run-in, including instructions to smoke at a normal rate across contexts and cues, and use of an extinction cue to enhance generalization. Participants were randomly assigned to one of three varenicline interventions: standard (1-week run-in), extended (4-week run-in), and extended + FE. Interventions were delivered prior to the target quit date (TQD). Assessments were conducted in weeks 1 and 4 pre-TQD and 1 and 3 months post-TQD, with focus on feasibility indices. Results Recruitment and retention goals were met (N = 58). Treatment satisfaction was high across groups. The majority of FE participants adhered to instructions and maintained their usual smoking rate during the run-in period. Greater decreases in craving and smoking satisfaction were observed among participants in both extended groups versus the standard group (p < .005). Conclusions Feasibility was demonstrated. Participants adhered to the FE intervention, thereby optimizing the number and variety of extinction trials. Findings support testing the novel FE smoking cessation intervention in a fully powered trial. Implications This study expands the research on the clinical benefits of extending the pre-cessation run-in period of varenicline. It introduces the hypothesis that further benefit might be achieved by translating basic behavioral research, as well as cue-exposure research and therapy for other disorders, to improve the extinction and generalization processes thought to underlie much of varenicline's effect. A FE intervention was developed and found acceptable to smokers and feasible to implement in a research setting. The study sets the stage for a subsequent randomized controlled trial.
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Affiliation(s)
- Thomas H Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.,Department of Psychology, University of South Florida, Tampa, FL
| | - Marina Unrod
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.,Department of Psychology, University of South Florida, Tampa, FL
| | - David J Drobes
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.,Department of Psychology, University of South Florida, Tampa, FL
| | - Steven K Sutton
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.,Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL
| | - Larry W Hawk
- Department of Psychology, State University of New York at Buffalo, Buffalo, NY
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.,Department of Psychology, University of South Florida, Tampa, FL
| | - Karen O Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Richard G Roetzheim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.,Department of Psychology, University of South Florida, Tampa, FL
| | - Lauren R Meltzer
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Ralph R Miller
- Department of Psychology, State University of New York at Binghamton, Binghamton, NY
| | - Shawn P Cahill
- Department of Psychology, University of Wisconsin, Milwaukee, WI
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Medina-Ramírez P, Sutton SK, Martínez Ú, Meade CD, Byrne MM, Brandon KO, Meltzer LR, Gonzales FM, Brandon TH, Simmons VN. A randomized controlled trial of a smoking cessation self-help intervention for Spanish-speaking Hispanic/Latinx smokers: Study design and baseline characteristics. Contemp Clin Trials 2019; 85:105836. [PMID: 31473331 DOI: 10.1016/j.cct.2019.105836] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/21/2019] [Accepted: 08/27/2019] [Indexed: 11/24/2022]
Abstract
Although the current smoking prevalence among Hispanics/Latinxs (10%) is lower than in non-Hispanic whites (15%), higher prevalence is observed among certain subgroups (e.g., Puerto Rican males, 19%). Hispanic/Latinx smokers face unique challenges such as lower awareness and acceptability of nicotine replacement aids, lower prevalence of using counseling or medication, and receiving less advice to quit by their health care providers. Despite these barriers to smoking cessation, few interventions specifically targeted to Hispanic/Latinx smokers have been developed and evaluated. This paper summarizes the design, methods, analysis plan, and sample baseline characteristics of an ongoing randomized controlled trial to assess the efficacy of a Spanish-language self-help smoking cessation intervention among Hispanics/Latinxs. Current smokers who prefer health education materials in Spanish were randomized to one of two conditions. The usual care group received a standard smoking cessation booklet developed by the National Cancer Institute. The intervention group received 10 booklets, 9 pamphlets and a booklet for family and friends mailed monthly over 18 months. All participants complete self-report surveys every 6 months over 2 years. Smoking abstinence is biochemically verified at 12- and 24-month follow-up. A total of 2387 smokers were screened, 2056 were eligible and 1417 were enrolled in the study. The primary outcome is self-reported 7-day point prevalence abstinence. If the intervention is deemed efficacious, it has potential to have a large public health impact with respect to reducing smoking rates and smoking related morbidity and mortality among a large underserved minority population.
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Affiliation(s)
| | - Steven K Sutton
- H. Lee Moffitt Cancer Center, Tampa, FL, USA; University of South Florida, USA
| | | | - Cathy D Meade
- H. Lee Moffitt Cancer Center, Tampa, FL, USA; University of South Florida, USA
| | - Margaret M Byrne
- H. Lee Moffitt Cancer Center, Tampa, FL, USA; University of South Florida, USA
| | | | | | | | - Thomas H Brandon
- H. Lee Moffitt Cancer Center, Tampa, FL, USA; University of South Florida, USA
| | - Vani N Simmons
- H. Lee Moffitt Cancer Center, Tampa, FL, USA; University of South Florida, USA.
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Harrell PT, Brandon TH, England KJ, Barnett TE, Brockenberry LO, Simmons VN, Quinn GP. Vaping Expectancies: A Qualitative Study among Young Adult Nonusers, Smokers, Vapers, and Dual Users. Subst Abuse 2019; 13:1178221819866210. [PMID: 31456638 PMCID: PMC6702779 DOI: 10.1177/1178221819866210] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 03/04/2019] [Accepted: 07/05/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND "Expectancies," or beliefs about outcomes, robustly correlate with and predict several behaviors including electronic nicotine delivery system ("e-cigarette") use. However, there is limited qualitative research available regarding relevant e-cigarette vaping expectancies. OBJECTIVES The present study used a qualitative approach to derive and refine e-cigarette expectancy themes among young adults. METHODS We conducted 12 focus groups and two individual interviews with young adult nonusers, e-cigarette vapers, cigarette smokers, and dual users to assess beliefs about the effects of e-cigarettes. After a series of open-ended questions, follow-up questions assessed reactions to domains previously examined in expectancy measures for cigarette smoking and e-cigarette vaping. The constant comparative method was used to derive themes from transcripts. RESULTS Four main themes (Positive Reinforcement, Social Benefits, Negative Affect Reduction, Negative Consequences) emerged from the results. Each theme contained three associated subthemes (Positive Reinforcement: Sensorimotor Experiences, Taste, Stimulation; Social Benefits: Social Facilitation, Influence on Others, Convenience; Negative Affect Reduction: Stress Reduction, Appetite Reduction, Boredom Reduction; and Negative Consequences: Health Risks, Addiction, Secondhand Effects). CONCLUSIONS/IMPORTANCE Previously identified smoking expectancies appear relevant for young adult vaping, with some notable refinements. Positive reinforcement aspects encompassed aerosol clouds, vaping tricks, and unique flavors. Social benefits included influencing others via social media and competitive activity, as well as the convenience of use in a variety of places. Negative affect reduction was controversial among user groups, but vaping was seen as more interesting than smoking and thus more effective at boredom reduction. Young adults were uncertain regarding negative consequences, but appreciated a potential for secondhand effects. Measure refinement via qualitative research and future field testing can enhance our understanding of this relatively new behavior, supporting tobacco control surveillance, marketing/labeling regulations, and counter-advertising development/evaluation.
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Affiliation(s)
- Paul T Harrell
- Division of Community Health & Research, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA
- Department of Psychiatry & Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Kelli J England
- Division of Community Health & Research, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA
- Department of Psychiatry & Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Tracey E Barnett
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Laurel O Brockenberry
- Division of Community Health & Research, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA
- Department of Psychiatry & Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Gwendolyn P Quinn
- Department of Population Health, New York University, New York, NY, USA
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Martínez Ú, Brandon KO, Sutton SK, Brandon TH, Simmons VN. Does smoking abstinence predict cancer patients' quality of life over time? Psychooncology 2019; 28:1702-1711. [PMID: 31212391 DOI: 10.1002/pon.5145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/30/2019] [Accepted: 06/06/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Smoking cessation improves quality of life (QOL) in the general population. However, there is limited information on the role of smoking status on QOL among cancer patients. Moreover, previous studies tended to analyze smoking status dichotomously and at a single point in time, potentially reducing the strength of the relation between smoking cessation and QOL. This study examined the association of smoking abstinence and QOL over time, including depression, pain, and fatigue in patients with a wide variety of cancers. METHODS Participants were 332 cancer patients (eg, gynecologic, breast, thoracic, head and neck, and genitourinary) who had been abstinent for at least 24 hours. Days abstinent and QOL were assessed at baseline and 2, 6, and 12 months later. Latent growth curve models examined if days abstinent was associated with QOL at each assessment. Baseline demographics (eg, sex and income) and smoking history variables (eg, nicotine dependence) were used as time-invariant covariates. RESULTS The final model for each QOL component had good-to-excellent fit. More days abstinent was associated with lower depression at all follow-ups and with lower fatigue at 12 months but was not associated with pain. CONCLUSIONS QOL was better among patients who quit smoking for longer periods. Findings suggest different timelines, with smoking abstinence most immediately associated with lower depression, followed by lower fatigue. Although pain decreased over time, it was not associated with length of smoking abstinence. Results reinforce the relationship between sustained smoking cessation and QOL, which should be communicated to patients.
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Affiliation(s)
- Úrsula Martínez
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Karen O Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Steven K Sutton
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida
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Martínez Ú, Martínez-Loredo V, Simmons VN, Meltzer LR, Drobes DJ, Brandon KO, Palmer AM, Eissenberg T, Bullen CR, Harrell PT, Brandon TH. Erratum: How Does Smoking and Nicotine Dependence Change After Onset of Vaping? A Retrospective Analysis of Dual Users. Nicotine Tob Res 2019; 22:864. [PMID: 31184754 DOI: 10.1093/ntr/ntz078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Permuth JB, Clark Daly A, Jeong D, Choi JW, Cameron ME, Chen D, Teer JK, Barnett TE, Li J, Powers BD, Kumar NB, George TJ, Ali KN, Huynh T, Vyas S, Gwede CK, Simmons VN, Hodul PJ, Carballido EM, Judge AR, Fleming JB, Merchant N, Trevino JG. Racial and ethnic disparities in a state-wide registry of patients with pancreatic cancer and an exploratory investigation of cancer cachexia as a contributor to observed inequities. Cancer Med 2019; 8:3314-3324. [PMID: 31074202 PMCID: PMC6558500 DOI: 10.1002/cam4.2180] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 03/29/2019] [Accepted: 04/03/2019] [Indexed: 12/18/2022] Open
Abstract
Pancreatic cancer (PC) is characterized by racial/ethnic disparities and the debilitating muscle-wasting condition, cancer cachexia. Florida ranks second in the number of PC deaths and has a large and understudied minority population. We examined the primary hypothesis that PC incidence and mortality rates may be highest among Black Floridians and the secondary hypothesis that biological correlates of cancer cachexia may underlie disparities. PC incidence and mortality rates were estimated by race/ethnicity, gender, and county using publicly available state-wide cancer registry data that included approximately 2700 Black, 25 200 Non-Hispanic White (NHW), and 3300 Hispanic/Latino (H/L) Floridians diagnosed between 2004 and 2014. Blacks within Florida experienced a significantly (P < 0.05) higher incidence (12.5/100 000) and mortality (10.97/100 000) compared to NHW (incidence = 11.2/100 000; mortality = 10.3/100 000) and H/L (incidence = 9.6/100 000; mortality = 8.7/100 000), especially in rural counties. To investigate radiologic and blood-based correlates of cachexia, we leveraged data from a subset of patients evaluated at two geographically distinct Florida Cancer Centers. In Blacks compared to NHW matched on stage, markers of PC-induced cachexia were more frequent and included greater decreases in core musculature compared to corresponding healthy control patients (25.0% vs 10.1% lower), greater decreases in psoas musculature over time (10.5% vs 4.8% loss), lower baseline serum albumin levels (3.8 vs 4.0 gm/dL), and higher platelet counts (332.8 vs 268.7 k/UL). Together, these findings suggest for the first time that PC and cachexia may affect Blacks disproportionately. Given its nearly universal contribution to illness and PC-related deaths, the early diagnosis and treatment of cachexia may represent an avenue to improve health equity, quality of life, and survival.
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Affiliation(s)
- Jennifer B. Permuth
- Department of Cancer EpidemiologyMoffitt Cancer CenterTampaFlorida
- Department of Gastrointestinal OncologyMoffitt Cancer CenterTampaFlorida
| | - Ashley Clark Daly
- Division of Behavioral HealthIdaho Department of Health and WelfareBoiseIdaho
| | - Daniel Jeong
- Department of Diagnostic RadiologyMoffitt Cancer CenterTampaFlorida
| | - Jung W. Choi
- Department of Cancer Imaging & MetabolismMoffitt Cancer CenterTampaFlorida
| | - Miles E. Cameron
- Department of Surgery, Division of General SurgeryUniversity of Florida Health Sciences CenterGainesvilleFlorida
| | - Dung‐Tsa Chen
- Department of Biostatistics and BioinformaticsMoffitt Cancer CenterTampaFlorida
| | - Jamie K. Teer
- Department of Biostatistics and BioinformaticsMoffitt Cancer CenterTampaFlorida
| | - Tracey E. Barnett
- School of Public HealthUniversity of North Texas Health Science CenterFort WorthTexas
| | - Jiannong Li
- Department of Biostatistics and BioinformaticsMoffitt Cancer CenterTampaFlorida
| | - Benjamin D. Powers
- Department of Gastrointestinal OncologyMoffitt Cancer CenterTampaFlorida
| | | | - Thomas J. George
- Department of MedicineUniversity of Florida Health Sciences CenterGainesvilleFlorida
| | - Karla N. Ali
- Department of Cancer EpidemiologyMoffitt Cancer CenterTampaFlorida
| | - Tri Huynh
- Department of Cancer EpidemiologyMoffitt Cancer CenterTampaFlorida
| | - Shraddha Vyas
- Department of Cancer EpidemiologyMoffitt Cancer CenterTampaFlorida
| | - Clement K. Gwede
- Department of Health Outcomes and BehaviorMoffitt Cancer CenterTampaFlorida
| | - Vani N. Simmons
- Department of Health Outcomes and BehaviorMoffitt Cancer CenterTampaFlorida
| | - Pamela J. Hodul
- Department of Gastrointestinal OncologyMoffitt Cancer CenterTampaFlorida
| | | | - Andrew R. Judge
- Department of Physical TherapyUniversity of FloridaGainesvilleFlorida
| | - Jason B. Fleming
- Department of Gastrointestinal OncologyMoffitt Cancer CenterTampaFlorida
| | - Nipun Merchant
- Department of Surgical Oncology, Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of MedicineMiamiFlorida
| | - Jose G. Trevino
- Department of Surgery, Division of General SurgeryUniversity of Florida Health Sciences CenterGainesvilleFlorida
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Brandon KO, Simmons VN, Meltzer LR, Drobes DJ, Martínez Ú, Sutton SK, Palmer AM, Bullen CR, Harrell PT, Brandon TH. Vaping characteristics and expectancies are associated with smoking cessation propensity among dual users of combustible and electronic cigarettes. Addiction 2019; 114:896-906. [PMID: 30644627 PMCID: PMC6629519 DOI: 10.1111/add.14551] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 09/18/2018] [Revised: 11/21/2018] [Accepted: 01/04/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND AIMS Most e-cigarette users who also smoke combustible cigarettes (dual users) begin vaping to quit smoking, yet only a subset succeeds. We hypothesized that reinforcing characteristics of e-cigarettes (vaping reinforcement) would positively predict smoking cessation propensity (SCP) among dual users. DESIGN Secondary analysis of cross-sectional baseline data from dual users in an ongoing smoking cessation trial. Exploratory and confirmatory factor analysis (EFA and CFA) created latent variables for vaping reinforcement and SCP. A structural equation modeling (SEM) approach was used to test the hypothesis. SETTING United States. PARTICIPANTS A national sample of dual users of combustible and electronic cigarettes who smoke and vape at least once per week (n = 2896) were enrolled (63% male; mean age = 29.9 years) into a randomized controlled trial in which they would receive either smoking cessation materials or no smoking cessation materials. MEASUREMENTS Vaping reinforcement was indexed by vaping frequency (days/week vaping, times/day vaping, puffs/e-cigarette use), e-cigarette characteristics [numbers of modifications and tobacco or non-tobacco flavors, nicotine content (mg) and positive e-cigarette expectancies]. SCP was measured by items of confidence, commitment to being smoke-free, cessation motivation (contemplation ladder), change in cigarettes per day since beginning e-cigarette use and negative smoking expectancies. FINDINGS Four factors emerged from the EFA: vaping propensity (vaping frequency, positive expectancies), vaping enthusiasm (e-cigarette modifications, using non-tobacco flavors, puffs per use), nicotine/tobacco flavor (nicotine strength, tobacco flavors) and SCP (negative expectancies about smoking, motivation to quit smoking, reduction in smoking). A CFA upheld the exploratory factor structure [root mean square error of approximation (RMSEA) = 0.046, CFI = 0.91]. An SEM with the three vaping latent variables directly predicting SCP had good model fit (RMSEA = 0.030, CFI = 0.97) with a positive relationship of vaping propensity (0.509, P < 0.001), and small negative relationships of vaping enthusiasm (-0.158, P = 0.014) and nicotine/tobacco flavor (-0.230, P < 0.001). CONCLUSIONS Among e-cigarette users who also smoke combustible cigarettes, frequent vaping combined with positive e-cigarette expectancies appears to predict greater smoking cessation propensity. However, vaping enthusiasm (measured by e-cigarette modifications, using non-tobacco flavors and puffs per use), higher nicotine content and use of tobacco flavored solution may reduce cessation propensity.
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Affiliation(s)
- Karen O. Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Vani N. Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA,Department of Psychology, University of South Florida,Tampa, FL, USA,Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Lauren R. Meltzer
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - David J. Drobes
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA,Department of Psychology, University of South Florida,Tampa, FL, USA,Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Úrsula Martínez
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Steven K. Sutton
- Department of Psychology, University of South Florida,Tampa, FL, USA,Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA,Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Amanda M. Palmer
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA,Department of Psychology, University of South Florida,Tampa, FL, USA
| | - Christopher R. Bullen
- School of Population Health, Faculty of Medical and Health Science, University of Auckland, New Zealand
| | - Paul T. Harrell
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Thomas H. Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA,Department of Psychology, University of South Florida,Tampa, FL, USA,Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
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Li L, Lee JH, Sutton SK, Simmons VN, Brandon TH. A Bayesian transition model for missing longitudinal binary outcomes and an application to a smoking cessation study. STAT MODEL 2019; 20:310-338. [PMID: 33854408 DOI: 10.1177/1471082x18821489] [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: 11/16/2022]
Abstract
Smoking cessation intervention studies often produce data on smoking status at discrete follow-up assessments, often with missing data in different amounts at each assessment. Smoking status in these studies is a dynamic process with individuals transitioning from smoking to abstinent, as well as abstinent to smoking, at different times during the intervention. Directly assessing transitions provides an opportunity to answer important questions like 'Does the proposed intervention help smokers remain abstinent or quit smoking more effectively than other interventions?' In this article, we model changes in smoking status and examine how interventions and other covariates affect the transitions. We propose a Bayesian approach for fitting the transition model to the observed data and impute missing outcomes based on a logistic model, which accounts for both missing at random (MAR) and missing not at random (MNAR) mechanisms. The proposed Bayesian approach treats missing data as additional unknown quantities and samples them from their posterior distributions. The performance of the proposed method is investigated through simulation studies and illustrated by data from a randomized controlled trial of smoking cessation interventions. Finally, posterior predictive checking and log pseudo marginal likelihood (LPML) are used to assess model assumptions and perform model comparisons, respectively.
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Affiliation(s)
- Li Li
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, NM, USA
| | - Ji-Hyun Lee
- Division of Quantitative Sciences, University of Florida Health Cancer Center; Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Steven K Sutton
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Vani N Simmons
- Department of Health Outcomes and Behaviour, Moffitt Cancer Center, Tampa, FL, USA
| | - Thomas H Brandon
- Department of Health Outcomes and Behaviour, Moffitt Cancer Center, Tampa, FL, USA
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Meltzer LR, Unrod M, Simmons VN, Brandon KO, Piñeiro B, Palmer AM, Brandon TH. Capitalizing on a teachable moment: Development of a targeted self-help smoking cessation intervention for patients receiving lung cancer screening. Lung Cancer 2019; 130:121-127. [PMID: 30885332 DOI: 10.1016/j.lungcan.2019.02.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 02/14/2019] [Accepted: 02/16/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The goal of the current study was to develop and examine the feasibility and acceptability of a self-help smoking cessation intervention targeted to the teachable moment of smokers undergoing low-dose computed tomography (LDCT) lung cancer screening. MATERIALS AND METHODS We used a multi-phase qualitative approach, including focus groups (N = 15) and learner verification interviews (N = 16) to develop a targeted intervention for patients receiving a LDCT screening, by extending and modifying a previously validated, self-help intervention. The new intervention was then tested in a feasibility study for acceptability and receptivity by smokers (N = 18) receiving a LDCT screening. RESULTS The main themes that emerged from the focus group findings included a need to address the counterproductive thoughts regarding a negative lung screen result, the desire to enjoy a healthy and smoke-free retirement, the need to increase self-efficacy regarding smoking cessation, and the desire to see statistics regarding survival after quitting smoking. Learner verification findings showed that participants responded favorably to most booklet and pamphlet changes. Minor changes were made to improve comprehension and enhance self-efficacy. Formative findings led to the development of a new initial booklet titled, "Lung Cancer Screening & Quitting Smoking: Taking Control of Your Health," as well as modifications of the existing self-help cessation intervention. The intervention was designed to be initiated at the LDCT appointment, prior to receipt of scan results, and with minimal disruption of clinic work-flow. Results from the feasibility study indicated that acceptability and satisfaction with the new intervention were high. CONCLUSION A validated self-help smoking-cessation intervention was modified for smokers receiving LDCT screening for lung cancer based on formative research guided by the teachable moment concept. The new intervention is ready for testing in a randomized controlled trial.
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Affiliation(s)
- Lauren R Meltzer
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Marina Unrod
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA; Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA; Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Karen O Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Bárbara Piñeiro
- Oklahoma Tobacco Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Amanda M Palmer
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA; Department of Psychology, University of South Florida, Tampa, FL, USA.
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50
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Webb Hooper M, Asfar T, Unrod M, Dorsey A, Correa JB, Brandon KO, Simmons VN, Antoni MA, Koru-Sengul T, Lee DJ, Brandon TH. Reasons for Exclusion from a Smoking Cessation Trial: An Analysis by Race/Ethnicity. Ethn Dis 2019; 29:23-30. [PMID: 30713413 DOI: 10.18865/ed.29.1.23] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [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: 11/18/2022] Open
Abstract
Objective The exclusion criteria of tobacco cessation randomized clinical trials (RCTs) may have unintended consequences on inclusion and cessation disparities. We examined racial/ethnic differences in: a) exclusion from a group-based cessation RCT; and b) reasons for exclusion. Design Quasi-experimental. Inclusion criteria were self-identification as African American/Black, non-Hispanic White, or Hispanic (any race), adults, minimum five cigarettes/day or carbon monoxide reading of ≥ 8 parts per million (ppm), interest in quitting, and spoke/read English. Data were obtained from a parent trial, which is ongoing and will be completed in 2019. Analyses for our present study on participant screening and enrollment were conducted in 2018. Main Outcome Measures Study ineligibility, and reasons for exclusion (contraindications for nicotine patch use, serious mental illness [SMI, eg, bipolar disorder or schizophrenia], alcohol dependence or illicit drug use, current tobacco treatment, attendance barriers [eg, transportation], and other concerns [eg, aggressive, intoxicated, disruptive, visibly ill]). Results Of 1,206 individuals screened, 36% were ineligible. The most frequent reasons were SMI (28%), alcohol dependence or drug use (10%), and attendance barriers (7%). Ineligibility was greater among African Americans (42%) and Hispanics (37%), compared with Whites (24%; P<.001). Compared with African Americans and Hispanics, Whites were more likely to be excluded for single reasons, including attendance barriers, and medical conditions (P<.05). African Americans were more than twice as likely as Whites to be excluded for 3 or more reasons (12% vs 5% respectively, P<.05). Conclusions A notable proportion of smokers were ineligible for this RCT, with SMI as the greatest single cause. Racial/ethnic minorities were more likely to be excluded, with African Americans deemed ineligible for multiple reasons. Findings have implications for RCT generalizability, addressing tobacco disparities and health equity.
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Affiliation(s)
| | - Taghrid Asfar
- University of Miami Miller School of Medicine, Department of Public Health Sciences and Sylvester Comprehensive Cancer Center
| | | | - Asha Dorsey
- University of Miami Miller School of Medicine, Department of Public Health Sciences and Sylvester Comprehensive Cancer Center
| | - John B Correa
- VA San Diego Healthcare System.,University of California, San Diego
| | | | | | - Michael A Antoni
- University of Miami Miller School of Medicine, Department of Public Health Sciences and Sylvester Comprehensive Cancer Center.,University of Miami, Department of Psychology
| | - Tulay Koru-Sengul
- University of Miami Miller School of Medicine, Department of Public Health Sciences and Sylvester Comprehensive Cancer Center
| | - David J Lee
- University of Miami Miller School of Medicine, Department of Public Health Sciences and Sylvester Comprehensive Cancer Center
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