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Morgan SE, Harrison TR, Wright KO, Jia X, Deal B, Malova K. The role of perceived expertise and trustworthiness in research study and clinical trial recruitment: Perspectives of clinical research coordinators and African American and Black Caribbean patients. PLoS One 2023; 18:e0275770. [PMID: 37342999 DOI: 10.1371/journal.pone.0275770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 04/11/2023] [Indexed: 06/23/2023] Open
Abstract
This study investigates the role of source credibility on minority participant recruitment, particularly African American and Black Caribbean patients. A total of nine focus groups (N = 48 participants) were conducted with both patient groups and clinical research coordinators (CRCs). Using the elaboration likelihood model as a guiding framework for analysis, this study found that the credibility of research coordinators (or other professionals who recruit for research studies and clinical trials) was instrumental in shaping attitudes of prospective participants. The perspectives of patients and CRCs aligned closely, with few exceptions. For both groups, professionalism and professional displays (clothing, institutional artifacts) enhanced perceived expertise, a core component of credibility. Trustworthiness, another important component of credibility, was fostered through homophily between recruiter and patient, expressions of goodwill and assuaging anxiety about CRCs' financial motivations for recruitment. Additionally, CRCs believed that credibility was supported when CRCs could emphasize transparency and truthfulness in communication. The importance of these findings for the development of empirically-based training programs to improve communication practices in recruitment contexts is discussed.
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Affiliation(s)
- Susan E Morgan
- Communication Studies Department, School of Communication, University of Miami, Coral Gables, FL, United States of America
| | - Tyler R Harrison
- Communication Studies Department, School of Communication, University of Miami, Coral Gables, FL, United States of America
| | - Kallia O Wright
- Communication Studies Department, School of Communication, University of Miami, Coral Gables, FL, United States of America
| | - Xiaofeng Jia
- School of Communication, University of Miami, Coral Gables, FL, United States of America
| | - Bonnie Deal
- School of Communication, University of Miami, Coral Gables, FL, United States of America
| | - Kate Malova
- Simon Business School, University of Rochester, Rochester, NY, United States of America
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Social networks of oncology clinicians as a means for increasing survivorship clinic referral. COMMUNICATIONS MEDICINE 2022; 2:89. [PMID: 35856083 PMCID: PMC9287406 DOI: 10.1038/s43856-022-00153-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
Background Specialized cancer survivorship clinics are recommended for addressing treatment-related health concerns of long-term survivors, but their relative newness in medical oncology necessitates strategies to expand services and clinic referrals. This study used social network analysis to identify personal and/or network factors associated with referral of patients to a survivorship clinic. Methods We conducted a cross-sectional social network survey of clinical personnel at a National Cancer Institute-designated comprehensive cancer center. Participants identified colleagues with whom they consult for advice (advice network) and/or discuss patient care (discussion network). Exponential random graph models and logistic regression were used to identify key opinion leaders in the network and factors associated with referral of patients to the center’s survivorship clinic. Results Here we show that of the respondents (n = 69), 78.0% report being aware of the survivorship clinic, yet only 30.4% had ever referred patients to it. Individuals tend to associate with others in the same occupational role (homophily). In the discussion network, holding an influential network position (betweenness centrality) is associated with patient referral to the survivorship clinic. In the advice network, several social workers are identified as opinion leaders. Conclusions This study shows that there is strong homophily in both networks, potentially inhibiting information sharing between groups. In designing an inclusive network intervention, persons occupying influential network positions and opinion leaders (e.g., social workers in this case) are well-positioned to promote survivorship clinic referrals. Specialized cancer survivorship clinics are an attractive but under-utilized option for monitoring long-term survivors at risk for developing serious health problems after treatment. The purpose of this survey-based social network analysis was to describe clinician interactions within a cancer center and explore opportunities for developing interventions to increase survivorship clinic referrals. We asked cancer clinicians to identify which colleagues they consult for advice about patient care and whether they were already referring survivors to the clinic. We found that clinicians in central ‘gatekeeper’ positions were more likely to refer survivors and facilitate information sharing among clinician groups. Social workers were sought most often for advice about patient care, suggesting an intervention utilizing these professionals could potentially raise awareness about survivorship clinic among colleagues and result in increased referrals. Piombo et al. analyse social networks of cancer clinicians to study referral practices to a cancer survivorship clinic at a comprehensive cancer centre. The authors identify key opinion leaders within the networks and suggest interventions to improve referrals to survivorship services.
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Kwesiga D, Eriksson L, Orach CG, Tawiah C, Imam MA, Fisker AB, Enuameh Y, Lawn JE, Blencowe H, Waiswa P, Bradby H, Malqvist M. Adverse pregnancy outcome disclosure and women's social networks: a qualitative multi-country study with implications for improved reporting in surveys. BMC Pregnancy Childbirth 2022; 22:292. [PMID: 35387593 PMCID: PMC8988398 DOI: 10.1186/s12884-022-04622-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 03/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background Globally, approximately 6,700 newborn deaths and 5,400 stillbirths occur daily. The true figure is likely higher, with under reporting of adverse pregnancy outcomes (APOs) noted. Decision-making in health is influenced by various factors, including one’s social networks. We sought to understand APOs disclosure within social networks in Uganda, Ghana, Guinea-Bissau and Bangladesh and how this could improve formal reporting of APOs in surveys. Methods A qualitative, exploratory multi-country study was conducted within four health and demographic surveillance system sites. 16 focus group discussions were held with 147 women aged 15–49 years, who had participated in a recent household survey. Thematic analysis, with both deductive and inductive elements, using three pre-defined themes of Sender, Message and Receiver was done using NVivo software. Results Disclosure of APOs was a community concern, with news often shared with people around the bereaved for different reasons, including making sense of what happened and decision-making roles of receivers. Social networks responded with comfort, providing emotional, in-kind and financial support. Key decision makers included men, spiritual and traditional leaders. Non-disclosure was usually to avoid rumors in cases of induced abortions, or after a previous bad experience with health workers, who were frequently excluded from disclosure, except for instances where a woman sought advice on APOs. Conclusions Communities must understand why they should report APOs and to whom. Efforts to improve APOs reporting could be guided by diffusion of innovation theory, for instance for community entry and sensitization before the survey, since it highlights how information can be disseminated through community role models. In this case, these gatekeepers we identified could promote reporting of APOs. The stage at which a person is in decision-making, what kind of adopter they are and their take on the benefits and other attributes of reporting are important. In moving beyond survey reporting to getting better routine data, the theory would be applicable too. Health workers should demonstrate a more comforting and supportive response to APOs as the social networks do, which could encourage more bereaved women to inform them and seek care. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04622-1.
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Affiliation(s)
- Doris Kwesiga
- Department of Women's and Children's Health, Uppsala University; Uppsala Global Health Research On Implementation and Sustainability (UGHRIS), Uppsala University, Uppsala, Sweden. .,Department of Health Policy, Planning and Management, School of Public Health, Makerere University, Kampala, Uganda.
| | - Leif Eriksson
- Department of Women's and Children's Health, Uppsala University; Uppsala Global Health Research On Implementation and Sustainability (UGHRIS), Uppsala University, Uppsala, Sweden
| | - Christopher Garimoi Orach
- Department of Community Health and Behavioral Sciences, School of Public Health, Makerere University, Kampala, Uganda
| | | | - Md Ali Imam
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Ane B Fisker
- Bandim Health Project, Bissau, Guinea-Bissau.,Research Centre for Vitamins and Vaccines, Statens Serum Institut, Copenhagen, Denmark.,Open Patient Data Explorative Network (OPEN), University of Southern Denmark, Odense, Denmark
| | - Yeetey Enuameh
- Kintampo Health Research Centre, Kintampo, Ghana.,Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joy E Lawn
- Maternal, Adolescent, Reproductive & Child Health Centre (MARCH), London School of Hygiene & Tropical Medicine, London, UK
| | - Hannah Blencowe
- Maternal, Adolescent, Reproductive & Child Health Centre (MARCH), London School of Hygiene & Tropical Medicine, London, UK
| | - Peter Waiswa
- Department of Health Policy, Planning and Management, School of Public Health, Makerere University, Kampala, Uganda.,Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Hannah Bradby
- Department of Sociology, Uppsala University, Uppsala, Sweden
| | - Mats Malqvist
- Department of Women's and Children's Health, Uppsala University; Uppsala Global Health Research On Implementation and Sustainability (UGHRIS), Uppsala University, Uppsala, Sweden
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Solanki H, Tiwari AK, Vashisht N, Raina V, Sharma G. Barriers and Support-System while Considering Hematopoietic Stem Cell Transplant (HSCT): A Qualitative Study of Pre-HSCT Acute Leukemia Patients from a Standalone Transplant Laboratory in India. Indian J Med Paediatr Oncol 2021. [DOI: 10.1055/s-0041-1730091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Abstract
Introduction Hematopoietic stem cell transplant (HSCT) is the definite treatment for acute leukemia but considering HSCT is challenging for the patients. There are many studies that have described the patients’ experience after HSCT but very few studies have reported their experience before going for HSCT and there is no published report in India on patients’ experience before HSCT.
Objective We conducted a qualitative study to understand barriers, and support-system while considering HSCT and the chances of getting matched unrelated donor (MUD) for these patients.
Materials and Methods The present study was a qualitative study. Demographic details of 514 patients who consented for the study were noted and the patients and their families were interviewed using a semistructured interview booklet before HSCT. The interview sessions were recorded, transcribed verbatim, and analyzed for emerging themes. The study data were analyzed using QDA Miner Lite 4.0 software (Provalis Research, Montreal, Canada). Descriptive statistics such as frequency and percentage were used. The chances of getting a human leukocyte antigen (HLA)-matched donor were also computed by “HLA-matching software.”
Results Acute myeloid leukemia (64.01%) was commoner than acute lymphoid leukemia (35.99%) with male: female ratio as 1.98:1. The study showed nine themes as barriers and six themes emerged in regard to the support system for HSCT decision making. The biggest barriers identified among these patients pre-HSCT were related to cost, probability of “success of transplant,” and probable “quality of life.” The family support was the biggest support system variable followed by “treating doctor.” The chances of getting a MUD for these patients were 13.22% and 5.44% in global and Indian data pool, respectively.
Conclusion Deciding upon HSCT can be challenging for patients and understanding of barriers and support-system variables among these patients would provide important insights and help design better counseling techniques for such patients of HSCT and future studies in this context.
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Affiliation(s)
- Hina Solanki
- Chimera Transplant Research Foundation, South Extension Part-II, Masjid Moth, New Delhi, India
- Centre for Medical Biotechnology, Amity Institute of Biotechnology, Amity University Uttar Pradesh, Noida, India
| | - Aseem K. Tiwari
- Department of Transfusion Medicine, Medanta The Medicity, Gurgaon, Haryana, India
| | - Naveen Vashisht
- Chimera Transplant Research Foundation, South Extension Part-II, Masjid Moth, New Delhi, India
| | - Vimarsh Raina
- Chimera Transplant Research Foundation, South Extension Part-II, Masjid Moth, New Delhi, India
| | - Girish Sharma
- Centre for Medical Biotechnology, Amity Institute of Biotechnology, Amity University Uttar Pradesh, Noida, India
- Amity Center for Cancer Epidemiology & Cancer Research, Amity University Uttar Pradesh, Noida, India
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Rauscher EA, Dean M, Campbell-Salome G, Barbour JB. "How do we rally around the one who was positive?" Familial uncertainty management in the context of men managing BRCA-related cancer risks. Soc Sci Med 2019; 242:112592. [PMID: 31629161 DOI: 10.1016/j.socscimed.2019.112592] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/30/2019] [Accepted: 10/05/2019] [Indexed: 02/06/2023]
Abstract
RATIONALE Men with BRCA-related cancer risks face increased disease risk as well as the prospect of passing on their risk to children. OBJECTIVE This study investigates men's communicative appraisal and management of uncertainty related to BRCA-related cancer risks and decision-making. METHODS Guided by uncertainty management theory (UMT), a directed content analysis approach was utilized to analyze interviews with 25 men who either carry a pathogenic BRCA variant or have a 50% chance of carrying a variant but have not yet been tested. RESULTS Participants appraised their individual uncertainty as irrelevant or dangerous but appraised their familial uncertainty as dangerous. Men appraising their uncertainty as a danger exhibited more proactive information seeking healthcare behaviors-such as genetic testing and following recommended screenings-than men who appraised their uncertainty as irrelevant. Participants appraised familial uncertainty as a danger and were engaged in information management with family members, as well as encouraging family members to engage in proactive healthcare decision-making. CONCLUSIONS Men with BRCA-related cancer risks lack understanding about their risks and how to manage them. Increased attention should be paid to the development of interventions tailored specifically to men. Further, interventions focusing on strategically developing proactive family communication behaviors would also be beneficial to men and their families.
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Affiliation(s)
- Emily A Rauscher
- Department of Communication, University of Utah, 255 S Central Campus Dr, Salt Lake City, UT, 84112, USA.
| | - Marleah Dean
- Department of Communication, University of South Florida, 4202 E. Fowler Ave, Tampa, FL, 33620, USA.
| | - Gemme Campbell-Salome
- Genomic Medicine Institute, Geisinger, 100 N. Academy Ave, Danville, PA, 17822, USA.
| | - Joshua B Barbour
- Department of Communication, University of Texas, Austin, 2504A Whitis Ave. (A1105), Austin, TX, 78712-0115, USA.
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