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Kashif R, Wallace-Farquharson T, Adams-Mitchell C, Yao Y, Molokie RE, Wilkie DJ, Mack AK. Promise of Composite Pain Index as a single pain outcome for sickle cell disease across the lifespan. Pediatr Blood Cancer 2024; 71:e30958. [PMID: 38572597 DOI: 10.1002/pbc.30958] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/30/2024] [Accepted: 02/27/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND This study aimed to validate a Composite Pain Index (CPI) as a single pain outcome measure for sickle cell disease (SCD) across the lifespan from 8 years of age. PROCEDURE This prospective, cross-sectional study included 55 participants with SCD who completed the PAINReportIt tool and Adolescent Pediatric Pain Tool (APPT) in random order during outpatient visits to derive respective CPI scores for comparison. RESULTS Of the 55 participants with SCD, 46 (84%) had HgbSS, eight (15%) HgbSC, and one (2%) HgbSβ0+. The mean age of all participants was 17.5 ± 2.6 years, and 28 (51%) were female, 52 (95%) were Black, 42 (98%) were non-Hispanic, and 39 (71%) had a ninth grade or higher education. Correlation analyses between the APPT and PAINReportIt revealed positive associations for the number of pain sites (r = .57, p < .001), pain intensity (r = .46, p < .001), pain quality (r = .74, p < .001), and pain pattern (r = .34, p = .01). Patients' mean CPI scores derived from the PAINReportIt was slightly higher than the APPT; 34.2 (SD = 14.7) and 30.0 (SD = 19.0), respectively. Regression analyses showed that the APPT CPI significantly predicted the PAINReportIt CPI (B = .497, t(53) = 6.051, p < .001). This finding holds true even when accounting for the order of measurement or patient's age. CONCLUSION The initial validation of CPI as a single pain outcome measure represents a significant advancement in pain assessment for SCD. Further validation is warranted for the CPI as a measure is for both clinicians and researchers to enable longitudinal pain assessment from age 8 years across the lifespan as children age into adult care.
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Affiliation(s)
- Reema Kashif
- Department of Pediatrics, Division of Hematology/Oncology/Stem Cell Transplant, University of Florida, Gainesville, Florida, USA
| | - Tanya Wallace-Farquharson
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Candice Adams-Mitchell
- Department of Speech, Language and Hearing, University of Florida, Gainesville, Florida, USA
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Robert E Molokie
- Department of Medicine, Division of Hematology/Oncology, Sickle Cell Center, University of Illinois, Chicago, Illinois, USA
- Jessie Brown VA Medical Center, University of Illinois, Chicago, Illinois, USA
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - A Kyle Mack
- Department of Pediatrics, Division of Hematology/Oncology/Stem Cell Transplant, Northwestern University, Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
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Dyal BW, Yoon SL, Powell-Roach KL, Li D, Kittelson S, Weaver M, Krieger JL, Wilkie DJ. Perceptions of Palliative Care: Demographics and Health Status Among the General Population in Florida and the United States. Am J Hosp Palliat Care 2024; 41:363-372. [PMID: 37379569 PMCID: PMC10783876 DOI: 10.1177/10499091231186819] [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: 06/30/2023] Open
Abstract
BACKGROUND Palliative care (PC) helps maintain quality of life for seriously ill patients, yet, many Americans lack knowledge of PC. AIM To explore the relationships between knowledge of PC of individuals living in north-central Florida and throughout the United States. DESIGN This cross-sectional survey with three sampling approaches, one was a community-engaged sample and two were panel respondent samples. Respondents and setting: Respondents of the Florida sample (n1 = 329) and the community-engaged sample (n2 = 100), were representative of the 23 Florida county general population. Respondents of the national sample (n = 1800) were adult members of a panel owned by a cloud-based survey platform. RESULTS Young adults compared with adults (OR 1.62, 95% CI 1.14-2.28, P .007), middle-adults (OR 2.47, 95% CI 1.58-3.92, P < .001) and older-adults (OR 3.75, 95% CI 2.50-5.67, P < .001) were less likely to agree that the goal of PC is to help friends and family cope with a patient's illness, and that the goal of PC is to manage pain and other physical symptoms compared with adults (OR 1.67, 95% CI 1.20-2.30, P .002) middle-adults (OR 2.58, 95% CI 1.71-3.95, P < .001) and older-adults (OR 7.19, 95% CI 4.68-11.2, P < .001). Participants with greater rural identity (OR 1.39, 95% CI 1.31-1.48, P < .001) were more likely to agree that accepting PC means giving up. CONCLUSIONS Increased knowledge of PC might be influenced through targeting educational interventions and educating the general population through social media use.
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Affiliation(s)
- Brenda W. Dyal
- Family, Community and Health System Science, University of Florida College of Nursing, Gainesville, FL, USA
| | - Saunjoo L. Yoon
- Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, FL, USA
| | - Keesha L. Powell-Roach
- Department of Community and Population Health, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Derek Li
- University of Florida Health Science Center, University of Florida, Gainesville, FL, USA
| | - Sheri Kittelson
- Division of Palliative Care, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Michael Weaver
- Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, FL, USA
| | - Janice L. Krieger
- College of Journalism and Communications, University of Florida, Gainesville, FL, USA
| | - Diana J. Wilkie
- Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, FL, USA
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Adams-Mitchell CJ, Smith WR, Wilkie DJ. Dysphagia in patients with sickle cell disease: An understudied problem. J Natl Med Assoc 2024; 116:126-130. [PMID: 38262892 DOI: 10.1016/j.jnma.2023.11.005] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/02/2023] [Accepted: 11/20/2023] [Indexed: 01/25/2024]
Abstract
Dysphagia which is defined as disordered swallowing is well known as one of the most common and dangerous symptoms of many diseases, including neurological disorders such as Parkinson's disease, amyotrophic lateral sclerosis, myasthenia gravis, and most commonly, stroke. Strokes are a potentially devastating complication of sickle cell disease (SCD), the most common genetic hemoglobinopathy worldwide, yet little is known about dysphagia as it relates to SCD. Thus, the purposes of this article are to review briefly the primary causes and health consequences of dysphagia, to highlight the relevance of dysphagia to SCD, to review what little is known about dysphagia in SCD, to recommend, based on our consensus and the available literature, when to screen, evaluate, and monitor dysphagia in patients with SCD, and to outline unanswered questions where research on dysphagia in SCD might improve health outcomes.
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Affiliation(s)
- Candice J Adams-Mitchell
- Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, FL, United States.
| | - Wally R Smith
- Florence Neal Cooper Smith Professor of Sickle Cell Disease Vice-Chair for Research, Division of General Internal Medicine Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science University of Florida, Gainesville, FL, United States
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Fitchett G, Yao Y, Emanuel LL, Guay MOD, Handzo G, Hauser J, Kittelson S, O'Mahony S, Quest T, Rabow M, Schoppee TM, Solomon S, Wilkie DJ, Chochinov HM. Examining Moderation of Dignity Therapy Effects by Symptom Burden or Religious/Spiritual Struggles. J Pain Symptom Manage 2024; 67:e333-e340. [PMID: 38215893 PMCID: PMC10939845 DOI: 10.1016/j.jpainsymman.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/18/2023] [Accepted: 01/03/2024] [Indexed: 01/14/2024]
Abstract
CONTEXT Dignity therapy (DT) is a well-researched psychotherapeutic intervention but it remains unclear whether symptom burden or religious/spiritual (R/S) struggles moderate DT outcomes. OBJECTIVE To explore the effects of symptom burden and R/S struggles on DT outcomes. METHODS This analysis was the secondary aim of a randomized controlled trial that employed a stepped-wedge design and included 579 participants with cancer, recruited from six sites across the United States. Participants were ages 55 years and older, 59% female, 22% race other than White, and receiving outpatient specialty palliative care. Outcome measures included the seven-item dignity impact scale (DIS), and QUAL-E subscales (preparation for death; life completion); distress measures were the Edmonton Symptom Assessment Scale (ESAS-r) (symptom burden), and the Religious Spiritual Struggle Scale (RSS-14; R/S). RESULTS DT effects on DIS were significant for patients with both low (P = 0.03) and moderate/high symptom burden (P = 0.001). They were significant for patients with low (P = 0.004) but not high R/S struggle (P = 0.10). Moderation effects of symptom burden (P = 0.054) and R/S struggle (P = 0.52) on DIS were not significant. DT effects on preparation and completion were not significant, neither were the moderation effects of the two distress measures. CONCLUSION Neither baseline symptom burden nor R/S struggle significantly moderated the effect of DT on DIS in this sample. Further study is warranted including exploration of other moderation models and development of measures sensitive to effects of DT and other end-of-life psychotherapeutic interventions.
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Affiliation(s)
- George Fitchett
- Department of Religion, Health and Human Values (G.F.), Rush University Medical Center, Chicago, Illinois, USA.
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, College of Nursing (Y.Y., T.M.S., D.J.W.), University of Florida, Gainesville, Florida, USA
| | - Linda L Emanuel
- Department of Medicine (L.L.E., J.H.), Northwestern University, Chicago, Illinois, USA; Mongan Institute (L.L.E.), Harvard University, Boston, Massachusetts, USA
| | - Marvin O Delgado Guay
- Department of Palliative, Rehabilitation, and Integrative Medicine (M.O.D.G.), MD Anderson Cancer Institute, Houston, Texas, USA
| | - George Handzo
- HealthCare Chaplaincy Network (G.H.), New York, New York, USA
| | - Joshua Hauser
- Department of Medicine (L.L.E., J.H.), Northwestern University, Chicago, Illinois, USA; Jesse Brown VA Medical Center (J.H.), Chicago, Illinois, USA
| | - Sheri Kittelson
- Department of Medicine (S.K.), University of Florida; Gainesville, Florida, USA
| | - Sean O'Mahony
- Department of Medicine (S.M.), Rush University Medical Center, Chicago, Illinois, USA
| | - Tammie Quest
- Department of Family and Preventive Medicine (T.Q.), Emory University, Atlanta, Georgia, USA
| | - Michael Rabow
- Department of Medicine (M.R.), University of California San Francisco, San Francisco, California, USA
| | - Tasha M Schoppee
- Department of Biobehavioral Nursing Science, College of Nursing (Y.Y., T.M.S., D.J.W.), University of Florida, Gainesville, Florida, USA; Community Hospice and Palliative Care (T.M.S.), Jacksonville, Florida, USA
| | - Sheldon Solomon
- Department of Psychology (S.S.), Skidmore College, Saratoga Springs, New York, USA
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing (Y.Y., T.M.S., D.J.W.), University of Florida, Gainesville, Florida, USA
| | - Harvey Max Chochinov
- Department of Psychiatry and Cancer Care Manitoba Research Institute (H.M.C.), University of Manitoba, Winnipeg, Manitoba, Canada
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Sauers B, Dyal BW, Johnson-Mallard V, Ezenwa MO, Halan S, Fillingim RB, Kalyanaraman S, Wilkie DJ. Feasibility of Nurse-led Development of Custom Virtual Reality Experiences for Health Care Interventions. J Nurs Educ 2024; 63:261-264. [PMID: 37738044 DOI: 10.3928/01484834-20230712-10] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
BACKGROUND The immersive and interactive nature of virtual reality (VR) renders it a potential pedagogical approach for nursing education. A bottleneck for exploiting VR advantages has been the complexity of creating new experiences; however, recent advances with VR hardware and software enable novice users to create compelling experiences. METHOD A case study describes an undergraduate nursing student with minimal technical skills using off-the-shelf VR software to create a pain management VR experience. RESULTS Using off-the-shelf hardware and software platforms eliminates the need to work with computer code. The team created a virtual environment and the objects in it through easy manipulation with click-and-drag techniques and by toggling simple settings. CONCLUSION The insights gained from this case suggest nurse educators can create simple yet powerful VR experiences themselves, which can greatly enhance existing tools for nursing education. [J Nurs Educ. 2024;63(4):261-264.].
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Mochona B, Redda KK, Offringa IA, Allen J, Carpten JD, Stern MC, Reams RR, Wilkie DJ. Mentoring Minority Cancer Researchers of Tomorrow: Comparison of the Face-to-Face, Virtual, and Hybrid Training Methods of the CaRE 2 Summer Cancer Research Education and Training Program. J Cancer Educ 2024:10.1007/s13187-024-02426-9. [PMID: 38520478 DOI: 10.1007/s13187-024-02426-9] [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] [Accepted: 03/10/2024] [Indexed: 03/25/2024]
Abstract
In our previous publication, we reported a framework to develop an undergraduate cancer research training program at Florida A&M University (FAMU) under the umbrella of the Florida-California Cancer Research, Education, and Engagement (CaRE2) Health Equity Center activity by harnessing the resources available at FAMU, the University of Florida (UF), and the University of Southern California (USC) Cancer Centers. The implementation of the CaRE2 face-to-face training platform was dramatically affected by the COVID-19 pandemic during the summer of 2020 and 2021 training periods. However, a concerted effort was made to restructure the face-to-face training model into virtual and hybrid training methods to maintain the continuity of the program during the pandemic. This article compared the three methods to identify the best platform for training URM students in cancer disparity research. The program's effectiveness was measured through motivation, experiences, and knowledge gained by trainees during and one year after the completion of the program. The results showed that the participants were highly positive in their feedback about the professional and academic values of the program. Although the virtual and hybrid methods experienced significant challenges during the pandemic, the hybrid training module offered an "above average" effectiveness in performance, like the face-to-face mentoring platform in mentoring URM students in cancer disparity research.
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Affiliation(s)
- Bereket Mochona
- Department of Chemistry, College of Science & Technology, Florida A&M University, Tallahassee, FL, 32307, USA.
| | - Kinfe K Redda
- College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida A&M University, Tallahassee, FL, 32307, USA
| | - Ite A Offringa
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - John Allen
- College of Pharmacy and College of Medicine, University of Florida Research and Academic Center, Lake Nona, FL, 32827, USA
| | - John D Carpten
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Mariana C Stern
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Renee R Reams
- College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida A&M University, Tallahassee, FL, 32307, USA
| | - Diana J Wilkie
- College of Nursing, University of Florida, Gainesville, FL, 32611, USA
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7
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Ezenwa MO, Smith TB, Richey J, Smith UD, Stern MC, Reams R, Wilkie DJ. Social network analysis of the CaRE 2 health equity center: Team science in full display. Clin Transl Sci 2024; 17:e13747. [PMID: 38445540 PMCID: PMC10915722 DOI: 10.1111/cts.13747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 03/07/2024] Open
Abstract
Cancer health disparities that exist in the Black or African American and Hispanic or Latino/x communities are scientific challenges, yet there are limited team science approaches to mitigate these challenges. This article's purpose is to evaluate the team science collaborations of the National Institutes of Health-funded Florida-California Cancer Research, Education & Engagement (CaRE2 ) Center partnership underscoring the inclusion of multidisciplinary team members and future under-represented minority (URM) cancer researchers. To understand our collaborative efforts, we conducted a social network analysis (SNA) of the CaRE2 Center partnership among University of Florida, Florida A&M University, and University of Southern California with data collected via the dimensions.ai application programming interface. We downloaded metadata for all publications associated with dimensions.ai IDs. The CaRE2 collaboration network increased over time as evidenced by accruing more external collaborators and more publishing of collaborative works. Degree centrality of key personnel was stable in each wave of the networks. CaRE2 key personnel averaged a total of 60.8 collaborators in 2018-2019 (SD = 57.4, minimum = 3, maximum = 221), and 65.8 collaborators in 2020-2021 (SD = 56.06, minimum = 4, maximum = 222). Betweenness was largely stable across all groups and waves. We observed a steady decline in transitivity, the probability that a pair of CaRE2 co-authors shared a third co-author, from 0.74 in 2018 to 0.47 in 2022. The SNA findings suggest that the CaRE2 Center partnership's publications show growth in team science collaborations with the inclusion of multidisciplinary team members from the three partner institutions and future URM cancer researchers who were mentored as trainees and early-stage investigators.
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Affiliation(s)
- Miriam O. Ezenwa
- Department of Biobehavioral Nursing Science, College of NursingUniversity of FloridaGainesvilleFloridaUSA
| | - Thomas Bryan Smith
- Bureau of Economic and Business ResearchUniversity of FloridaGainesvilleFloridaUSA
| | - Joyce Richey
- Department of Physiology & Neuroscience, Department of Medical EducationKeck School of Medicine of USC, University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Ukamaka D. Smith
- Department of Clinical Affairs, Pharmacy Practice Division, College of Pharmacy and Pharmaceutical Sciences, Institute of Public HealthFlorida A&M UniversityTallahasseeFloridaUSA
| | - Mariana C. Stern
- Department of Population and Public Health Sciences and Urology, Keck School of Medicine of USC, Norris Comprehensive Cancer CenterUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Renee Reams
- College of Pharmacy and Pharmaceutical Sciences, Institute of Public HealthFlorida Agricultural and Mechanical UniversityTallahasseeFloridaUSA
| | - Diana J. Wilkie
- Department of Biobehavioral Nursing Science, College of NursingUniversity of FloridaGainesvilleFloridaUSA
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Eades-Brown NT, Oguntoye AO, Aldossary D, Ezenwa MO, Duckworth L, Dede D, Johnson-Mallard V, Yao Y, Gallo A, Wilkie DJ. Adherence to a reproductive health intervention for young adults with sickle cell. J Am Assoc Nurse Pract 2024:01741002-990000000-00207. [PMID: 38408228 DOI: 10.1097/jxx.0000000000000997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 12/29/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND The CHOICES intervention is tailored specifically for young adults with sickle cell disease (SCD) or sickle cell trait (SCT). The face-to-face (F2F) delivery format is feasible with efficacy for improving knowledge about reproductive health for those with SCD or SCT. PURPOSE The purpose of the study was to compare the participant adherence to a remote online CHOICES intervention study (N = 107) and a F2F CHOICES intervention study (N = 234). METHODOLOGY In both studies, participants with SCD or SCT were randomized into experimental or usual care control groups. Descriptive statistics were collected for all participants by group in both studies. Adherence was measured by retention at each data collection time point. Independent t-tests were conducted to compare mean participant adherence of the F2F and online studies postbaseline (6, 12, 18, and 24 months). RESULTS There was a significant difference in mean adherence postbaseline between the studies (p = .005). The results suggest that more research is necessary for proper online participant retention. CONCLUSION Advance practice nurses that are well informed on CHOICES can transmit the availability of this evidence-based intervention to this special population. Special referral for the CHOICES intervention, which is tailored specifically for young adults with SCD or SCT, may increase adherence to the intervention if it comes from trusted health care providers. IMPLICATIONS Nurse practitioners are educators in primary and acute care settings. Encounters with reproductive age populations with SCD or SCT can occur in both settings.
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Affiliation(s)
| | - Anne O Oguntoye
- College of Nursing, University of Florida, Gainesville, Florida
| | - Dalal Aldossary
- College of Nursing, University of Florida, Gainesville, Florida
- Department of Nursing Fundamentals, College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Miriam O Ezenwa
- College of Nursing, University of Florida, Gainesville, Florida
| | | | - Duane Dede
- College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | | | - Yingwei Yao
- College of Nursing, University of Florida, Gainesville, Florida
| | - Agatha Gallo
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois
| | - Diana J Wilkie
- College of Nursing, University of Florida, Gainesville, Florida
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Wilkie DJ, Fitchett G, Yao Y, Schoppee T, Delgado Guay MO, Hauser J, Kittelson S, O'Mahony S, Rabow M, Quest T, Solomon S, Handzo G, Chochinov HM, Emanuel LL. Engaging Mortality: Effective Implementation of Dignity Therapy. J Palliat Med 2024; 27:176-184. [PMID: 37676977 PMCID: PMC10825264 DOI: 10.1089/jpm.2023.0336] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 09/09/2023] Open
Abstract
Background: Patients consider the life review intervention, Dignity Therapy (DT), beneficial to themselves and their families. However, DT has inconsistent effects on symptoms and lacks evidence of effects on spiritual/existential outcomes. Objective: To compare usual outpatient palliative care and chaplain-led or nurse-led DT for effects on a quality-of-life outcome, dignity impact. Design/Setting/Subjects: In a stepped-wedge trial, six sites in the United States transitioned from usual care to either chaplain-led or nurse-led DT in a random order. Of 638 eligible cancer patients (age ≥55 years), 579 (59% female, mean age 66.4 ± 7.4 years, 78% White, 61% stage 4 cancer) provided data for analysis. Methods: Over six weeks, patients completed pretest/posttest measures, including the Dignity Impact Scale (DIS, ranges 7-35, low-high impact) and engaged in DT+usual care or usual care. They completed procedures in person (steps 1-3) or via Zoom (step 4 during pandemic). We used multiple imputation and regression analysis adjusting for pretest DIS, study site, and step. Results: At pretest, mean DIS scores were 24.3 ± 4.3 and 25.9 ± 4.3 for the DT (n = 317) and usual care (n = 262) groups, respectively. Adjusting for pretest DIS scores, site, and step, the chaplain-led (β = 1.7, p = 0.02) and nurse-led (β = 2.1, p = 0.005) groups reported significantly higher posttest DIS scores than usual care. Adjusting for age, sex, race, education, and income, the effect on DIS scores remained significant for both DT groups. Conclusion: Whether led by chaplains or nurses, DT improved dignity for outpatient palliative care patients with cancer. This rigorous trial of DT is a milestone in palliative care and spiritual health services research. clinicaltrials.gov: NCT03209440.
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Affiliation(s)
- Diana J. Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - George Fitchett
- Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, Illinois, USA
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Tasha Schoppee
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida, USA
- Community Hospice & Palliative Care, Jacksonville, Florida, USA
| | - Marvin O. Delgado Guay
- Department of Palliative, Rehabilitation, and Integrative Medicine, MD Anderson Cancer Institute, Houston, Texas, USA
| | - Joshua Hauser
- Department of Medicine, Northwestern University and Jesse Brown VA Medical Center, Chicago, Illinois, USA
| | - Sheri Kittelson
- Department of Medicine, University of Florida, Gainesville, Florida, USA
| | - Sean O'Mahony
- Department of Medicine, Rush University, Chicago, Illinois, USA
| | - Michael Rabow
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Tammie Quest
- Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia, USA
| | - Sheldon Solomon
- Department of Psychology, Skidmore College, Saratoga Springs, New York, USA
| | - George Handzo
- HealthCare Chaplaincy Network, New York, New York, USA
| | - Harvey Max Chochinov
- Department of Psychiatry and Cancer Care Manitoba Research Institute, University of Manitoba, Winnipeg, Canada
| | - Linda L. Emanuel
- Mongan Institute, Harvard University, Boston, Massachusetts, USA; Supportive Oncology, Robert H Lurie Comprehensive Cancer Center, Northwestern Medical Group, Feinberg School of Medicine, Northwestern University Chicago, Illinois, USA
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10
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Wilkie DJ, Telisnor G, Powell-Roach K, Rangel AP, Greenlee AL, Ezenwa MO, Gallo AM, Black LV, Gomes de Siqueira A, Dyal BW, Kalyanaraman S, Yao Y. CHOICES for sickle cell reproductive health: A protocol of a randomized preconception intervention model for a single gene disorder. PLoS One 2023; 18:e0294907. [PMID: 38060589 PMCID: PMC10703323 DOI: 10.1371/journal.pone.0294907] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/25/2023] [Indexed: 12/18/2023] Open
Abstract
Our long-term goal is to foster genetically informed reproductive health knowledge and behaviors among young adults with sickle cell disease (SCD) or sickle cell trait (SCT) with a web-based, tailored, multimedia intervention called CHOICES. CHOICES is designed to help young adults with SCD or SCT preconception to gain knowledge of genetic inheritance, specify their reproductive health intentions (their parenting plan), and engage in reproductive health behaviors concordant with their parenting plan. In a previous study, we found high acceptability of both the e-Book (usual care control) and CHOICES interventions. We also found sustained (24 months), significant effects on knowledge but not on behavior, most likely because half of the recruited group was not at risk for their children inheriting SCD. Hence, we propose an adequately powered randomized controlled trial with the CHOICES intervention and an e-Book control to compare their effects on genetic inheritance knowledge and at-risk reproductive health behaviors (immediate posttest and at 6, 12, 18, and 24 months). We will conduct subgroup analyses to provide insight into the baseline knowledge and behavior as well as the intervention effects in different demographic or acceptability groups. Given the scalability and low cost of CHOICES, if proved to be effective, it can reach the affected population at low cost.
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Affiliation(s)
- Diana J. Wilkie
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
| | - Guettchina Telisnor
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
| | - Keesha Powell-Roach
- College of Nursing, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Andrea P. Rangel
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
| | - Amelia L. Greenlee
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
| | - Miriam O. Ezenwa
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
| | - Agatha M. Gallo
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
| | - L. Vandy Black
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
| | | | - Brenda W. Dyal
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
| | - Sriram Kalyanaraman
- College of Journalism and Communications, University of Florida, Gainesville, Florida, United States of America
| | - Yingwei Yao
- College of Nursing, University of Florida, Gainesville, Florida, United States of America
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11
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Allen JM, Awunti M, Guo Y, Bian J, Rogers SC, Scarton L, DeRemer DL, Wilkie DJ. Unraveling Racial Disparities in Supportive Care Medication Use among End-of-Life Pancreatic Cancer Patients: Focus on Pain Management and Psychiatric Therapies. Cancer Epidemiol Biomarkers Prev 2023; 32:1675-1682. [PMID: 37788369 PMCID: PMC10690138 DOI: 10.1158/1055-9965.epi-23-0251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/06/2023] [Accepted: 09/11/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Supportive care medication use differences may contribute to racial disparities observed in health-related quality of life in patients with pancreatic cancer. METHODS In this observation study using the Surveillance, Epidemiology, and End Results-Medicare linked database, we sought to examine supportive care medication use disparities in patients with pancreatic cancer from 2005 to 2017 by race and ethnicity. RESULTS Among 74,309 patients included in the final analysis, racial and ethnic disparities in the use of supportive care medications were identified. After adjustment for confounding factors and compared with non-Hispanic Whites, minorities had significantly less use of opioids [Black: adjusted OR (aOR), 0.84; 95% confidence interval (CI), 0.79-0.88; Asian: aOR, 0.84; 95% CI, 0.79-0.90), and skeletomuscular relaxants (Black: aOR, 0.90; 95% CI, 0.82-0.99; Hispanic: aOR, 0.82; 95% CI, 0.74-0.91; Asian: aOR, 0.59; 95% CI, 0.51-0.68), and increased use of non-opioid analgesics (Hispanic: aOR, 1.16; 95% CI, 1.01-1.14; Asian: aOR, 1.37; 95% CI, 1.26-1.49). Racial and ethnic minorities had less use of antidepressants (Black: aOR, 0.56; 95% CI, 0.53-0.59; Hispanic: aOR, 0.77; 95% CI, 0.73-0.82; Asian: aOR, 0.47; 95% CI, 0.44-0.51), anxiolytics (Black: aOR, 0.78; 95% CI, 0.74-0.82; Hispanic: aOR, 0.66; 95% CI, 0.62-0.71; Asian: aOR, 0.52; 95% CI, 0.48-0.57), and antipsychotics (Hispanic: aOR, 0.90; 95% CI, 0.82-0.99; Asian: aOR, 0.84; 95% CI, 0.74-0.95). CONCLUSIONS Racial and ethnic disparities in the use of supportive care medications among patients with pancreatic cancer were observed, with the differences unexplained by sociodemographic factors. IMPACT Future studies should identify strategies to promote equitable use of supportive care medications among racial minorities and explore factors that may influence their use in these populations.
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Affiliation(s)
- John M. Allen
- Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Orlando, Florida
| | - MegCholack Awunti
- Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Orlando, Florida
| | - Yi Guo
- Department of Health Outcomes & Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida
| | - Jiang Bian
- Department of Health Outcomes & Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida
| | - Sherise C. Rogers
- Division of Hematology & Oncology, University of Florida College of Medicine, Gainesville, Florida
| | - Lisa Scarton
- Department of Family, Community, and Health Systems Science, University of Florida College of Nursing, Gainesville, Florida
| | - David L. DeRemer
- Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, Florida
| | - Diana J. Wilkie
- Department of Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, Florida
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12
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Hensel B, Askins N, Ibarra E, Aristizabal C, Guzman I, Barahona R, Hazelton-Glenn B, Lee J, Zhang Z, Odedina F, Wilkie DJ, Stern MC, Baezconde-Garbanati L, Suther S, Webb F. Florida-California Cancer Health Equity Center (CaRE 2) Community Scientist Research Advocacy Program. J Cancer Educ 2023; 38:1429-1439. [PMID: 37642919 PMCID: PMC10509126 DOI: 10.1007/s13187-023-02351-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/30/2023] [Indexed: 08/31/2023]
Abstract
The Community Scientist Program (CSP), a model connecting researchers with community members, is effective to inform and involve the general population in health-related clinical research. Given the existing cancer disparities among Black/African American and Hispanic/Latino/a populations, more models describing how cancer-related CSPs are designed, implemented, and evaluated are needed. The Florida-California Cancer Research, Education and Engagement (CaRE2) Health Equity Center is a tri-institutional, bicoastal center created to eliminate cancer health disparities among Black/African American and Hispanic/Latino/a populations living in California and in Florida. The CaRE2 Center created a Community Scientist Research Advocacy (CSRA) training program for community members to become cancer research advocates. The CSRA program is currently a 13-week program conducted 100% virtually with all materials provided in English and Spanish for participants to learn more about prostate, lung, and pancreas cancers, ongoing research at CaRE2, and ways to share cancer research throughout their communities. Participants attend didactic lectures on cancer research during weeks 1-5. In week 4, participants join CSRA self-selected groups based on cancer-related topics of interest. Each group presents their cancer-related advocacy project developed during weeks 5-12 at the final session. In this paper, we describe the CaRE2 Health Equity Center's CSRA program, share results, and discuss opportunities for improvement in future program evaluation as well as replication of this model in other communities.
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Affiliation(s)
- B Hensel
- Department of Biobehavioral Nursing Science, University of Florida, Orlando, FL, USA.
| | - N Askins
- Department of Research and Graduate Programs, Florida State University, Orlando, FL, USA
| | - E Ibarra
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - C Aristizabal
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - I Guzman
- Department of Biobehavioral Nursing Science, University of Florida, Orlando, FL, USA
| | - R Barahona
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - B Hazelton-Glenn
- Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, FL, USA
| | - J Lee
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Z Zhang
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - F Odedina
- Mayo Clinic Comprehensive Cancer Center, Jacksonville, FL, USA
| | - D J Wilkie
- Department of Biobehavioral Nursing Science, University of Florida, Gainesville, FL, USA
| | - M C Stern
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - L Baezconde-Garbanati
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - S Suther
- Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, FL, USA
| | - F Webb
- Department of Surgery, University of Florida, Jacksonville, FL, USA
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13
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Gehling GM, Powell-Roach K, Wilkie DJ, Dungan JR. Single nucleotide polymorphisms and sickle cell disease-related pain: a systematic review. Front Pain Res (Lausanne) 2023; 4:1223309. [PMID: 37781219 PMCID: PMC10538969 DOI: 10.3389/fpain.2023.1223309] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/21/2023] [Indexed: 10/03/2023] Open
Abstract
Background Scientists have speculated genetic variants may contribute to an individual's unique pain experience. Although research exists regarding the relationship between single nucleotide polymorphisms and sickle cell disease-related pain, this literature has not been synthesized to help inform future precision health research for sickle cell disease-related pain. Our primary aim of this systematic review was to synthesize the current state of scientific literature regarding single nucleotide polymorphisms and their association with sickle cell disease-related pain. Methods Using the Prisma guidelines, we conducted our search between December 2021-April 2022. We searched PubMed, Web of Science, CINAHL, and Embase databases (1998-2022) and selected all peer-reviewed articles that included reports of associations between single nucleotide polymorphisms and sickle cell disease-related pain outcomes. Results Our search yielded 215 articles, 80 of which were duplicates, and after two reviewers (GG, JD) independently screened the 135 non-duplicate articles, we retained 22 articles that met the study criteria. The synthesis of internationally generated evidence revealed that this scientific area remains predominantly exploratory in nature, with only three studies reporting sufficient power for genetic association. Sampling varied across studies with a range of children to older adults with SCD. All of the included articles (n = 22) examined acute pain, while only nine of those studies also examined chronic pain. Conclusion Currently, the evidence implicating genetic variation contributing to acute and chronic sickle cell disease-related pain is characterized by modestly powered candidate-gene studies using rigorous SCD-pain outcomes. Effect sizes and directions vary across studies and are valuable for informing the design of future studies. Further research is needed to replicate these associations and extend findings with hypothesis-driven research to inform precision health research.
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Affiliation(s)
- Gina M. Gehling
- College of Nursing, University of Florida, Gainesville, FL, United States
| | - Keesha Powell-Roach
- College of Nursing, Department of Community and Population Health, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Diana J. Wilkie
- College of Nursing, University of Florida, Gainesville, FL, United States
| | - Jennifer R. Dungan
- College of Nursing, University of Florida, Gainesville, FL, United States
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14
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Fullwood D, Booker S, Fallon E, Means S, Asto-Flores E, Stickley ZL, Ellie-Turenne MC, Wilkie DJ. A descriptive study of physical function and performance in older black men with low back pain. Geriatr Nurs 2023; 53:78-84. [PMID: 37454422 PMCID: PMC10530352 DOI: 10.1016/j.gerinurse.2023.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
The purpose of this paper is to describe physical function and performance scores and examine the relationships between measures of physical performance in older Black men with low back pain. The Mobility, Aging, Pain, and Disparities study used a cross-sectional, observational design to objectively measure physical performance on the Short Physical Performance Battery (SPPB), the Back Performance Scale (BPS), and the 400-meter Walk Test along with subjective ratings of pain intensity in the past 24 hours. Sixty community-based Black men aged 61-87 (x̄= 70 ± 6) years had an average BPS score of 7.0 ± 4 and total score on the SPPB 8.5 ± 2.1. Average 400-meter Walk time was 6.3 ± 3.1 minutes. Men's average pain intensity in the past 24 hours was 5.7 ± 2, indicating moderate pain. In conclusion, older Black men with low back pain demonstrated low physical function scores and a higher level of disability.
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Affiliation(s)
- Dottington Fullwood
- Mayo Clinic Florida, Cancer Health Equity Research Program, Jacksonville, Florida, USA.
| | - Staja Booker
- Department of Biobehavioral Nursing Science, University of Florida, Gainesville Florida, USA
| | - Elizabeth Fallon
- Mayo Clinic Florida, Cancer Health Equity Research Program, Jacksonville, Florida, USA
| | - Sydney Means
- Mayo Clinic Florida, Cancer Health Equity Research Program, Jacksonville, Florida, USA
| | - Emelina Asto-Flores
- Mayo Clinic Florida, Cancer Health Equity Research Program, Jacksonville, Florida, USA
| | - Zachary L Stickley
- Department of Educational Psychology, Leadership, & Counseling, Texas Tech University, Lubbock, Texas, USA
| | - Marie-Carmelle Ellie-Turenne
- Department of Emergency Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, University of Florida, Gainesville Florida, USA
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15
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Suarez ML, Angulo R, Suarez AJ, Fullwood D, Allen J, Stern MC, Flores-Rozas H, Wilkie DJ. Cognitive Testing of PAIN Report It-Spanish in Monolingual Hispanic Adults. Cancer Nurs 2023; 46:364-374. [PMID: 37607372 PMCID: PMC10232677 DOI: 10.1097/ncc.0000000000001123] [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: 12/13/2022]
Abstract
BACKGROUND A Spanish language computerized tool would facilitate cancer pain assessment and management for the underserved population of native Spanish speakers who do not speak or lack command of the English language. OBJECTIVE Our aim was to identify Spanish-speaking adults' understanding and interpretation of the PAIN Report It-Spanish items and instructions as well as translation and technical issues. METHODS In a cross-sectional study, 20 mostly monolingual Spanish-speaking adults engaged in 1.5- to 2-hour, audio-recorded cognitive interviews as they completed the multidimensional PAIN Report It-Spanish. Three bilingual researchers conducted content data analysis. RESULTS Sixteen women and 4 men generally understood the translated text, but some had interpretation issues regarding the 0 to 10 number scale and understanding of the pain quality descriptors. Many participants found the program easy to complete, even when they had problems in some areas. Most participants welcomed the opportunity to report pain in their native language and appreciated research to help Hispanics with the management of their pain. CONCLUSION PAIN Report It-Spanish is a valid tool to assess pain in a Spanish-speaking population. Improved orientation to the pain reporting tasks and alternate translations for several problematic/confusing Spanish words require additional study, especially among underrepresented black Hispanics and males. IMPLICATION FOR PRACTICE Findings indicate that Spanish-speaking adults (1) easily use a body outline to report their pain location, (2) may use a 0 to 10 scale differently than other individuals, and (3) may have a limited repertoire of pain quality and pattern descriptors.
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Affiliation(s)
- Marie L Suarez
- Author Affiliations: College of Nursing, University of Illinois Chicago (Dr Suarez, Mr Angulo, and Mr Suarez); Institute on Aging, University of Florida (Dr Fullwood), Gainesville; College of Pharmacy, University of Florida (Dr Allen), Gainesville; Department of Population and Public Health Sciences and Department of Urology, Keck School of Medicine of USC, Norris Comprehensive Cancer Center (Dr Stern), Los Angeles, CA; College of Pharmacy, Florida Agricultural and Mechanical University (Dr Flores-Rozas), Tallahassee; and College of Nursing, University of Florida (Dr Wilkie), Gainesville
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16
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Yao Y, Dunn Lopez K, Bjarnadottir RI, Macieira TGR, Dos Santos FC, Madandola OO, Cho H, Priola KJB, Wolf J, Wilkie DJ, Keenan G. Examining Care Planning Efficiency and Clinical Decision Support Adoption in a System Tailoring to Nurses' Graph Literacy: National, Web-Based Randomized Controlled Trial. J Med Internet Res 2023; 25:e45043. [PMID: 37566456 PMCID: PMC10457701 DOI: 10.2196/45043] [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: 12/14/2022] [Revised: 03/16/2023] [Accepted: 06/20/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND The proliferation of health care data in electronic health records (EHRs) is fueling the need for clinical decision support (CDS) that ensures accuracy and reduces cognitive processing and documentation burden. The CDS format can play a key role in achieving the desired outcomes. Building on our laboratory-based pilot study with 60 registered nurses (RNs) from 1 Midwest US metropolitan area indicating the importance of graph literacy (GL), we conducted a fully powered, innovative, national, and web-based randomized controlled trial with 203 RNs. OBJECTIVE This study aimed to compare care planning time (CPT) and the adoption of evidence-based CDS recommendations by RNs randomly assigned to 1 of 4 CDS format groups: text only (TO), text+table (TT), text+graph (TG), and tailored (based on the RN's GL score). We hypothesized that the tailored CDS group will have faster CPT (primary) and higher adoption rates (secondary) than the 3 nontailored CDS groups. METHODS Eligible RNs employed in an adult hospital unit within the past 2 years were recruited randomly from 10 State Board of Nursing lists representing the 5 regions of the United States (Northeast, Southeast, Midwest, Southwest, and West) to participate in a randomized controlled trial. RNs were randomly assigned to 1 of 4 CDS format groups-TO, TT, TG, and tailored (based on the RN's GL score)-and interacted with the intervention on their PCs. Regression analysis was performed to estimate the effect of tailoring and the association between CPT and RN characteristics. RESULTS The differences between the tailored (n=46) and nontailored (TO, n=55; TT, n=54; and TG, n=48) CDS groups were not significant for either the CPT or the CDS adoption rate. RNs with low GL had longer CPT interacting with the TG CDS format than the TO CDS format (P=.01). The CPT in the TG CDS format was associated with age (P=.02), GL (P=.02), and comfort with EHRs (P=.047). Comfort with EHRs was also associated with CPT in the TT CDS format (P<.001). CONCLUSIONS Although tailoring based on GL did not improve CPT or adoption, the study reinforced previous pilot findings that low GL is associated with longer CPT when graphs were included in care planning CDS. Higher GL, younger age, and comfort with EHRs were associated with shorter CPT. These findings are robust based on our new innovative testing strategy in which a diverse national sample of RN participants (randomly derived from 10 State Board of Nursing lists) interacted on the web with the intervention on their PCs. Future studies applying our innovative methodology are recommended to cost-effectively enhance the understanding of how the RN's GL, combined with additional factors, can inform the development of efficient CDS for care planning and other EHR components before use in practice.
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Affiliation(s)
- Yingwei Yao
- University of Florida College of Nursing, Gainesville, FL, United States
| | - Karen Dunn Lopez
- University of Iowa College of Nursing, Iowa City, IA, United States
| | | | | | | | | | - Hwayoung Cho
- University of Florida College of Nursing, Gainesville, FL, United States
| | - Karen J B Priola
- University of Florida College of Nursing, Gainesville, FL, United States
| | - Jessica Wolf
- University of Iowa College of Nursing, Iowa City, IA, United States
| | - Diana J Wilkie
- University of Florida College of Nursing, Gainesville, FL, United States
| | - Gail Keenan
- University of Florida College of Nursing, Gainesville, FL, United States
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17
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Al Yacoub R, Rangel AP, Shum-Jimenez A, Greenlee A, Yao Y, Schoppee TM, Fitchett G, Handzo G, Chochinov HM, Emanuel LL, Kittelson S, Wilkie DJ. Cost considerations for implementing dignity therapy in palliative care: Insights and implications. Palliat Support Care 2023:1-5. [PMID: 37565429 PMCID: PMC10858976 DOI: 10.1017/s1478951523001177] [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] [Indexed: 08/12/2023]
Abstract
OBJECTIVES Despite the clinical use of dignity therapy (DT) to enhance end-of-life experiences and promote an increased sense of meaning and purpose, little is known about the cost in practice settings. The aim is to examine the costs of implementing DT, including transcriptions, editing of legacy document, and dignity-therapists' time for interviews/patient's validation. METHODS Analysis of a prior six-site, randomized controlled trial with a stepped-wedge design and chaplains or nurses delivering the DT. RESULTS The mean cost per transcript was $84.30 (SD = 24.0), and the mean time required for transcription was 52.3 minutes (SD = 14.7). Chaplain interviews were more expensive and longer than nurse interviews. The mean cost and time required for transcription varied across the study sites. The typical total cost for each DT protocol was $331-$356. SIGNIFICANCE OF RESULTS DT implementation costs varied by provider type and study site. The study's findings will be useful for translating DT in clinical practice and future research.
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Affiliation(s)
- Raed Al Yacoub
- Department of Medicine, College of Medicine, University of Florida, Gainesville, FLUSA
| | - Andrea P Rangel
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FLUSA
| | - Adriana Shum-Jimenez
- Department of Medicine, College of Medicine, University of Florida, Gainesville, FLUSA
| | - Amelia Greenlee
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FLUSA
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FLUSA
| | - Tasha M Schoppee
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FLUSA
- Community Hospice & Palliative Care, Jacksonville, FLUSA
| | - George Fitchett
- Department of Religion, Health and Human Values, College of Health Sciences, Rush University Medical Center, Chicago, ILUSA
| | | | - Harvey Max Chochinov
- Department of Psychiatry and Cancer Care Manitoba Research Institute, University of Manitoba, Winnipeg, MB, Canada
| | | | - Sheri Kittelson
- Department of Medicine, College of Medicine, University of Florida, Gainesville, FLUSA
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FLUSA
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18
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Piel FB, Rees DC, DeBaun MR, Nnodu O, Ranque B, Thompson AA, Ware RE, Abboud MR, Abraham A, Ambrose EE, Andemariam B, Colah R, Colombatti R, Conran N, Costa FF, Cronin RM, de Montalembert M, Elion J, Esrick E, Greenway AL, Idris IM, Issom DZ, Jain D, Jordan LC, Kaplan ZS, King AA, Lloyd-Puryear M, Oppong SA, Sharma A, Sung L, Tshilolo L, Wilkie DJ, Ohene-Frempong K. Defining global strategies to improve outcomes in sickle cell disease: a Lancet Haematology Commission. Lancet Haematol 2023; 10:e633-e686. [PMID: 37451304 DOI: 10.1016/s2352-3026(23)00096-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [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: 01/31/2023] [Revised: 03/31/2023] [Accepted: 04/12/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Frédéric B Piel
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
| | - David C Rees
- Department of Paediatric Haematology, King's College London, King's College Hospital, London, UK
| | - Michael R DeBaun
- Department of Pediatrics, Vanderbilt-Meharry Center of Excellence for Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Obiageli Nnodu
- Department of Haematology and Blood Transfusion, College of Health Sciences and Centre of Excellence for Sickle Cell Disease Research and Training, University of Abuja, Abuja, Nigeria
| | - Brigitte Ranque
- Department of Internal Medicine, Georges Pompidou European Hospital, Assistance Publique-Hopitaux de Paris Centre, University of Paris Cité, Paris, France
| | - Alexis A Thompson
- Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Russell E Ware
- Division of Hematology and Global Health Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Miguel R Abboud
- Department of Pediatrics and Adolescent Medicine, and Sickle Cell Program, American University of Beirut, Beirut, Lebanon
| | - Allistair Abraham
- Division of Blood and Marrow Transplantation, Children's National Hospital, Washington, DC, USA
| | - Emmanuela E Ambrose
- Department of Paediatrics and Child Health, Bugando Medical Centre, Mwanza, Tanzania
| | - Biree Andemariam
- New England Sickle Cell Institute, University of Connecticut Health, Connecticut, USA
| | - Roshan Colah
- Department of Haematogenetics, Indian Council of Medical Research National Institute of Immunohaematology, Mumbai, India
| | - Raffaella Colombatti
- Pediatric Oncology Hematology Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Nicola Conran
- Department of Clinical Medicine, School of Medical Sciences, Center of Hematology and Hemotherapy (Hemocentro), University of Campinas-UNICAMP, Campinas, Brazil
| | - Fernando F Costa
- Department of Clinical Medicine, School of Medical Sciences, Center of Hematology and Hemotherapy (Hemocentro), University of Campinas-UNICAMP, Campinas, Brazil
| | - Robert M Cronin
- Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Mariane de Montalembert
- Department of Pediatrics, Necker-Enfants Malades Hospital, Assistance Publique-Hopitaux de Paris Centre, Paris, France
| | - Jacques Elion
- Paris Cité University and University of the Antilles, Inserm, BIGR, Paris, France
| | - Erica Esrick
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - Anthea L Greenway
- Department Clinical Haematology, Royal Children's Hospital, Parkville and Department Haematology, Monash Health, Clayton, VIC, Australia
| | - Ibrahim M Idris
- Department of Hematology, Aminu Kano Teaching Hospital/Bayero University Kano, Kano, Nigeria
| | - David-Zacharie Issom
- Department of Business Information Systems, School of Management, HES-SO University of Applied Sciences and Arts of Western Switzerland, Geneva, Switzerland
| | - Dipty Jain
- Department of Paediatrics, Government Medical College, Nagpur, India
| | - Lori C Jordan
- Department of Pediatrics, Division of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Zane S Kaplan
- Department of Clinical Haematology, Monash Health and Monash University, Melbourne, VIC, Australia
| | - Allison A King
- Departments of Pediatrics and Internal Medicine, Divisions of Pediatric Hematology and Oncology and Hematology, Washington University School of Medicine, St Louis, MO, USA
| | - Michele Lloyd-Puryear
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Samuel A Oppong
- Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana
| | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Lillian Sung
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Leon Tshilolo
- Institute of Biomedical Research/CEFA Monkole Hospital Centre and Official University of Mbuji-Mayi, Mbuji-Mayi, Democratic Republic of the Congo
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
| | - Kwaku Ohene-Frempong
- Division of Hematology, Children's Hospital of Philadelphia, Pennsylvania, USA; Sickle Cell Foundation of Ghana, Kumasi, Ghana
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Kashyap Y, He Y, Sadhu N, Yao Y, Wilkie DJ, Molokie RE, Wang ZJ. An alcohol dehydrogenase 7 gene polymorphism associates with both acute and chronic pain in sickle cell disease. Pharmacogenomics 2023; 24:641-649. [PMID: 37712142 PMCID: PMC10621759 DOI: 10.2217/pgs-2023-0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/04/2023] [Indexed: 09/16/2023] Open
Abstract
Introduction: As the most distressing complication of sickle cell disease (SCD), pain is marked by considerable heterogenicity. In this study we explored the potential association of alcohol dehydrogenase 7 gene (ADH7) polymorphism rs971074 with sickle cell pain. Methods: We analyzed clinical phenotypes and the rs971074 single-nucleotide polymorphism in ADH7 by MassARRAY-iPlex analysis in a cohort of SCD patients. Results: The synonymous rs971074 was significantly associated with both acute and chronic pain in SCD. Patients with the minor T allele(s) recorded significantly more crisis episodes and severe chronic pain symptoms. Conclusion: Our study has identified the rs971074 minor T allele as a genetic biomarker potentially influencing acute and chronic pain. These findings may ultimately help inform strategies to develop precision pain therapies in SCD.
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Affiliation(s)
- Yavnika Kashyap
- Department of Pharmaceutical Sciences, University of Illinois College of Pharmacy, Chicago, IL 60612, USA
| | - Ying He
- Department of Pharmaceutical Sciences, University of Illinois College of Pharmacy, Chicago, IL 60612, USA
- Comprehensive Sickle Cell Center, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Nilanjana Sadhu
- Department of Pharmaceutical Sciences, University of Illinois College of Pharmacy, Chicago, IL 60612, USA
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, FL 32610, USA
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, FL 32610, USA
| | - Robert E Molokie
- Department of Pharmaceutical Sciences, University of Illinois College of Pharmacy, Chicago, IL 60612, USA
- Comprehensive Sickle Cell Center, University of Illinois Chicago, Chicago, IL 60612, USA
- Jesse Brown Veteran's Administration Medical Center, Chicago, IL 60612, USA
- Division of Hematology/Oncology, University of Illinois College of Medicine, Chicago, IL 60612, USA
| | - Zaijie Jim Wang
- Department of Pharmaceutical Sciences, University of Illinois College of Pharmacy, Chicago, IL 60612, USA
- Comprehensive Sickle Cell Center, University of Illinois Chicago, Chicago, IL 60612, USA
- Department of Neurology & Rehabilitation, University of Illinois College of Medicine, Chicago, IL 60612, USA
- Department of Biomedical Engineering, University of Illinois Chicago College of Engineering, Chicago, IL 60607, USA
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20
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Sadhu N, He Y, Yao Y, Wilkie DJ, Molokie RE, Wang ZJ. Candidate gene association study suggests potential role of dopamine beta-hydroxylase in pain heterogeneity in sickle cell disease. Front Genet 2023; 14:1193603. [PMID: 37384335 PMCID: PMC10296203 DOI: 10.3389/fgene.2023.1193603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/23/2023] [Indexed: 06/30/2023] Open
Abstract
Introduction: Pain is a lifelong companion of individuals with sickle cell disease (SCD) and has a severe impact on their quality of life. Both acute crisis pain and chronic non-crisis pain exhibit high variability between individuals, making it difficult to effectively manage sickle cell-related pain. We investigated the role of dopamine beta-hydroxylase (DBH) gene polymorphisms on pain variability in SCD. DBH is a key enzyme in the catecholamine biosynthesis pathway that catalyzes the conversion of dopamine to norepinephrine, both of which are known mediators of pain and pain-related behaviors. Methods: Acute crisis pain-related utilization and non-crisis chronic pain scores of 131 African Americans with SCD were obtained. Results and discussion: Association analyses revealed that the T allele of upstream variant rs1611115 and downstream variant rs129882 correlated with higher severity of chronic pain in an additive model. On the other hand, the A allele of missense variant rs5324 associated with lower risk of both acute crisis pain and chronic pain. Similarly, the C allele of intronic variant rs2797849 was associated with lower incidence of acute crisis pain in the additive model. In addition, tissue-specific eQTL revealed that the T allele of rs1611115 correlated with decreased expression of DBH in the frontal cortex and anterior cingulate cortex (GTEx), and decreased expression of DBH-AS1 in blood (eQTLGen). Bioinformatic approaches predicted that rs1611115 may be altering a transcription factor binding site, thereby, contributing to its potential effect. Taken together, findings from this study suggest that potential functional polymorphisms of DBH may modulate pain perception in SCD.
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Affiliation(s)
- Nilanjana Sadhu
- Department of Pharmaceutical Sciences, University of Illinois Chicago College of Pharmacy, Chicago, IL, United States
| | - Ying He
- Department of Pharmaceutical Sciences, University of Illinois Chicago College of Pharmacy, Chicago, IL, United States
- Comprehensive Sickle Cell Center, University of Illinois Chicago, Chicago, IL, United States
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, FL, United States
| | - Diana J. Wilkie
- Department of Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, FL, United States
| | - Robert E. Molokie
- Department of Pharmaceutical Sciences, University of Illinois Chicago College of Pharmacy, Chicago, IL, United States
- Comprehensive Sickle Cell Center, University of Illinois Chicago, Chicago, IL, United States
- Jesse Brown Veteran’s Administration Medical Center, Chicago, IL, United States
- Division of Hematology/Oncology, University of Illinois Chicago College of Medicine, Chicago, IL, United States
| | - Zaijie Jim Wang
- Department of Pharmaceutical Sciences, University of Illinois Chicago College of Pharmacy, Chicago, IL, United States
- Comprehensive Sickle Cell Center, University of Illinois Chicago, Chicago, IL, United States
- Department of Neurology and Rehabilitation, University of Illinois Chicago College of Medicine, Chicago, IL, United States
- Department of Biomedical Engineering, University of Illinois Chicago College of Engineering, Chicago, IL, United States
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21
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Fullwood D, Means S, Paxton R, Wells B, Riley JL, Stickley Z, Tucker C, You L, Elie M, Thomas C, Anton S, Pahor M, Wilkie DJ. Avoidance-Endurance Model in Older Black Men with Low Back Pain: Exploring Relationships. J Racial Ethn Health Disparities 2023; 10:1310-1318. [PMID: 35501598 PMCID: PMC10597575 DOI: 10.1007/s40615-022-01316-4] [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: 01/13/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The objective of the study was to investigate functional performance and pain intensity outcomes for associations with negative cognitive orientations, avoidance behaviors, and fear of pain in older Black men with low back pain (LBP). METHODS Sixty Black men aged 60 and older (70 years[Formula: see text]) with LBP completed the Short Physical Performance Battery (SPPB), the 400-m walk test, and subjective measures of avoidance behaviors, back performance, pain intensity, and pain catastrophizing (i.e., rumination, magnification, and helplessness). Multiple regression models were used to examine associations. RESULTS Higher helplessness scores were associated with worse back performance (ß = 0.55, p = 0.02), slower walking speed (ß = 0.30, p = 0.02), and higher average pain intensity (ß = 0.22, [Formula: see text] p = 0.03). Higher rumination scores were associated with better back performance (ß = - 0.36, p = 0.04). Avoidance behaviors, fear of pain, and magnification were not significantly associated with any of the variables included in the tested models. CONCLUSION Negative cognitive internalization is associated with limitations in functional performance in older Black men with LBP. Additional research is needed to further examine the cognitive orientations for understanding experienced pain and function in this population. Such research may inform the development of interventions for improving functional performance outcomes of older Black men with LBP.
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Affiliation(s)
- Dottington Fullwood
- Institute On Aging, University of Florida, 2004 Mowry Road, CTRB 3118, Gainesville, FL, 32611, USA.
| | - Sydney Means
- Institute On Aging, University of Florida, 2004 Mowry Road, CTRB 3118, Gainesville, FL, 32611, USA
| | - Raheem Paxton
- Department of Community Medicine and Population Health, University of Alabama, Tuscaloosa, AL, USA
| | - Brandi Wells
- Jacksonville Aging Studies Center, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA
| | - Joseph L Riley
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Zachary Stickley
- Department of Educational Psychology, Leadership, & Counseling, Texas Tech University, Lubbock, TX, USA
| | - Carolyn Tucker
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Lu You
- Health Informatics Institute, University of South Florida, Tampa, FL, USA
| | - Marie Elie
- Department of Emergency Medicine, University of Florida, Gainesville, FL, USA
| | - Carol Thomas
- Y Healthy Living Center, Johnson Family YMCA, Jacksonville, FL, USA
| | - Stephen Anton
- Institute On Aging, University of Florida, 2004 Mowry Road, CTRB 3118, Gainesville, FL, 32611, USA
| | - Marco Pahor
- Institute On Aging, University of Florida, 2004 Mowry Road, CTRB 3118, Gainesville, FL, 32611, USA
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, University of Florida, Gainesville, FL, USA
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22
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Scarton L, Nelson T, Yao Y, DeVaughan-Circles A, Legaspi AB, Donahoo WT, Segal R, Goins RT, Manson SM, Wilkie DJ. Association of Medication Adherence With HbA1c Control Among American Indian Adults With Type 2 Diabetes Using Tribal Health Services. Diabetes Care 2023; 46:1245-1251. [PMID: 37068266 PMCID: PMC10234744 DOI: 10.2337/dc22-1885] [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] [Received: 09/27/2022] [Accepted: 03/20/2023] [Indexed: 04/19/2023]
Abstract
OBJECTIVE To examine HbA1c levels and adherence to oral glucose-lowering medications and their association with future HbA1c levels among American Indian adults with type 2 diabetes (T2D) receiving medications at no cost from a tribal health care system. RESEARCH DESIGN AND METHODS Tribal citizens with T2D who used Choctaw Nation Health Services Authority (CNHSA) and Pharmacies and had HbA1c data during 2017-2018 were included in this study. Medication adherence (proportion of days covered [PDC] ≥0.80) was calculated using 2017 CNHSA electronic health record data. RESULTS Of the 74,000 tribal citizens living on tribal lands, 4,560 were eligible; 32% had HbA1c at or below target (≤7%), 36% were above target (>7 to ≤9%), and 32% were uncontrolled (>9%) in 2017. The percentage of patients with PDC ≥0.80 was 66% for those using biguanides, 72% for sulfonylureas, 75% for dipeptidyl peptidase 4 inhibitors, and 83% for sodium-glucose cotransporter 2 inhibitors. The proportion of patients with HbA1c at or below target increased slightly from 32% in 2017 to 42% in 2018. Higher average PDC in 2017 was associated with lower HbA1c levels in 2018 (β = -1.143; P < 0.001). CONCLUSIONS Medication adherence was higher than that found in previous studies using self-report methods in American Indian populations, although a smaller proportion of patients had HbA1c at or below target relative to U.S. adults with T2D. Medication adherence was associated with improved HbA1c levels for most oral glucose-lowering medication classes. Future studies of American Indians should use both longitudinal prescription data from both electronic health records and pharmacy refills.
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Affiliation(s)
- Lisa Scarton
- College of Nursing, University of Florida, Gainesville, FL
| | - Tarah Nelson
- College of Nursing, University of Florida, Gainesville, FL
| | - Yingwei Yao
- College of Nursing, University of Florida, Gainesville, FL
| | | | | | | | - Richard Segal
- College of Pharmacy, University of Florida, Gainesville, FL
| | - R. Turner Goins
- College of Health and Human Sciences, Western Carolina University, Cullowhee, NC
| | - Spero M. Manson
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
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23
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Abudawood K, Yoon SL, Garg R, Yao Y, Molokie RE, Wilkie DJ. Quantification of Patient-Reported Pain Locations: Development of an Automated Measurement Method. Comput Inform Nurs 2023; 41:346-355. [PMID: 36067491 PMCID: PMC9981814 DOI: 10.1097/cin.0000000000000875] [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: 11/25/2022]
Abstract
Patient-reported pain locations are critical for comprehensive pain assessment. Our study aim was to introduce an automated process for measuring the location and distribution of pain collected during a routine outpatient clinic visit. In a cross-sectional study, 116 adults with sickle cell disease-associated pain completed PAIN Report It Ⓡ . This computer-based instrument includes a two-dimensional, digital body outline on which patients mark their pain location. Using the ImageJ software, we calculated the percentage of the body surface area marked as painful and summarized data with descriptive statistics and a pain frequency map. The painful body areas most frequently marked were the left leg-front (73%), right leg-front (72%), upper back (72%), and lower back (70%). The frequency of pain marks in each of the 48 body segments ranged from 3 to 79 (mean, 33.2 ± 21.9). The mean percentage of painful body surface area per segment was 10.8% ± 7.5% (ranging from 1.3% to 33.1%). Patient-reported pain locations can be easily analyzed from digital drawings using an algorithm created via the free ImageJ software. This method may enhance comprehensive pain assessment, facilitating research and personalized care over time for patients with various pain conditions.
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Affiliation(s)
- Khulud Abudawood
- College of Nursing, King Saudi bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Saunjoo L. Yoon
- Department of Biobehavioral Nursing Science,College of Nursing, University of Florida, Gainesville, Florida
| | - Rishabh Garg
- Herbert Wertheim College of Engineering, University of Florida, Gainesville, Florida
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science,College of Nursing, University of Florida, Gainesville, Florida
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL
| | - Robert E. Molokie
- Department of Medicine, College of Medicine, University of Illinois at Chicago and Jesse Brown Veterans Administration Medical Center, Chicago, IL
| | - Diana J. Wilkie
- Department of Biobehavioral Nursing Science,College of Nursing, University of Florida, Gainesville, Florida
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL
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Fullwood D, Means S, Stickley ZL, Elie-Turenne MC, Wilkie DJ. Improvement Opportunities for PAINReportIt ® Delivered on a Wireless Tablet: Rated by Black Older Men With Low Back Pain. Res Gerontol Nurs 2023; 16:108-114. [PMID: 37040308 PMCID: PMC10754271 DOI: 10.3928/19404921-20230405-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
Health care professionals and researchers can implement technology to improve older adults' acceptability of providing health information and to better include older adults in sharing information with health providers. However, older adults' engagement with technology remains low. This study focused on 60 Black older men (mean age = 70 years, SD = 6 years) with low back pain who completed the 13-item Computer Acceptability Scale after using the PAINReportIt® software on an Apple iPad®. On average, the sample found it acceptable to use PAINReportIt® software to share their pain or discomfort but that this was no replacement for oral dialogue with their health care provider. These findings contribute valuable information about the acceptability of using technology and indicate potential opportunities to improve PAINReportIt® software. Community interventions with acceptable tablet devices can offer new insight into collecting pain or discomfort data in populations with low presence in clinical research studies. [Research in Gerontological Nursing, 16(3), 108-114.].
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25
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Nelson T, Wilkie DJ, Scarton L. Medication Adherence in American Indians With Type 2 Diabetes: An Integrative Review. Diabetes Spectr 2023; 36:193-200. [PMID: 37193204 PMCID: PMC10182960 DOI: 10.2337/ds21-0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Tarah Nelson
- University of Florida College of Nursing, Gainesville, FL
| | | | - Lisa Scarton
- University of Florida College of Nursing, Gainesville, FL
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Hensel BM, Webb FJ, Ibarra E, Aristizabal C, Barahona R, Wilkie DJ, Suther S, Baezconde-Garbanati L, Stern MC. Abstract 4189: Community cancer scientist program: A model for community member advocacy for cancer research. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-4189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Community Cancer Scientist (CCS) programs are designed to educate community members on the importance and ethical conduct of clinical research that serves to connect researchers and the general population. This type of program allows research advocates to interact with their community, helping minoritized individuals to form trust with cancer researchers and in clinical trials.The purpose of our study was to develop and evaluate a novel bi-coastal and bilingual program to inform, educate and empower community members to become cancer research advocates in Florida (FL) and California (CA). Our program was tailored for African American (AA) and Hispanic/Latinx (H/L) adults. Primary objectives are to increase person power for cancer research advocacy and increase multi-directional communication between cancer advocates with cancer survivors, community members, academic scientists and policy makers. The CCS program is a 13-week program implemented 100% virtual by the FL-CA Cancer Research, Education and Engagement (CaRE2) Health Equity Center, a bi-coastal partnership between the Florida A&M University, University of Florida, and University of Southern California where participants learned about cancers that disproportionately impact AA and H/L adults. Participants completed surveys at program start, midway, and end to assess knowledge gained and satisfaction, and a mentored advocacy project for community implementation. Five months after program end, we surveyed participants on impact and to provide support for their research advocacy.To date, a total of 26 adults have graduated from our program. We present data from the 2022 CCS cohort (N = 20) that included participants from FL and CA, which are among the top five states in the U.S with the largest AA and H/L populations. Regarding race and ethnicity, 13 participants were AA, 6 H/L, and 1 White, with 80% female participants. This cohort had 90% program completion (N = 18) and 5 advocacy projects: 2 on breast cancer, 1 on lung cancer, 1 on pancreas cancer, and 1 on prostate cancer. More than 50% of participants showed increased knowledge regarding cancer incidence, mortality and standard screening practices while program satisfaction remained high at end of program. Participants also provided feedback and recommendations such as offering a hybrid model for participants to interact with cancer researchers, and desired visiting CaRE2 scientific laboratories for hands-on engagement. In conclusion, we present findings from a novel virtual CCS bi-coastal and bilingual training program tailored for AA and H/L adults that can foster multi-directional communication between cancer research advocates with multiple stakeholders. We also discuss how these research advocacy cancer programs can be tailored to focus on specific initiatives important to eliminate cancer health disparities such as or examining cancer health disparities from a lifespan perspective.
Citation Format: Brooke M. Hensel, Fern J. Webb, Eduardo Ibarra, Carolina Aristizabal, Rosa Barahona, Diana J. Wilkie, Sandra Suther, Lourdes Baezconde-Garbanati, Mariana C. Stern. Community cancer scientist program: A model for community member advocacy for cancer research. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4189.
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Affiliation(s)
| | | | - Eduardo Ibarra
- 3University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - Carolina Aristizabal
- 4University of Sothern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - Rosa Barahona
- 5University of California Norris Comprehensive Cancer Center, Los Angeles, CA
| | | | - Sandra Suther
- 7Florida Agricultural and Mechanical University, Tallahassee, FL
| | | | - Mariana C. Stern
- 3University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
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Erden S, Yikar SK, Doğan SD, Lucero RJ, Yıldız KS, Gezer S, Nazik E, Arslan S, Yao Y, Wilkie DJ. Validation of the tablet-based Turkish-PAINReportIt® for lung cancer patients after thoracotomy in Turkey. Appl Nurs Res 2023; 70:151673. [PMID: 36933901 PMCID: PMC10257141 DOI: 10.1016/j.apnr.2023.151673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 02/07/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Digital pain assessment is advantageous and timely for healthcare priorities in Turkey. However, a multi-dimensional, tablet-based pain assessment tool is not available in the Turkish language. PURPOSE To validate the Turkish-PAINReportIt® as a multi-dimensional measure of post-thoracotomy pain. METHODS In the first of a two-phased study, 32 Turkish patients (mean age 47.8 ± 15.6 years, 72 % male) participated in individual cognitive interviews as they completed the tablet-based Turkish-PAINReportIt® once during the first four days post-thoracotomy, and 8 clinicians participated in a focus group discussion of implementation barriers. In the second phase, 80 Turkish patients (mean age 59.0 ± 12.7 years, 80 % male) completed the Turkish-PAINReportIt® preoperatively, on postoperative days 1-4, and at the two-week post-operative follow-up visit. RESULTS Patients generally interpreted accurately the Turkish-PAINReportIt® instructions and items. We eliminated some items unnecessary for daily assessment based on focus-group suggestions. In the second study phase, pain scores (intensity, quality, pattern) were low pre-thoracotomy for lung cancer and high postoperatively high on day 1, decreasing on days 2, 3 and 4, and back down to pre-surgical levels at 2-weeks. Over time, pain intensity decreased from post-operative day 1 to post-operative day 4 (p < .001) and from post-operative day 1 to post-operative week 2 (p < .001). CONCLUSIONS The formative research supported proof of concept and informed the longitudinal study. Findings showed strong validity of the Turkish-PAINReportIt® to detect reduced pain over time as healing occurs after thoracotomy.
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Affiliation(s)
- Sevilay Erden
- Department of Surgical Nursing, Faculty of Health Sciences, Cukurova University, Adana, Turkey.
| | - Seda Karacay Yikar
- Department of Obstetrics and Gynecologic Nursing, Faculty of Health Sciences, Cukurova University, Adana, Turkey
| | - Sevgi Deniz Doğan
- Uluborlu Selahattin Karasoy Vocational School, Isparta University of Applied Sciences, Isparta, Turkey
| | - Robert J Lucero
- University of California, Los Angeles, School of Nursing, Los Angeles, CA, United States of America.
| | - Kardelen Simal Yıldız
- University of Central Florida Orlando, FLORIDA Biomedical Sciences, FL, ABD, United States of America
| | - Suat Gezer
- Chest Surgery, Cukurova University, Adana, Turkey
| | - Evsen Nazik
- Department of Obstetrics and Gynecologic Nursing, Faculty of Health Sciences, Cukurova University, Adana, Turkey
| | - Sevban Arslan
- Department of Surgical Nursing, Faculty of Health Sciences, Cukurova University, Adana, Turkey
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, University of Florida, Gainesville, FL, United States of America.
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, University of Florida, Gainesville, FL, United States of America.
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28
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Kittelson S, Lo MC, Hagen M, Barker PC, Yacoub RA, Hahn P, Turpening P, Wilkie DJ, Cattier C, Romanello T, Karver SB, Adkins-Dodd B, Shum-Jimenez AS, Weisbrod N, Ledford PA, Ponder-Stansel S. Advancing Palliative Care Systematically Using Education Through a Grassroots Coalition. Palliat Med Rep 2023; 4:89-91. [PMID: 36969739 PMCID: PMC10036073 DOI: 10.1089/pmr.2022.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 03/24/2023] Open
Affiliation(s)
- Sheri Kittelson
- Department of Medicine, University of Florida, Gainesville, Florida, USA
- Address correspondence to: Sheri Kittelson, MD, University of Florida, PO Box 100283, Gainesville, FL 32610-0238, USA.
| | - Margaret C. Lo
- Department of Medicine, University of Florida, Gainesville, Florida, USA
| | - Melanie Hagen
- Department of Medicine, University of Florida, Gainesville, Florida, USA
| | - Paige C. Barker
- Department of Medicine, University of Florida, Gainesville, Florida, USA
| | - Raed Al Yacoub
- Department of Medicine, University of Florida, Gainesville, Florida, USA
| | - Paulette Hahn
- Department of Medicine, University of Florida, Gainesville, Florida, USA
| | - Paula Turpening
- College of Nursing, University of Florida Health, Gainesville, Florida, USA
| | - Diana J. Wilkie
- Catholic Hospice and Catholic Palliative Care Services, Miami Lakes, Florida, USA
| | - Celine Cattier
- Department of Medicine, University of Florida, Gainesville, Florida, USA
| | - Tracy Romanello
- Catholic Hospice and Catholic Palliative Care Services, Miami Lakes, Florida, USA
| | - Sloan B. Karver
- United Healthcare Community Plan, Hot Springs, Arkansas, USA
| | | | | | - Neal Weisbrod
- Department of Medicine, University of Florida, Gainesville, Florida, USA
| | - Paul A. Ledford
- Florida Hospice and Palliative Care Association, Tallahassee, Florida, USA
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Scarton L, Cobas H, Velazquez I, McClaren M, Legaspi A, Iyer S, Choate A, Cannady TK, Wilkie DJ. Method of Developing a Culturally Tailored Diabetes Intervention for American Indians. Prog Community Health Partnersh 2023. [DOI: 10.1353/cpr.2023.0022] [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: 03/21/2023]
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Emanuel LL, Solomon S, Chochinov HM, Delgado Guay MO, Handzo G, Hauser J, Kittelson S, O'Mahony S, Quest TE, Rabow MW, Schoppee TM, Wilkie DJ, Yao Y, Fitchett G. Death Anxiety and Correlates in Cancer Patients Receiving Palliative Care. J Palliat Med 2023; 26:235-243. [PMID: 36067074 PMCID: PMC9894592 DOI: 10.1089/jpm.2022.0052] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Death anxiety is powerful, potentially contributes to suffering, and yet has to date not been extensively studied in the context of palliative care. Availability of a validated Death Anxiety and Distress Scale (DADDS) opens the opportunity to better assess and redress death anxiety in serious illness. Objective: We explored death anxiety/distress for associations with physical and psychosocial factors. Design: Ancillary to a randomized clinical trial (RCT) of Dignity Therapy (DT), we enrolled a convenience sample of 167 older adults in the United States with cancer and receiving outpatient palliative care (mean age 65.9 [7.3] years, 62% female, 84% White, 62% stage 4 cancer). They completed the DADDS and several measures for the stepped-wedged RCT, including demographic factors, religious struggle, dignity-related distress, existential quality of life (QoL), and terminal illness awareness (TIA). Results: DADDS scores were generally unrelated to demographic factors (including religious affiliation, intrinsic religiousness, and frequency of prayer). DADDS scores were positively correlated with religious struggle (p < 0.001) and dignity-related distress (p < 0.001) and negatively correlated with existential QoL (p < 0.001). TIA was significantly nonlinearly associated with both the total DADDS (p = 0.007) and its Finitude subscale (p ≤ 0.001) scores. There was a statistically significant decrease in Finitude subscale scores for a subset of participants who completed a post-DT DADDS (p = 0.04). Conclusions: Findings, if replicable, suggest that further research on death anxiety and prognostic awareness in the context of palliative medicine is in order. Findings also raise questions about the optimal nature and timing of spiritual and psychosocial interventions, something that might entail evaluation or screening for death anxiety and prognostic awareness for maximizing the effectiveness of care.
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Affiliation(s)
- Linda L. Emanuel
- Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Northwestern Medicine, Chicago, Illinois, USA
| | - Sheldon Solomon
- Department of Psychology, Skidmore College, Saratoga Springs, New York, USA
| | - Harvey Max Chochinov
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
- CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Marvin Omar Delgado Guay
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - George Handzo
- Health Services Research and Quality, HealthCare Chaplaincy Network, New York, New York, USA
| | - Joshua Hauser
- Department of Medicine, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
- Jesse Brown VA Medical Center, Chicago, Illinois, USA
| | - Sheri Kittelson
- Division of Palliative Care, Department of Medicine and University of Florida, Gainesville, Florida, USA
| | - Sean O'Mahony
- Section of Palliative Medicine, Department of Internal Medicine and Health, and Human Values, Rush University Medical Center, Chicago, Illinois, USA
| | - Tammie E. Quest
- Department of Family and Preventive Medicine and Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michael W. Rabow
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California, USA
| | - Tasha M. Schoppee
- Community Hospice and Palliative Care, Jacksonville, Florida, USA
- Center for Palliative Care Research and Education, University of Florida, Gainesville, Florida, USA
| | - Diana J. Wilkie
- Center for Palliative Care Research and Education, University of Florida, Gainesville, Florida, USA
| | - Yingwei Yao
- Center for Palliative Care Research and Education, University of Florida, Gainesville, Florida, USA
| | - George Fitchett
- Department of Religion, Health, and Human Values, Rush University Medical Center, Chicago, Illinois, USA
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Wallace-Farquharson T, Rhee H, Oguntoye AO, Elder JH, Ezenwa MO, Fedele D, Duckworth L, Wilkie DJ. Adolescents' practical knowledge of asthma self-management and experiences in the context of acute asthma: a qualitative content analysis. J Asthma 2023; 60:277-287. [PMID: 35195484 PMCID: PMC9470766 DOI: 10.1080/02770903.2022.2045309] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 02/12/2022] [Accepted: 02/18/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To characterize adolescents' practical knowledge of asthma self-management and experiences during acute asthma episodes, and compare practical knowledge between minority and non-minority groups. METHODS We conducted a secondary analysis using a qualitative descriptive design of textual data collected from 126 adolescents that participated in a randomized controlled trial of an asthma self-management program. Directed content analysis was conducted using four constructs of asthma self-management including symptom prevention, symptom monitoring, acute symptom management, and symptom communication. RESULTS Most of the adolescents knew how to prevent exercised-induced bronchoconstriction, but had limited understanding about how to assess and monitor the severity of acute symptoms, appropriately use bronchodilators, seek timely medical help, and communicate acute symptoms to caregivers or healthcare providers during a slow-onset and rapid-onset asthma attack. More minority participants monitored asthma using peak expiratory flow than non-minority participants, who often relied on symptom-based monitoring. Minority adolescents more frequently mentioned bronchodilator use to manage asthma attacks, while non-minority adolescents often reported use of complementary and alternative approaches. Minority youth mentioned accessing healthcare services for acute episodes more often than their non-minority counterparts. Minority participants mentioned communicating acute symptoms to their providers, or family members less frequently than non-minority youth. CONCLUSIONS Adolescents have insufficient practical knowledge about ways to prevent and manage acute asthma. Periodic assessment of learning needs related to asthma attacks should be considered a routine part of clinical visits for adolescents to provide targeted information support to address their identified needs.
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Affiliation(s)
- Tanya Wallace-Farquharson
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
| | - Hyekyun Rhee
- School of Nursing, University of Texas at Austin, Austin, TX, USA
| | - Anne O. Oguntoye
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
| | | | - Miriam O. Ezenwa
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
| | - David Fedele
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, USA
| | - Laurie Duckworth
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
| | - Diana J. Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
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32
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Powell-Roach KL, Yao Y, Cao X, Chamala S, Wallace MR, Cruz-Almeida Y, Molokie RE, Wang ZJ, Wilkie DJ. Analysis of AVPR1A, thermal and pressure pain thresholds, and stress in sickle cell disease. Front Pain Res (Lausanne) 2023; 3:1060245. [PMID: 36688082 PMCID: PMC9845903 DOI: 10.3389/fpain.2022.1060245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/06/2022] [Indexed: 01/05/2023] Open
Abstract
Aim In patients with sickle cell disease (SCD), negative physical and emotional experiences result from intense chronic and acute pain episodes, but factors underlying these, and their interactions, are not well understood. The arginine vasopressin receptor 1a gene (AVPR1A) single nucleotide polymorphism rs10877969 has been previously associated with aspects of acute pain and stress related pain. In this study, we tested for associations between this SNP, thermal and pressure pain thresholds, clinical pain, and stress in people with SCD. Methods 150 adults enrolled with SCD completed pain intensity measures (Average Pain Intensity, API) and the Perceived Stress Questionnaire (PSQ). Thermal and pressure pain threshold data were available from quantitative sensory testing (QST), and rs10877969 genotypes were obtained. Results In models adjusted for age and gender, between rs10877969 genotypes, we observed no significant differences in thermal (cold, p = 0.66; heat, p = 0.91) and mechanical (pressure, p = 0.33) pain thresholds. The association of rs10877969 with API (p = 0.09) was borderline, but non-significant with PSQ (p = 0.51). The correlation between clinical pain and environmental stress was significant, r = 0.18, p = 0.024, however, the interaction of genotype and PSQ was not significant (p = 0.63). Conclusion Clinical and experimental pain were not significantly associated with the rs10877969 genotype. The rs10877969 genotype did not moderate the correlation between environmental stress and clinical pain in this population. However, a trend toward a protective T allele effect on average pain rating in SCD warrants future exploration of this SNP/gene in SCD.
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Affiliation(s)
- Keesha L. Powell-Roach
- Department of Community and Population Health, University of Tennessee Health Science Center, College of Nursing, Memphis, TN, United States
- Department of Biobehavioral Nursing Science, University of Florida, College of Nursing, Gainesville, FL, United States
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, University of Florida, College of Nursing, Gainesville, FL, United States
| | - Xueyuan Cao
- Department of Community and Population Health, University of Tennessee Health Science Center, College of Nursing, Memphis, TN, United States
| | - Srikar Chamala
- Department of Pathology and Laboratory Medicine, Childrens Hospital of Los Angeles, Los Angeles, CA, United States
| | - Margaret R. Wallace
- Department of Molecular Genetics and Microbiology, University of Florida, College of Medicine, Gainesville, FL, United States
- University of Florida Genetics Institute, Gainesville, FL, United States
| | - Yenisel Cruz-Almeida
- College of Dentistry, University of Florida, Gainesville, FL, United States
- Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, United States
| | - Robert E. Molokie
- Department of Medicine, University of Illinois at Chicago, College of Medicine, Chicago, IL, United States
- Department of Pharmaceutical Sciences, Neurology and Bioengineering, University of Illinois College of Pharmacy, Chicago, IL, United States
- Medical Service, Jesse Brown VA Medical Center, Chicago, IL, United States
| | - Zaijie Jim Wang
- Department of Pharmaceutical Sciences, Neurology and Bioengineering, University of Illinois College of Pharmacy, Chicago, IL, United States
| | - Diana J. Wilkie
- Department of Biobehavioral Nursing Science, University of Florida, College of Nursing, Gainesville, FL, United States
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Reams RR, Odedina FT, Carpten JD, Redda K, Stern MC, Krieger JL, Aparicio J, Hensel B, Askins N, Abreu A, Adams A, Agyare E, Ali J, Allen JM, Aló R, Baezconde-Garbanati L, Brant J, Brown CP, Buxbaum SG, Cohen P, Cozen W, Ezenwa MO, Falzarano S, Fillingim RB, Flores-Rozas H, Fredenburg KM, George T, Han B, Huang Y, Hughes Halbert C, Kiros GE, Lamango NS, Lee JH, Lyon DE, Mitchell DA, Mochona B, Nieva JJ, Offringa IA, Okunieff P, Parker A, Rhie SK, Richey JM, Rogers SC, Salhia B, Schmittgen TD, Segal R, Setiawan VW, Smith U, Su LM, Suther S, Trevino J, Velazquez-Villarreal EI, Webb FJ, Wu AH, Yao Y, Wilkie DJ. Florida-California Cancer Research, Education and Engagement (CaRE 2) Health Equity Center: Structure, Innovations, and Initial Outcomes. Cancer Control 2023; 30:10732748231197878. [PMID: 37703814 PMCID: PMC10501072 DOI: 10.1177/10732748231197878] [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: 05/22/2023] [Revised: 07/21/2023] [Accepted: 08/03/2023] [Indexed: 09/15/2023] Open
Abstract
INTRODUCTION The Florida-California Cancer Research, Education, and Engagement (CaRE2) Health Equity Center is a triad partnership committed to increasing institutional capacity for cancer disparity research, the diversity of the cancer workforce, and community empowerment. This article provides an overview of the structure, process innovations, and initial outcomes from the first 4 years of the CaRE2 triad partnership. METHODS CaRE2 serves diverse populations in Florida and California using a "molecule to the community and back" model. We prioritize research on the complex intersection of biological, environmental, and social determinants health, working together with scientific and health disparities communities, sharing expertise across institutions, bidirectional training, and community outreach. Partnership progress and outcomes were assessed using mixed methods and four Program Steering Committee meetings. RESULTS Research capacity was increased through development of a Living Repository of 81 cancer model systems from minority patients for novel cancer drug development. CaRE2 funded 15 scientific projects resulting in 38 publications. Workforce diversity entailed supporting 94 cancer trainees (92 URM) and 34 ESIs (32 URM) who coauthored 313 CaRE2-related publications and received 48 grants. Community empowerment was promoted via outreaching to more than 3000 individuals, training 145 community cancer advocates (including 28 Community Scientist Advocates), and publishing 10 community reports. CaRE2 members and trainees together have published 639 articles, received 61 grants, and 57 awards. CONCLUSION The CaRE2 partnership has achieved its initial aims. Infrastructure for translational cancer research was expanded at one partner institution, and cancer disparities research was expanded at the two cancer centers.
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Affiliation(s)
- R. Renee Reams
- College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, FL, USA
| | | | - John D. Carpten
- Department of Translational Genomics, University of Southern California, Los Angeles, CA, USA
| | - Kinfe Redda
- College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, FL, USA
| | - Mariana C. Stern
- Departments of Population and Public Health Sciences, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Janice L. Krieger
- Department of Advertising, University of Florida, Gainesville, FL, USA
| | - Jose Aparicio
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Brooke Hensel
- Department of Behavioral Nursing Science, University of Florida, Gainesville, FL, USA
| | - Nissa Askins
- Florida State University College of Medicine, Tallahassee, FL, USA
| | - Andre Abreu
- Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Angela Adams
- Department of Pharmaceutics, University of Florida, Gainesville, FL, USA
| | - Edward Agyare
- College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, FL, USA
| | - Jamel Ali
- College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, FL, USA
- Department of Chemical and Biomedical Engineering, Florida State University, Tallahassee, FL, USA
| | - John M. Allen
- Department of Pharmacotherapy & Translational Research, University of Florida, Orlando, FL, USA
| | - Richard Aló
- College of Science and Technology, Florida Agricultural and Mechanical University, Tallahassee, FL, USA
| | - Lourdes Baezconde-Garbanati
- Departments of Population and Public Health Sciences, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Jason Brant
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Clyde P. Brown
- College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, FL, USA
| | - Sarah G. Buxbaum
- College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, FL, USA
| | - Pinchas Cohen
- University of Southern California Leonard Davis School of Gerontology, Los Angeles, CA, USA
| | - Wendy Cozen
- Division of Hematology/Oncology, School of Medicine, University of California, Irvine, CA, USA
| | - Miriam O. Ezenwa
- Department of Behavioral Nursing Science, University of Florida, Gainesville, FL, USA
| | - Sara Falzarano
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, USA
| | - Roger B. Fillingim
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Hernan Flores-Rozas
- College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, FL, USA
| | - Kristianna M. Fredenburg
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, USA
| | - Thomas George
- Department of Medicine in the College of Medicine, University of Florida, Gainesville, FL, USA
| | - Bo Han
- Departments of Surgery, University of Southern California, Los Angeles, CA, USA
| | - Yong Huang
- Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL, USA
| | - Chanita Hughes Halbert
- Departments of Population and Public Health Sciences, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Gebre-Egziabher Kiros
- College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, FL, USA
| | - Nazarius S. Lamango
- College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, FL, USA
| | - Ji-Hyun Lee
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Debra E. Lyon
- Department of Behavioral Nursing Science, University of Florida, Gainesville, FL, USA
| | - Duane A. Mitchell
- Department of Neurosurgery, University of Florida, Gainesville, FL, USA
| | - Bereket Mochona
- Department of Chemistry, Florida Agricultural and Mechanical University, Tallahassee, FL USA
| | - Jorge J. Nieva
- Department of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ite A. Offringa
- Departments of Surgery, University of Southern California, Los Angeles, CA, USA
- Department of Biochemistry and Molecular Medicine, University of Southern California, Los Angeles, CA, USA
| | - Paul Okunieff
- Department of Radiation Oncology, University of Florida, Gainesville, FL, USA
| | - Alexander Parker
- College of Medicine, University of Florida, Jacksonville, FL, USA
| | - Suhn K. Rhie
- Department of Biochemistry and Molecular Medicine, University of Southern California, Los Angeles, CA, USA
| | - Joyce M. Richey
- Department of Clinical Physiology and Neuroscience, University of Southern California, Los Angeles, CA, USA
| | - Sherise C. Rogers
- Department of Medicine in the College of Medicine, University of Florida, Gainesville, FL, USA
| | - Bodour Salhia
- Department of Translational Genomics, University of Southern California, Los Angeles, CA, USA
| | | | - Richard Segal
- Department of Pharmaceutical Outcome and Policy, University of Florida, Gainesville, FL, USA
| | | | - Ukamaka Smith
- College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, FL, USA
| | - Li-Ming Su
- Department of Urology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Sandra Suther
- College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, FL, USA
| | - Jose Trevino
- Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Fern J. Webb
- Department of Surgery, University of Florida, Jacksonville, FL, USA
| | - Anna H. Wu
- Department of Translational Genomics, University of Southern California, Los Angeles, CA, USA
| | - Yingwei Yao
- Department of Behavioral Nursing Science, University of Florida, Gainesville, FL, USA
| | - Diana J. Wilkie
- Department of Behavioral Nursing Science, University of Florida, Gainesville, FL, USA
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Desloge AA, Patil CL, Glayzer JE, Suarez ML, Kobak WH, Meinel M, Steffen AD, Burke LA, Yao Y, Takayama M, Yajima H, Kaptchuk TJ, Takakura N, Foster DC, Wilkie DJ, Schlaeger JM. Women's Experience of Living with Vulvodynia Pain: Why They Participated in a Randomized Controlled Trial of Acupuncture. J Integr Complement Med 2023; 29:50-54. [PMID: 36130137 PMCID: PMC9917314 DOI: 10.1089/jicm.2022.0647] [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] [Indexed: 01/12/2023]
Abstract
Introduction: Vulvodynia is vulvar pain lasting at least 3-months without clear identifiable cause that may have other associated factors. The aim, to explore motivations of women participating in a double-blind randomized controlled trial of acupuncture for vulvodynia. Methods: Responses to the question: "Tell me about why you decided to participate in this study" were analyzed using conceptual content analysis to identify patterns in motivation for study participation. Results: Four patterns emerged: 1) desire to address uncontrolled pain, 2) desire for understanding, 3) wish to contribute to knowledge generation, and 4) need to remove cost barriers. Conclusion: Motivations indicate vulvodynia-specific aspects of acceptability of acupuncture. Clinical Trial Registration: NCT03364127.
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Affiliation(s)
- Allissa A. Desloge
- School of Public Health, University of Illinois Chicago, Chicago, IL, USA
| | - Crystal L. Patil
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Jennifer E. Glayzer
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Marie L. Suarez
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - William H. Kobak
- Department of Obstetrics and Gynecology, College of Medicine, University of Illinois Chicago, Chicago, IL, USA
| | - Monya Meinel
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Alana D. Steffen
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Larisa A. Burke
- Office of Research Facilitation, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, FL, USA
| | - Miho Takayama
- Department of Acupuncture and Moxibustion, Faculty of Health Sciences, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Hiroyoshi Yajima
- Department of Acupuncture and Moxibustion, Faculty of Health Sciences, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Ted J. Kaptchuk
- Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Nobuari Takakura
- Department of Acupuncture and Moxibustion, Faculty of Health Sciences, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - David C. Foster
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Diana J. Wilkie
- Department of Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, FL, USA
| | - Judith M. Schlaeger
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
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Cooks EJ, Vilaro MJ, Dyal BW, Wang S, Mertens G, Raisa A, Kim B, Campbell-Salome G, Wilkie DJ, Odedina F, Johnson-Mallard V, Yao Y, Krieger JL. What did the pandemic teach us about effective health communication? Unpacking the COVID-19 infodemic. BMC Public Health 2022; 22:2339. [PMID: 36514047 PMCID: PMC9747260 DOI: 10.1186/s12889-022-14707-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The spread of unvetted scientific information about COVID-19 presents a significant challenge to public health, adding to the urgency for increased understanding of COVID-19 information-seeking preferences that will allow for the delivery of evidence-based health communication. This study examined factors associated with COVID-19 information-seeking behavior. METHODS An online survey was conducted with US adults (N = 1800) to identify key interpersonal (e.g., friends, health care providers) and mediated (e.g., TV, social media) sources of COVID-19 information. Logistic regression models were fitted to explore correlates of information-seeking. RESULTS Study findings show that the first sought and most trusted sources of COVID-19 information had different relationships with sociodemographic characteristics, perceived discrimination, and self-efficacy. Older adults had greater odds of seeking information from print materials (e.g., newspapers and magazines) and TV first. Participants with less educational attainment and greater self-efficacy preferred interpersonal sources first, with notably less preference for mass media compared to health care providers. Those with more experiences with discrimination were more likely to seek information from friends, relatives, and co-workers. Additionally, greater self-efficacy was related to increased trust in interpersonal sources. CONCLUSION Study results have implications for tailoring health communication strategies to reach specific subgroups, including those more vulnerable to severe illness from COVID-19. A set of recommendations are provided to assist in campaign development.
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Affiliation(s)
- Eric J. Cooks
- grid.15276.370000 0004 1936 8091STEM Translational Communication Center, College of Journalism and Communications, University of Florida, Weimer Hall 2043, PO Box 118400, Gainesville, FL 32611-8400 USA
| | - Melissa J. Vilaro
- grid.15276.370000 0004 1936 8091Department of Family, Youth, and Community Sciences, University of Florida, Gainesville, USA
| | - Brenda W. Dyal
- grid.15276.370000 0004 1936 8091Department of Biobehavioral Nursing Science, University of Florida, Gainesville, USA
| | - Shu Wang
- grid.15276.370000 0004 1936 8091Department of Biostatistics, University of Florida, Gainesville, USA
| | - Gillian Mertens
- grid.15276.370000 0004 1936 8091STEM Translational Communication Center, College of Journalism and Communications, University of Florida, Weimer Hall 2043, PO Box 118400, Gainesville, FL 32611-8400 USA
| | - Aantaki Raisa
- grid.15276.370000 0004 1936 8091STEM Translational Communication Center, College of Journalism and Communications, University of Florida, Weimer Hall 2043, PO Box 118400, Gainesville, FL 32611-8400 USA
| | - Bumsoo Kim
- grid.444004.00000 0004 0647 1620Department of Media and Communication, Joongbu University, Geumsan, South Korea
| | - Gemme Campbell-Salome
- grid.280776.c0000 0004 0394 1447Department of Population Health Sciences, Geisinger, Danville, USA
| | - Diana J. Wilkie
- grid.15276.370000 0004 1936 8091Department of Biobehavioral Nursing Science, University of Florida, Gainesville, USA
| | - Folake Odedina
- grid.417467.70000 0004 0443 9942Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, USA
| | | | - Yingwei Yao
- grid.15276.370000 0004 1936 8091Department of Biobehavioral Nursing Science, University of Florida, Gainesville, USA
| | - Janice L. Krieger
- grid.15276.370000 0004 1936 8091STEM Translational Communication Center, College of Journalism and Communications, University of Florida, Weimer Hall 2043, PO Box 118400, Gainesville, FL 32611-8400 USA
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36
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Oguntoye AO, Eades NT, Ezenwa MO, Krieger J, Jenerette C, Adegbola M, Jacob E, Johnson-Mallard V, Yao Y, Gallo A, Wilkie DJ. Factors associated with young adult engagement with a web-based sickle cell reproductive health intervention. PEC Innov 2022; 1:100063. [PMID: 36618121 PMCID: PMC9815666 DOI: 10.1016/j.pecinn.2022.100063] [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] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective To determine the factors predicting the engagement of young adults who have sickle cell disease (SCD) or sickle cell trait (SCT) with an online reproductive health education intervention and engagement effects on knowledge. Methods The cross-sectional study included 167 participants who completed the web-based intervention either face-to-face (F2F) or online delivery (OL). Measures include: time used relative to length of the intervention narration and media (engagement) and the SCKnowIQ questionnaire. Ordinal regression was conducted. Results The sample mean age was 26-years (SD=5), 68% were female, 54% had SCD, and 68% were in the F2F group. Adjusting for age, partner sickle cell status, marital status, and education, participants who were female (p=.003), had SCD (p=.018), or had F2F delivery (p < .001) were more likely to spend more time on the intervention. Adjusting for baseline knowledge and modality, more time spent on the intervention was associated with higher posttest knowledge (p=.006). Conclusions Future studies are necessary to understand reasons underpinning engagement and to investigate other unmeasured factors, such as intervention interactivity elements, that could also be associated with engagement. Innovation This study of young adults with SCD or SCT provides much needed insight about their engagement with online reproductive health education.
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Affiliation(s)
- Anne O. Oguntoye
- College of Nursing, University of Florida, Gainesville, FL, USA,Corresponding author at: College of Nursing, University of Florida Gainesville, FL 32611, USA. (A.O. Oguntoye)
| | - Nyema T. Eades
- College of Nursing, University of Florida, Gainesville, FL, USA
| | | | - Janice Krieger
- College of Journalism & Communications, University of Florida, Gainesville, FL, USA
| | | | - Maxine Adegbola
- College of Nursing and Health Innovation, University of Texas Arlington, Arlington, TX, USA
| | - Eufemia Jacob
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Yingwei Yao
- College of Nursing, University of Florida, Gainesville, FL, USA
| | - Agatha Gallo
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Diana J. Wilkie
- College of Nursing, University of Florida, Gainesville, FL, USA
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Abudawood K, Yoon SL, Yao Y, Grundmann O, Ezenwa MO, Molokie RE, Wilkie DJ. A Novel Measure of Pain Location in Adults with Sickle Cell Disease. Pain Manag Nurs 2022; 23:693-702. [PMID: 36261305 PMCID: PMC10314740 DOI: 10.1016/j.pmn.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 09/05/2022] [Accepted: 09/21/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Pain intensity remains a primary focus clinically for sickle cell disease pain assessment despite the fact that pain quality and pain location and distribution are critical for clinical diagnosis and treatment of its etiology. However, in part because of measurement issues, scant evidence is available about pain location or its relationship to intensity and quality in adults with SCD. AIM Our study aim was to examine sickle cell disease pain location for relationships with pain quality and intensity measured in outpatient and inpatient settings. METHODS We used an existing longitudinal dataset prospectively collected with the valid and reliable tablet-based PAINReportItⓇ. Adults with sickle cell disease (n = 99) reported pain location, intensity, and quality during a routine outpatient clinic visit and again during a subsequent hospitalization. From their digital body outline drawings and using the ImageJ software, we computed the pain-affected body surface area. With Pearson's correlations and paired t tests, we examined relationships between pain-affected body surface area and other pain variables across outpatient and inpatient visits. RESULTS The mean pain-affected body surface area was 14.4% ± 15.0% of the total body surface area for outpatient visits (min-max: 0.0%-90.2%) and 13.5% ± 14.7% (min-max: 0.0%-73.0%) for inpatient stay. Pain-affected body surface area was positively correlated with pain quality scores for both visits but not significantly correlated with pain intensity at either visit. Compared with the outpatient visit, mean pain intensity for inpatient stay was higher (p < .001); pain quality (p = .12) and pain-affected body surface area (p = .60) did not differ significantly between visits. CONCLUSIONS Unknown is the explanation for pain-affected body surface area association with SCD pain quality but not pain intensity at outpatient and inpatient visits. Additional research is warranted to explore these findings and examine the clinical utility of pain-affected body surface area for chronic sickle cell disease pain and acute sickle cell disease crisis pain.
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Affiliation(s)
- Khulud Abudawood
- College of Nursing, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Saunjoo L Yoon
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida.
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida; Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Oliver Grundmann
- College of Pharmacy, University of Florida, Gainesville, Florida
| | - Miriam O Ezenwa
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida; Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Robert E Molokie
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois; Jesse Brown Veterans Administration Medical Center, Chicago, Illinois
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida; Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
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Schlaeger JM, Suarez ML, Glayzer JE, Kobak WH, Meinel M, Steffen AD, Burke LA, Pauls HA, Yao Y, Takayama M, Yajima H, Kaptchuk TJ, Takakura N, Foster D, Wilkie DJ. Protocol for double-blind RCT of acupuncture for vulvodynia. Contemp Clin Trials Commun 2022; 30:101029. [PMID: 36387991 PMCID: PMC9649367 DOI: 10.1016/j.conctc.2022.101029] [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: 05/28/2022] [Revised: 10/07/2022] [Accepted: 10/26/2022] [Indexed: 11/09/2022] Open
Abstract
Background Vulvodynia, vulvar pain of unknown origin lasting at least 3 months, affects 7% of American women. Dyspareunia, its frequent companion, renders sexual intercourse virtually impossible. Although few therapies are efficacious and rapid pain relief is rarely possible, there have been no sham/placebo-controlled studies of acupuncture for vulvodynia. Aims are to: 1) determine efficacy of acupuncture for vulvodynia, 2) explore duration of the acupuncture effect. Methods In a pretest/posttest randomized controlled, double-blind (practitioner-patient) efficacy trial of a standardized acupuncture protocol, we will randomize 80 participants 1:1 to either penetrating needle or skin-touch placebo needle groups. Both types of needles are designed to blind both the acupuncturist and participant. Participants with vulvodynia will insert and remove a tampon as a standardized stimulus and complete primary measures of vulvar pain (pain intensity) and secondary measures of dyspareunia (Female Sexual Function Index, FSFI dyspareunia subscale score) and sexual function (FSFI total score) pretreatment, after the 10th acupuncture session, and pain measures weekly until return to pretest levels. Upon study completion control group participants will be offered 10 free real acupuncture sessions. Discussion This is the first multi-needle multi-session RCT using double-blind acupuncture needles as a reliable sham. We hypothesize that controlling for baseline, at posttest there will be statistically significant less vulvar pain and dyspareunia and more sexual function over five weeks in the penetrating needle group compared to the skin touch placebo group. Conclusion This study is responsive to the need for efficacious pain management for women with vulvodynia.ClinicalTrials.gov Identifier: NCT03364127.
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Affiliation(s)
- Judith M Schlaeger
- University of Illinois Chicago, College of Nursing, Department of Human Development Nursing Science, USA
| | - Marie L Suarez
- University of Illinois Chicago, College of Nursing, Department of Human Development Nursing Science, USA
| | - Jennifer E Glayzer
- University of Illinois Chicago, College of Nursing, Department of Human Development Nursing Science, USA
| | - William H Kobak
- University of Illinois Chicago, College of Medicine, Department of Obstetrics and Gynecology, USA
| | - Monya Meinel
- University of Illinois Chicago, College of Nursing, Department of Human Development Nursing Science, USA
| | - Alana D Steffen
- University of Illinois Chicago, College of Nursing, Department of Population Health Nursing Science, USA
| | - Larisa A Burke
- University of Illinois Chicago, College of Nursing, Office of Research Facilitation, USA
| | - Heather A Pauls
- University of Illinois Chicago, College of Nursing, Office of Research Facilitation, USA
| | - Yingwei Yao
- University of Florida College of Nursing, Department of Biobehavioral Nursing Science, USA
| | - Miho Takayama
- Tokyo Ariake University of Medical and Health Sciences, Faculty of Health Sciences, Department of Acupuncture and Moxibustion, Japan
| | - Hiroyoshi Yajima
- Tokyo Ariake University of Medical and Health Sciences, Faculty of Health Sciences, Department of Acupuncture and Moxibustion, Japan
| | - Ted J Kaptchuk
- Beth Israel Deaconess Medical Center/Harvard Medical School, Program in Placebo Studies, USA
| | - Nobuari Takakura
- Tokyo Ariake University of Medical and Health Sciences, Faculty of Health Sciences, Department of Acupuncture and Moxibustion, Japan
| | - David Foster
- University of Rochester School of Medicine and Dentistry, USA
| | - Diana J Wilkie
- University of Florida College of Nursing, Department of Biobehavioral Nursing Science, USA
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Scarton L, Nelson T, Yao Y, Segal R, Donahoo WT, Goins RT, DeVaughan-Circles A, Manson SM, Wilkie DJ. Medication Adherence and Cardiometabolic Control Indicators Among American Indian Adults Receiving Tribal Health Services: Protocol for a Longitudinal Electronic Health Records Study. JMIR Res Protoc 2022; 11:e39193. [PMID: 36279173 PMCID: PMC9641513 DOI: 10.2196/39193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 07/26/2022] [Accepted: 07/26/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND American Indian adults have the highest prevalence of type 2 diabetes (T2D) in any racial or ethnic group and experience high rates of comorbidities. Uncontrolled cardiometabolic risk factors-insulin resistance, resulting in impaired glucose tolerance, dyslipidemia, and hypertension-increase the risk of mortality. Mortality is significantly reduced by glucose- and lipid-lowering and antihypertensive medication adherence. Medication adherence is low among American Indian adults living in non-Indian Health Service health care settings. Virtually nothing is known about the nature and extent of medication adherence among reservation-dwelling American Indian adults who primarily receive their medications without cost from Indian Health Service or tribal facilities. Electronic health records (EHRs) offer a rich but underused data source regarding medication adherence and its potential to predict cardiometabolic control indicators (C-MCIs). With the support of the Choctaw Nation of Oklahoma (CNO), we address this oversight by using EHR data generated by this large, state-of-the-art tribal health care system to investigate C-MCIs. OBJECTIVE Our specific aims are to determine, using 2018 EHR data, the bivariate relationships between medication adherence and C-MCIs, demographics, and comorbidities and each C-MCI and demographics and comorbidities; develop machine learning models for predicting future C-MCIs from the previous year's medication adherence, demographics, comorbidities, and common laboratory tests; and identify facilitators of and barriers to medication adherence within the context of social determinants of health (SDOH), EHR-derived medication adherence, and C-MCIs. METHODS Drawing on the tribe's EHR (2018-2021) data for CNO patients with T2D, we will characterize the relationships among medication adherence (to glucose- and lipid-lowering and antihypertensive drugs) and C-MCIs (hemoglobin A1c ≤7%, low-density lipoprotein cholesterol <100 mg/dL, and systolic blood pressure <130 mm Hg); patient demographics (eg, age, sex, SDOH, and residence location); and comorbidities (eg, BMI ≥30, cardiovascular disease, and chronic kidney disease). We will also characterize the association of each C-MCI with demographics and comorbidities. Prescription and pharmacy refill data will be used to calculate the proportion of days covered with medications, a typical measure of medication adherence. Using machine learning techniques, we will develop prediction models for future (2019-2021) C-MCIs based on medication adherence, patient demographics, comorbidities, and common laboratory tests (eg, lipid panel) from the previous year. Finally, key informant interviews (N=90) will explore facilitators of and barriers to medication adherence within the context of local SDOH. RESULTS Funding was obtained in early 2022. The University of Florida and CNO approved the institutional review board protocols and executed the data use agreements. Data extraction is in process. We expect to obtain results from aims 1 and 2 in 2024. CONCLUSIONS Our findings will yield insights into improving medication adherence and C-MCIs among American Indian adults, consistent with CNO's State of the Nation's Health Report 2017 goal of reducing T2D and its complications. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/39193.
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Affiliation(s)
- Lisa Scarton
- College of Nursing, University of Florida, Gainesville, FL, United States
| | - Tarah Nelson
- College of Nursing, University of Florida, Gainesville, FL, United States
| | - Yingwei Yao
- College of Nursing, University of Florida, Gainesville, FL, United States
| | - Richard Segal
- College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - William T Donahoo
- College of Medicine, University of Florida, Gainesville, FL, United States
| | - R Turner Goins
- College of Health and Human Sciences, Western Carolina University, Cullowhee, NC, United States
| | | | - Spero M Manson
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Diana J Wilkie
- College of Nursing, University of Florida, Gainesville, FL, United States
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40
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Handzo GF, Chochinov HM, Emanuel L, Fitchett G, Hauser J, Kittelson S, Schoppee TM, Yao Y, Solomon S, Wilkie DJ. Letter to the Editor: Feasibility of Dignity Therapy to Reduce Death Anxiety. J Palliat Med 2022; 25:1458-1459. [DOI: 10.1089/jpm.2022.0263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
| | - Harvey Max Chochinov
- CancerCare Manitoba Research Institute, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Linda Emanuel
- Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - George Fitchett
- Department of Religion, Health, and Human Values, College of Health Sciences, Rush University, Chicago, Illinois, USA
| | - Joshua Hauser
- Jesse Brown (Chicago) VA Medical Center, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sherri Kittelson
- Division of Palliative Care, Department of Medicine, University of Florida, Gainesville, Florida, USA
| | - Tasha M. Schoppee
- Center for Palliative Care Research & Education, University of Florida, Gainesville, Florida, USA
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Sheldon Solomon
- Department of Psychology, Skidmore College, Saratoga Springs, New York, USA
| | - Diana J. Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida, USA
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41
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Oguntoye AO, Eades NT, Aldossary D, Kuenzli G, Gehling G, Ezenwa MO, Johnson-Mallard V, Yao Y, Gallo AM, Wilkie DJ. Tailored Parenting Plans of Young Adults With Sickle Cell Disease or Sickle Cell Trait. Comput Inform Nurs 2022; 40:633-640. [PMID: 35930415 PMCID: PMC9464668 DOI: 10.1097/cin.0000000000000933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Our study purpose was to evaluate the variation and accuracy of tailored parenting plans individually generated as a supplement to reproductive health education on the genetic inheritance of sickle cell disease or sickle cell trait. We present a secondary data analysis of experimental group data from a randomized controlled trial. Participants completed the valid and reliable Internet-based Sickle Cell Reproductive Health Knowledge Parenting Intent Questionnaire. We created a computerized algorithm that used participants' responses to generate tailored parenting plans based on their parenting preferences and partner's sickle cell status. Thirty-one different parenting plans were generated to meet the variety in the participants' preferences. The most frequently generated plan was for participants with sickle cell disease who had a partner with hemoglobin AA, who wanted to be a parent, was not likely to be pregnant, and wanted their child to be sickle cell disease free. More than half of the participants required alteration in their reproductive behavior to achieve their parenting goals. Findings provide insight into the variety and accuracy of computer algorithm-generated parenting plans, which could further guide refinement of the algorithm to produce patient-centered, tailored parenting plans supplemental to Internet-based genetic inheritance education.
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Affiliation(s)
- Anne O Oguntoye
- Author Affiliations: College of Nursing, University of Florida (Drs Oguntoye, Eades, Ezenwa, Johnson-Mallard, Yao, and Wilkie; Mrs Aldossary, Ms Kuenzli, and Mrs Gehling), Gainesville; and College of Nursing, University of Illinois at Chicago (Dr Gallo)
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42
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Powell-Roach KL, Yao Y, Wallace MR, Chamala S, Cruz-Almeida Y, Jhun E, Molokie RE, Wang ZJ, Wilkie DJ. HUMAN STUDY COMT and DRD3 haplotype-associated pain intensity and acute care utilization in adult sickle cell disease. Exp Biol Med (Maywood) 2022; 247:1601-1608. [PMID: 35285297 PMCID: PMC9554168 DOI: 10.1177/15353702221080716] [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] [Indexed: 12/13/2022] Open
Abstract
A previous exploratory analysis of a COMT gene single-nucleotide polymorphism (SNP) and a DRD3 SNP by our group suggested possible contributions to pain-related acute care utilization in people with sickle cell disease (SCD). Our aim was to extend the analysis to gene-spanning haplotypes of COMT SNPs and DRD3 SNPs to investigate possible associations with pain intensity and pain-related acute care utilization in an SCD cohort. Genotyping was conducted, and clinical data were collected, including self-reported pain intensity using PAINReportIt® (average of current pain and least and worst in past 24 hours, average pain intensity [API]) and medical record-extracted, pain-related acute care utilization data of 130 adults with SCD. Haplotype blocks were identified based on linkage disequilibria (COMT = 7 haploblocks; DRD3 = 8 haploblocks). Regression analyses were tested for association between haplotypes and API and utilization, yielding several significant findings. For COMT block 1 (rs2075507, rs4646310, rs737865), the A-G-G haplotype was associated with higher API compared to the reference A-G-A (p = 0.02), whereas the A-A-A haplotype was associated with higher utilization (p = 0.02). For DRD3 block 2 (rs9817063, rs2134655, rs963468, and rs3773679), relative to reference T-C-G-C, the T-T-G-C haplotype was associated with higher utilization (p = 0.01). For DRD3 block 4 (rs167770, rs324029, and rs324023), the A-G-T haplotype was associated with higher API (p = 0.04) and utilization (p < 0.001) relative to reference G-A-T, whereas the A-A-T haplotype was associated with higher utilization (p = 0.01). We found COMT and DRD3 haplotypes associated with pain-related SCD features, suggesting that in future studies more emphasis be placed on cis effects of SNP alleles in evaluating genetic contributions to SCD pain and acute care utilization for pain.
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Affiliation(s)
- Keesha L Powell-Roach
- Department of Health Promotion and Disease Prevention, College of Nursing, The University of Tennessee Health Science Center, Memphis, TN 38163, USA,Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL 32603, USA,Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL 32610, USA,Keesha L Powell-Roach.
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL 32603, USA
| | - Margaret R Wallace
- Department of Molecular Genetics and Microbiology, College of Medicine, University of Florida, Gainesville, FL 32610, USA,University of Florida Genetics Institute, Gainesville, FL 32608, USA
| | - Srikar Chamala
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Yenisel Cruz-Almeida
- Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL 32610, USA,College of Dentistry, University of Florida, Gainesville, FL 32610, USA
| | - Ellie Jhun
- Clinical Development Team, OneOme, LLC, Minneapolis, MN 55413, USA
| | - Robert E Molokie
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA,Jesse Brown VA Medical Center, Chicago, IL 60612, USA
| | - Zajie Jim Wang
- Department of Biopharmaceutical Sciences, College of Pharmacy, University of Illinois, Chicago, IL 60612, USA
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL 32603, USA
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Moosvi K, Schoppee TM, Xavier S, Henderson K, Suarez ML, Yao Y, Wilkie DJ. Feasibility and Burden of Lay Caregivers Providing Daily Massages to Patients With Cancer Receiving Hospice and Palliative Care. Am J Hosp Palliat Care 2022; 39:1475-1483. [PMID: 35613662 DOI: 10.1177/10499091221105881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Professional massages reduce symptoms experienced by cancer patients, but are costly. A cost-effective way to include this therapy routinely in hospice care is to teach family caregivers to give massages as part of their caregiving activities. However, the burden on caregivers is unknown and might offset patient benefits or cost savings. The pilot study aim was to explore feasibility issues related to licensed massage therapists training caregivers to give massages at home, the burden of giving four daily massages to hospice patients, and feedback about the training and massage delivery. In this pretest/posttest study, caregivers completed the Caregiver Reaction Assessment (CRA), received training on standardized massage techniques from a licensed massage therapist who evaluated their proficiency the following day. Caregivers gave daily massages for 3 days and afterward completed the CRA. Then a researcher interviewed the dyad for feedback about the training and massage delivery. We used paired t tests to evaluate CRA scores and content analysis of interview data. Thirty-nine caregivers (mean age = 46 years, 69% female) completed the study. After training, all but three caregivers provided daily massages. Some caregivers reported minor logistical challenges in massage delivery and documentation, mutual satisfaction, relaxation, and tender moments ranging from laughter and story sharing to closure activities. Mean CRA scores were not significantly different pretest to posttest. We conclude that repeated-dose massages by caregivers to patients dying of cancer is feasible and is worthy of further study to determine the benefits of massage therapy, caregiver and patient experiences, and caregiver burden.
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Affiliation(s)
- Karen Moosvi
- Department of Family, Community and Health System Science, College of Nursing, 3463University of Florida, Gainesville, FL, USA
| | - Tasha M Schoppee
- Department of Biobehavioral Nursing Science, College of Nursing, 3463University of Florida, Gainesville, FL, USA.,Community Hospice & Palliative Care, Jacksonville, FL, USA.,Center for Palliative Care Research & Education, College of Nursing, 3463University of Florida, Gainesville, FL, USA
| | - Stacy Xavier
- College of Nursing, 3463University of Florida, Gainesville, FL, USA
| | | | - Marie L Suarez
- Department of Biobehavioral Health Science, College of Nursing, 14681University of Illinois Chicago, Chicago, IL, USA
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, College of Nursing, 3463University of Florida, Gainesville, FL, USA.,Center for Palliative Care Research & Education, College of Nursing, 3463University of Florida, Gainesville, FL, USA
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing, 3463University of Florida, Gainesville, FL, USA.,Center for Palliative Care Research & Education, College of Nursing, 3463University of Florida, Gainesville, FL, USA
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44
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Telisnor G, Garg R, Glayzer JE, Kobak WH, Kiros GE, Yao Y, Wilkie DJ, Schlaeger JM. Image-based documentation of vulvodynia pain location. Pain Manag 2022; 12:417-424. [PMID: 35060761 PMCID: PMC8981421 DOI: 10.2217/pmt-2021-0110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Aims: Better documentation of vulvar pain is needed. We examined pain locations marked on general body and genital specific outlines among women with vulvodynia. Methods: 62 women (mean age 32.1 ± 9.5 years) with vulvodynia marked their pain on a digital genital specific outline (22 segments) and 59 of those women also marked their pain on a digital general body outline (48 segments). We used ImageJ software to determine body surface area (BSA) for each outline. Results: On the general body outline, 24/48 segments were marked; 22/22 segments were marked on the genital specific outline. There was a moderate correlation (r = 0.43; p = 0.001) between the BSA marked on the general body outline and the BSA marked on the genital area outline. Conclusions: Findings support concurrent validity of the BSA as a measure of pain location using either outline.
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Affiliation(s)
- Guettchina Telisnor
- Department of Biobehavioral Health Nursing Science, University of Florida College of Nursing, Gainesville, FL 32611, USA
| | - Rishabh Garg
- Department of Biobehavioral Health Nursing Science, University of Florida College of Nursing, Gainesville, FL 32611, USA
| | - Jennifer E Glayzer
- Department of Human Development Nursing Science, University of Illinois Chicago College of Nursing, Chicago, IL 60612, USA
| | - William H Kobak
- Department of Obstetrics & Gynecology, University of Illinois Chicago College of Medicine, Chicago, IL 60612, USA
| | - Gebre-Egziabher Kiros
- College of Pharmacy, Florida Agricultural & Mechanical University, Tallahassee, FL 32307, USA
| | - Yingwei Yao
- Department of Biobehavioral Health Nursing Science, University of Florida College of Nursing, Gainesville, FL 32611, USA
| | - Diana J Wilkie
- Department of Biobehavioral Health Nursing Science, University of Florida College of Nursing, Gainesville, FL 32611, USA
| | - Judith M Schlaeger
- Department of Human Development Nursing Science, University of Illinois Chicago College of Nursing, Chicago, IL 60612, USA,Author for correspondence: Tel.: +1 312 413 4669;
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45
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Dos Santos FC, Macieira TG, Yao Y, Hunter S, Madandola OO, Cho H, Bjarnadottir RI, Dunn Lopez K, Wilkie DJ, Keenan GM. Spiritual Interventions Delivered by Nurses to Address Patients' Needs in Hospitals or Long-Term Care Facilities: A Systematic Review. J Palliat Med 2022; 25:662-677. [PMID: 35085471 PMCID: PMC8982123 DOI: 10.1089/jpm.2021.0578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 11/12/2022] Open
Abstract
Introduction: Despite increasing evidence of the benefits of spiritual care and nurses' efforts to incorporate spiritual interventions into palliative care and clinical practice, the role of spirituality is not well understood and implemented. There are divergent meanings and practices within and across countries. Understanding the delivery of spiritual interventions may lead to improved patient outcomes. Aim: We conducted a systematic review to characterize spiritual interventions delivered by nurses and targeted outcomes for patients in hospitals or assisted long-term care facilities. Methodology: The systematic review was developed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and a quality assessment was performed. Our protocol was registered on PROSPERO (Registration No. CRD42020197325). The CINAHL, Embase, PsycINFO, and PubMed databases were searched from inception to June 2020. Results: We screened a total of 1005 abstracts and identified 16 experimental and quasi-experimental studies of spiritual interventions delivered by nurses to individuals receiving palliative care or targeted at chronic conditions, such as advanced cancer diseases. Ten studies examined existential interventions (e.g., spiritual history, spiritual pain assessment, touch, and psychospiritual interventions), two examined religious interventions (e.g., prayer), and four investigated mixed interventions (e.g., active listening, presence, and connectedness with the sacred, nature, and art). Patient outcomes associated with the delivery of spiritual interventions included spiritual well-being, anxiety, and depression. Conclusion: Spiritual interventions varied with the organizational culture of institutions, patients' beliefs, and target outcomes. Studies showed that spiritual interventions are associated with improved psychological and spiritual patient outcomes. The studies' different methodological approaches and the lack of detail made it challenging to compare, replicate, and validate the applicability and circumstances under which the interventions are effective. Further studies utilizing rigorous methods with operationalized definitions of spiritual nursing care are recommended.
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Affiliation(s)
- Fabiana Cristina Dos Santos
- Department of Family, Community, and Health System Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Tamara G.R. Macieira
- Department of Family, Community, and Health System Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Yingwei Yao
- Department of Family, Community, and Health System Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Samantha Hunter
- Department of Family, Community, and Health System Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Olatunde O. Madandola
- Department of Family, Community, and Health System Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Hwayoung Cho
- Department of Family, Community, and Health System Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Ragnhildur I. Bjarnadottir
- Department of Family, Community, and Health System Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | | | - Diana J. Wilkie
- Department of Family, Community, and Health System Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Gail M. Keenan
- Department of Family, Community, and Health System Science, College of Nursing, University of Florida, Gainesville, Florida, USA
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Evelyn AE, Kittelson S, Mandernach MW, Black V, Duckworth L, Wilkie DJ. Nursing Education for the Acute Care Nurse on Pain Mechanisms of Sickle Cell Disease. J Contin Educ Nurs 2022; 53:137-144. [PMID: 35244458 DOI: 10.3928/00220124-20220210-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background It is unknown whether nurses' knowledge about pain among patients with sickle cell disease (SCD) reflects the current standard of care. The authors evaluated changes in nurses' knowledge and simulated practice behavior after a continuing education program. Method Inpatient nurses completed an e-learning program on SCD pain; a pretest and a posttest with the same 10 questions; and two patient cases with four pain intervention options at the posttest. Results On the pretest, the mean percentage of correct answers was 83% (SD = 13%). The mean percentage of correct answers increased by 12% (p < .0001) on the posttest. For the first simulated patient case, 100% (n = 31) of the nurses selected an appropriate pain intervention option based on the patient-reported pain score. For the second simulated patient case, 84% (n = 26) did so. Conclusion Increased knowledge does not always translate into simulated practice change. The reasons for this are unknown, but they could include implicit bias from exposure to patients who have high use of acute care, although the minority of patients with SCD fit this description. [J Contin Educ Nurs. 2022;53(3):137-144.].
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Schoppee TM, Scarton L, Bluck S, Yao Y, Keenan G, Samuels V, Fitchett G, Handzo G, Chochinov HM, Emanuel LL, Wilkie DJ. Dignity therapy intervention fidelity: a cross-sectional descriptive study with older adult outpatients with cancer. BMC Palliat Care 2022; 21:8. [PMID: 35016670 PMCID: PMC8751346 DOI: 10.1186/s12904-021-00888-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 11/17/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives Intervention fidelity is imperative to ensure confidence in study results and intervention replication in research and clinical settings. Like many brief protocol psychotherapies, Dignity Therapy lacks sufficient evidence of intervention fidelity. To overcome this gap, our study purpose was to examine intervention fidelity among therapists trained with a systematized training protocol. Methods For preliminary fidelity evaluation in a large multi-site stepped wedge randomized controlled trial, we analyzed 46 early transcripts of interviews from 10 therapists (7 female; 7 White, 3 Black). Each transcript was evaluated with the Revised Dignity Therapy Adherence Checklist for consistency with the Dignity Therapy protocol in terms of its Process (15 dichotomous items) and Core Principles (6 Likert-type items). A second rater independently coded 26% of the transcripts to assess interrater reliability. Results Each therapist conducted 2 to 10 interviews. For the 46 scored transcripts, the mean Process score was 12.4/15 (SD = 1.2), and the mean Core Principles score was 9.9/12 (SD = 1.8) with 70% of the transcripts at or above the 80% fidelity criterion. Interrater reliability (Cohen’s kappa and weighted kappa) for all Adherence Checklist items ranged between .75 and 1.0. For the Core Principles items, Cronbach’s alpha was .92. Conclusions Preliminary findings indicate that fidelity to Dignity Therapy delivery was acceptable for most transcripts and provide insights for improving consistency of intervention delivery. The systematized training protocol and ongoing monitoring with the fidelity audit tool will facilitate consistent intervention delivery and add to the literature about fidelity monitoring for brief protocol psychotherapeutic interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-021-00888-y.
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Rantanen P, Chochinov HM, Emanuel LL, Handzo G, Wilkie DJ, Yao Y, Fitchett G. Existential Quality of Life and Associated Factors in Cancer Patients Receiving Palliative Care. J Pain Symptom Manage 2022; 63:61-70. [PMID: 34332045 PMCID: PMC8766863 DOI: 10.1016/j.jpainsymman.2021.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 01/03/2023]
Abstract
CONTEXT Enhancing quality of life (QoL) is a goal of palliative care. Existential QoL is an important aspect of this. OBJECTIVES This study sought to advance our understanding of existential QoL at the end of life through examining levels of Preparation and Completion, subscales of the QUAL-E, and their associated factors. METHODS We used data from a multi-site study of 331 older cancer patients receiving palliative care. We examined levels of Preparation and Completion and their association with demographic, religious, and medical factors, and with the Patient Dignity Inventory. RESULTS Preparation and Completion scores were moderately high. In adjusted models, being 10 years older was associated with an increase of 0.77 in Preparation (P = 0.002). Non-white patients had higher Preparation (1.03, P = 0.01) and Completion (1.56, P = 0.02). Single patients reported Completion score 1.75 point lower than those married (P = 0.01). One-point increase in intrinsic religiousness was associated with a 0.86-point increase in Completion (P = 0.03). One-point increase in terminal illness awareness was associated with 0.75-point decrease in Preparation (P = 0.001). A 10-point increase in symptom burden was associated with a decrease of 0.55 in Preparation (P < 0.001) and a decrease of 1.0 in Completion (P < 0.001). The total Patient Dignity Inventory score and all of its subscales were negatively correlated with Preparation (r from -.26 to -.52, all P < 0.001) and Completion (r from -.18 to -.31, all P < 0.001). CONCLUSION While most patients reported moderate to high levels of existential QoL, a subgroup reported low existential QoL. Terminal illness awareness and symptom burden may be associated with lower existential QoL.
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Affiliation(s)
- Petra Rantanen
- University of Rochester School of Medicine and Dentistry (P.R.) Rochester, New York, USA
| | - Harvey Max Chochinov
- Research Institute of Oncology and Hematology (H.M.C.), Cancer Care Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada, USA
| | - Linda L Emanuel
- Buehler Center on Aging (L.L.E.), Heatlh and Society, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
| | - George Handzo
- Health Services Research & Quality (G.H.), HealthCare Chaplaincy Network, Caring for the Human Spirit TM, New York, New York, USA
| | - Diana J Wilkie
- Center for Palliative Care Research and Education (D.J.W., Y.Y.), College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Yingwei Yao
- Center for Palliative Care Research and Education (D.J.W., Y.Y.), College of Nursing, University of Florida, Gainesville, Florida, USA
| | - George Fitchett
- Department of Religion (G.F.), Health and Human Values, Rush University Medical Center, Chicago, Illinois, USA.
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Chen Z, Ansari R, Wilkie DJ. Learning Pain from Action Unit Combinations: A Weakly Supervised Approach via Multiple Instance Learning. IEEE Trans Affect Comput 2022; 13:135-146. [PMID: 35242282 PMCID: PMC8890070 DOI: 10.1109/taffc.2019.2949314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Patient pain can be detected highly reliably from facial expressions using a set of facial muscle-based action units (AUs) defined by the Facial Action Coding System (FACS). A key characteristic of facial expression of pain is the simultaneous occurrence of pain-related AU combinations, whose automated detection would be highly beneficial for efficient and practical pain monitoring. Existing general Automated Facial Expression Recognition (AFER) systems prove inadequate when applied specifically for detecting pain as they either focus on detecting individual pain-related AUs but not on combinations or they seek to bypass AU detection by training a binary pain classifier directly on pain intensity data but are limited by lack of enough labeled data for satisfactory training. In this paper, we propose a new approach that mimics the strategy of human coders of decoupling pain detection into two consecutive tasks: one performed at the individual video-frame level and the other at video-sequence level. Using state-of-the-art AFER tools to detect single AUs at the frame level, we propose two novel data structures to encode AU combinations from single AU scores. Two weakly supervised learning frameworks namely multiple instance learning (MIL) and multiple clustered instance learning (MCIL) are employed corresponding to each data structure to learn pain from video sequences. Experimental results show an 87% pain recognition accuracy with 0.94 AUC (Area Under Curve) on the UNBC-McMaster Shoulder Pain Expression dataset. Tests on long videos in a lung cancer patient video dataset demonstrates the potential value of the proposed system for pain monitoring in clinical settings.
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Affiliation(s)
- Zhanli Chen
- Department of Electrical and Computer Engineering, University of Illinois at Chicago
| | - Rashid Ansari
- Department of Electrical and Computer Engineering, University of Illinois at Chicago
| | - Diana J Wilkie
- Department of Biobehavioral Nursing, University of Florida
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Dyal BW, Uscanga ZL, Bailey Z, Schmit S, Hoehn A, Garcia J, Gwede CK, Brownstein N, Powell-Roach K, Johnson-Mallard V, Krieger JL, Kobetz E, Vadaparampil S, Odedina FT, Wilkie DJ. Developing the Florida Academic Cancer Center Alliance Health Disparities Common Measure: The Florida Health and Ancestry Survey. Cancer Control 2022; 29:10732748221110897. [PMID: 35758601 PMCID: PMC9244925 DOI: 10.1177/10732748221110897] [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] [Indexed: 11/21/2022] Open
Abstract
Purpose Our specific aim was to develop and assess the consensus-based validity of common measures for understanding health behaviors and ancestry in Florida’s population subgroups and establish the feasibility of wide-scale implementation of the measures and biospecimen collection within three cancer centers’ catchment areas. Methods Using the National Cancer Institute’s Grid-Enabled Measures web-based platform and an iterative process, we developed the Florida Health and Ancestry Survey (FHAS). We then used three sampling approaches to implement the FHAS: community-engaged, panel respondent, and random digit dialing (RDD). We asked a subset of participants to provide a saliva sample for future validation of subjective ancestry report with DNA-derived ancestry markers. Results This process supported the FHAS content validity. As an indicator of feasibility, the goals for completed surveys by sampling approach were met for two of the three cancer centers, yielding a total of 1438 completed surveys. The RDD approach produced the most representative sample. The panel sampling approach produced inadequate representation of older individuals and males. The community-engaged approach along with social media recruitment produced extreme underrepresentation only for males. Two of the cancer centers mailed biospecimen kits, whereas one did not due to resource constraints. On average, the community engaged approach was more productive in obtaining returned biospecimen samples (80%) than the panel approach (48%). Conclusions We successfully developed and implemented the FHAS as a common measure to show its feasibility for understanding cancer health disparities in Florida. We identified sampling approach successes and challenges to obtaining biospecimens for ancestry research.
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Affiliation(s)
- Brenda W Dyal
- College of Nursing, Department of Biobehavioral Nursing Science, 3463University of Florida, Gainesville, FL, USA
| | - Zulema L Uscanga
- The Office of Community Outreach, Engagement and Equity, 25301Moffitt Cancer Center, Tampa, FL, USA
| | - Zinzi Bailey
- University of Miami Miller School of Medicine, Miami, FL, and Division of Medical Oncology, Department of Medicine, University of Miami Miller School of Medicine, 33315Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Stephanie Schmit
- Cleveland Clinic, Genomic Medicine Institute, Cleveland, OH, US and (2) Population and Cancer Prevention Program, Case Comprehensive Cancer Center, 196246Cleveland Clinic, Genomic Medicine Institute, Cleveland, OH, USA
| | - Alina Hoehn
- Department of Cancer Epidemiology, 25301Moffitt Cancer Center, Tampa, FL, USA
| | - Jennifer Garcia
- Department of Health Outcomes & Behaviors, Moffitt Cancer Center, Tampa, FL, USA
| | - Clement K Gwede
- Department of Health Outcomes & Behaviors, Moffitt Cancer Center, Tampa, FL, USA
| | - Naomi Brownstein
- Department of Biostatistics and Bioinformatics, 25301Moffitt Cancer Center, Tampa, FL, USA
| | - Keesha Powell-Roach
- College of Nursing, Department of Biobehavioral Nursing Science, Gainesville, FL, USA and University of Tennessee Health Science Center, Department of Health Promotion and Disease Prevention, 3463University of Florida, Memphis, TN, USA
| | - Versie Johnson-Mallard
- College of Nursing, Department of Family, Community and Health System Science, 3463University of Florida, Gainesville, Florida, USA
| | - Janice L Krieger
- STEM Translational Communication Center, 3463University of Florida, Gainesville, FL, USA
| | - Erin Kobetz
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, and Division of Medical Oncology, Department of Medicine, 12235University of Miami Miller School of Medicine, Miami, FL, USA
| | - Susan Vadaparampil
- Moffitt Cancer Center, The Office of Community Outreach, Engagement and Equity, Tampa, FL, USA.,Moffitt Cancer Center, Department of Health Outcomes & Behaviors, Moffitt Cancer Center, Tampa, FL, USA
| | - Folakemi T Odedina
- Moffitt Cancer Center, Department of Health Outcomes & Behaviors, Moffitt Cancer Center, Tampa, FL, USA
| | - Diana J Wilkie
- College of Nursing, Department of Biobehavioral Nursing Science, 3463University of Florida, Gainesville, FL, USA
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