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Hankins JS, Potter MB, Fernandez ME, Melvin C, DiMartino L, Jacobs SR, Bosworth HB, King AA, Simon J, Glassberg JA, Kutlar A, Gordeuk VR, Shah N, Baumann AA, Klesges LM. Evaluating the implementation of a multi-level mHealth study to improve hydroxyurea utilization in sickle cell disease. Front Health Serv 2023; 2:1024541. [PMID: 36925803 PMCID: PMC10012741 DOI: 10.3389/frhs.2022.1024541] [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] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 12/09/2022] [Indexed: 01/22/2023]
Abstract
Background Sickle Cell Disease (SCD) is a progressive genetic disease that causes organ damage and reduces longevity. Hydroxyurea is an underutilized evidence-based medication that reduces complications and improves survival in SCD. In a multi-site clinical trial, part of the NIH-funded Sickle Cell Disease Implementation Consortium (SCDIC), we evaluate the implementation of a multi-level and multi-component mobile health (mHealth) patient and provider intervention to target the determinants and context of low hydroxyurea use. Given the complexity of the intervention and contextual variability in its implementation, we combined different behavioral and implementation theories, models, and frameworks to facilitate the evaluation of the intervention implementation. In this report, we describe engagement with stakeholders, planning of the implementation process, and final analytical plan to evaluate the implementation outcomes. Methods During 19 meetings, a 16-member multidisciplinary SCDIC implementation team created, conceived, and implemented a project that utilized Intervention Mapping to guide designing an intervention and its evaluation plan. The process included five steps: (1) needs assessment of low hydroxyurea utilization, (2) conceptual framework development, (3) intervention design process, (4) selection of models and frameworks, and (5) designing evaluation of the intervention implementation. Results Behavioral theories guided the needs assessment and the design of the multi-level mHealth intervention. In designing the evaluation approach, we combined two implementation frameworks to best account for the contextual complexity at the organizational, provider, and patient levels: (1) the Consolidated Framework for Implementation Research (CFIR) that details barriers and facilitators to implementing the mHealth intervention at multiple levels (users, organization, intervention characteristics, broader community), and (2) the Technology Acceptance Model (TAM), a conceptual model specific for explaining the intent to use new information technology (including mHealth). The Reach Effectiveness Adoption Implementation and Maintenance (RE-AIM) framework was used to measure the outcomes. Discussion Our research project can serve as a case study of a potential approach to combining different models/frameworks to help organize and plan the evaluation of interventions to increase medication adherence. The description of our process may serve as a blueprint for future studies developing and testing new strategies to foster evidence-based treatments for individuals living with SCD.
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Affiliation(s)
- J. S Hankins
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - M. B Potter
- Department of Family and Community Medicine, University of California San Francisco School of Medicine, San Francisco, CA, United States
- Clinical, Family, and Community Medicine, University of California San Francisco, CA, United States
| | - M. E Fernandez
- Health Promotion and Behavioral Sciences, University of Texas Health Science Center, School of Public Health at Houston, Houston, TX, United States
| | - C Melvin
- The Medical University of South Carolina, Charleston, SC, United States
| | - L DiMartino
- RTI International, Research triangle park, NC, United States
| | - S. R Jacobs
- RTI International, Research triangle park, NC, United States
| | - H. B Bosworth
- Department of Population Health Studies, Duke University, Durham, NC, United States
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Medical Center, Durham, NC, United States
| | - A. A King
- Department of Pediatrics, Washington University, Saint louis, MO, United States
| | - J Simon
- Department of Emergency Medicine, Ichan School of Medicine at Mount Sinai, New York, NY, United States
| | - J. A Glassberg
- Department of Emergency Medicine, Ichan School of Medicine at Mount Sinai, New York, NY, United States
| | - A Kutlar
- Augusta University, Augusta, GA, United States
| | - V. R Gordeuk
- Department of Medicine, the University of Illinois at Chicago, Chicago, IL, United States
| | - N Shah
- Department of Pediatric Hematology and Oncology, Duke University, Durham, NC, United States
| | - A. A Baumann
- Division of Public Health Sciences, Department of Surgery, Washington University, Saint louis, MO, United States
| | - L. M Klesges
- Division of Public Health Sciences, Department of Surgery, Washington University, Saint louis, MO, United States
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Witzig T, Sokol L, Jacobsen E, Advani R, Mondejar R, Piris M, Burrows F, Melvin C, Mishra V, Scholz C, Gualberto A. PRELIMINARY RESULTS FROM AN OPEN-LABEL, PHASE II STUDY OF TIPIFARNIB IN RELAPSED OR REFRACTORY PERIPHERAL T-CELL LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- T. Witzig
- Laboratory Medicine and Pathology; Mayo Clinic; Rochester USA
| | - L. Sokol
- Medical Oncology; H. Lee Moffitt Cancer Center & Research Institute; Tampa USA
| | - E. Jacobsen
- Medical Oncology; Dana Farber Cancer Institute; Boston USA
| | - R. Advani
- Medicine - Med/Oncology; Stanford Cancer Institute; Palo Alto USA
| | - R. Mondejar
- Laboratorio de Genómica del Cáncer, IDIVAL-Instituto de Investigación Marqués de Valdecilla; Santander Spain
| | - M. Piris
- Pathology Service, Fundación Jiménez Díaz; Madrid Spain
| | - F. Burrows
- Research & Development; Kura Oncology; La Jolla USA
| | - C. Melvin
- Research & Development; Kura Oncology; La Jolla USA
| | - V. Mishra
- Research & Development; Kura Oncology; La Jolla USA
| | - C. Scholz
- Research & Development; Kura Oncology; La Jolla USA
| | - A. Gualberto
- Research & Development; Kura Oncology; La Jolla USA
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Downe S, Finlayson K, Melvin C, Spiby H, Ali S, Diggle P, Gyte G, Hinder S, Miller V, Slade P, Trepel D, Weeks A, Whorwell P, Williamson M. Self-hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness. BJOG 2015; 122:1226-34. [PMID: 25958769 PMCID: PMC4690197 DOI: 10.1111/1471-0528.13433] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [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] [Accepted: 03/17/2015] [Indexed: 01/19/2023]
Abstract
Objective (Primary) To establish the effect of antenatal group self-hypnosis for nulliparous women on intra-partum epidural use. Design Multi-method randomised control trial (RCT). Setting Three NHS Trusts. Population Nulliparous women not planning elective caesarean, without medication for hypertension and without psychological illness. Methods Randomisation at 28–32 weeks’ gestation to usual care, or to usual care plus brief self-hypnosis training (two × 90-minute groups at around 32 and 35 weeks’ gestation; daily audio self-hypnosis CD). Follow up at 2 and 6 weeks postnatal. Main outcome measures Primary: epidural analgesia. Secondary: associated clinical and psychological outcomes; cost analysis. Results Six hundred and eighty women were randomised. There was no statistically significant difference in epidural use: 27.9% (intervention), 30.3% (control), odds ratio (OR) 0.89 [95% confidence interval (CI): 0.64–1.24], or in 27 of 29 pre-specified secondary clinical and psychological outcomes. Women in the intervention group had lower actual than anticipated levels of fear and anxiety between baseline and 2 weeks post natal (anxiety: mean difference −0.72, 95% CI −1.16 to −0.28, P = 0.001); fear (mean difference −0.62, 95% CI −1.08 to −0.16, P = 0.009) [Correction added on 7 July 2015, after first online publication: ‘Mean difference’ replaced ‘Odds ratio (OR)’ in the preceding sentence.]. Postnatal response rates were 67% overall at 2 weeks. The additional cost in the intervention arm per woman was £4.83 (CI −£257.93 to £267.59). Conclusions Allocation to two-third-trimester group self-hypnosis training sessions did not significantly reduce intra-partum epidural analgesia use or a range of other clinical and psychological variables. The impact of women's anxiety and fear about childbirth needs further investigation. Tweetable abstract Going to 2 prenatal self-hypnosis groups didn't reduce labour epidural use but did reduce birth fear & anxiety postnatally at < £5 per woman.
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Affiliation(s)
- S Downe
- Research in Childbirth and Health (ReaCH) group, University of Central Lancashire, Preston, UK
| | - K Finlayson
- Research in Childbirth and Health (ReaCH) group, University of Central Lancashire, Preston, UK
| | - C Melvin
- Women & Children's Health Research Team, East Lancashire Hospitals NHS Trust, Burnley General Hospital, Burnley, UK
| | - H Spiby
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - S Ali
- Department of Health Sciences, University of York, York, UK
| | - P Diggle
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - G Gyte
- Cochrane Pregnancy and Childbirth Group, Department of Women and Childrens' Health, Liverpool Women's NHS Foundation Trust, University of Liverpool, Liverpool, UK
| | - S Hinder
- RaFT Research, Clitheroe, Lancashire, UK
| | - V Miller
- University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
| | - P Slade
- Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
| | - D Trepel
- Department of Health Sciences, University of York, York, UK
| | - A Weeks
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - P Whorwell
- Centre for Gastrointestinal Sciences, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
| | - M Williamson
- Women & Children's Health Research Team, East Lancashire Hospitals NHS Trust, Burnley General Hospital, Burnley, UK
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Paz-Ares L, Pollak M, Eisenberg P, Blakely L, Haluska P, Cohen R, Kreisman H, Melvin C, Gualberto A, Karp D. 6508 ORAL CP-751, 871, an anti-IGF-IR antibody, in combination with paclitaxel and carboplatin or paclitaxel and carboplatin alone as first-line treatment for advanced non-small cell lung cancer (NSCLC): A phase Ib/randomized phase II, non-comparative, open label trial. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71336-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Gualberto A, Alsina M, Lacy M, Poutney S, Birgin A, Littman B, Melvin C, Petersen J. Inhibition of the insulin like growth factor 1 receptor by a specific monoclonal antibody in multiple myeloma. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A. Gualberto
- Pfizer Global Rsrch & Dev, New London, CT; H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Mayo Clinic, Rochester, MN
| | - M. Alsina
- Pfizer Global Rsrch & Dev, New London, CT; H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Mayo Clinic, Rochester, MN
| | - M. Lacy
- Pfizer Global Rsrch & Dev, New London, CT; H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Mayo Clinic, Rochester, MN
| | - S. Poutney
- Pfizer Global Rsrch & Dev, New London, CT; H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Mayo Clinic, Rochester, MN
| | - A. Birgin
- Pfizer Global Rsrch & Dev, New London, CT; H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Mayo Clinic, Rochester, MN
| | - B. Littman
- Pfizer Global Rsrch & Dev, New London, CT; H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Mayo Clinic, Rochester, MN
| | - C. Melvin
- Pfizer Global Rsrch & Dev, New London, CT; H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Mayo Clinic, Rochester, MN
| | - J. Petersen
- Pfizer Global Rsrch & Dev, New London, CT; H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Mayo Clinic, Rochester, MN
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Melvin C, Bodley R, Booth A, Meagher T, Record C, Savage P. Managing errors in radiology: a working model. Clin Radiol 2004; 59:841-5. [PMID: 15351251 DOI: 10.1016/j.crad.2004.01.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2003] [Revised: 01/12/2004] [Accepted: 01/20/2004] [Indexed: 10/26/2022]
Abstract
AIM To develop a practical mechanism for reviewing reporting discrepancies as addressed in the Royal College of Radiologists publication "To err is human. The case for review of reporting discrepancies". MATERIALS AND METHODS A regular meeting was developed, and has evolved, within the department to review discrepancies. Standard forms were devised for submission of cases as well as recording and classification of discrepancies. This has resulted in availability of figures that can be audited annually. RESULTS Eighty-one cases involving error were reviewed over a 12-month period. Seven further cases flagged as discrepancies were not identified on peer review. Twenty-four reports were amended subsequent to the meeting. Nineteen additional cases were brought to the meeting as illustrative of teaching points or for discussion. CONCLUSION We have evolved a successful process of reviewing reporting errors, which enjoys the confidence and support of all clinical radiologists, and is perceived as a method of improving patient care through an increasing awareness of lapses in performance.
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Affiliation(s)
- C Melvin
- Department of Radiology, Stoke Mandeville Hospital, Aylesbury HP21 8AL, UK.
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Ahluwalia IB, Johnson C, Rogers M, Melvin C. Pregnancy Risk Assessment Monitoring System (PRAMS): unintended pregnancy among women having a live birth. PRAMS Working Group. J Womens Health Gend Based Med 1999; 8:587-9. [PMID: 10839641 DOI: 10.1089/jwh.1.1999.8.587] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Morel DR, Huttemeier PC, Skoskiewicz MJ, Nguyenduy T, Melvin C, Robinson DR, Zapol WM. Dose-dependent effects of a pyridoquinazoline thromboxane synthetase inhibitor on arachidonic acid metabolites and hemodynamics during E. coli endotoxemia in anesthetized sheep. Prostaglandins 1987; 33:879-902. [PMID: 3118413 DOI: 10.1016/0090-6980(87)90116-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
We investigated the effects of a new pyridoquinazoline thromboxane synthetase inhibitor infused before administering Escherichia Coli endotoxin into 18 anesthetized sheep with lung lymph fistulas. In normal sheep increasing plasma Ro 23-3423 concentrations were associated with increased plasma levels of 6-keto-PGF1 alpha, a reduced systemic vascular resistance (SVR, r = -0.80) and systemic arterial pressure (SAP, r = -0.92), the mean SAP falling from 80 to 50 mm Hg at the 20 and 30 mg/kg doses. Endotoxin infused into normal sheep caused transient pulmonary vasoconstriction associated with increased TxB2 and 6-keto-PGF1 alpha levels while vasoconstriction and TxB2 increase were significantly inhibited by pretreatment with Ro 23-3423 in a dose-dependent manner. When compared to controls, plasma and lymph levels of 6-keto-PGF1 alpha, PGF2 alpha and PGE2 after endotoxin infusion were increased several-fold by administering Ro 23-3423 up to plasma levels of 10 micrograms/ml. Doses over 30 mg/kg with blood levels above 10 micrograms/ml reduced plasma and lymph levels of 6-keto-PGF1 alpha, PGF2 alpha and PGE2, suggesting cyclooxygenase blockade at this dose. The peak 6-keto-PGF1 alpha levels at 60 min after endotoxin infusion in sheep with Ro-23-3423 levels below 10 micrograms/ml were associated with the greatest systemic hypotension due to a reduced SVR (r = -0.86). After endotoxin infusion the leukotrienes B4, C4, D4 and E4 in lung lymph were assayed by radioimmunoassay and high pressure liquid chromatography and remained at baseline values.
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Affiliation(s)
- D R Morel
- Department of Anesthesia, Massachusetts General Hospital, Boston 02114
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Robinson DR, Skoskiewicz M, Bloch KJ, Castorena G, Hayes E, Lowenstein E, Melvin C, Michelassi F, Zapol WM. Cyclooxygenase blockade elevates leukotriene E4 production during acute anaphylaxis in sheep. J Exp Med 1986; 163:1509-17. [PMID: 3011947 PMCID: PMC2188117 DOI: 10.1084/jem.163.6.1509] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
We examined changes in the levels of eicosanoids in blood and pulmonary lymph of anesthetized sheep undergoing acute anaphylaxis. Within 1-3 min of intravenous antigenic challenge of previously sensitized sheep, there were approximately 7-30-fold elevations in mean arterial plasma levels of thromboxane B2 and 6-ketoprostaglandin F1 alpha, respectively, as measured by RIA. Negligible changes in levels of these cyclooxygenase products were found in both nonsensitized sheep and in sensitized sheep treated with indomethacin before antigenic challenge. In contrast, no changes in levels of sulfidopeptide leukotrienes (SPLT) in pulmonary lymph were detectable by RIA during anaphylaxis in sensitized or nonsensitized sheep, but levels of SPLT in indomethacin-treated sensitized sheep increased more than fivefold above levels in lymph from both other groups of animals. The immunoreactive SPLT in lymph from indomethacin-treated sheep was accounted for as LTE4, as demonstrated by mobility on HPLC and absorbance at 280 nm. These results support the possibility that certain undesirable effects of nonsteroidal antiinflammatory drugs, such as cardiopulmonary reactions in aspirin-sensitive individuals, and impaired renal and cardiac function during therapy with these drugs, may be related in part to augmented synthesis of the 5-lipoxygenase pathway products, especially those of the sulfidopeptide class. Increased LT production could also limit the antiinflammatory effectiveness of these drugs in many disease states.
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Liberman A, Melvin C, Bustamante M, Willey E. A community services approach to quality assurance in a mental retardation facility. Med Rec News 1978; 49:64, 66-7, 69 passim. [PMID: 10273094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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