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Auletta JJ, Holter-Chakrabarty J, Jain T, Miller B, Ward E, Khera N, Gomez-Arteaga A, Hall A, Nemecek E, Robb D, Yusuf RA, Davies SM. Proceedings of the 2023 Second Annual ASTCT-NMDP ACCESS Initiative Workshop. Transplant Cell Ther 2023; 29:739-746. [PMID: 37805142 DOI: 10.1016/j.jtct.2023.09.026] [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: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/09/2023]
Abstract
Here the proceedings from the Second Annual American Society for Transplantation and Cellular Therapy (ASTCT) and National Marrow Donor Program (NMDP) ACCESS Initiative are reviewed to inform the hematopoietic cell transplantation (HCT) and cellular therapy (CT) ecosystem about progress and direction of the collaborative. Highlights from the meeting, including updates on the progress of projects from the Awareness, Poverty, and Racial Inequity Committees, are presented. The ACCESS Initiative continues to evolve and will remain dependent on the HCT/CT ecosystem's continued dedication to reduce barriers and improve outcome disparities for all patients in need of HCT/CT.
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Affiliation(s)
- Jeffery J Auletta
- National Marrow Donor Program, Minneapolis, Minnesota; Hematology/Oncology/Blood and Marrow Transplant and Infectious Diseases; Nationwide Children's Hospital, Columbus, Ohio.
| | | | - Tania Jain
- Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
| | - Becca Miller
- National Marrow Donor Program, Minneapolis, Minnesota
| | - Emily Ward
- National Marrow Donor Program, Minneapolis, Minnesota
| | | | | | | | | | - Delilah Robb
- National Marrow Donor Program, Minneapolis, Minnesota
| | | | - Stella M Davies
- Bone Marrow Transplant and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Auletta JJ, Khera N, DeMartino P, Kelkar AH, Yusuf RA, Davies SM, Knutson J, Beaver E, Maloney A, Majhail NS. Assessing Medicaid Coverage for Hematopoietic Cell Transplantation and Chimeric Antigen Receptor T Cell Therapy: A Project from the American Society for Transplantation and Cellular Therapy and the National Marrow Donor Program ACCESS Initiative. Transplant Cell Ther 2023; 29:713-720. [PMID: 37579920 DOI: 10.1016/j.jtct.2023.08.007] [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: 07/24/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/16/2023]
Abstract
The American Society for Transplantation and Cellular Therapy (ASTCT) and the National Marrow Donor Program (NMDP) formed the ACCESS Initiative to address and reduce barriers to hematopoietic cell transplantation (HCT) and cellular therapy (CT) to ensure equal access and outcomes for all patients in need. The 3 committees, addressing awareness, poverty, and racial and ethnic inequity, defined pilot projects focusing on addressing relevant barriers to HCT/CT. Because many socioeconomically disadvantaged HCT/CT recipients receive care through state Medicaid programs, the Poverty Committee conducted a Medicaid scan of all 50 US states with the following objectives: to define beneficiary coverage for allogeneic and autologous HCT and chimeric antigen receptor (CAR) T cell therapy; to define support for travel, temporary lodging, and meals for both beneficiaries and caregivers; and to determine search and cell acquisition payment procedures. Here we summarize the results of the Medicaid scan and highlight significant variations and gaps in coverage for HCT/CT recipients. We also provide an initial roadmap for addressing gaps in Medicaid support for HCT and CAR-T therapy recipients.
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Affiliation(s)
- Jeffery J Auletta
- National Marrow Donor Program, Minneapolis, Minnesota; Hematology/Oncology/Blood and Marrow Transplant and Infectious Diseases, Nationwide Children's Hospital, Columbus, Ohio.
| | | | | | | | | | - Stella M Davies
- Bone Marrow Transplant and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Ellie Beaver
- National Marrow Donor Program, Minneapolis, Minnesota
| | - Alycia Maloney
- American Society for Transplantation and Cellular Therapy, Chicago, Illinois
| | - Navneet S Majhail
- Sarah Cannon Transplant and Cellular Therapy Network, Nashville, Tennessee
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Yusuf RA, Preussler JM, Meyer CL, Schoeppner K, Sees Coles JA, Ruffin A, McCann M, Devine SM, Auletta JJ. Reducing barriers of access and care related to hematopoietic cell transplantation and cellular therapy: The mission-driven role of the national marrow donor program. Best Pract Res Clin Haematol 2023; 36:101480. [PMID: 37353289 DOI: 10.1016/j.beha.2023.101480] [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: 05/20/2023] [Accepted: 05/23/2023] [Indexed: 06/25/2023]
Abstract
The treatment of malignant and nonmalignant hematologic disorders continues to benefit from significant scientific advancement and progress in the use of hematopoietic cell transplantation and cellular therapies. However, barriers associated with receiving these lifesaving treatments and care remain, which necessitate innovative approaches to overcome, so all persons in need can receive these therapies. This article reviews barriers to receiving hematopoietic cell transplantation and cellular therapies, and highlights novel approaches taken by the National Marrow Donor Program in reducing barriers for all patients in need.
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Affiliation(s)
- Rafeek A Yusuf
- National Marrow Donor Program, Minneapolis, MN, USA; Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA.
| | - Jaime M Preussler
- National Marrow Donor Program, Minneapolis, MN, USA; Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA.
| | - Christa L Meyer
- National Marrow Donor Program, Minneapolis, MN, USA; Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA.
| | | | | | - Amber Ruffin
- National Marrow Donor Program, Minneapolis, MN, USA.
| | - Meggan McCann
- National Marrow Donor Program, Minneapolis, MN, USA.
| | - Steven M Devine
- National Marrow Donor Program, Minneapolis, MN, USA; Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA.
| | - Jeffery J Auletta
- National Marrow Donor Program, Minneapolis, MN, USA; Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA.
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Salihu HM, Yusuf Z, Dongarwar D, Aliyu SH, Yusuf RA, Aliyu MH, Aliyu G. Development of a Quality Assurance Score for the Nigeria AIDS Indicator and Impact Survey (NAIIS) Database: Validation Study. JMIR Form Res 2022; 6:e25752. [PMID: 35089143 PMCID: PMC8838544 DOI: 10.2196/25752] [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: 11/13/2020] [Revised: 04/27/2021] [Accepted: 11/27/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In 2018, Nigeria implemented the world's largest HIV survey, the Nigeria AIDS Indicator and Impact Survey (NAIIS), with the overarching goal of obtaining more reliable metrics regarding the national scope of HIV epidemic control in Nigeria. OBJECTIVE This study aimed to (1) describe the processes involved in the development of a new database evaluation tool (Database Quality Assurance Score [dQAS]) and (2) assess the application of the dQAS in the evaluation and validation of the NAIIS database. METHODS The dQAS tool was created using an online, electronic Delphi (e-Delphi) methodology with the assistance of expert review panelists. Thematic categories were developed to form superordinate categories that grouped themes together. Subordinate categories were then created that decomposed themes for more specificity. A validation score using dQAS was employed to assess the technical performance of the NAIIS database. RESULTS The finalized dQAS tool was composed of 34 items, with a total score of 81. The tool had 2 sections: validation item section, which contains 5 subsections, and quality assessment score section, with a score of "1" for "Yes" to indicate that the performance measure item was present and "0" for "No" to indicate that the measure was absent. There were also additional scaling scores ranging from "0" to a maximum of "4" depending on the measure. The NAIIS database achieved 78 out of the maximum total score of 81, yielding an overall technical performance score of 96.3%, which placed it in the highest category denoted as "Exceptional." CONCLUSIONS This study showed the feasibility of remote internet-based collaboration for the development of dQAS-a tool to assess the validity of a locally created database infrastructure for a resource-limited setting. Using dQAS, the NAIIS database was found to be valid, reliable, and a valuable source of data for future population-based, HIV-related studies.
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Affiliation(s)
- Hamisu M Salihu
- Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, TX, United States.,Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Zenab Yusuf
- Menninger Department of Psychiatry and Behavioral Sciences, Center for Innovations in Quality, Effectiveness and Safety, JP McGovern Campus, Baylor College of Medicine, Houston, TX, United States
| | - Deepa Dongarwar
- Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, TX, United States
| | - Sani H Aliyu
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Rafeek A Yusuf
- Department of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Muktar H Aliyu
- Institute for Global Health, Vanderbilt University, Nashville, TN, United States
| | - Gambo Aliyu
- National Agency for the Control of AIDS, Abuja, Nigeria
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Hussein MR, Dongarwar D, Yusuf RA, Yusuf Z, Aliyu GG, Elmessan GR, Salihu HM. Health Insurance Status of Pregnant Women and the Likelihood of Receipt of Antenatal Screening for HIV in Sub-Saharan Africa. Curr HIV Res 2021; 19:248-259. [PMID: 33622225 DOI: 10.2174/1570162x19666210223124835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 01/08/2021] [Accepted: 01/21/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND We investigated if initiating preventive care against HIV vertical transmission by antenatal HIV screening is independent of the patients' source of financial reimbursement for the care received in sub-Saharan Africa (SSA). METHODS Using information from the WHO's Global Health Expenditure Database and the Demographic Health Surveys Database for 27 sub-Saharan countries, we used Spearman's correlation and adjusted survey logistic regression to determine the potential relationship between enrollment in health insurance and the likelihood that expectant mothers would be offered antenatal HIV screening. RESULTS We found that expectant mothers covered by health insurance were more than twice as likely to be offered antenatal screening for HIV compared to the uninsured. The likelihood differed by the type of insurance plan the expectant mother carried. DISCUSSION Health insurance is more of a financial tool that this study finds to be necessary to boost the uptake of preventive and therapeutic HIV care in SSA. CONCLUSION The ensuing disparity in receiving proper care could hinder the goals of 90-90-90 and the forthcoming 95-95-95 plan in SSA.
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Affiliation(s)
- Muhammad Ragaa Hussein
- Department of Management, Policy, and Community Health (MPACH), University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Houston, TX, United States
| | - Deepa Dongarwar
- Center of Excellence in Health Equity, Training & Research, Baylor College of Medicine, Houston, TX, United States
| | - Rafeek A Yusuf
- Department of Management, Policy, and Community Health (MPACH), University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Houston, TX, United States
| | - Zenab Yusuf
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA; Houston VA Health Services Research and Development Service Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston TX, USA and VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, United States
| | | | - George Ryan Elmessan
- Center of Excellence in Health Equity, Training & Research, Baylor College of Medicine, Houston, TX, United States
| | - Hamisu M Salihu
- Center of Excellence in Health Equity, Training & Research, Baylor College of Medicine, Houston, TX, United States
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Yusuf ZI, Dongarwar D, Yusuf RA, Udoetuk SC, Salihu HM. The burden of oral health problems in children with mental health disorders in the United States. J Public Health Dent 2020; 82:138-147. [PMID: 33354771 DOI: 10.1111/jphd.12438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 11/08/2020] [Accepted: 12/11/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Mental health disorders (MHDs) are major public health concerns with increasing risk of morbidity and mortality among children. Oral health problems (OHPs) are receiving attention as associated comorbidities. This study assessed the burden of oral health problems in children aged 3-17 years with MHD in the United States. METHODS Cross sectional analyses was performed using the National Survey of Children's Health database 2016-2017 containing information of 60,655,439 children. Weighted survey binomial logistic regression generating odds ratio for association between MHD and OHP were calculated. Weighted dose-response models captured incremental effects of MHD severity on oral health conditions. Population attributable risk (PAR) to quantify proportions of potentially avertable OHP as a result of intervention targeted at different levels of MHD severity were estimated. RESULTS Prevalence of OHP among those with any MHD was 22.5 percent. Children with MHD were more likely to be non-Hispanic White, living in poorer households, and having private health insurance P < 0.001. Dose-response analyses showed children with mild MHD were 85 percent more likely [OR = 1.85 (95% CI: 1.47-2.32)], and those with moderate/severe MHD 93 percent more likely (OR = 1.93, 95% CI: 1.50-2.49) to experience OHP, compared to children without MHD. Population attributable risk (PAR) revealed that if mild and moderate/severe MHD were improved by 75 percent, OHP would be averted in 152,206 children with mild and 255,851 with moderate/severe MHD, respectively. CONCLUSION Our results suggest that disparities persist among the pediatric population with MHD who suffer OHP in the United States.
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Affiliation(s)
- Zenab I Yusuf
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Houston VA Health Services Research and Development Service Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA.,VA South Central Mental Illness Research, Education and Clinical Center, USA
| | - Deepa Dongarwar
- Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, TX, USA
| | - Rafeek A Yusuf
- Department of Management, Policy, and Community Health, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| | - Sade C Udoetuk
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Hamisu M Salihu
- Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, TX, USA
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Abstract
BACKGROUND Childhood obesity is one of the foremost threats to population health in the United States (U.S.) leading to the emergence of co-morbidities and increased healthcare cost. We explore the influence of selected social determinants of health (SDOH) on overweight and obesity among U.S. children. METHODS We utilized the National Survey of Children's Health (NSCH) 2016-17 dataset for this analysis. Overweight was defined as Body Mass Index (BMI) ≥ 85th to<95th, while obesity was defined as BMI ≥95th percentile for age and sex. Based on the literature and pathway plausibility, we examined several SDOH variables as predictors of childhood overweight or obesity in the US. Survey log-binomial regression models were built to generate prevalence ratio (PR) estimates to capture the associations between SDOH and overweight or obesity. RESULTS About 30.6 million children were surveyed of which 9.5 million (31.0%) were either overweight or obese. The likelihood of obesity was elevated among non-Hispanic Black and Hispanic children (PR = 1.53; 95% CI = 1.01-2.31) and (PR = 1.50; 95% CI = 1.18-1.90) respectively. Overweight was more frequent in younger children, children of single parents, and children who lived in a neighborhood with no amenities. Parental attainment of college education, health insurance coverage, female gender, and language spoken in home other than Spanish were protective against overweight or obesity. CONCLUSIONS AND GLOBAL HEALTH IMPLICATIONS SDOH represent markers of overweight or obesity in children. We recommend the development of innovative interventions using SDOH risk and protective pathways as guide to address the current epidemic of childhood overweight and obesity.
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Affiliation(s)
- Zenab I Yusuf
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA; Houston VA Health Services Research and Development Service Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston; and VA South Central Mental Illness Research, Education and Clinical Center
| | - Deepa Dongarwar
- Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, TX, USA
| | - Rafeek A Yusuf
- Department of Management, Policy, and Community Health, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| | - Meishon Bell
- Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, TX, USA
| | - Toi Harris
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA; and Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, TX, USA
| | - Hamisu M Salihu
- FCM-Adminstartion Research, Baylor College of Medicine, Houston, TX, USA; Department of Environmental and Occupational Health, University of South Florida, College of Public Health Tampa, Florida, USA; Department of Epidemiology and Biostatistics, University of South Florida, College of Public Health Tampa, Florida, USA; and Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, TX, USA
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Yusuf ZI, Dongarwar D, Yusuf RA, Salihu HM. Oral Health Problems among Children with Neurodevelopmental Disorders in the United States. Int J MCH AIDS 2020; 9:157-160. [PMID: 32123640 PMCID: PMC7031871 DOI: 10.21106/ijma.342] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Children with neurodevelopmental disabilities (NDD) suffer poor oral health problems (OHP) leading to adverse health outcomes. We examined the association between NDD and OHP among children in the United States (US) ages 3-17 years using data from the National Survey of Children's Health (NSCH) 2016-17. The prevalence of OHP was 19.1%. Children with NDD had about 40% greater likelihood of poor oral health compared to their non-NDD counterparts (p <0.0001). Living at or above 200%-300% of the federal poverty level (FPL), private insurance coverage, and living with a least a college educated adult were found to be protective factors against poor oral health among children.
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Affiliation(s)
- Zenab I Yusuf
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Houston VA Health Services Research and Development Service Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA; and VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA
| | - Deepa Dongarwar
- Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, TX, USA
| | - Rafeek A Yusuf
- Department of Management, Policy, and Community Health, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| | - Hamisu M Salihu
- FCM-Adminstartion Research, Baylor College of Medicine, Houston, TX, USA; and Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, TX, USA
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Yusuf RA, Dongarwar D, Yusuf ZI, Salihu HM. Association between Intimate Partner Violence, Knowledge and Use of Contraception in Africa: Comparative Analysis across Five African Regions. Int J MCH AIDS 2019; 9:42-52. [PMID: 32123627 PMCID: PMC7031882 DOI: 10.21106/ijma.323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND OR OBJECTIVES Intimate partner violence (IPV) against women is common globally, and is associated with several adverse consequences. This study provides a comparative analysis of potential regional differences in the association between IPV and knowledge and use of contraceptives within Africa. METHODS A multi-country cross-sectional study was conducted using data on women of reproductive age 15-49 years from the Demographic and Health Surveys covering five African regions. Exposure and outcome variables were IPV and reproductive literacy (comprising modern contraception knowledge and contraception usage) respectively. We used survey log-binomial regression models to generate prevalence ratios that estimated the association between IPV versus knowledge and usage of modern contraception. RESULTS Overall IPV prevalence in Africa was 30.8% with notable regional differences. Demographic, socioeconomic, and reproductive history markers of IPV were more pronounced in younger women, rural residents, women of low socioeconomic status and those with copious knowledge but poor usage of modern contraception. The level of knowledge of contraception was 84% greater among African women who were victims of IPV compared to their counterparts who were not victims of IPV (p < 0.0001). IPV was not associated with actual usage of modern contraception (p = 0.21). CONCLUSION AND GLOBAL HEALTH IMPLICATIONS IPV against women in Africa may incentivize knowledge seeking of modern contraception as protective mechanisms. Regional variations notwithstanding, understanding the existing and new characteristics predictive of IPV may inform policy development, resource allocation and prevention of IPV globally.
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Affiliation(s)
- Rafeek A. Yusuf
- Department of Management, Policy, and Community Health, University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas, USA
| | - Deepa Dongarwar
- Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, Texas, USA
| | - Zenab I. Yusuf
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA; Houston VA Health Services Research and Development Service Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas; and VA South Central Mental Illness Research, Education and Clinical Center, Houston, Texas, USA
| | - Hamisu M. Salihu
- FCM-Adminstartion Research, Baylor College of Medicine, Houston, TX, USA; Department of Environmental and Occupational Health, University of South Florida, College of Public Health Tampa, Florida, USA; Department of Epidemiology and Biostatistics, University of South Florida, College of Public Health Tampa, Florida, USA; and Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, Texas, USA
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Brown LD, Adeboye AA, Yusuf RA, Chaudhary P. Engaging vulnerable populations in parent-led support groups: Testing a recruitment strategy. Eval Program Plann 2018; 69:18-24. [PMID: 29656058 PMCID: PMC5997542 DOI: 10.1016/j.evalprogplan.2018.04.004] [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] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/12/2018] [Accepted: 04/03/2018] [Indexed: 06/08/2023]
Abstract
Despite the proven benefits of parenting interventions, parent engagement in such interventions remains low and is particularly challenging among vulnerable populations. This theoretically grounded study tested the effectiveness of a recruitment strategy - a simulated parent-led support group (PSG) - to increase intentions to attend a PSG in a predominantly low income, minority sample. The study also examined sociodemographic characteristics that may influence the effectiveness of the recruitment strategy and engagement in PSGs. Surveys assessing intentions to attend a PSG were administered before and after the simulation, and a 2-month follow-up survey assessed subsequent PSG attendance. A total of 95 participants were included in this study. Results indicate that participants' intentions to attend a PSG significantly increased following the PSG simulation (Cohen's d = 1.15), especially among Hispanics. However, PSG attendance in the 2 months following the PSG simulation was relatively low, with only 13% of parents attending a PSG or a planning meeting to start a new PSG. Nevertheless, this recruitment strategy may serve as an important component of a larger engagement effort, especially given the substantial challenges of engaging vulnerable populations in PSGs and other parenting interventions to reduce educational and health disparities.
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Affiliation(s)
- Louis D Brown
- The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, 1851 Wiggins Way, HSN 486, El Paso, TX, 79968, United States.
| | - Adeniyi A Adeboye
- The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, 1200 Pressler Street, Houston, TX, 77030, United States.
| | - Rafeek A Yusuf
- The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, 1200 Pressler Street, Houston, TX, 77030, United States.
| | - Pooja Chaudhary
- The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, 1200 Pressler Street, Houston, TX, 77030, United States.
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Abstract
Teaching hospitals are large and complex, and under constant financial pressure. In this study, we examine the financial performance of 80 large teaching hospitals in the 20 largest cities in the U.S. over the last five years, to identify which strategic and operational management factors separate high-performing hospitals from lower-performing ones. Results suggest that growth strategies should continue to be sought for improving long-term financial condition. Operational efficiency was less important than market share, economic status of surrounding community, hospital size, and teaching intensity. This study's findings should help guide strategic planning for teaching hospitals.
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Affiliation(s)
- James R Langabeer
- a Healthcare Management and Informatics , University of Texas Health Science Center , Houston , Texas , USA
| | - Karima H Lalani
- b Healthcare Management , School of Public Health, University of Texas Health Science Center , Houston , Texas , USA
| | - Rafeek A Yusuf
- b Healthcare Management , School of Public Health, University of Texas Health Science Center , Houston , Texas , USA
| | - Jeffrey R Helton
- c Healthcare Management , Metropolitan State University , Denver , Colorado , USA
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Rogith D, Yusuf RA, Hovick SR, Fellman BM, Peterson SK, Burton-Chase AM, Li Y, Bernstam EV, Meric-Bernstam F. Patient knowledge and information-seeking about personalized cancer therapy. Int J Med Inform 2016; 88:52-7. [PMID: 26878762 DOI: 10.1016/j.ijmedinf.2016.01.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 01/11/2016] [Accepted: 01/14/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Understanding patients' knowledge and prior information-seeking regarding personalized cancer therapy (PCT) may inform future patient information systems, consent for molecular testing and PCT protocols. We evaluated breast cancer patients' knowledge and information-seeking behaviors regarding PCT. METHODS Newly registered female breast cancer patients (n=100) at a comprehensive cancer center completed a self-administered questionnaire prior to their first clinic visit. RESULTS Knowledge regarding cancer genetics and PCT was moderate (mean 8.7±3.8 questions correct out of 16). A minority of patients (27%) indicated that they had sought information regarding PCT. Higher education (p=0.009) and income levels (p=0.04) were associated with higher knowledge scores and with seeking PCT information (p=0.04). Knowledge was not associated with willingness to participate in PCT research. CONCLUSION Educational background and financial status impact patient knowledge as well as information-seeking behavior. For most patients, clinicians are likely to be patients' initial source of information about PCT. Understanding patients' knowledge deficits at presentation may help inform patient education efforts.
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Affiliation(s)
- Deevakar Rogith
- The University of Texas School of Biomedical Informatics, Houston, TX 77030, United States
| | - Rafeek A Yusuf
- The University of Texas School of Biomedical Informatics, Houston, TX 77030, United States
| | - Shelley R Hovick
- The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States; The Ohio State University, Columbus, OH 43210, United States
| | - Bryan M Fellman
- The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States
| | - Susan K Peterson
- The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States
| | - Allison M Burton-Chase
- The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States; Albany College of Pharmacy and Health Sciences, Albany, NY 12208, United States
| | - Yisheng Li
- The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States
| | - Elmer V Bernstam
- The University of Texas School of Biomedical Informatics, Houston, TX 77030, United States; Division of General Internal Medicine, Department of Internal Medicine, The University of Texas Health Science Center at Houston, TX 77030, United States
| | - Funda Meric-Bernstam
- The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States.
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Rogith D, Yusuf RA, Hovick SR, Fellman BM, Peterson SK, Burton-Chase A, Li Y, Bernstam EV, Meric-Bernstam F. Abstract P2-12-13: Knowledge and Information seeking about personalized breast cancer therapy. Cancer Res 2015. [DOI: 10.1158/1538-7445.sabcs14-p2-12-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
INTRODUCTION: Breast cancer patients and providers are increasingly interested in personalized cancer therapy. Information-seeking behaviors and knowledge about personalized cancer therapy, cancer genetics, and molecular testing may influence patients’ participation in clinical trials and decision making regarding their care. We evaluated breast cancer patients’ knowledge and information seeking behaviors regarding personalized cancer therapy (PCT).
METHODS: The study population included newly registered female breast cancer patients at The University of Texas MD Anderson Cancer Center prior to their first clinical visit. Of 308 consecutive patients who were invited to participate, 100 (32%) completed a self-administered questionnaire assessing their knowledge and information seeking preferences regarding PCT. Knowledge regarding cancer genetics and PCT research was assessed using 16 true/false questions (Cronbach’s α=0.88). A knowledge score was computed from the total number of correct responses.
RESULTS: Respondents were predominantly white (70%), older (median age 55 years; SD=12.9; range 26-84), educated (78% with college degree or higher) and higher incomes (54% >$50,000/year); 71% had been diagnosed with breast cancer for at most one year at time of participation. Knowledge regarding cancer genetics and PCT was moderate (M=8.68, SD=3.8). Although most participants (85%) could correctly identify the definition of PCT, many (59%) did not know that somatic mutations are not hereditary. Many (75%) knew that molecular testing can reveal risk for other hereditary cancers. Less than half (46.5%) knew about the availability of PCT in clinical trials. A minority (27%) indicated that they had sought information regarding PCT. They sought for information related to specific treatment options. Higher education (p<0.01) and income levels (p<0.05) were associated with higher knowledge scores and with seeking PCT information (p<0.01). Those who had previously undergone any genetic testing also were more likely to seek information about PCT (29.6% vs 9.9%, p<0.05). Other demographic and clinical variables like age, race, duration of illness, cancer stage did not correlate with the knowledge score or information seeking behavior.
CONCLUSION: Study participants could define PCT, but had limited knowledge of its availability and underlying treatment principles. This may be due, in part, to the fact that few participants had sought information about PCT. Understanding patients’ knowledge and prior information seeking regarding PCT may inform clinicians, who are likely to be patients’ initial source of information about PCT.
Citation Format: Deevakar Rogith, Rafeek A Yusuf, Shelley R Hovick, Bryan M Fellman, Susan K Peterson, Allison Burton-Chase, Yisheng Li, Elmer V Bernstam, Funda Meric-Bernstam. Knowledge and Information seeking about personalized breast cancer therapy [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-12-13.
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Affiliation(s)
| | | | | | | | | | | | - Yisheng Li
- 3University of Texas MD Anderson Cancer Center
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Yusuf RA, Rogith D, Hovick SRA, Peterson SK, Burton-Chase AM, Fellman BM, Li Y, McKinney C, Bernstam EV, Meric-Bernstam F. Attitudes toward molecular testing for personalized cancer therapy. Cancer 2014; 121:243-50. [PMID: 25209923 DOI: 10.1002/cncr.28966] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 06/13/2014] [Accepted: 06/25/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND This study assessed attitudes of breast cancer patients toward molecular testing for personalized therapy and research. METHODS A questionnaire was given to female breast cancer patients presenting to a cancer center. Associations between demographic and clinical variables and attitudes toward molecular testing were evaluated. RESULTS Three hundred eight patients were approached, and 100 completed the questionnaire (a 32% response rate). Most participants were willing to undergo molecular testing to assist in the selection of approved drugs (81%) and experimental therapy (59%) if testing was covered by insurance. Most participants were white (71%). Even if testing was financially covered, nonwhite participants were less willing to undergo molecular testing for the selection of approved drugs (54% of nonwhites vs 90% of whites, odds ratio [OR] = 0.13, P = .0004) or experimental drugs (35% vs 68%, OR = 0.26, P = .0072). Most participants (75%) were willing to undergo a biopsy to guide therapy, and 46% were willing to undergo research biopsies. Nonwhite participants were less willing to undergo research biopsies (17% vs 55%, OR = 0.17, P = .0033). Most participants wanted to be informed when research results had implications for treatment (91%), new cancer risk (90%), and other preventable/treatable diseases (87%). CONCLUSIONS Most patients were willing to undergo molecular testing and minimally invasive procedures to guide approved or experimental therapy. There were significant differences in attitudes toward molecular testing between racial groups; nonwhites were less willing to undergo testing even if the results would guide their own therapy. Novel approaches are needed to prevent disparities in the delivery of genomically informed care and to increase minority participation in biomarker-driven trials. Cancer 2015;121:243-50. © 2014 American Cancer Society.
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Affiliation(s)
- Rafeek A Yusuf
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas
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Rogith D, Yusuf RA, Hovick SR, Peterson SK, Burton-Chase AM, Li Y, Meric-Bernstam F, Bernstam EV. Attitudes regarding privacy of genomic information in personalized cancer therapy. J Am Med Inform Assoc 2014; 21:e320-5. [PMID: 24737606 DOI: 10.1136/amiajnl-2013-002579] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To evaluate attitudes regarding privacy of genomic data in a sample of patients with breast cancer. METHODS Female patients with breast cancer (n=100) completed a questionnaire assessing attitudes regarding concerns about privacy of genomic data. RESULTS Most patients (83%) indicated that genomic data should be protected. However, only 13% had significant concerns regarding privacy of such data. Patients expressed more concern about insurance discrimination than employment discrimination (43% vs 28%, p<0.001). They expressed less concern about research institutions protecting the security of their molecular data than government agencies or drug companies (20% vs 38% vs 44%; p<0.001). Most did not express concern regarding the association of their genomic data with their name and personal identity (49% concerned), billing and insurance information (44% concerned), or clinical data (27% concerned). Significantly fewer patients were concerned about the association with clinical data than other data types (p<0.001). In the absence of direct benefit, patients were more willing to consent to sharing of deidentified than identified data with researchers not involved in their care (76% vs 60%; p<0.001). Most (85%) patients were willing to consent to DNA banking. DISCUSSION While patients are opposed to indiscriminate release of genomic data, privacy does not appear to be their primary concern. Furthermore, we did not find any specific predictors of privacy concerns. CONCLUSIONS Patients generally expressed low levels of concern regarding privacy of genomic data, and many expressed willingness to consent to sharing their genomic data with researchers.
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Affiliation(s)
- Deevakar Rogith
- The University of Texas School of Biomedical Informatics, Houston, Texas, USA
| | - Rafeek A Yusuf
- The University of Texas School of Biomedical Informatics, Houston, Texas, USA
| | - Shelley R Hovick
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA The Ohio State University, Columbus, Ohio, USA
| | - Susan K Peterson
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Allison M Burton-Chase
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA Albany College of Pharmacy and Health Sciences, Albany, New York, USA
| | - Yisheng Li
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Elmer V Bernstam
- The University of Texas School of Biomedical Informatics, Houston, Texas, USA Division of General Internal Medicine, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, USA
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