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Wu YP, Stump TK, Hay JL, Buller DB, Jensen JD, Grossman D, Shen J, Haaland BA, Jones J, Tercyak KP. Protocol for a cluster-randomized trial of a school-based skin cancer preventive intervention for adolescents. Contemp Clin Trials 2024; 140:107494. [PMID: 38458557 PMCID: PMC11065585 DOI: 10.1016/j.cct.2024.107494] [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: 09/19/2023] [Revised: 02/06/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Adolescents infrequently use sun protection and engage in intentional tanning more frequently compared to other age groups, leading to increased ultraviolet radiation (UVR) exposure that heightens skin cancer risk across the lifespan. High schools are therefore an ideal setting for offering skin cancer preventive interventions. Yet, there are limited UVR protection interventions for high school students, especially those that are personalized, tested using randomized designs, and include long-term outcome assessment to determine the durability of intervention effects. METHOD The Sun-safe Habits Intervention and Education (SHINE) cluster-randomized trial will test a novel, personalized intervention that targets high school adolescents' sun protection and tanning behaviors, and tracks their outcomes for up to one year following intervention. Enrolled high schools will be randomized to receive either the personalized SHINE intervention, which includes facial UVR photographs and sun protection action planning, or standard education using publicly available materials. Students in both conditions will receive information about skin cancer, sun protection, and skin self-examination. Outcome variables will include students' sun protection and tanning behaviors and sunburn occurrence. Potential moderators (e.g., race/ethnicity) and mediators (e.g., self-efficacy) will also be assessed and tested. CONCLUSIONS This trial examines the efficacy of a personalized intervention targeting sun protection and tanning of high school students. The project will lead to new scientific understanding of the theoretical mechanisms underlying outcomes and moderators of the intervention effects, which will inform future intervention tailoring to meet the needs of vulnerable subgroups.
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Affiliation(s)
- Yelena P Wu
- Department of Dermatology, University of Utah, 30 N. Mario Capecchi Dr., Salt Lake City, UT 84112, USA; Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Tammy K Stump
- Department of Dermatology, University of Utah, 30 N. Mario Capecchi Dr., Salt Lake City, UT 84112, USA; Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
| | - David B Buller
- Klein Buendel, Inc., 1667 Cole Boulevard, Suite 220, Golden, CO 80401, USA.
| | - Jakob D Jensen
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA; Department of Communication, University of Utah, Salt Lake City, UT, USA.
| | - Douglas Grossman
- Department of Dermatology, University of Utah, 30 N. Mario Capecchi Dr., Salt Lake City, UT 84112, USA; Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Jincheng Shen
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
| | - Benjamin A Haaland
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
| | - Jacey Jones
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
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Wu YP, Brady HL, Wankier AP, Tanguy WJ, Smith HJ, Brunsgaard EK, Chipman J, DeSantis S, Abildso C, Haaland B, Schlechter CR, Wetter DW, Tercyak KP. Preliminary effects of a rural skin cancer prevention intervention for youths. Health Psychol 2024; 43:339-351. [PMID: 38206847 PMCID: PMC11031317 DOI: 10.1037/hea0001355] [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] [Indexed: 01/13/2024]
Abstract
OBJECTIVES To pilot and assess the feasibility, acceptability, and preliminary effects of the Rural Adult and Youth Sun (RAYS) protection program, a multilevel skin cancer preventive intervention for young children living in rural U.S. communities, delivered through community-organized team sports. METHOD Three rural counties in Utah participated with two receiving the intervention and the third serving as a control. Youth sports leagues were recruited through recreation departments and the study took place from May through October 2021. Intervention leagues received sun protection supplies for players and coaches, educational materials for parents, and coaches were offered training on skin cancer and sun protection behaviors. RESULTS The RAYS program is both feasible to deliver and acceptable to coaches, parents, and players. The intervention also demonstrates beneficial preliminary effects on components of observed child sun-protective behaviors, coach sun protection behaviors, knowledge of skin cancer prevention recommendations, and self-efficacy in skin cancer prevention. CONCLUSIONS Multilevel interventions for skin cancer prevention among young children can be successfully delivered through community organizations and their settings. A priority moving forward is the identification of ways to optimize delivery of such programs to positively influence skin cancer preventive behaviors among children living in diverse rural areas. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Yelena P. Wu
- Department of Dermatology, University of Utah, Salt Lake City, Utah
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Hannah L. Brady
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Ali P. Wankier
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | | | | | - Elise K. Brunsgaard
- Department of Dermatology, University of Utah, Salt Lake City, Utah
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Jonathan Chipman
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Sarah DeSantis
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Christiaan Abildso
- Department of Social and Behavioral Sciences, West Virginia University, Morgantown, West Virginia
| | - Benjamin Haaland
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Chelsey R. Schlechter
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - David W. Wetter
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Kenneth P. Tercyak
- Georgetown University Lombardi Comprehensive Cancer Center, Washington, D.C
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Wu YP, Yang XY, Lyu L, Zhao ZH, Tian YX, Li FC, Wang K, Fan YC. [The predictive value of dynamic changes of neutrophil/lymphocyte ratio (NLR) combined with the model of end-stage liver disease (MELD) score in patients with acute-on-chronic hepatitis B liver failure]. Zhonghua Yi Xue Za Zhi 2024; 104:1050-1056. [PMID: 38561300 DOI: 10.3760/cma.j.cn112137-20240103-00016] [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] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Objective: To determine the predictive value of dynamic changes of neutrophil/lymphocyte ratio (NLR) combined with the model of end-stage liver disease (MELD) score in patients with acute-on-chronic hepatitis B liver failure. Methods: Patients with acute-on-chronic hepatitis B liver failure who were hospitalized in the Department of Hepatology of Qilu Hospital of Shandong University from January 2010 to July 2023 were retrospectively enrolled. According to the clinical outcomes of patients within 30 days of admission, they were divided into the survival group and the death group. The dynamic changes in NLR and initial values on day 3, 5, 8, and 12 in two groups were analyzed for the diagnostic value of 30-day prognosis in patients with acute-on-chronic hepatitis B liver failure. Logistic regression analysis and machine learning XGBoost algorithm were used to evaluate the risk factors influencing the prognosis of patients at 30 days. Receiver operating characteristic(ROC) curve was used to evaluate the diagnostic value of NLR and initial value change combined with MELD score on day 12 of admission in patients with chronic acute hepatitis B liver failure. Results: A total of 243 patients were enrolled in the study, including 145 patients in the survival group [115 males, 30 females, aged 25-74 (47±11)] and 98 patients in the death group [80 males, 18 females, aged 22-80 (49±13) ]. The median initial NLR of survival group and death group were 3.5 (2.1, 5.3) and 4.9 (2.9, 8.3), respectively, and the difference was statistically significant (P=0.003). The variation of NLR from the initial value on day 3, 5, 8, and 12 in the survival group [1.6 (0, 4.3), 1.9 (-0.2, 4.1), 2.0 (-0.1, 4.3) and 2.9 (0.3, 7.0), respectively] were lower than that in the death group [3.2 (0.9, 7.5), 5.1 (1.8, 7.6), 5.8 (2.0, 10.6) and 9.6 (3.5, 16.4), respectively] (all P<0.001). Logistic regression multivariate analysis showed that the changes in NLR on the 12th day and initial value (OR=1.07,95%CI:1.01-1.14, P=0.014), the changes in NLR on the 3rd day and initial value (OR=2.71, 95%CI: 1.32-5.55, P=0.007), the initial value of NLR (OR=1.18,95%CI:1.01-1.37,P=0.035) and fibrinogen (OR=0.21,95%CI:0.05-0.96,P=0.044) were related factors for death within 30 days. Machine learning XGBoost algorithm showed that the weight of the change between the NLR on the 12th day and the initial value was the highest. The area under the ROC curve of the combined MELD score was 0.812 (95%CI: 0.728-0.895), the specificity was 67.78%, and the sensitivity was 82.35%. Conclusion: Dynamic change of NLR combined with MELD score has high predictive value for the short-term prognosis of patients with acute-on-chronic hepatitis B liver failure.
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Affiliation(s)
- Y P Wu
- Department of Hepatology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - X Y Yang
- Department of Hepatology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - L Lyu
- Department of Outpatient and Follow up Center, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Z H Zhao
- Department of Hepatology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Y X Tian
- Department of Hepatology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - F C Li
- Department of Hepatology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - K Wang
- Department of Hepatology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Y C Fan
- Department of Hepatology, Qilu Hospital of Shandong University, Jinan 250012, China
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Wu YP, Tercyak KP, Wankier AP, Brunsgaard EK, Parsons BG, Devine KA, Stump TK, Boucher KM, Hay JL. Moderating influences on parents' fatalistic beliefs about cancer and their association with sun safety behaviors among children of melanoma survivors: Implications for treatment. J Health Psychol 2024; 29:481-491. [PMID: 37968969 DOI: 10.1177/13591053231209167] [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: 11/17/2023] Open
Abstract
The purpose of this study is to examine the association between parents' fatalism about melanoma and their children's sun protection, and the potential moderating role of parent-child communication. In this observational study of N = 69 melanoma-surviving parents of children ages 8-17, parents reported on their own melanoma fatalism, as well as their children's sun safety behaviors and parent-child discussion about sun safety. Parent gender, family history of melanoma, and frequency of parent-child discussions moderated the relationship between parents' fatalism and children's sun safety behaviors. Among mothers and parents with a family history of melanoma, high fatalism was associated with lower child sunscreen use, especially when discussions were less frequent. Melanoma surviving parents' fatalistic beliefs about cancer indirectly influence their children's health behavior and are a risk factor for unsafe sun behavior. Attending to parent gender, family history, and their communications about protective behaviors as co-factors of this risk could inform future intervention targeting.
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Affiliation(s)
- Yelena P Wu
- University of Utah, USA
- Huntsman Cancer Institute, USA
| | | | | | | | | | | | - Tammy K Stump
- University of Utah, USA
- Huntsman Cancer Institute, USA
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5
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Duan LL, Zhao YB, Er YL, Ye PP, Wang W, Gao X, Deng X, Jin Y, Wang Y, Ji CR, Ma XY, Gao C, Zhao YH, Zhu SQ, Su SZ, Guo XE, Peng JJ, Yu Y, Yang C, Su YY, Zhao M, Guo LH, Wu YP, Luo YN, Meng RL, Xu HF, Liu HZ, Ruan HH, Xie B, Zhang HM, Liao YH, Chen Y, Wang LH. [The effect of Ba Duan Jin on the balance of community-dwelling older adults: a cluster randomized control trial]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:250-256. [PMID: 38413065 DOI: 10.3760/cma.j.cn112338-20230506-00283] [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] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Objective: To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults. Methods: A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test. Results: A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95%CI: 2.23-3.88) points (P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95%CI: 4.03-5.37) points (P<0.001). Ba Duan Jin showed significant improvement (P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions: This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.
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Affiliation(s)
- L L Duan
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Y B Zhao
- Shijiazhuang People's Hospital, Shijiazhuang 050031, China
| | - Y L Er
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - P P Ye
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - W Wang
- National Clinical Research Center for Cardiovascular Diseases/National Center for Cardiovascular Diseases/Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - X Gao
- Office of Chronic Disease and Ageing Health Management, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - X Deng
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Y Jin
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Y Wang
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - C R Ji
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - X Y Ma
- Institute for Chronic and Non-communicable Disease Control and Prevention, Shijiazhuang Municipal Center for Disease Control and Prevention, Shijiazhuang 050011, China
| | - C Gao
- Institute for Chronic and Non-communicable Disease Control and Prevention, Shijiazhuang Municipal Center for Disease Control and Prevention, Shijiazhuang 050011, China
| | - Y H Zhao
- Shijiazhuang Chang'an District Center for Disease Control and Prevention, Shijiazhuang 050011, China
| | - S Q Zhu
- Department of Chronic Prevention and Control, Shijiazhuang Chang'an District Center for Disease Control and Prevention, Shijiazhuang 050011, China
| | - S Z Su
- Department of Nursing, Shijiazhuang Hospital of Traditional Chinese Medicine, Shijiazhuang 050051, China
| | - X E Guo
- Department of Nursing, Shijiazhuang Hospital of Traditional Chinese Medicine, Shijiazhuang 050051, China
| | - J J Peng
- Department of Injury Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Y Yu
- Department of Injury Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - C Yang
- Department of Cancer and Injury Control and Prevention, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai 200136, China
| | - Y Y Su
- Department of Cancer and Injury Control and Prevention, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai 200136, China
| | - M Zhao
- Department of Chronic and Non-communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - L H Guo
- Department of Chronic and Non-communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Y P Wu
- General Office, Cixi Municipal Center for Disease Control and Prevention of Zhejiang Province, Ningbo 315302, China
| | - Y N Luo
- General Office, Cixi Municipal Center for Disease Control and Prevention of Zhejiang Province, Ningbo 315302, China
| | - R L Meng
- Department of Chronic and Non-communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511483, China
| | - H F Xu
- Department of Chronic and Non-communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511483, China
| | - H Z Liu
- Guangzhou Municipal Center for Disease Control and Prevention, Guangzhou 510440, China
| | - H H Ruan
- Department of Chronic and Non-communicable Disease Control and Prevention, Chronic Disease Prevention and Control Station of Guangzhou Panyu District, Guangzhou 511400, China
| | - B Xie
- Department of Psychiatric, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China
| | - H M Zhang
- Department of Psychiatric, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China
| | - Y H Liao
- Department of Psychiatric, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China
| | - Y Chen
- Department of Psychiatric, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China
| | - L H Wang
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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Modi AC, Beal SJ, Becker SP, Boerner KE, Burton ET, Chen D, Crosby LE, Hilliard ME, Hood AM, Kahhan NA, Law E, Long KA, McGrady ME, Sweenie RE, Thurston IB, Valrie C, Wu YP, Duncan CL. Editorial: Recommendations on inclusive language and transparent reporting relating to diversity dimensions for the Journal of Pediatric Psychology and Clinical Practice in Pediatric Psychology. J Pediatr Psychol 2024; 49:1-12. [PMID: 38167955 PMCID: PMC10799720 DOI: 10.1093/jpepsy/jsad094] [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: 10/27/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024] Open
Affiliation(s)
- Avani C Modi
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sarah J Beal
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Katelynn E Boerner
- Department of Pediatrics, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - E Thomaseo Burton
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Diane Chen
- Potocsnak Family Division of Adolescent and Young Adult Medicine & Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
- Departments of Psychiatry & Behavioral Sciences, and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lori E Crosby
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
| | - Anna M Hood
- Division of Psychology and Mental Health, Manchester Centre for Health Psychology University of Manchester, UK
| | - Nicole A Kahhan
- Division of Psychology & Neuropsychology, Nemours Children’s Health, Jacksonville, FL, USA
| | - Emily Law
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Kristin A Long
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Meghan E McGrady
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Rachel E Sweenie
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Idia B Thurston
- Department of Health Sciences and Applied Psychology, Northeastern University, Boston, MA, USA
| | - Cecelia Valrie
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Yelena P Wu
- Department of Dermatology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
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Mooney R, Wu YP, Kehoe K, Volkmar M, Kohlmann W, Koptiuch C, Kaphingst KA. Experiences of patients and family members with follow-up care, information needs and provider support after identification of Lynch Syndrome. Hered Cancer Clin Pract 2023; 21:28. [PMID: 38115072 PMCID: PMC10731879 DOI: 10.1186/s13053-023-00273-1] [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: 08/31/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Lynch Syndrome is among the most common hereditary cancer syndromes and requires ongoing cancer surveillance, repeated screenings and potential risk-reducing surgeries. Despite the importance of continued surveillance, there is limited understanding of patient experiences after initial testing and counseling, the barriers or facilitators they experience adhering to recommendations, and how they want to receive information over time. METHODS A cross-sectional, observational study was conducted among 127 probands and family members who had received genetic testing for Lynch Syndrome. We conducted semi-structured interviews to determine proband and family member experiences after receiving genetic testing results including their surveillance and screening practices, information needs, and interactions with health care providers. Both closed-ended and open-ended data were collected and analyzed. RESULTS Both probands (96.9%) and family members (76.8%) received recommendations for follow-up screening and all probands (100%) and most family members (98.2%) who tested positive had completed at least one screening. Facilitators to screening included receiving screening procedure reminders and the ease of making screening and surveillance appointments. Insurance coverage to pay for screenings was a frequent concern especially for those under 50 years of age. Participants commented that their primary care providers were often not knowledgeable about Lynch Syndrome and surveillance recommendations; this presented a hardship in navigating ongoing surveillance and updated information. Participants preferred information from a knowledgeable health care provider or a trusted internet source over social media or support groups. CONCLUSIONS Probands and family members receiving genetic testing for Lynch Syndrome generally adhered to initial screening and surveillance recommendations. However, factors such as insurance coverage and difficulty finding a knowledgeable healthcare provider presented barriers to receiving recommended follow-up care. There is an opportunity to improve care through better transitions in care, procedures to keep primary care providers informed of surveillance guidelines, and practices so that patients receive reminders and facilitated appointment setting for ongoing screening and surveillance at the time they are due.
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Affiliation(s)
- Ryan Mooney
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
| | - Yelena P Wu
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - Kelsey Kehoe
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA
| | - Molly Volkmar
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Wendy Kohlmann
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Cathryn Koptiuch
- VA Medical Center, National TeleOncology Service, Durham, NC, USA
| | - Kimberly A Kaphingst
- Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
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Brunsgaard EK, Wu YP, Grossman D. Melanoma in skin of color: Part I. Epidemiology and clinical presentation. J Am Acad Dermatol 2023; 89:445-456. [PMID: 35533771 DOI: 10.1016/j.jaad.2022.04.056] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/07/2022] [Accepted: 04/14/2022] [Indexed: 11/27/2022]
Abstract
Although there is a higher incidence of melanoma among non-Hispanic White individuals, melanoma is diagnosed at more advanced stages and associated with worse survival rates among individuals with skin of color (SOC). The proportions of melanoma subtypes differ across racial groups, with acral lentiginous melanoma and mucosal melanoma representing higher proportions of melanoma diagnoses in individuals with SOC compared to White individuals. The recognition of distinct differences in anatomic locations and dermatoscopic patterns may facilitate the appropriate differentiation of physiologic from pathologic pigmentation. The first article of this continuing medical education series will focus on the epidemiology and clinical presentation of melanoma in individuals with SOC, with the aim of improving early diagnoses and clinical outcomes.
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Affiliation(s)
- Elise K Brunsgaard
- Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Yelena P Wu
- Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah; Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Douglas Grossman
- Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah; Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, Utah; Department of Oncological Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah.
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9
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Wu YP, Stump TK, Hay JL, Aspinwall LG, Boucher KM, Deboeck PR, Grossman D, Mooney K, Leachman SA, Smith KR, Wankier AP, Brady HL, Hancock SE, Parsons BG, Tercyak KP. The Family Lifestyles, Actions and Risk Education (FLARE) study: Protocol for a randomized controlled trial of a sun protection intervention for children of melanoma survivors. Contemp Clin Trials 2023; 131:107276. [PMID: 37393004 PMCID: PMC10529923 DOI: 10.1016/j.cct.2023.107276] [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: 03/14/2023] [Revised: 06/08/2023] [Accepted: 06/28/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Children of parents who had melanoma are more likely to develop skin cancer themselves owing to shared familial risks. The prevention of sunburns and promotion of sun-protective behaviors are essential to control cancer among these children. The Family Lifestyles, Actions and Risk Education (FLARE) intervention will be delivered as part of a randomized controlled trial to support parent-child collaboration to improve sun safety outcomes among children of melanoma survivors. METHODS FLARE is a two-arm randomized controlled trial design that will recruit dyads comprised of a parent who is a melanoma survivor and their child (aged 8-17 years). Dyads will be randomized to receive FLARE or standard skin cancer prevention education, which both entail 3 telehealth sessions with an interventionist. FLARE is guided by Social-Cognitive and Protection Motivation theories to target child sun protection behaviors through parent and child perceived risk for melanoma, problem-solving skills, and development of a family skin protection action plan to promote positive modeling of sun protection behaviors. At multiple assessments through one-year post-baseline, parents and children complete surveys to assess frequency of reported child sunburns, child sun protection behaviors and melanin-induced surface skin color change, and potential mediators of intervention effects (e.g., parent-child modeling). CONCLUSION The FLARE trial addresses the need for melanoma preventive interventions for children with familial risk for the disease. If efficacious, FLARE could help to mitigate familial risk for melanoma among these children by teaching practices which, if enacted, decrease sunburn occurrence and improve children's use of well-established sun protection strategies.
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Affiliation(s)
- Yelena P Wu
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT 84132, USA; Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Tammy K Stump
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, NY, New York 10021, USA.
| | - Lisa G Aspinwall
- Department of Psychology, University of Utah, 380 North 1530 East, Salt Lake City, UT 84112, USA.
| | - Kenneth M Boucher
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA; Department of Internal Medicine, University of Utah, 30 North 1900 East, Salt Lake City, UT, USA.
| | - Pascal R Deboeck
- Department of Psychology, University of Utah, 380 North 1530 East, Salt Lake City, UT 84112, USA.
| | - Douglas Grossman
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT 84132, USA; Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Kathi Mooney
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA; College of Nursing, University of Utah, 10 North, 2000 E, Salt Lake City, UT 84112, USA.
| | - Sancy A Leachman
- Department of Dermatology & Knight Cancer Institute, Oregon Health & Science University, 3303 SW Bond Ave; Suite 16D, Portland, OR 97239, USA.
| | - Ken R Smith
- Utah Population Database Pedigree and Population Resource, Department of Population Sciences, Huntsman Cancer Institute, University of Utah, 675 Arapeen Drive; Suite 200, Salt Lake City, UT 84112, USA.
| | - Ali P Wankier
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Hannah L Brady
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Samuel E Hancock
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Bridget G Parsons
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA
| | - Kenneth P Tercyak
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 2115 Wisconsin Ave, NW, Washington, DC 20007, USA.
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10
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Uthappa DM, Mann TK, Goldman JL, Schuster JE, Newland JG, Anderson WB, Dozier A, Inkelas M, Foxe JJ, Gwynn L, Gurnett CA, McDaniels-Davidson C, Walsh T, Watterson T, Holden-Wiltse J, Potts JM, D’Agostino EM, Zandi K, Corbett A, Spallina S, DeMuri GP, Wu YP, Pulgaron ER, Kiene SM, Oren E, Allison-Burbank JD, Okihiro M, Lee RE, Johnson SB, Stump TK, Coller RJ, Mast DK, Haroz EE, Kemp S, Benjamin DK, Zimmerman KO. Common Data Element Collection in Underserved School Communities: Challenges and Recommendations. Pediatrics 2023; 152:e2022060352N. [PMID: 37394503 PMCID: PMC10312277 DOI: 10.1542/peds.2022-060352n] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 07/04/2023] Open
Abstract
OBJECTIVES To provide recommendations for future common data element (CDE) development and collection that increases community partnership, harmonizes data interpretation, and continues to reduce barriers of mistrust between researchers and underserved communities. METHODS We conducted a cross-sectional qualitative and quantitative evaluation of mandatory CDE collection among Rapid Acceleration of Diagnostics-Underserved Populations Return to School project teams with various priority populations and geographic locations in the United States to: (1) compare racial and ethnic representativeness of participants completing CDE questions relative to participants enrolled in project-level testing initiatives and (2) identify the amount of missing CDE data by CDE domain. Additionally, we conducted analyses stratified by aim-level variables characterizing CDE collection strategies. RESULTS There were 15 study aims reported across the 13 participating Return to School projects, of which 7 (47%) were structured so that CDEs were fully uncoupled from the testing initiative, 4 (27%) were fully coupled, and 4 (27%) were partially coupled. In 9 (60%) study aims, participant incentives were provided in the form of monetary compensation. Most project teams modified CDE questions (8/13; 62%) to fit their population. Across all 13 projects, there was minimal variation in the racial and ethnic distribution of CDE survey participants from those who participated in testing; however, fully uncoupling CDE questions from testing increased the proportion of Black and Hispanic individuals participating in both initiatives. CONCLUSIONS Collaboration with underrepresented populations from the early study design process may improve interest and participation in CDE collection efforts.
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Affiliation(s)
- Diya M. Uthappa
- Duke University School of Medicine, Doctor of Medicine Program
| | - Tara K. Mann
- Duke Clinical Research Institute, Duke University School of Medicine
| | - Jennifer L. Goldman
- Division of Pediatric Infectious Diseases, Children’s Mercy Kansas City, University of Missouri-Kansas City, Kansas City, Missouri
| | - Jennifer E. Schuster
- Division of Pediatric Infectious Diseases, Children’s Mercy Kansas City, University of Missouri-Kansas City, Kansas City, Missouri
| | | | | | | | - Moira Inkelas
- Department of Health Policy and Management, UCLA Fielding School of Public Health UCLA Clinical and Translational Science Institute, Los Angeles, California
| | - John J. Foxe
- The Del Monte Institute for Neuroscience and The Department of Neuroscience, University of Rochester School of Medicine, Rochester, New York
| | - Lisa Gwynn
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida USA
| | - Christina A. Gurnett
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri
| | | | - Tyler Walsh
- Department of Pediatrics, Division of Infectious Diseases
| | | | | | | | | | | | | | | | - Gregory P. DeMuri
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Yelena P. Wu
- Department of Dermatology
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | | | - Susan M. Kiene
- School of Public Health, San Diego State University, San Diego, California
| | - Eyal Oren
- School of Public Health, San Diego State University, San Diego, California
| | | | - May Okihiro
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii Manoa, Honolulu, Hawaii
| | - Rebecca E. Lee
- Edson College of Nursing & Health Innovation, Center for Health Promotion and Disease Prevention, Senior Global Futures Scientist, Julie Ann Wrigley Global Futures Laboratory, Arizona State University, Phoenix, Arizona
| | - Sara B. Johnson
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Tammy K. Stump
- Department of Dermatology
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Ryan J. Coller
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | | | - Emily E. Haroz
- Department of International Health & Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Steven Kemp
- Duke Clinical Research Institute, Duke University School of Medicine
| | - Daniel K. Benjamin
- Duke Clinical Research Institute, Duke University School of Medicine
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
- The ABC Science Collaborative, Durham, North Carolina
| | - Kanecia O. Zimmerman
- Duke Clinical Research Institute, Duke University School of Medicine
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
- The ABC Science Collaborative, Durham, North Carolina
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11
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Stump TK, Wetter DW, Kuzmenko T, Orleans B, Kolp L, Wirth J, Del Fiol G, Chipman J, Haaland B, Kaphingst KA, Hersh AL, Wu YP. Preliminary Reach of an Information Technology Approach to Support COVID-19 Testing in Schools. Pediatrics 2023; 152:e2022060352E. [PMID: 37394508 PMCID: PMC10312282 DOI: 10.1542/peds.2022-060352e] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 07/04/2023] Open
Abstract
OBJECTIVES SCALE-UP Counts tests population health management interventions to promote coronavirus disease 2019 (COVID-19) testing in kindergarten through 12th-grade schools that serve populations that have been historically marginalized. METHODS Within 6 participating schools, we identified 3506 unique parents/guardians who served as the primary contact for at least 1 student. Participants were randomized to text messaging (TM), text messaging + health navigation (HN) (TM + HN), or usual care. Bidirectional texts provided COVID-19 symptom screening, along with guidance on obtaining and using tests as appropriate. If parents/guardians in the TM + HN group were advised to test their child but either did not test or did not respond to texts, they were called by a trained health navigator to address barriers. RESULTS Participating schools served a student population that was 32.9% non-white and 15.4% Hispanic, with 49.6% of students eligible to receive free lunches. Overall, 98.8% of parents/guardians had a valid cell phone, of which 3.8% opted out. Among the 2323 parents/guardians included in the intervention, 79.6% (n = 1849) were randomized to receive TM, and 19.1% (n = 354) engaged with TM (ie, responded to at least 1 message). Within the TM + HN group (40.1%, n = 932), 1.3% (n = 12) qualified for HN at least once, of which 41.7% (n = 5) talked to a health navigator. CONCLUSIONS TM and HN are feasible ways to reach parents/guardians of kindergarten through 12th-grade students to provide COVID-19 screening messages. Strategies to improve engagement may strengthen the impact of the intervention.
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Affiliation(s)
- Tammy K. Stump
- Departments of Dermatology
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - David W. Wetter
- Population Health Sciences
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | | | - Brian Orleans
- Population Health Sciences
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Leighann Kolp
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Jennifer Wirth
- Population Health Sciences
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | | | - Jonathan Chipman
- Population Health Sciences
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Benjamin Haaland
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | | | | | - Yelena P. Wu
- Departments of Dermatology
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
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12
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Wu YP, Hamilton JG, Kaphingst KA, Jensen JD, Kohlmann W, Parsons BG, Lillie HM, Wang X, Haaland B, Wankier AP, Grossman D, Hay JL. Increasing Skin Cancer Prevention in Young Adults: the Cumulative Impact of Personalized UV Photography and MC1R Genetic Testing. J Cancer Educ 2023; 38:1059-1065. [PMID: 36306029 PMCID: PMC10502947 DOI: 10.1007/s13187-022-02232-1] [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: 10/19/2022] [Indexed: 06/02/2023]
Abstract
Skin cancer has become increasingly common among young adults; however, this population does not consistently adhere to recommended methods for preventing the disease. Interventions in college settings have relied on appearance-focused appeals and have not been able to examine the cumulative effect of multiple behavior change and skin cancer risk communication strategies. The goal of the current study was to examine the unique and combined impacts of personalized ultraviolet (UV) radiation photographs, genetic testing for skin cancer risk, and general skin cancer prevention education. Participants were randomly assigned to one of four conditions: (1) skin cancer prevention education, (2) education + UV photo, (3) education + genetic testing, and (4) education + UV photo + genetic testing. Self-reported sun protection, tanning, and sunburn were assessed at baseline, immediately post-intervention, and 1 month post-intervention. The findings indicated benefits of the interventions to skin cancer prevention behaviors in the overall sample; however, the combined (UV photo + genetic testing) intervention had the most consistent positive effects on behaviors. Intervention effects were distinct across seasons. These results suggest that interventions containing multiple skin cancer risk communication strategies hold promise in benefitting health-promoting behavior changes in an at-risk, young adult population.Trial Registration Number: NCT03979872; Registered 6/5/2019.
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Affiliation(s)
- Yelena P Wu
- Department of Dermatology, University of Utah Health Sciences Center, 30 North 1900 East, 4A330-Salt Lake City, UT, 84132, USA.
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA.
| | - Jada G Hamilton
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Kimberly A Kaphingst
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA
- Department of Communication, University of Utah, 255 Central Campus Drive, Salt Lake City, UT, 84112, USA
| | - Jakob D Jensen
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA
- Department of Communication, University of Utah, 255 Central Campus Drive, Salt Lake City, UT, 84112, USA
| | - Wendy Kohlmann
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA
| | - Bridget G Parsons
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA
| | - Helen M Lillie
- Department of Communication, University of Utah, 255 Central Campus Drive, Salt Lake City, UT, 84112, USA
| | - Xuechen Wang
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA
- Department of Population Health Sciences, University of Utah, 295 Chipeta Way, Williams Building Room 1N410, Salt Lake City, UT, 84108, USA
| | - Benjamin Haaland
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA
- Department of Population Health Sciences, University of Utah, 295 Chipeta Way, Williams Building Room 1N410, Salt Lake City, UT, 84108, USA
| | - Ali P Wankier
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA
| | - Douglas Grossman
- Department of Dermatology, University of Utah Health Sciences Center, 30 North 1900 East, 4A330-Salt Lake City, UT, 84132, USA
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Rm LL376, Salt Lake City, UT, 84112, USA
| | - Jennifer L Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
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13
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Stump TK, Fastner S, Jo Y, Chipman J, Haaland B, Nagelhout ES, Wankier AP, Lensink R, Zhu A, Parsons B, Grossman D, Wu YP. Objectively-Assessed Ultraviolet Radiation Exposure and Sunburn Occurrence. Int J Environ Res Public Health 2023; 20:5234. [PMID: 37047850 PMCID: PMC10094127 DOI: 10.3390/ijerph20075234] [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] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/09/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
Ultraviolet radiation (UVR) exposure is the primary modifiable risk factor for melanoma. Wearable UVR sensors provide a means of quantifying UVR exposure objectively and with a lower burden than self-report measures used in most research. The purpose of this study was to evaluate the relationship between detected UVR exposure and reported sunburn occurrence. In this study, a UVR monitoring device was worn by 97 parent-child dyads during waking hours for 14 days to measure instantaneous and accumulated UVR exposure. The results showed that the participants' total UVR exposure was associated with reported sunburn after adjusting for Fitzpatrick skin type and geographic location. It was observed that one standard erythemal dose (SED) increase in the participants' daily total UVR exposure was associated with reported sunburn (an odds ratio (OR) of 1.26 with a 95% CI of 1.13 and 1.41, and p < 0.001 for parents and an OR of 1.28 with a 95% CI of 1.12 and 1.47, and p < 0.001 for children). A one-SED increase in the participants' UVR exposure from 10 am to 4 pm was also associated with reported sunburn (an OR of 1.31 with a 95% CI of 1.15 and 1.49, and p < 0.001 for parents and an OR of 1.33 with a 95% CI of 1.12 and 1.59, and p = 0.001 for children). We found that elevated UVR exposure recordings measured by the UVR sensor were associated with reported sunburn occurrence. Future directions for wearable UVR sensors may include their use as an intervention tool to support in-the-moment sunburn prevention.
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Affiliation(s)
- Tammy K. Stump
- Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Suzanne Fastner
- Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Yeonjung Jo
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA
| | - Jonathan Chipman
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA
| | - Benjamin Haaland
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA
| | - Elizabeth S. Nagelhout
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA
| | - Ali P. Wankier
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Riley Lensink
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Angela Zhu
- Department of Pediatrics, University of Utah, Salt Lake City, UT 84113, USA
| | - Bridget Parsons
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Douglas Grossman
- Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Yelena P. Wu
- Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
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14
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Liu J, Wang J, Zhu J, Zhang Y, Lu SY, Sun FF, Huang JT, Wu YP, Cai FY, Cai RQ, Zhen ZZ, Sun XF, Zhang YZ. [Clinical analysis of 11 cases of high-grade B-cell lymphoma in children]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:151-153. [PMID: 36948871 PMCID: PMC10033267 DOI: 10.3760/cma.j.issn.0253-2727.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Affiliation(s)
- J Liu
- Department of Pediatric Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China Department of Pediatric Oncology, The Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou 510700, China
| | - J Wang
- Department of Pediatric Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
| | - J Zhu
- Department of Pediatric Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
| | - Y Zhang
- Department of Pathology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
| | - S Y Lu
- Department of Pediatric Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
| | - F F Sun
- Department of Pediatric Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
| | - J T Huang
- Department of Pediatric Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
| | - Y P Wu
- Department of Pediatric Oncology, The Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou 510700, China
| | - F Y Cai
- Department of Pediatric Oncology, The Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou 510700, China
| | - R Q Cai
- Department of Pediatric Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
| | - Z Z Zhen
- Department of Pediatric Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
| | - X F Sun
- Department of Pediatric Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
| | - Y Z Zhang
- Department of Pediatric Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
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15
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Jensen JD, Parsons BG, Nagelhout ES, Pokharel M, Christy KR, Ratcliff CL, Grossman D, Haaland B, Wu YP. Tailored visuals, implementation interventions, and sun safe behavior: A longitudinal message experiment. Health Psychol 2023; 42:5-14. [PMID: 36074598 DOI: 10.1037/hea0001195] [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] [Indexed: 01/06/2023]
Abstract
OBJECTIVE One way to communicate skin cancer risk is through ultraviolet (UV) photographs, which can depict the target person (tailored visual) or someone else (stock visual). There is a need for more longitudinal research examining the relative impact of tailored UV photographs compared with other message interventions that could increase sun safe behaviors. METHOD Students 14-18 years of age (N = 654) at eleven high schools in Utah were recruited to participate in a longitudinal experiment (assessments: pretest, posttest, 1 month follow-up) comparing the relative persuasive impact of receiving either (a) stock and tailored UV photographs or (b) stock UV photographs and an implementation intervention on outdoor tanning behavior. Participants completed measures of fear, appearance norms and benefits, threat susceptibility/severity, self-efficacy, response efficacy, freedom threat, reactance, and outdoor tanning behavior. RESULTS Compared with the implementation intervention, participants in the tailored UV condition reported increased fear and freedom threat and decreased appearance norms and benefits of tanning immediately following exposure to the intervention and decreased outdoor tanning 1 month after the intervention. Indirect effects also emerged with tailored UV exposure decreasing outdoor tanning via appearance benefits and increasing outdoor tanning when immediate fear triggered psychological reactance. CONCLUSIONS The results contribute to research on lay reactions to tailored visuals, implementation interventions, and theorizing the indirect effects of affect and cognition across time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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16
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Brady HL, Hamilton JG, Kaphingst KA, Jensen JD, Kohlmann W, Parsons BG, Lillie HM, Wankier AP, Smith HJ, Grossman D, Hay JL, Wu YP. 'I had a bigger cancer risk than I thought…': The experience of receiving personalized risk information as part of a skin cancer prevention intervention in the college setting. Health Expect 2022; 25:2937-2949. [PMID: 36225123 PMCID: PMC9700178 DOI: 10.1111/hex.13601] [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: 12/21/2021] [Revised: 07/25/2022] [Accepted: 08/25/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Diagnoses of both melanoma and nonmelanoma skin cancers are becoming increasingly common among young adults. Interventions in this population are a priority because they do not consistently follow skin cancer prevention recommendations. OBJECTIVES The goal of the current study was to examine college students' perspectives on and experience with receiving a skin cancer prevention intervention that provided personalized skin cancer risk feedback in the form of an ultraviolet (UV) photograph, the results of genetic testing for common skin cancer risk variants, and/or general skin cancer prevention education. METHODS Qualitative interviews were conducted with 38 college students who received a skin cancer prevention intervention. The interview covered students' feelings about their personal skin cancer risk information, the impact of the intervention on their skin cancer risk perceptions, actions or intentions to act with regard to their sun protection practices and feedback for improvement of the intervention content or delivery. RESULTS Participants reported that different intervention components contributed to increased awareness of their sun protection behaviours, shifts in cognitions about and motivation to implement sun protection strategies and reported changes to their skin cancer prevention strategies. CONCLUSION Our findings indicate that college students are interested in and responsive to these types of multicomponent skin cancer preventive interventions. Further, students demonstrate some motivation and intentionality toward changing their skin cancer risk behaviour in the short term. PATIENT OR PUBLIC CONTRIBUTION Participants involved in this study were members of the public (undergraduate students) who were involved in a skin cancer prevention intervention, then participated in semistructured interviews, which provided the data analysed for this study.
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Affiliation(s)
- Hannah L. Brady
- Cancer Control and Population Sciences Division, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Jada G. Hamilton
- Department of Psychiatry & Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA,Department of MedicineMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Kimberly A. Kaphingst
- Cancer Control and Population Sciences Division, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA,Department of CommunicationUniversity of UtahSalt Lake CityUtahUSA
| | - Jakob D. Jensen
- Department of CommunicationUniversity of UtahSalt Lake CityUtahUSA,Department of DermatologyUniversity of Utah Health Sciences CenterSalt Lake CityUtahUSA
| | - Wendy Kohlmann
- Cancer Control and Population Sciences Division, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Bridget G. Parsons
- Cancer Control and Population Sciences Division, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Helen M. Lillie
- Department of CommunicationUniversity of UtahSalt Lake CityUtahUSA
| | - Ali P. Wankier
- Cancer Control and Population Sciences Division, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Heather J. Smith
- Cancer Control and Population Sciences Division, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Douglas Grossman
- Cancer Control and Population Sciences Division, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA,Department of DermatologyUniversity of Utah Health Sciences CenterSalt Lake CityUtahUSA
| | - Jennifer L. Hay
- Department of Psychiatry & Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Yelena P. Wu
- Cancer Control and Population Sciences Division, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA,Department of DermatologyUniversity of Utah Health Sciences CenterSalt Lake CityUtahUSA
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17
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Waters AR, Mann K, Vaca Lopez PL, Kepka D, Wu YP, Kirchhoff AC. HPV Vaccine Experiences and Preferences Among Young Adult Cancer Survivors and Caregivers of Childhood Cancer Survivors. J Cancer Educ 2022; 37:1519-1524. [PMID: 33740231 PMCID: PMC8454692 DOI: 10.1007/s13187-021-01992-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/07/2021] [Indexed: 05/23/2023]
Abstract
Cancer survivors are at higher risk of developing HPV-associated cancers later in life, yet their HPV vaccination rates remain lower than the general population. Improving HPV vaccination uptake among survivors is essential to preventing second malignancies. We interviewed HPV vaccine eligible adolescent and young adult (AYA) cancer survivors (18-26 years) and caregivers of HPV vaccine eligible childhood cancer survivors approaching the AYA age range (9-17 years) about their HPV vaccine experiences and preferences as informed by the HPV Vaccination Roundtable Best Practices. Interviews (N = 20) were recorded, transcribed, and analyzed using interpretive description. Of AYA survivors (n = 10), 50% had received at least one HPV vaccine dose. Of caregivers (n = 10), 30% reported their child had received at least one HPV vaccine dose. Three distinct categories emerged including (1) HPV vaccine knowledge, (2) HPV vaccination recommendation preferences, and (3) HPV vaccination reminder preferences. The first two categories were oncology focused. Participants lacked knowledge regarding HPV vaccine safety and applicability due to their complex cancer history. Most participants strongly preferred that their oncologist provide an HPV vaccine recommendation. The third category was mixed, with some participants preferring oncology-based HPV vaccine reminders while others preferred primary care-based reminders. Almost all participants preferred digital reminders (e.g., text messages). Our results suggest that oncologists play an essential role in recommending the HPV vaccine and providing information to assist survivors and caregivers with vaccine decision-making. Additionally, HPV vaccination uptake among pediatric and childhood and AYA survivors could be improved through the use of tailored, electronically delivered vaccine reminders.
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Affiliation(s)
- Austin R Waters
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA.
| | - Karely Mann
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Perla L Vaca Lopez
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Deanna Kepka
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
- College of Nursing, University of Utah, Salt Lake City, UT, 84112, USA
| | - Yelena P Wu
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
- Department of Dermatology, University of Utah, Salt Lake City, UT, 84112, USA
| | - Anne C Kirchhoff
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
- Department of Pediatrics, University of Utah, Salt Lake City, UT, 84112, USA
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18
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Wu YP, Parsons B, Jo Y, Chipman J, Haaland B, Nagelhout ES, Carrington J, Wankier AP, Brady H, Grossman D. Outdoor activities and sunburn among urban and rural families in a Western region of the US: Implications for skin cancer prevention. Prev Med Rep 2022; 29:101914. [PMID: 35911574 PMCID: PMC9326324 DOI: 10.1016/j.pmedr.2022.101914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/07/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022] Open
Abstract
Skin cancer risk differs between individuals in rural versus urban communities. Differing skin cancer risk could be due to unique patterns of outdoor activities. Rural versus urban adults and children engage in different outdoor activities. Preventive interventions could target activities with high sunburn risk.
Prevention of skin cancer involves decreasing exposure to ultraviolet radiation (UVR) and avoiding sunburn, especially early in life. Individuals living in urban versus rural areas, as defined by the Rural Urban Commuting Area (RUCA) code classification, have different risks for skin cancer, likely due to differing patterns of outdoor activities and preventive behaviors employed when outdoors. However, few studies have examined differences in outdoor activities between rural and urban individuals and examined this among both adults and children. This study compared the outdoor activities, sun protection strategies, tanning behaviors, and sunburn occurrence of adults and children (n = 97 dyads) in rural versus urban settings in a Western region of the United States. The relationships between outdoor activities and sunburn occurrence were examined in both groups. Analyses employed Barnard’s Exact Test and logistic generalized estimating equations models. Individuals in rural and urban areas reported differences in sun protection strategies used, tanning behaviors, and outdoor activities. Individuals in urban areas more commonly reported use of certain forms of sun protection, such as sunscreen and shade, whereas long pants and skirt wearing were more common for children in rural areas. Individuals in rural areas were more likely than those in urban areas to engage in farm work, yard work, and youth sports. Gender differences in these outcomes were also identified. Skin cancer preventive interventions could be tailored for rural and urban families to target sun protection strategies to outdoor activities and to situations in which sunburns are likely to occur.
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Affiliation(s)
- Yelena P Wu
- Department of Dermatology, University of Utah Health Sciences Center, 30 North 1900 East, 4A330 - Salt Lake City, UT 84132, USA.,Huntsman Cancer Institute, University of Utah, 1950, 2000 Cir of Hope Dr, Salt Lake City, UT 84112, USA
| | - Bridget Parsons
- Huntsman Cancer Institute, University of Utah, 1950, 2000 Cir of Hope Dr, Salt Lake City, UT 84112, USA
| | - Yeonjung Jo
- Department of Population Health Sciences, University of Utah, 295 Chipeta Way, Williams Building, Room 1N410, Salt Lake City, UT 84108, USA
| | - Jonathan Chipman
- Huntsman Cancer Institute, University of Utah, 1950, 2000 Cir of Hope Dr, Salt Lake City, UT 84112, USA.,Department of Population Health Sciences, University of Utah, 295 Chipeta Way, Williams Building, Room 1N410, Salt Lake City, UT 84108, USA
| | - Benjamin Haaland
- Huntsman Cancer Institute, University of Utah, 1950, 2000 Cir of Hope Dr, Salt Lake City, UT 84112, USA.,Department of Population Health Sciences, University of Utah, 295 Chipeta Way, Williams Building, Room 1N410, Salt Lake City, UT 84108, USA
| | | | - James Carrington
- School of Medicine, University of Utah, 30 N 1900 E, Salt Lake City, UT 84132, USA
| | - Ali P Wankier
- Huntsman Cancer Institute, University of Utah, 1950, 2000 Cir of Hope Dr, Salt Lake City, UT 84112, USA
| | - Hannah Brady
- Huntsman Cancer Institute, University of Utah, 1950, 2000 Cir of Hope Dr, Salt Lake City, UT 84112, USA
| | - Douglas Grossman
- Department of Dermatology, University of Utah Health Sciences Center, 30 North 1900 East, 4A330 - Salt Lake City, UT 84132, USA.,Huntsman Cancer Institute, University of Utah, 1950, 2000 Cir of Hope Dr, Salt Lake City, UT 84112, USA
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19
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Upshaw SJ, Jensen JD, Giorgi EA, Pokharel M, Lillie HM, Adams DR, John KK, Wu YP, Grossman D. Developing skin cancer education materials for darker skin populations: crowdsourced design, message targeting, and acral lentiginous melanoma. J Behav Med 2022:10.1007/s10865-022-00362-x. [PMID: 36125669 DOI: 10.1007/s10865-022-00362-x] [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: 03/17/2021] [Accepted: 09/28/2021] [Indexed: 11/26/2022]
Abstract
Despite decreased susceptibility, darker skin individuals who develop melanoma have worse survival. This disparity in melanoma mortality is the largest for any cancer, and partly driven by a lack of patient education materials targeted to darker skin populations in whom acral lentiginous melanoma (ALM) is the most common subtype. To address this communication disparity, the current study reports a multi-phase design process that leverages crowdsourcing and message testing to develop ALM-focused patient education materials for darker skin populations. Crowdsourced design was utilized to develop a pool of designs (phase 1), the pool was narrowed and thematically analyzed (phase 2), and select designs were evaluated via a message experiment (N = 1877). For darker skin populations, designs that depicted people enhanced knowledge of ALM through message memorability. The current study engages melanoma disparities by providing ALM patient education materials for darker skin populations vetted via a multi-phase process.
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Affiliation(s)
- Sean J Upshaw
- Moody College of Communication, University of Texas-Austin, Austin, TX, USA.
| | - Jakob D Jensen
- Department of Communication, University of Utah, Salt Lake City, UT, USA
| | - Elizabeth A Giorgi
- Department of Communication, University of Utah, Salt Lake City, UT, USA
| | - Manusheela Pokharel
- Department of Communication Studies, Texas State University, San Marcos, TX, USA
| | - Helen M Lillie
- Department of Communication Studies, University of Iowa, Iowa City, IA, USA
| | - Dallin R Adams
- Department of Communication, University of Utah, Salt Lake City, UT, USA
| | - Kevin K John
- School of Communications, Brigham Young University, Provo, UT, USA
| | - Yelena P Wu
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Douglas Grossman
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
- Huntsman Cancer Institute, Salt Lake City, UT, USA
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20
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Thompson D, Deatrick JA, Knafl KA, Swallow VM, Wu YP. A Pragmatic Guide to Qualitative Analysis for Pediatric Researchers. J Pediatr Psychol 2022; 47:1019-1030. [PMID: 35552750 DOI: 10.1093/jpepsy/jsac040] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/05/2022] [Accepted: 04/05/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To describe four approaches to qualitative analysis in order to provide a pragmatic, application-oriented guide to their use in research focused on children and their families. METHODS Four commonly used approaches to qualitative analysis-framework analysis, rapid qualitative analysis, content analysis, and reflexive thematic analysis-are described and compared, including their analytic strategies, tips for use, terminology, and application to a hypothetical example. RESULTS A pragmatic guide to each method is provided as well as examples of how each analytic approach could be utilized to analyze the same dataset. CONCLUSIONS A variety of approaches to qualitative analysis are available to both novice and experienced qualitative researchers. The approach selected from the options presented in this article will depend on numerous factors, such as the clinical problem being explored, research context, aims, objectives, research questions, and resources available such as time and funds, and the qualitative expertise of the team.
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Affiliation(s)
- Debbe Thompson
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Janet A Deatrick
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Kathleen A Knafl
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Veronica M Swallow
- Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, UK
| | - Yelena P Wu
- Department of Dermatology and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
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21
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Bowers JM, Hamilton JG, Wu YP, Moyer A, Hay JL. Acculturation, Sun Tanning Behavior, and Tanning Attitudes Among Asian College Students in the Northeastern USA. Int J Behav Med 2022; 29:25-35. [PMID: 33942255 PMCID: PMC9272584 DOI: 10.1007/s12529-021-09993-x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND College students participate in high levels of tanning, a skin cancer risk behavior due to ultraviolet radiation exposure, yet little is known about Asian college students' behavior. This study examined the relationship between tanning attitudes, acculturation to the USA (cultural assimilation), and tanning behavior. METHOD An online survey was used to recruit 211 Asian college students in the northeastern USA (47.4% born outside of the USA) to respond to questions about recent tanning behavior, sun protection strategies, attitudes about tanning, and acculturation to the USA. RESULTS Attitudes about tanning, particularly desire for a darker skin tone and social norms, along with acculturation to the USA, were predictive of intentional tanning. The sample reported high levels of sun protection, which was associated with low acculturation. CONCLUSION The significant role of acculturation in this study indicates that it may be a useful factor to include in future tanning intervention studies of relevant populations.
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Affiliation(s)
- Jennifer M. Bowers
- Department of Psychology, Stony Brook University, 100 Nichols Road, Stony Brook, NY 11794-2500, USA,Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
| | - Jada G. Hamilton
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
| | - Yelena P. Wu
- Department of Dermatology, University of Utah, Salt Lake City, UT 84132, USA
| | - Anne Moyer
- Department of Psychology, Stony Brook University, 100 Nichols Road, Stony Brook, NY 11794-2500, USA
| | - Jennifer L. Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
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22
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Law WK, Yaremych HE, Ferrer RA, Richardson E, Wu YP, Turbitt E. Decision-making about genetic health information among family dyads: a systematic literature review. Health Psychol Rev 2021; 16:412-429. [PMID: 34546151 DOI: 10.1080/17437199.2021.1980083] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Decisions involving two individuals (i.e., dyadic decision-making) have been increasingly studied in healthcare research. There is evidence of bi-directional influences in decision-making processes among spousal, provider-patient and parent-child dyads. Genetic information can directly impact biologically related individuals. Thus, it is important to understand dyadic decision-making about genetic health information among family members. This systematic literature review aimed to identify literature examining decision-making among family dyads. Peer-reviewed publications were included if they reported quantitative empirical research on dyadic decision-making about genetic information, published between January 1998 and August 2020 and written in English. The search was conducted in 6 databases and returned 3167 articles, of which 15 met the inclusion criteria. Most studies were in the context of cancer genetic testing (n = 8) or reproductive testing or screening (n = 5). Studies reported two broad categories of decisions with dyadic influence: undergoing screening or testing (n = 10) and sharing information with family (n = 5). Factors were correlated between dyads such as attitudes, knowledge, behaviors and psychological wellbeing. Emerging evidence shows that dyad members influence each other when making decisions about receiving or sharing genetic information. Our findings emphasize the importance of considering both members of a dyad in intervention design and clinical interactions.
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Affiliation(s)
- Wai Ki Law
- The Discipline of Genetic Counselling, The University of Technology Sydney, Ultimo, Australia
| | - Haley E Yaremych
- Department of Psychology & Human Development, Vanderbilt University, Nashville, TN, USA.,Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, MD, USA
| | - Rebecca A Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, National Cancer Institute, Bethesda, MD, USA
| | - Ebony Richardson
- The Discipline of Genetic Counselling, The University of Technology Sydney, Ultimo, Australia
| | - Yelena P Wu
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA.,Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Erin Turbitt
- The Discipline of Genetic Counselling, The University of Technology Sydney, Ultimo, Australia.,Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, MD, USA
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23
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Parsons BG, Nagelhout ES, Wankier AP, Hu N, Lensink R, Zhu A, Nottingham K, Grossman D, Jensen JD, Wu YP. Reactivity to UV Radiation Exposure Monitoring Using Personal Exposure Devices for Skin Cancer Prevention: Longitudinal Observational Study. JMIR Mhealth Uhealth 2021; 9:e29694. [PMID: 34581683 PMCID: PMC8512190 DOI: 10.2196/29694] [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: 04/22/2021] [Revised: 06/23/2021] [Accepted: 08/03/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Emerging UV radiation (UVR) monitoring devices may present an opportunity to integrate such technology into skin cancer prevention interventions. However, little is known about the effects of using a wearable UVR monitor on adults' and children's sun protection-related behaviors and attitudes (eg, cancer worry and perceived risk). Understanding the potential role of reactivity and seasonal effects will help inform the use of objective monitors in the context of skin cancer prevention research, including intervention studies. OBJECTIVE The aim of this study is to examine the potential reactivity associated with a wearable personal UVR monitor, specifically the effects associated with reported sun-protective behaviors and skin cancer-related attitudes, which are often the targets of skin cancer preventive interventions. METHODS Child-parent dyads (n=97 dyads) were asked to wear a UVR monitoring device during waking hours for 2 weeks. Participants were asked to sync the device daily with a smartphone app that stored the UVR exposure data. Participants were blinded to their UVR exposure data during the 2-week period; thus, the smartphone app provided no feedback to the participants on their UVR exposure. Participants completed self-report questionnaires assessing sun-protective behaviors, sunburn, tanning, skin self-examination, skin cancer-related knowledge, perceived risk, cancer worry, response efficacy, and intentions to change behaviors over the 2-week period. Linear regressions were conducted to investigate changes in the outcomes over time and to account for the role of the season of study participation. RESULTS Regression results revealed that there was a significant decrease over time for several sun protection outcomes in children, including time spent outdoors on weekends (P=.02) and weekdays (P=.008), sunscreen use (P=.03), reapplication (P<.001), and unintentional tanning (P<.001). There were no significant changes over time in children's and parents' UVR exposure, sunburn occurrence, or sun protection attitudes. Season of participation was associated with several outcomes, including lower sunscreen use (P<.001), reapplication (P<.001), sunburns (P=.01), intentions to change sun-protective behaviors (P=.02), and intentional (P=.008) and unintentional tanning (P=.01) for participants who participated in the fall versus the summer. CONCLUSIONS The findings from this study suggest that daily use of a UVR monitoring device over a 2-week period may result in changes in certain sun-protective behaviors. These results highlight the importance of identifying and addressing potential reactivity to UVR monitoring devices, especially in the context of skin cancer preventive intervention research. Ultimately, objectively assessed UVR exposure could be integrated into the outcome assessment for future testing of skin cancer prevention interventions.
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Affiliation(s)
- Bridget G Parsons
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | | | - Ali P Wankier
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Nan Hu
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | - Riley Lensink
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Angela Zhu
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Katy Nottingham
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Douglas Grossman
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Jakob D Jensen
- Department of Communication, University of Utah, Salt Lake City, UT, United States
| | - Yelena P Wu
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States.,Department of Dermatology, University of Utah, Salt Lake City, UT, United States
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24
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Palermo TM, Alderfer MA, Boerner KE, Hilliard ME, Hood AM, Modi AC, Wu YP. Editorial: Diversity, Equity, and Inclusion: Reporting Race and Ethnicity in the Journal of Pediatric Psychology. J Pediatr Psychol 2021; 46:731-733. [PMID: 34270747 PMCID: PMC8502460 DOI: 10.1093/jpepsy/jsab063] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 05/05/2021] [Revised: 05/09/2021] [Accepted: 05/10/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Tonya M Palermo
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle Children’s Research Institute
| | - Melissa A Alderfer
- Center for Healthcare Delivery Science, Nemours Children’s Health System and Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University
| | - Katelynn E Boerner
- Department of Pediatrics, University of British Columbia, BC Children’s Hospital Research Institute
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital
| | - Anna M Hood
- Developmental Neurosciences Unit and Biomedical Research Centre, University College London Great Ormond Street Institute of Child Health
| | - Avani C Modi
- Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati-College of Medicine
| | - Yelena P Wu
- Department of Dermatology, University of Utah, Huntsman Cancer Institute
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25
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Jin H, Chen L, Li J, An X, Wu YP, Zhu L, Yi H, Li KH. Vertically stacked RGB LEDs with optimized distributed Bragg reflectors. Opt Lett 2020; 45:6671-6674. [PMID: 33325867 DOI: 10.1364/ol.408416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 09/18/2020] [Indexed: 06/12/2023]
Abstract
The design and fabrication of a vertically stacked red-green-blue (RGB) light-emitting diode (LED) with novel, to the best of our knowledge, wavelength-selective distributed Bragg reflectors (DBRs) are demonstrated. The two DBRs are optimized to achieve selective reflectance in the RGB spectral region through theoretical calculations and simulation modeling. The insertion of optimal DBRs into the stack structure can effectively reflect downward emission from the upper chip without filtering the emission from the lower chips, thereby increasing the luminous efficiency for white emission with a color temperature range of 3000-8000 K by 1.6-7.4%. The optical performances of stacked devices with and without DBRs are thoroughly studied, verifying the effectiveness of the proposed wavelength-selective DBR structure.
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26
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Abstract
OBJECTIVE The incidence of melanoma is increasing. Other than limiting UV exposure, few factors prevent or reduce the risk of melanoma. The aim of this study is to evaluate the relationship between vitamin D intake and melanoma risk in the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial. METHODS A secondary data analysis was performed on PLCO data. More than 1,300 participants developed melanoma. RESULTS Melanoma risk may be increased among men within the highest quartile of vitamin D intake (HR 1.27, 95% CI 0.99, 1.61). Women in the highest quartile of vitamin D intake had a decreased risk of invasive melanoma (HR 0.63, 95% CI 0.41, 0.96). Higher education and being white corresponded with deeper tumors (P < .001). CONCLUSION High reported vitamin D intake resulted in an increased risk of melanoma among men. Vitamin D intake yielded a protective effect against invasive melanoma in women.
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Affiliation(s)
- Mark A Hyde
- At the University of Utah Health Sciences Center in Salt Lake City, Mark A. Hyde is an assistant professor of dermatology at the Huntsman Cancer Institute and an assistant professor in the department of community and public health at Utah Valley University, Douglas Grossman is a professor in the Department of Dermatology and codirector of the melanoma and cutaneous oncology program at the Huntsman Cancer Institute, Yelena P. Wu is an assistant professor in the Department of Dermatology, Saundra Buys is a professor in the Department of Medicine and medical director of the High Risk Breast Cancer Clinic at the Huntsman Cancer Institute, Lisa H. Gren is an associate professor in the Department of Family and Preventive Medicine, and Mia Hashibe is an associate professor in the Department of Family and Preventive Medicine and at the Huntsman Cancer Institute. This work was supported by the National Cancer Institute (NCI) of the National Institutes of Health (K07CA196985). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or NCI. The authors have disclosed no other potential conflicts of interest, financial or otherwise
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27
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Abstract
Photo-plethysmography (PPG) making use of a monochromic light source and a photoelectric sensor is a non-invasive detection method to record blood volume changes in vessels and can be used to extract cardiac-related heart pulse information. Here, we demonstrated the fabrication of a monolithic photonic chip by integrating light-emitting diodes (LEDs) with photodetectors (PDs) on the same GaN-on-sapphire wafer containing InGaN/GaN multi-quantum wells (MQWs). The MQWs simultaneously act as light emitters in the LEDs and detectors in the PDs, and their mechanism has been studied. The fabricated chip operating in reflection mode is flip-chip bonded on a flexible polydimethylsiloxane (PDMS) strip, enabling the sapphire surface in close contact with the skin. The optical and electrical properties of the LED and PD have been thoroughly characterized, confirming that the PDs using identical MQWs can detect the reflected light from the LEDs. By attaching the chip to the wrist, PPG heart pulse signals from the arterial blood flow can be obtained, thereby verifying the feasibility of the proposed monolithic chip.
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28
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Nagelhout ES, Lensink R, Zhu A, Parsons BG, Haaland B, Hashibe M, Grossman D, VanDerslice J, Gren LH, Jensen JD, Wu YP. Higher Ultraviolet Radiation Exposure Among Rural-Dwelling Versus Urban-Dwelling Adults and Children: Implications for Skin Cancer Prevention. J Community Health 2020; 46:147-155. [PMID: 32542551 DOI: 10.1007/s10900-020-00860-6] [Citation(s) in RCA: 4] [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] [Indexed: 11/26/2022]
Abstract
Ultraviolet radiation (UVR) exposure is a primary risk factor for the development of melanoma. However, adults and adolescents often do not engage in preventive behaviors to reduce UVR exposure. Rural residents may be at higher risk for melanoma due to lower use of sun protection strategies, which increases their overall UVR exposure compared to those who live in urban areas. The purpose of this study was to evaluate differences in UVR exposure between rural and urban residents in a geographic area with high incidence of melanoma. Children (aged 8-17 years) and adults (≥ 18 years) from rural and urban areas of Utah were asked to wear a UVR monitoring device for 14 days. The sample included 97 children and 97 adults. Data was collected from June to October 2018. Non-parametric Mann-Whitney tests and quantile regression were used to compare UVR exposure levels between urban and rural participants, separately for adults and children. For adults, rural residence significantly increased total UVR dose ( β: 24.6; 95% CI 3.75, 42.74) and the UVR dose during peak UVR hours among participants with the highest UVR doses (β: 16.3; 95% CI 17.4, 24.63). Rural children exhibited significantly higher UVR doses for peak UVR hours for the entire study period (β: 4.14; 95% CI 0.83, 7.46) and on weekdays (β: 0.39; 95% CI 0.05, 0.73). The findings from this study indicate that rural residents may receive higher levels of UVR exposure than urban residents, and that prevention efforts could be tailored to address these geographical differences.
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Affiliation(s)
- Elizabeth S Nagelhout
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA
| | - Riley Lensink
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Angela Zhu
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Bridget G Parsons
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Benjamin Haaland
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
- Division of Biostatistics, Department of Population Health Sciences, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Mia Hashibe
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA
| | - Douglas Grossman
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
- Department of Oncological Sciences, University of Utah, 201 Presidents Circle, Salt Lake City, UT, 84112, USA
- Department of Dermatology, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA
| | - James VanDerslice
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA
| | - Lisa H Gren
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA
| | - Jakob D Jensen
- Department of Communication, University of Utah, 255 Central Campus Dr #2400, Salt Lake City, UT, 84112, USA
| | - Yelena P Wu
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA.
- Department of Dermatology, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA.
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Parsons BG, Hay JL, Aspinwall LG, Zaugg K, Zhu A, Mooney RH, Klein SZ, Grossman D, Leachman SA, Wu YP. Understanding Skin Screening Practices Among Children at Elevated Risk for Melanoma to Inform Interventions for Melanoma Prevention and Control. J Cancer Educ 2020; 35:509-514. [PMID: 30771212 PMCID: PMC6697232 DOI: 10.1007/s13187-019-01489-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Melanoma is the deadliest form of skin cancer. Screening can aid in early disease detection, when treatment is more effective. Although there are currently no consensus guidelines regarding skin screening for pediatric populations with elevated familial risk for melanoma, at-risk children with the help of their parents and healthcare providers may implement skin self-exams. Healthcare providers may also recommend screening practices for these children. The goal of the current study was to describe current screening behaviors and provider recommendation for screening among children of melanoma survivors. Parents of children with a family history of melanoma completed a questionnaire that included items on children's screening frequency, thoroughness, and who performed the screening. Seventy-four percent of parents reported that their children (mean age = 9.0 years, SD = 4.8) had engaged in parent-assisted skin self-exams (SSEs) in the past 6 months. Only 12% of parents reported that children received SSEs once per month (the recommended frequency for adult melanoma survivors). In open-ended responses, parents reported that healthcare providers had provided recommendations around how to conduct SSEs, but most parents did not report receiving information on recommended SSE frequency. Twenty-six percent of parents (n = 18) reported that children had received a skin exam by a healthcare provider in the past 6 months. The majority of children with a family history of melanoma are reportedly engaging in skin exams despite the lack of guidelines on screening in this population. Future melanoma preventive interventions should consider providing families guidance about implementing screening with their children.
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Affiliation(s)
- Bridget G Parsons
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT, 84112, USA
| | - Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Lisa G Aspinwall
- Department of Psychology, University of Utah, 380 South 1530 East, Room 502, Salt Lake City, UT, 84112, USA
| | - Kelsey Zaugg
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT, 84112, USA
| | - Angela Zhu
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT, 84112, USA
| | - Ryan H Mooney
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT, 84112, USA
| | - Stephanie Z Klein
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT, 84132, USA
| | - Douglas Grossman
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT, 84112, USA
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT, 84132, USA
| | - Sancy A Leachman
- Department of Dermatology & Knight Cancer Institute, Oregon Health & Science University, 3303 SW Bond Avenue, Portland, OR, 97239, USA
| | - Yelena P Wu
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT, 84112, USA.
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT, 84132, USA.
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Mann K, Wu YP, Pannier ST, Hacking C, Warner EL, Rosen S, Acharya A, Wright J, Gerdy C, Kirchhoff AC. Healthcare provider perspectives on pediatric cancer survivorship care plans: a single institution pilot study. Support Care Cancer 2020; 29:697-706. [PMID: 32435970 DOI: 10.1007/s00520-020-05522-w] [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: 11/19/2019] [Accepted: 05/06/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Survivorship care plans (SCPs) are used to facilitate communication between oncology and primary care providers (PCPs) after cancer treatment and to assist cancer survivors with healthcare decisions. We evaluated pediatric oncology providers' experiences creating and delivering SCPs. We also evaluated PCPs' opinions of SCPs. METHODS Together, oncology nurses and oncologists created individualized SCPs for leukemia patients treated at a children's hospital in Utah, with nurses in charge of inputting the majority of SCP content. We surveyed providers after each SCP was completed. We also mailed SCPs to PCPs with a survey on SCP content and their knowledge and comfort level caring for cancer survivors. Descriptive statistics were used to summarize survey content. RESULTS A total of 6 nurses and 8 oncologists created 21 SCPs. On average, nurses assisted with 3.5 SCPs and spent 209 min (range 100-600 min) on completing their sections of each SCP, whereas oncologists assisted with 2.6 SCPs and spent 47.4 min (range 15-120). For most SCPs, there was agreement that they should be shared with PCPs (nurse surveys 71.4%, oncologist surveys 100%). Of the 15 participating PCPs, only 28% felt prepared to manage long-term effects in pediatric cancer survivors. They agreed that the SCP would improve communication with their patient's oncologist (80%) and their knowledge for future care (100%). CONCLUSIONS SCPs require substantial clinician time to create, but are seen as useful by PCPs. PCPs require specific guidelines and resources concerning ongoing care for pediatric cancer survivors.
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Affiliation(s)
- Karely Mann
- Huntsman Cancer Institute, Cancer Control and Population Sciences, Salt Lake City, UT, USA.
| | - Yelena P Wu
- Huntsman Cancer Institute, Cancer Control and Population Sciences, Salt Lake City, UT, USA.,Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - Samantha T Pannier
- Huntsman Cancer Institute, Cancer Control and Population Sciences, Salt Lake City, UT, USA
| | - Claire Hacking
- Huntsman Cancer Institute, Cancer Control and Population Sciences, Salt Lake City, UT, USA
| | - Echo L Warner
- Huntsman Cancer Institute, Cancer Control and Population Sciences, Salt Lake City, UT, USA.,University of Utah, College of Nursing, Salt Lake City, UT, USA
| | - Stephanie Rosen
- Huntsman Cancer Institute, Cancer Control and Population Sciences, Salt Lake City, UT, USA
| | - Akanksha Acharya
- Huntsman Cancer Institute, Cancer Control and Population Sciences, Salt Lake City, UT, USA
| | | | - Cheryl Gerdy
- Primary Children's Hospital, Intermountain Healthcare, Salt Lake City, UT, USA
| | - Anne C Kirchhoff
- Huntsman Cancer Institute, Cancer Control and Population Sciences, Salt Lake City, UT, USA.,Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
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Nagelhout ES, Lensink R, Zhu A, Parsons BG, Jensen JD, Wu YP. The Feasibility and Acceptability of Using a Wearable UV Radiation Exposure Monitoring Device in Adults and Children: Cross-Sectional Questionnaire Study. JMIR Dermatol 2020; 3:e15711. [PMID: 33043275 PMCID: PMC7546527 DOI: 10.2196/15711] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In the United States, melanoma is the 5th most common cancer. Reducing ultraviolet radiation (UVR) exposure is essential for the prevention of melanoma. Objectively assessing individual-level UVR exposure with the use of wearable technology offers a promising tool for reducing UVR exposure. However, the feasibility and acceptability of using UVR monitoring wearable devices have not been assessed. OBJECTIVE The aim of this study was to assess the feasibility and acceptability of a commercially available UVR monitoring wearable device among adults and children. METHODS The study recruited families (one parent and one child) to test a new, commercially-available UVR monitoring device (Shade). Participants wore the Shade device for two weeks and completed questionnaires assessing the feasibility and acceptability of wearing the device. Qualitative analyses were conducted to summarize participants' open-ended responses regarding device feasibility. RESULTS A total of 194 individuals (97 adults and 97 children) participated. Participating children were on average 12.7 years old. Overall, adults and children reported moderate satisfaction with wearing the Shade device. Feasibility of use of the Shade device was adequate with 73% of adults and 61% of children reporting that they wore the device "all of the time they were outside." Through open-ended responses, participants reported appreciating the device's ease of use, compact size, and that it increased their awareness about their UVR exposure. CONCLUSIONS A new, wearable UVR monitoring device can be feasibly used by adults and children and use of the device was acceptable to participants. The device could be integrated into melanoma preventive interventions to increase individual's and families' awareness of their UVR exposure and to facilitate the use of recommended melanoma preventive strategies.
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Affiliation(s)
- Elizabeth S. Nagelhout
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108
| | - Riley Lensink
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112
| | - Angela Zhu
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112
| | - Bridget G. Parsons
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112
| | - Jakob D. Jensen
- Department of Communication, University of Utah, 255 Central Campus Dr #2400, Salt Lake City, UT 84112
| | - Yelena P. Wu
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, Utah 84132
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32
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Chen JT, Zhou CY, He N, Wu YP. Optimal acquisition time to discriminate between breast cancer subtypes with contrast-enhanced cone-beam CT. Diagn Interv Imaging 2020; 101:391-399. [PMID: 32008993 DOI: 10.1016/j.diii.2020.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 12/29/2019] [Accepted: 01/02/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE To identify the optimal acquisition time to best discriminate between benign and malignant breast lesions on contrast-enhanced cone beam CT (CE-CBCT) and evaluate the potential of CE-CBCT to differentiate between breast cancer subtypes. MATERIAL AND METHOD A total of 98 women with a mean age of 49±10 (SD) years (range: 29-77 years) with 100 BI-RADS 4 or 5 breast lesions were prospectively included. CE-CBCT images were obtained at 1- and 2-min after intravenous administration of iodinated contrast material. Contrast enhancement of breast lesions on CE-CBCT were evaluated and compared between different subtypes. Cut-off values for best discriminating between benign and malignant breast lesions with CE-CBCT were obtained from receiver operating characteristic curves. RESULTS Malignant breast lesions showed greater enhancement than benign ones at 1-min (67.28±39.79 [SD] HU vs. 42.27±40.31 [SD] HU, respectively; P=0.007) and 2-min (70.93±38.05 [SD] HU vs. 48.94±41.83 [SD] HU, respectively; P=0.016) after intravenous administration of contrast material. At 1-min after intravenous administration of contrast material, an optimal cut-off value of 54.43 HU was found to best discriminate between malignant and benign breast lesions (AUC=0.681; 95%CI: 0.558-0.805; P=0.006) yielding 69.0% sensitivity (95%CI: 56.9-79.5%) and 69.2% specificity (95% CI: 48.2-85.7%). At 2-min, an optimal cut-off value of 72.65 HU was found to best discriminate between malignant and benign breast lesions (AUC=0.654; 95%CI: 0.535-0.774; P=0.020) yielding 50.7% sensitivity (95%CI: 38.6-62.8%) and 80.8% specificity (95%CI: 60.6-93.4%). CE-CBCT helped differentiate between immunohistochemical subtypes of breast lesions with lowest enhancement for triple negative lesions. No differences in enhancement were found among histopathological subtypes lesions at 1-min (P=0.478) and 2-min (P=0.625). CONCLUSION CE-CBCT helps discriminate between malignant and benign breast lesions, with best capabilities obtained at 1-min after intravenous administration of contrast material. For malignant lesions, quantitative analysis of enhancement on CE-CBCT helps differentiate between immunohistochemical subtypes.
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Affiliation(s)
- J T Chen
- Department of Medical Imaging and Image-guided Therapy, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 510060 Guangzhou, China
| | - C Y Zhou
- Department of Medical Imaging and Image-guided Therapy, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 510060 Guangzhou, China
| | - N He
- Department of Medical Imaging and Image-guided Therapy, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 510060 Guangzhou, China
| | - Y P Wu
- Department of Medical Imaging and Image-guided Therapy, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 510060 Guangzhou, China.
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Coffin T, Wu YP, Mays D, Rini C, Tercyak KP, Bowen D. Relationship of parent-child sun protection among those at risk for and surviving with melanoma: Implications for family-based cancer prevention. Transl Behav Med 2020; 9:480-488. [PMID: 31094442 DOI: 10.1093/tbm/ibz032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Preventing melanoma, the most serious form of skin cancer, is an important cancer control priority. This is especially true among children living in families previously affected by the disease because the risks for melanoma typically begin early in life. These risks accrue into adulthood but may be mitigated by parental intervention. Melanoma prevention behaviors that could be associated between adults and their children include use of sunscreen, protective clothing, seeking shade, or limiting sun exposure. This study sought to investigate how parent perceptions and behaviors influence sun protection and avoidance behaviors in their children, among relatives of melanoma survivors. In this cross-sectional study, parents (N = 313), all relatives of people diagnosed with melanoma, were surveyed about their melanoma risk-reduction behaviors and efforts to protect their children from sun exposure. Linear multiple regressions examined associations among parental behaviors, beliefs, and their reports of risk reduction for their children. Parents who practiced high sun protection themselves (i.e., wearing protective clothing, avoiding the sun, using sunscreen) were significantly more likely to report their child also wore protective clothing (B = 0.04, p < .004). Findings suggest that parents' use of risk-reducing behavioral measures extended to protective measures among their children. These findings have implications for the clinical care of melanoma survivors' families, including the design of targeted interventions that alter parental beliefs and behaviors surrounding both their own and their children's cancer prevention strategies.
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Affiliation(s)
- Tara Coffin
- Institute for Public Health Genetics, University of Washington, Washington, USA
| | - Yelena P Wu
- Huntsman Cancer Institute, University of Utah, Utah, USA.,Department of Dermatology, University of Utah, Utah, USA
| | - Darren Mays
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, NW, Washington, DC, USA
| | - Christine Rini
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, NW, Washington, DC, USA.,Department of Biomedical Research, John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Kenneth P Tercyak
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, NW, Washington, DC, USA
| | - Deborah Bowen
- Department of Bioethics & Humanities, University of Washington, Washington, USA
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34
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Wu YP, Parsons BG, Nagelhout E, Haaland B, Jensen J, Zaugg K, Caputo H, Lensink R, Harding G, Yancey J, Klein SZ, Leachman SA, Tercyak KP. A four-group experiment to improve Western high school students' sun protection behaviors. Transl Behav Med 2020; 9:468-479. [PMID: 31094440 DOI: 10.1093/tbm/ibz021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Multicomponent skin cancer preventive interventions for adolescents that aim to decrease ultraviolet radiation (UVR) exposure and sunburns are particularly needed given their intentional tanning and infrequent use of sun protection. The purpose of this study was to conduct an early-phase study within the Multiphase Optimization Strategy framework that experimentally tested four unique intervention components targeting high school students' skin cancer prevention behaviors. Schools (11 total, N = 1,573 students) were assigned to receive one of four interventions: skin cancer education (control), education plus a sunscreen activity (to illustrate sunscreen's UVR-blocking properties), or behavior change worksheet (sun protection goal setting and planning) or receipt of a personalized UV damage photograph (photograph of facial damage). Sun protection, sunburn, and tanning outcomes were assessed before intervention and at 1-month follow-up. Within- and between-intervention changes in outcomes were examined using generalized estimating equation modeling. All interventions were associated with significant improvements in sun protection. The photograph was superior in controlling intentional tanning and sunburn when compared to the behavior change worksheet (ps < .05). In contrast, the worksheet was associated with greater increases in sun protection use when compared with the photograph (ps < .05). In this experiment testing four skin cancer preventive intervention components that varied in approach, content, and interactivity, the behavior change worksheet was superior in improving sun protection use whereas the UV photograph was superior in controlling intentional tanning and sunburn. Future randomized trials to test combinations of these intervention components are needed, and could identify mechanisms underlying improved effects and demographic or behavioral moderators of intervention effects.
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Affiliation(s)
- Yelena P Wu
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA.,Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Bridget G Parsons
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Elizabeth Nagelhout
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Benjamin Haaland
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Jakob Jensen
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Department of Communication, University of Utah, Salt Lake City, UT, USA
| | - Kelsey Zaugg
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Heloisa Caputo
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Riley Lensink
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Garrett Harding
- Community Outreach and Prevention Education, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Jeffrey Yancey
- Community Outreach and Prevention Education, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Stephanie Z Klein
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - Sancy A Leachman
- Department of Dermatology, Oregon Health & Science University, Portland, OR, USA.,Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Kenneth P Tercyak
- Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, NW Washington, DC, USA
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35
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Wu YP, Boucher K, Hu N, Hay J, Kohlmann W, Aspinwall LG, Bowen DJ, Parsons BG, Nagelhout ES, Grossman D, Mooney K, Leachman SA, Tercyak KP. A pilot study of a telehealth family-focused melanoma preventive intervention for children with a family history of melanoma. Psychooncology 2020; 29:148-155. [PMID: 31520429 PMCID: PMC6980884 DOI: 10.1002/pon.5232] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/23/2019] [Accepted: 09/11/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Melanoma preventive interventions for children with familial risk are critically needed because ultraviolet radiation (UVR) exposure and sunburn occurrence early in life are the primary modifiable risk factors for melanoma. The current study examined the feasibility and acceptability of a new, family-focused telehealth intervention for children with familial risk for melanoma and their parents. The study also explored changes in child sun protection and risk behaviors, sunburn occurrence, and objectively measured UVR exposure. METHODS This was a prospective study with a single-group design (n = 21 parent-child dyads, children ages 8-17). Dyads were asked to participate in three in-person assessments and three live video teleconference intervention sessions. RESULTS The intervention was feasibly delivered, and the intervention content was acceptable to parents and children. The intervention was associated with improvements in child use of certain sun protection strategies over time and declines in child UVR exposure. CONCLUSIONS A telehealth-delivered,family-focused melanoma preventive intervention was feasibly delivered and was acceptable to parent-child dyads. Future melanoma preventive interventions for this at-risk population could incorporate eHealth technologies to facilitate improvements in use of sun protection and monitoring of UVR exposure. This trial was registered with Clinicaltrials.gov, number NCT02846714.
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Affiliation(s)
- Yelena P Wu
- Department of Dermatology, University of Utah, Salt Lake City, Utah
- Huntsman Cancer Institute, Salt Lake City, Utah
| | - Kenneth Boucher
- Huntsman Cancer Institute, Salt Lake City, Utah
- Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Nan Hu
- Huntsman Cancer Institute, Salt Lake City, Utah
- Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Jennifer Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Lisa G Aspinwall
- Department of Psychology, University of Utah, Salt Lake City, Utah
| | - Deborah J Bowen
- Department of Bioethics and Humanities, University of Washington, Seattle, Washington
| | | | - Elizabeth S Nagelhout
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah
| | - Douglas Grossman
- Department of Dermatology, University of Utah, Salt Lake City, Utah
- Huntsman Cancer Institute, Salt Lake City, Utah
| | - Kathi Mooney
- Huntsman Cancer Institute, Salt Lake City, Utah
- College of Nursing, University of Utah, Salt Lake City, Utah
| | - Sancy A Leachman
- Department of Dermatology & Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon
| | - Kenneth P Tercyak
- Cancer Control Program, Georgetown Lombardi Comprehensive Cancer Center, Washington, D.C
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Abstract
Individuals residing in U.S. frontier counties have limited access to dermatology care and higher melanoma mortality rates. Given these limitations, frontier residents rely disproportionately on skin self-examinations (SSE) for early detection of melanoma, though little is known about their SSE behaviors and barriers to conducting SSEs. The goal of the present study was to identify obstacles to SSE performance via a survey of adults (N = 107) living in a U.S. frontier county. Approximately 43% of participants were classified as inclined abstainers - individuals who intended to perform SSE, but failed to follow through. Compared to those who did follow through, inclined abstainers were more likely to be hindered by twelve barriers, including forgetting, letting other tasks get in the way of SSE, and struggling to identify a good time or routine for SSE performance. The barriers to action for these inclined abstainers are modifiable - for example, not remembering to do it - and well positioned for a behavioral intervention.
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Affiliation(s)
- Jakob D Jensen
- Department of Communication, University of Utah, Salt Lake City, UT, USA.,Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Manusheela Pokharel
- Department of Communication Studies, Texas State University, San Marcos, TX, USA
| | - Andy J King
- Greenlee School, Iowa State University, Ames, IA, USA
| | - Kevin K John
- School of Communications, Brigham Young University, Provo, UT, USA
| | - Yelena P Wu
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - Douglas Grossman
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Department of Dermatology, University of Utah, Salt Lake City, UT, USA.,Department of Oncological Sciences, University of Utah, Salt Lake City, UT, USA
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Nagelhout ES, Parsons BG, Haaland B, Tercyak KP, Zaugg K, Zhu A, Harding G, Yancey J, Jensen JD, Grossman D, Wetter DW, Wu YP. Differences in reported sun protection practices, skin cancer knowledge, and perceived risk for skin cancer between rural and urban high school students. Cancer Causes Control 2019; 30:1251-1258. [PMID: 31522321 PMCID: PMC6802938 DOI: 10.1007/s10552-019-01228-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 09/04/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of the current study was to evaluate differences in reported use of sun protection, tanning behaviors, skin cancer-related knowledge, and perceived risk between rural and urban high school students in a geographic area with high rates of melanoma. METHODS A total of 1,570 high school students (56.8% female) from urban (6 schools) and rural (7 schools) geographic areas in Utah completed questionnaires assessing sun protection and tanning behaviors, skin cancer-related knowledge, and perceived risk for skin cancer. Analyses examined potential differences in these outcomes between rural and urban students and by gender. RESULTS Compared to students in urban areas, those in rural areas had lower odds of wearing sunscreen (OR 0.71; 95% CI 0.53, 0.95; p = 0.022), re-applying sunscreen (OR 0.61; 95% CI 0.74, 1.02; p = 0.002), wearing long-sleeved shirts (OR 0.63 95% CI 0.46, 0.86; p = 0.004), and seeking shade (OR 0.67; 95% CI 0.50, 0.88; p = 0.005). CONCLUSIONS Rural students reported less adequate use of sun protection than urban students. Rural male students reported lower knowledge scores compared to urban males. Future skin cancer prevention efforts targeting rural high schoolers are warranted.
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Affiliation(s)
- Elizabeth S Nagelhout
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA
| | - Bridget G Parsons
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Benjamin Haaland
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
- Division of Biostatistics, Department of Population Health Sciences, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Kenneth P Tercyak
- Cancer Prevention & Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC, 20007, USA
| | - Kelsey Zaugg
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Angela Zhu
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Garrett Harding
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Jeffrey Yancey
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Jakob D Jensen
- Department of Communication, University of Utah, 255 Central Campus Dr #2400, Salt Lake City, UT, 84112, USA
| | - Douglas Grossman
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
- Department of Oncological Sciences, University of Utah, 201 Presidents Circle, Salt Lake City, UT, 84112, USA
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT, 84132, USA
| | - David W Wetter
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Yelena P Wu
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA.
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT, 84132, USA.
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Abstract
This narrative review describes the evidence regarding digital health interventions targeting adolescent and young adult (AYA) cancer survivors. We reviewed the published literature for studies involving Internet, mHealth, social media, telehealth, and other digital interventions for AYA survivors. We highlight selected studies to illustrate the state of the research in this unique patient population. Interventions have used various digital modalities to improve health behaviors (eg, physical activity, nutrition, tobacco cessation), enhance emotional well-being, track and intervene on cancer-related symptoms, and improve survivorship care delivery. The majority of studies have demonstrated feasibility and acceptability of digital health interventions for AYA survivors, but few efficacy studies have been conducted. Digital health interventions are promising to address unmet psychosocial and health information needs of AYA survivors. Researchers should use rigorous development and evaluation methods to demonstrate the efficacy of these approaches to improve health outcomes for AYA survivors.
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Affiliation(s)
- Katie A Devine
- Katie A. Devine, Adrienne S. Viola, and Elliot J. Coups, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Yelena P. Wu, Huntsman Cancer Institute, Salt Lake City, UT
| | - Adrienne S Viola
- Katie A. Devine, Adrienne S. Viola, and Elliot J. Coups, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Yelena P. Wu, Huntsman Cancer Institute, Salt Lake City, UT
| | - Elliot J Coups
- Katie A. Devine, Adrienne S. Viola, and Elliot J. Coups, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Yelena P. Wu, Huntsman Cancer Institute, Salt Lake City, UT
| | - Yelena P Wu
- Katie A. Devine, Adrienne S. Viola, and Elliot J. Coups, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Yelena P. Wu, Huntsman Cancer Institute, Salt Lake City, UT
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Soisson S, Ganz PA, Gaffney D, Rowe K, Snyder J, Wan Y, Deshmukh V, Newman M, Fraser A, Smith K, Herget K, Hanson HA, Wu YP, Stanford J, Al-Sarray A, Werner TL, Setiawan VW, Hashibe M. Long-term Cardiovascular Outcomes Among Endometrial Cancer Survivors in a Large, Population-Based Cohort Study. J Natl Cancer Inst 2019; 110:1342-1351. [PMID: 29741696 DOI: 10.1016/j.ygyno.2017.12.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [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: 09/26/2017] [Revised: 12/20/2017] [Accepted: 03/16/2018] [Indexed: 12/24/2022] Open
Abstract
Background Endometrial cancer is the second most common cancer among female cancer survivors in the United States. Cardiovascular disease is the leading cause of death among endometrial cancer survivors. Studies that examine long-term cardiovascular outcomes among endometrial cancer survivors are critical. Methods Cohorts of 2648 endometrial cancer survivors diagnosed between 1997 and 2012 and 10 503 age-matched women from the general population were identified. Cardiovascular disease diagnoses were identified from electronic medical records and statewide ambulatory surgery and statewide inpatient data. Cox regression models were used to estimate hazard ratios (HRs) at one to five years, more than five to 10 years, and more than 10 years after cancer diagnosis. Results Between one and five years after diagnosis, increased cardiovascular risks among endometrial cancer survivors were observed for phlebitis, thrombophlebitis, and thromboembolism (HR = 2.07, 99% confidence interval [CI] = 1.57 to 2.72), pulmonary heart disease (HR = 1.74, 99% CI = 1.26 to 2.40), and atrial fibrillation (HR = 1.50, 99% CI = 1.07 to 2.11). At more than five to 10 years, some elevated risk persisted for cardiovascular diseases. Compared with patients who had surgery, patients who additionally had radiation therapy and/or chemotherapy were at increased risk for heart and circulatory system disorders between one and five years after cancer diagnosis. Older age and obesity were also risk factors for hypertension and heart disease among endometrial cancer survivors. Conclusions Endometrial cancer survivors are at higher risk for various adverse long-term cardiovascular outcomes compared with women from the general population. This study suggests that increased monitoring for cardiovascular diseases may be necessary for endometrial cancer patients for 10 years after cancer diagnosis.
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Affiliation(s)
- Sean Soisson
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
- Huntsman Cancer Institute, Salt Lake City, UT
| | - Patricia A Ganz
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA
| | - David Gaffney
- Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City, UT
- Huntsman Cancer Institute, Salt Lake City, UT
| | - Kerry Rowe
- Intermountain Healthcare, Salt Lake City, UT
| | - John Snyder
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
- Intermountain Healthcare, Salt Lake City, UT
| | - Yuan Wan
- Pedigree and Population Resources, Population Sciences, Salt Lake City, UT
| | | | - Mike Newman
- University of Utah Health Sciences Center, Salt Lake City, UT
| | - Alison Fraser
- Pedigree and Population Resources, Population Sciences, Salt Lake City, UT
| | - Ken Smith
- Pedigree and Population Resources, Population Sciences, Salt Lake City, UT
| | | | - Heidi A Hanson
- Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT
- Pedigree and Population Resources, Population Sciences, Salt Lake City, UT
| | - Yelena P Wu
- Department of Dermatology, University of Utah School of Medicine, Salt Lake City, UT
- Huntsman Cancer Institute, Salt Lake City, UT
| | | | - Ali Al-Sarray
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
- Huntsman Cancer Institute, Salt Lake City, UT
| | - Theresa L Werner
- Division of Oncology, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT
- Huntsman Cancer Institute, Salt Lake City, UT
| | - Veronica W Setiawan
- Department of Preventive Medicine, Keck School of Medicine of USC, Los Angeles, CA
| | - Mia Hashibe
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
- Huntsman Cancer Institute, Salt Lake City, UT
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Wu YP, Parsons BG, Mooney R, Aspinwall LG, Cloyes K, Hay JL, Kohlmann W, Grossman D, Leachman SA. Barriers and Facilitators to Melanoma Prevention and Control Behaviors Among At-Risk Children. J Community Health 2019; 43:993-1001. [PMID: 29623503 DOI: 10.1007/s10900-018-0516-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Melanoma prevention is essential for children who are at elevated risk for the disease due to family history. However, children who carry a familial risk for the disease do not optimally adhere to recommended melanoma preventive behaviors. The current study sought to identify perceived barriers to and facilitators of children's engagement in melanoma preventive behaviors among children at elevated risk for melanoma due to family history of the disease (i.e., having a parent with a history of melanoma) from both parents' and childrens' perspectives. Qualitative methods were employed and consisted of separate focus group discussions with children (ages 8-17 years, n = 37) and their parents (n = 39). Focus group transcripts were coded using content analysis. Parents and children reported a number of barriers and facilitators, including on the individual (e.g., knowledge and awareness, preferences), social (e.g., peer influences, family modeling and communication), and contextual (e.g., healthcare provider communication) levels. The identified categories of barriers and facilitators both confirm and extend the literature documenting the reasons children who are at elevated risk for melanoma do not engage in melanoma prevention and control behaviors. Programs aiming to decrease melanoma risk among children of melanoma survivors could help families address their barriers to preventive behavior implementation and build on facilitators. Melanoma survivors and their children could benefit from support on their interactions with healthcare providers, schools, peers, and other caregivers about melanoma prevention.
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Affiliation(s)
- Yelena P Wu
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA. .,Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA.
| | - Bridget G Parsons
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
| | - Ryan Mooney
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - Lisa G Aspinwall
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Kristin Cloyes
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Wendy Kohlmann
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
| | - Douglas Grossman
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA.,Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
| | - Sancy A Leachman
- Department of Dermatology & Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
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Wu YP, Deatrick JA, McQuaid EL, Thompson D. A Primer on Mixed Methods for Pediatric Researchers. J Pediatr Psychol 2019; 44:905-913. [PMID: 31260042 PMCID: PMC6705711 DOI: 10.1093/jpepsy/jsz052] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/16/2019] [Accepted: 05/31/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To provide a primer on conducting and analyzing mixed methods research studies, and to provide guidance on the write-up of mixed methods research. METHODS A question and answer format is used to provide an overview of mixed methods research study designs, tasks and considerations related to conducting and analyzing mixed methods studies, and recommendations for the write-up of results for mixed methods studies. RESULTS Individuals who conduct mixed methods research are encouraged to delineate the quantitative, qualitative, and mixed methods features of the research and how these features fit with the overall study questions. Research teams will benefit from including individuals with expertise in qualitative, quantitative, and mixed methods research. Data integration should be a central component to the analysis and write-up of mixed methods research. CONCLUSIONS Increasing the use of mixed methods research in the field of pediatric psychology will contribute to advances in observational studies with children and families, intervention development and evaluation, and creation of new tools and assessments that aim to optimize child and family health outcomes.
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Affiliation(s)
- Yelena P Wu
- Department of Dermatology, University of Utah
- Cancer Control and Population Sciences, Huntsman Cancer Institute
| | | | - Elizabeth L McQuaid
- Departments of Psychiatry and Human Behavior and Pediatrics, Brown University, and
| | - Deborah Thompson
- Department of Pediatrics-Nutrition, USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine
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42
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Pokharel M, Christy KR, Jensen JD, Giorgi EA, John KK, Wu YP. Do ultraviolet photos increase sun safe behavior expectations via fear? A randomized controlled trial in a sample of U.S. adults. J Behav Med 2019; 42:401-422. [PMID: 30523504 PMCID: PMC6526068 DOI: 10.1007/s10865-018-9997-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2022]
Abstract
Ultraviolet (UV) photos reveal the world in a different light spectrum, including damage that is caused by UV light. In the context of skin cancer control, UV photos have the potential to communicate fear because they reveal underlying skin damage. U.S. adults (N = 2219) were assigned to a 5 (visual: UV skin damage, sun exposure, sunburn, photoaging, and mole removal) × 3 (replication: three examples of each visual condition) × 4 (efficacy: no efficacy, text only, visual, visual + text) randomized controlled trial. Compared to all other visual conditions combined, UV skin damage visuals generated greater fear which triggered increased sun safe behavior expectations. Compared with other visual conditions separately, only mole removal visuals produced equivalent fear as UV skin damage visuals. Visual efficacy conditions appeared to nullify rather than magnify the indirect path through fear. The results suggest one way UV images impact sun safe behavioral expectations is via fear and that researchers should continue to examine the position of fear in fear appeal theories.
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Affiliation(s)
- Manusheela Pokharel
- Department of Communication, University of Utah, 2618 LNCO, 255 S. Central Campus Drive, Salt Lake City, UT, 84112, USA.
| | - Katheryn R Christy
- School of Journalism and Mass Communication, University of Wisconsin-Madison, Madison, USA
| | - Jakob D Jensen
- Department of Communication, University of Utah, 2618 LNCO, 255 S. Central Campus Drive, Salt Lake City, UT, 84112, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, USA
| | - Elizabeth A Giorgi
- Department of Communication, University of Utah, 2618 LNCO, 255 S. Central Campus Drive, Salt Lake City, UT, 84112, USA
| | - Kevin K John
- School of Communications, Brigham Young University, Provo, USA
| | - Yelena P Wu
- Huntsman Cancer Institute, University of Utah, Salt Lake City, USA
- Department of Dermatology, University of Utah, Salt Lake City, USA
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43
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Wu YP, Hua JF, Zhou Z, Zhang J, Liu S, Peng B, Fang Y, Nie Z, Ning XN, Pai CH, Du YC, Lu W, Zhang CJ, Mori WB, Joshi C. Phase Space Dynamics of a Plasma Wakefield Dechirper for Energy Spread Reduction. Phys Rev Lett 2019; 122:204804. [PMID: 31172777 DOI: 10.1103/physrevlett.122.204804] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 04/19/2019] [Indexed: 06/09/2023]
Abstract
Plasma-based accelerators have made impressive progress in recent years. However, the beam energy spread obtained in these accelerators is still at the ∼1% level, nearly one order of magnitude larger than what is needed for challenging applications like coherent light sources or colliders. In plasma accelerators, the beam energy spread is mainly dominated by its energy chirp (longitudinally correlated energy spread). Here we demonstrate that when an initially chirped electron beam from a linac with a proper current profile is sent through a low-density plasma structure, the self-wake of the beam can significantly reduce its energy chirp and the overall energy spread. The resolution-limited energy spectrum measurements show at least a threefold reduction of the beam energy spread from 1.28% to 0.41% FWHM with a dechirping strength of ∼1 (MV/m)/(mm pC). Refined time-resolved phase space measurements, combined with high-fidelity three-dimensional particle-in-cell simulations, further indicate the real energy spread after the dechirper is only about 0.13% (FWHM), a factor of 10 reduction of the initial energy spread.
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Affiliation(s)
- Y P Wu
- Department of Engineering Physics, Tsinghua University, Beijing 100084, China
| | - J F Hua
- Department of Engineering Physics, Tsinghua University, Beijing 100084, China
| | - Z Zhou
- Department of Engineering Physics, Tsinghua University, Beijing 100084, China
| | - J Zhang
- Department of Engineering Physics, Tsinghua University, Beijing 100084, China
| | - S Liu
- Department of Engineering Physics, Tsinghua University, Beijing 100084, China
| | - B Peng
- Department of Engineering Physics, Tsinghua University, Beijing 100084, China
| | - Y Fang
- Department of Engineering Physics, Tsinghua University, Beijing 100084, China
| | - Z Nie
- Department of Engineering Physics, Tsinghua University, Beijing 100084, China
| | - X N Ning
- Department of Engineering Physics, Tsinghua University, Beijing 100084, China
| | - C-H Pai
- Department of Engineering Physics, Tsinghua University, Beijing 100084, China
| | - Y C Du
- Department of Engineering Physics, Tsinghua University, Beijing 100084, China
| | - W Lu
- Department of Engineering Physics, Tsinghua University, Beijing 100084, China
| | - C J Zhang
- University of Los Angeles, Los Angeles, California 90095, USA
| | - W B Mori
- University of Los Angeles, Los Angeles, California 90095, USA
| | - C Joshi
- University of Los Angeles, Los Angeles, California 90095, USA
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Wu YP, Herbert LJ, Walker-Harding LR, Tercyak KP. Introduction to the special issue on child and family health: the role of behavioral medicine in understanding and optimizing child health. Transl Behav Med 2019; 9:399-403. [PMID: 31094430 PMCID: PMC6520805 DOI: 10.1093/tbm/ibz056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 12/13/2022] Open
Abstract
Health promotion during early life and childhood can reduce the prevalence and impact of acute and chronic health conditions later in life. Research regarding factors that influence child and family health, prevention, and intervention programs that address them, and policies that promote implementation of best practices are needed to efficiently and effectively address the multi-faceted, biopsychosocial influences on child health, especially among youth from underserved backgrounds. The current special issue dedicated to child and family health offers a series of articles that illustrate how explanatory studies and targeted intervention programs for children, families, health care providers, and communities can be used to improve child health. Articles in this special issue are organized into three areas related to child and family health: (i) diet and nutrition, (ii) cancer prevention and control, and (iii) social determinants of health and health care. The articles included in this special issue underscore that behavioral medicine practitioners, researchers, and policy makers are well poised to lead innovative efforts to promote child health across clinical, community, health care, and population settings.
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Affiliation(s)
- Yelena P Wu
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - Linda J Herbert
- Division of Psychology and Behavioral Health, Children’s National Medical Center, Washington, DC, USA
- Department of Pediatrics, George Washington University School of Medicine, Washington, DC, USA
| | - Leslie R Walker-Harding
- Department of Pediatrics, University of Washington and Seattle Children’s Hospital, Seattle, WA, USA
| | - Kenneth P Tercyak
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
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Zhang Q, Cao L, Wu YP, Miao XD. Inflammatory responses and biological characteristics of human osteosarcoma cells and umbilical cord blood mononuclear cells in co-cultured microenvironment. J BIOL REG HOMEOS AG 2019; 33:857-862. [PMID: 31210050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Q Zhang
- Foot and Ankle Group of Department of Orthopaedics, the Second Hospital Affiliated to Zhejiang University School of Medicine, HangZhou, Zhejiang University, China
| | - L Cao
- Foot and Ankle Group of Department of Orthopaedics, the Second Hospital Affiliated to Zhejiang University School of Medicine, HangZhou, Zhejiang University, China
| | - Y P Wu
- Foot and Ankle Group of Department of Orthopaedics, the Second Hospital Affiliated to Zhejiang University School of Medicine, HangZhou, Zhejiang University, China
| | - X D Miao
- Foot and Ankle Group of Department of Orthopaedics, the Second Hospital Affiliated to Zhejiang University School of Medicine, HangZhou, Zhejiang University, China
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46
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Wu YP, Parsons BG, Aspinwall LG, Hay JL, Boucher KM, Caputo H, Mooney R, Grossman D, Leachman SA. Parent and child perspectives on perceived barriers to child sun protection and their association with sun protection strategies among children of melanoma survivors. Pediatr Dermatol 2019; 36:317-323. [PMID: 30895676 PMCID: PMC6525049 DOI: 10.1111/pde.13796] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES Children with an elevated familial risk for melanoma inconsistently implement sun protection behaviors that could mitigate their melanoma risk. Little is known about perceived barriers to child sun protection among this at-risk group and their parents, and the extent to which perceived barriers are associated with child sun protection. The goal of this study was to examine, among children with a family history of melanoma, the frequency with which children and their parents reported barriers to child sun protection and the extent to which barriers were associated with reported use of sun protection among children. METHODS Children with a family history of melanoma and their parents completed questionnaires assessing perceived barriers and reported child use of sun protection. RESULTS Common barriers to child sun protection included being bothered by implementing the behavior or forgetting. A greater number of perceived barriers were associated with less frequent child use of sunscreen, long-sleeved shirts, long pants, and shade. CONCLUSIONS Children at elevated risk for melanoma due to a family history of the disease and their parents perceive multiple barriers to sun protection that are associated with children's use of these melanoma preventive behaviors. Sun protection interventions for this at-risk population could provide families with specific strategies to address common barriers to implementing child sun protection.
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Affiliation(s)
- Yelena P Wu
- Department of Dermatology, University of Utah, Salt Lake City, Utah.,Huntsman Cancer Institute, Salt Lake City, Utah
| | | | - Lisa G Aspinwall
- Department of Psychology, University of Utah, Salt Lake City, Utah
| | - Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York City, New York
| | | | | | - Ryan Mooney
- Huntsman Cancer Institute, Salt Lake City, Utah
| | - Douglas Grossman
- Department of Dermatology, University of Utah, Salt Lake City, Utah.,Huntsman Cancer Institute, Salt Lake City, Utah
| | - Sancy A Leachman
- Department of Dermatology & Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon
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47
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Pannier ST, Mann K, Warner EL, Rosen S, Acharya A, Hacking C, Gerdy C, Wright J, Wu YP, Kirchhoff AC. Survivorship care plan experiences among childhood acute lymphoblastic leukemia patients and their families. BMC Pediatr 2019; 19:111. [PMID: 30979365 PMCID: PMC6461822 DOI: 10.1186/s12887-019-1464-0] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 03/19/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As survivorship care plan (SCP) use among childhood cancer survivors and their families has not been extensively researched, we report on their experiences with receiving an SCP after the completion of therapy. METHODS Eligible patients had acute lymphoblastic leukemia, completed therapy, and had no evidence of disease at enrollment. Patients aged 7 or older (N = 13) and at least one parent (N = 23 for 20 total patients) were surveyed and completed assessments at enrollment (Time 1, T1), SCP delivery (Time 2, T2), and follow-up (Time 3, T3) (retention 90.9%). Surveys assessed the delivery process and SCP format. McNemar tests were used to assess change from T2-T3. RESULTS Satisfaction with the SCP was generally high among parents. At T1 the majority of parents (69.6%) thought the SCP should be delivered after treatment but by T3 most preferred the plan to be delivered before the end of treatment (60.9%). While 95.7% of parents intended to share their child's SCP with another provider, family, or school at T2, only 60.9% had done so by T3 (P < 0.01). At both T2 and T3, 100% of parents agreed that the SCP would help make decisions about their child's future health care. Most patients at T3 (83.3%) felt they had learned something new from their SCP. CONCLUSIONS Pediatric oncology patients and families feel SCPs are useful and will help them make decisions about health care in the future.
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Affiliation(s)
- Samantha T Pannier
- Huntsman Cancer Institute, Cancer Control and Population Sciences, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Karely Mann
- Huntsman Cancer Institute, Cancer Control and Population Sciences, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Echo L Warner
- Huntsman Cancer Institute, Cancer Control and Population Sciences, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA.,University of Utah, College of Nursing, 10 2000 E, Salt Lake City, 84112, USA
| | - Stephanie Rosen
- Huntsman Cancer Institute, Cancer Control and Population Sciences, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Akanksha Acharya
- Huntsman Cancer Institute, Cancer Control and Population Sciences, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Claire Hacking
- Huntsman Cancer Institute, Cancer Control and Population Sciences, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Cheryl Gerdy
- Primary Children's Hospital, Intermountain Healthcare, 100 N. Mario Capecchi Dr, Salt Lake City, UT, 84113, USA
| | - Jennifer Wright
- Eli Lilly, 212 W 10th St # D180, Indianapolis, IN, 46202, USA
| | - Yelena P Wu
- Huntsman Cancer Institute, Cancer Control and Population Sciences, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA.,University of Utah Department of Dermatology, 30 North 1900 East, 4A330, Salt Lake City, 84132, USA
| | - Anne C Kirchhoff
- Huntsman Cancer Institute, Cancer Control and Population Sciences, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA. .,Department of Pediatrics, University of Utah, P.O. Box 581289, Salt Lake City, 84158, USA.
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Zhang Q, Cao L, Miao XD, Wu YP. Diagnostic value of TRACP5b expression in patients with bone tumors. J BIOL REG HOMEOS AG 2019; 33:557-562. [PMID: 30973000] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In order to investigate the diagnostic value of serum levels of tartrate-resistant acid phosphatase 5b (TRACP5b) in patients with bone tumors, enzyme linked immunosorbent assay (ELISA) was used to com¬pare serum levels of TRACP5b and alkaline phosphatase (ALP) in bone tumor patients (experimental group, 80 cases) and healthy controls (control group, 36 cases). It was found that the serum level of TRACP5b in the experimental group was significantly higher than that in the control group. In addition, the sensitivity and specificity of serum TRACP5b were higher than those of serum ALP in the diagnosis of bone tumors. Fur¬thermore, the serum level of TRACP5b was positively correlated with that of ALP. Therefore, it was conclud¬ed that the serum level of TRACP5b may be used as a sensitive indicator of bone tumors, and the sensitivity and specificity of TRACP5b are even higher than those of ALP in the diagnosis of bone tumors.
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Affiliation(s)
- Q Zhang
- Foot and Ankle Group of Department of Orthopaedics, The Second Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou, Zhejiang University, China
| | - L Cao
- Foot and Ankle Group of Department of Orthopaedics, The Second Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou, Zhejiang University, China
| | - X D Miao
- Foot and Ankle Group of Department of Orthopaedics, The Second Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou, Zhejiang University, China
| | - Y P Wu
- Foot and Ankle Group of Department of Orthopaedics, The Second Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou, Zhejiang University, China
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Liang YC, Xu N, Wu YP, Chen DN, Wei Y, Xue XY, Huang JB, Zheng QS. [Impact of diverse shapes of prostatic apex on positive apical margin rate and biochemical recurrence following laparoscopic radical prostatectomy]. Zhonghua Wai Ke Za Zhi 2019; 57:200-205. [PMID: 30861649 DOI: 10.3760/cma.j.issn.0529-5815.2019.03.008] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the effects of various forms of prostatic apex on positive apical margin rate (PAM) and biochemical recurrence (BCR) after laparoscopic radical prostatectomy. Methods: A retrospective analysis of 309 patients (aging (65±6) years) who were experienced laparoscopic radical prostatectomy from January 2010 to December 2016 at the Department of Urology, First Affiliated Hospital of Fujian Medical University. According to the relationship between prostate apex and membrane urethra at the mid-sagittal plane of preoperative MRI, all patients were classified into 4 categories. There were 31 patients for type 1, apex covering both anterior and posterior aspects of membranous urethra, 139 patients for type 2, apex covering anterior side of membranous urethra, 63 patients for type 3, apex covering posterior aspect of membranous urethra, 76 patients for type 4, apex not covering membranous urethra. PAM and BCR after operation were compared between this four groups respectively. The χ(2) test was used to compare PAM among the 4 types. Logistic regression analysis were undertaken to analyze the factors affecting PAM. Cox's proportional hazards regression model was undertaken to identify the variables influencing BCR. Results: There was no significant difference in the 4 groups concerning age, body mass index, prostate volume, preoperative prostate-specific antigen (PSA) value, postoperative Gleason score and pathological stage (P>0.05).The median follow-up time was 32 months (ranged from 12 to 60 months).The data showed that the apical type 3 patients has the highest PAM. There was statistical difference among the 4 groups in PAM (χ(2)=15.592, P=0.001). Preoperative level of PSA (OR=20.356, 95% CI: 2.440 to 169.810, P=0.005), postoperative Gleason score (OR=4.113, 95% CI: 1.911 to 8.849, P=0.001), pathological stage (OR=3.422, 95% CI: 1.600 to 7.319, P=0.002) and apical type 3 (OR=6.134, 95% CI: 2.196 to 17.132, P=0.001) were independent relactive factors of PAM. Preoperative level of PSA (HR=1.362, 95% CI: 1.006 to 1.843, P=0.045), postoperative Gleason score (HR=1.920, 95% CI: 1.384 to 2.665, P=0.001), pathological stage (HR=1.476, 95% CI: 1.098 to 1.983, P=0.010), PAM (HR=3.497, 95% CI: 2.407 to 5.081, P=0.001)and apical type 3 (HR=1.828, 95% CI: 1.266 to 2.639, P=0.001) were independent prognosis factors of BCR. Conclusion: Prostate apical type 3 could be a significant independent predictor of PAM, and an independent prognosis factor for BCR.
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Affiliation(s)
- Y C Liang
- Department of Urology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
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50
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Xiao H, Yi Z, Yang CC, Zeng N, Xu Y, Deng P, Wang HP, Wu YP, Wu M. [Regulation mechanism of E2F1 transcription factor on M2 macrophages in full-thickness skin defect wounds of mice]. Zhonghua Shao Shang Za Zhi 2019; 35:104-109. [PMID: 30798576 DOI: 10.3760/cma.j.issn.1009-2587.2019.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the regulatory mechanism of E2F1 transcription factor on M2 macrophages in full-thickness skin defect wounds of mice. Methods: E2F1 gene knockout heterozygotes C57BL/6 mice and wild-type C57BL/6 mice were introduced and self-reproduced. Two weeks after birth, E2F1 gene knockout homozygotes mice and wild-type mice were identified by polymerase chain reaction (PCR). Twelve identified 6-8 weeks old male E2F1 gene knockout homozygotes C57BL/6 mice and wild-type C57BL/6 mice were selected respectively according to the random number table and set as E2F1 gene knockout group and wild-type group. A full-thickness skin defect wound was made on the back of each mouse. On post injury day (PID) 2 and 7, 6 mice in each group were selected according to the random number table and sacrificed, and the wound tissue was excised. The expression of CD68 and CD206 double positive M2 macrophages was observed by immunofluorescence method, and the percentage of CD206 positive cells was calculated. The protein expression of CD206 was detected by Western blotting. The mRNA expression of arginase 1 was detected by real-time fluorescent quantitative reverse transcription PCR (RT-PCR). Wound tissue specimens of the two groups on PID 7 were obtained, and the protein and mRNA expressions of peroxisome proliferator-activated receptor gamma (PPAR-γ) were detected by Western blotting and real-time fluorescent quantitative RT-PCR respectively. The above-mentioned experiments were repeated four times. Three specimens of wound tissue of mice in wild-type group on PID 7 were obtained to detect the relationship between E2F1 and PPAR-γ by co-immunoprecipitation and Western blotting, and this experiment was repeated two times. Data were processed with unpaired t test. Results: The size of PCR products of E2F1 gene knockout homozygotes C57BL/6 mice and wild-type C57BL/6 mice were 227 and 172 bp respectively, which were the same as those of the designed DNA fragments. On PID 2 and 7, the number of CD68 and CD206 double positive M2 macrophages in the wound tissue of mice in E2F1 gene knockout group was more than that of wild-type group, and the percentages of CD206 positive cells in the wound tissue of mice in E2F1 gene knockout group were (0.234±0.032)% and (0.584±0.023)% respectively, which were significantly higher than (0.129±0.017)% and (0.282±0.071)% of wild-type group (t=3.29, 3.54, P<0.05). On PID 2 and 7, the protein expression of CD206 in the wound tissue of mice in E2F1 gene knockout group were 1.00±0.23 and 1.63±0.26 respectively, which were significantly higher than 0.43±0.06 and 0.97±0.08 of wild-type group (t=2.41, 2.45, P<0.05). On PID 2 and 7, the mRNA expressions of arginase 1 in the wound tissue of mice in E2F1 gene knockout group were 0.482±0.105 and 0.195±0.031 respectively, which were significantly higher than 0.163±0.026 and 0.108±0.017 of wild-type group (t=3.04, 2.86, P<0.05). On PID 7, the protein and mRNA expressions of PPAR-γ in the wound tissue of mice in E2F1 gene knockout group were 0.61±0.12 and 0.51±0.13 respectively, which were significantly higher than 0.20±0.04 and 0.20±0.04 of wild-type group (t=3.36, 2.86, P<0.05). On PID 7, detection of the wound tissue of mice in wild-type group showed that PPAR-γ had unidirectional effect on E2F1. Conclusions: E2F1 transcription factor affects the polarization of M2 macrophages by inhibiting the expression of PPAR-γ, thereby inhibiting the healing process of full-thickness skin defect wounds in mice.
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Affiliation(s)
- H Xiao
- Department of Plastic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China (Xiao Hui is now working at the Department of Breast Surgery, Henan Tumor Hospital, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou 463100, China)
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