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Ola I, Cardoso R, Hoffmeister M, Brenner H. Utilization of colorectal cancer screening tests across European countries: a cross-sectional analysis of the European health interview survey 2018-2020. Lancet Reg Health Eur 2024; 41:100920. [PMID: 38707865 PMCID: PMC11067466 DOI: 10.1016/j.lanepe.2024.100920] [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] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/10/2024] [Accepted: 04/15/2024] [Indexed: 05/07/2024]
Abstract
Background Colorectal cancer (CRC) screening has been shown to reduce CRC incidence and mortality, and most European countries have started to implement CRC screening programs in the past 20 years. Consequently, this study aimed to estimate the utilization of fecal tests and colonoscopy, as well as investigate factors associated with their utilization based on specific screening program characteristics in European countries. Methods We analyzed data from the European Health Interview Survey 2018-2020 to determine the utilization of fecal tests [guaiac-based fecal occult blood test (gFOBT) or fecal immunochemical test (FIT)] within the preceding 2 years or colonoscopy within the preceding 10 years among people aged 50-74 years, based on the type of screening offered in each country. Using multivariable logistic regression and sub-group meta-analysis, factors associated with screening use were determined. Findings The analyses included data from 129,750 respondents across 29 European countries, with participant counts ranging from 1511 individuals in Iceland to 11,755 individuals in Germany. Unit response rates ranged from 22% to 88%. The use of either test was highest among countries with fully rolled-out programs with fecal tests [from 37.7% (867/2379) in Croatia to 74.9% (2321/3085) in Denmark] and in countries offering colonoscopy as an alternative screening method [from 26.2% (854/3329) in Greece to 75.4% (1192/1760) in Luxembourg]. We observed the lowest utilization of either test in countries with no program or small-scale programs [6.3% (195/3179) in Bulgaria to 34.2% (722/2144) in Latvia]. Across all types of screening offers, younger age, being without a partner, low education, rural residence, and living in large households were associated with lower utilization, as were poor lifestyle scores and prolonged periods without physician consultation. Interpretation Our findings point to large disparities and much room for improvement in CRC screening offers and utilization across Europe. Funding There was no funding source for this study.
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Affiliation(s)
- Idris Ola
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
- Medical Faculty Heidelberg, University of Heidelberg, Heidelberg 69120, Germany
| | - Rafael Cardoso
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg 69120, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
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Wheeler SB, Lee RJ, Young AL, Dodd A, Ellis C, Weiner BJ, Ribisl KM, Adsul P, Birken SA, Fernández ME, Hannon PA, Hébert JR, Ko LK, Seaman A, Vu T, Brandt HM, Williams RS. The special sauce of the Cancer Prevention and Control Research Network: 20 years of lessons learned in developing the evidence base, building community capacity, and translating research into practice. Cancer Causes Control 2023; 34:217-239. [PMID: 37354320 PMCID: PMC10689533 DOI: 10.1007/s10552-023-01691-1] [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: 12/22/2022] [Accepted: 03/29/2023] [Indexed: 06/26/2023]
Abstract
PURPOSE The Cancer Prevention and Control Research Network (CPCRN) is a national network focused on accelerating the translation of cancer prevention and control research evidence into practice through collaborative, multicenter projects in partnership with diverse communities. From 2003 to 2022, the CPCRN included 613 members. METHODS We: (1) characterize the extent and nature of collaborations through a bibliometric analysis of 20 years of Network publications; and (2) describe key features and functions of the CPCRN as related to organizational structure, productivity, impact, and focus on health equity, partnership development, and capacity building through analysis of 22 in-depth interviews and review of Network documentation. RESULTS Searching Scopus for multicenter publications among the CPCRN members from their time of Network engagement yielded 1,074 collaborative publications involving two or more members. Both the overall number and content breadth of multicenter publications increased over time as the Network matured. Since 2004, members submitted 123 multicenter grant applications, of which 72 were funded (59%), totaling more than $77 million secured. Thematic analysis of interviews revealed that the CPCRN's success-in terms of publication and grant productivity, as well as the breadth and depth of partnerships, subject matter expertise, and content area foci-is attributable to: (1) its people-the inclusion of members representing diverse content-area interests, multidisciplinary perspectives, and geographic contexts; (2) dedicated centralized structures and processes to enable and evaluate collaboration; and (3) focused attention to strategically adapting to change. CONCLUSION CPCRN's history highlights organizational, strategic, and practical lessons learned over two decades to optimize Network collaboration for enhanced collective impact in cancer prevention and control. These insights may be useful to others seeking to leverage collaborative networks to address public health problems.
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Affiliation(s)
- Stephanie B Wheeler
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB#7411, McGavran Greenberg Hall, Chapel Hill, NC, 27599-7411, USA.
| | - Rebecca J Lee
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alexa L Young
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Adam Dodd
- Impact Measurement and Visualization Team, Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Charlotte Ellis
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB#7411, McGavran Greenberg Hall, Chapel Hill, NC, 27599-7411, USA
| | - Bryan J Weiner
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Kurt M Ribisl
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Prajakta Adsul
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- Cancer Control and Population Sciences Research Program, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Sarah A Birken
- Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - María E Fernández
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Peggy A Hannon
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - James R Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA
| | - Linda K Ko
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Aaron Seaman
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
| | - Thuy Vu
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Heather M Brandt
- HPV Cancer Prevention Program, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Rebecca S Williams
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Adsul P, Islam J, Chebli P, Kranick J, Nash S, Arem H, Wheeler S, Lopez-Pentecost M, Foster V, Sharma RK, Felder T, Risendal B, Chavarria EA, Kwon S, Hirschey R, Trinh-Shevrin C. Identifying research practices toward achieving health equity principles within the Cancer Prevention and Control Research Network. Cancer Causes Control 2023; 34:15-21. [PMID: 36826623 PMCID: PMC9950692 DOI: 10.1007/s10552-023-01674-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE Although there is national recognition for health equity-oriented research, there is limited guidance for researchers to engage partnerships that promote health equity in cancer research. The Cancer Prevention and Control Research Network's (CPCRN) Health Equity Work Group developed a toolkit to guide researchers in equitable collaborations. METHODS The CPCRN's Health Equity Work Group collectively outlined health and racial equity principles guiding research collaborations with partners that include communities, community-based organizations, implementing partners in the clinical setting including providers and health care organizations, and policy makers. Using a network-wide survey to crowdsource information around ongoing practices, we leveraged and integrated the network's experience and collaborations. RESULTS Data from the survey formed the preliminary basis for the toolkit, with a focus on sharing fiscal resources with partners, training and capacity building, collaborative decision-making, community-driven research agenda setting, and sustainability. The final toolkit provides reflection considerations for researchers and collated exemplary resources, supported by the contemporary research. CONCLUSIONS The toolkit provides a guide to researchers at all experience levels wanting to engage in equitable research collaborations. Future efforts are underway to evaluate whether and how researchers within and outside CPCRN are able to incorporate these principles in research collaborations.
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Affiliation(s)
- Prajakta Adsul
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA.
- Cancer Control and Populations Sciences Research Program, Cancer Research Facility (CRF), University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA.
| | | | - Perla Chebli
- Department of Population Health, NYU Grossman School of Medicine, Section for Health Equity, New York, NY, USA
| | - Julie Kranick
- Department of Population Health, NYU Grossman School of Medicine, Section for Health Equity, New York, NY, USA
| | - Sarah Nash
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Hannah Arem
- MedStar Health Research Institute, Washington, DC, USA
| | - Stephanie Wheeler
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Victoria Foster
- Department of Population Health, NYU Grossman School of Medicine, Section for Health Equity, New York, NY, USA
| | - Rashmi K Sharma
- Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | | | - Betsy Risendal
- Colorado School of Public Health, University of Colorado Cancer Center, Aurora, CO, USA
| | - Enmanuel A Chavarria
- Department of Behavioral, Social, and Health Education Sciences, Emory University, Rollins School of Public Health, Atlanta, GA, USA
| | - Simona Kwon
- Department of Population Health, NYU Grossman School of Medicine, Section for Health Equity, New York, NY, USA
| | - Rachel Hirschey
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Chau Trinh-Shevrin
- Department of Population Health, NYU Grossman School of Medicine, Section for Health Equity, New York, NY, USA
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Darabos K, Renna M. Ambiguity in cancer-related recommendations among young adults: Relationships with health behaviors and psychological distress. Patient Educ Couns 2023; 116:107943. [PMID: 37598584 DOI: 10.1016/j.pec.2023.107943] [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] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Young adulthood represents a sensitive period in which cancer-related lifestyle behaviors (e.g., substance use, poor physical activity) are developed and sustained into adulthood, having consequences for cancer morbidity and mortality. However, cancer prevention and control (CPC) recommendations are often ambiguous and multifaceted which may increase health-compromising behaviors and psychological distress among this vulnerable young adult (YA) population. OBJECTIVE We examined relationships between ambiguity in CPC recommendations and health behaviors and psychological distress. METHODS YAs (n = 811, aged 18-39) without cancer were drawn from the Health Information National Trends Survey 2019 data. RESULTS Regression analyses indicated that higher perceived CPC ambiguity was associated with higher health behavior recommendations not being met and higher psychological distress. CONCLUSION Focusing on elucidating CPC recommendations may reduce engagement in negative health behaviors and promote well-being. Future research may benefit from developing effective communication strategies aimed at elucidating health behavior recommendations to help educate this YA population. PRACTICAL VALUE Health care providers should be more aware of, and ready to address the potential ambiguity surrounding CPC recommendations and what that means for engagement in health-promoting and health-compromising behaviors and for psychological well-being.
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Affiliation(s)
- Katie Darabos
- Rutgers University School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA.
| | - Megan Renna
- University of Southern Mississippi, School of Psychology, 118 College Drive #5025 39406, Hattiesburg, MS 39406, USA
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Glasgow RE, Brtnikova M, Dickinson LM, Carroll JK, Studts JL. Implementation strategies preferred by primary care clinicians to facilitate cancer prevention and control activities. J Behav Med 2023; 46:821-836. [PMID: 37031347 PMCID: PMC10098247 DOI: 10.1007/s10865-023-00400-2] [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] [Received: 10/31/2022] [Accepted: 02/09/2023] [Indexed: 04/10/2023]
Abstract
Key clinical and community members need to be involved in the identification of feasible and impactful implementation strategies for translation of evidence-based interventions into practice. While a wide range of implementation strategies has been developed, there is little research on their applicability for cancer prevention and control (CPC) efforts in primary care. We conducted a survey of primary care physicians to identify implementation strategies they perceive as most feasible and impactful. The survey included both primary prevention behavior change counseling and cancer screening issues. Analyses contrasted ratings of feasibility and impact of nine implementation strategies, and among clinicians in different settings with a focus on comparisons between clinicians in rural vs. non-rural settings. We recruited a convenience sample of 326 respondents from a wide range of practice types from four practice-based research networks in 49 states and including 177 clinicians in rural settings. Ratings of impact were somewhat higher than those for feasibility. Few of the nine implementation strategies were high on both impact and feasibility. Only 'adapting to my practice' was rated higher than a 4 ("moderate") on both impact and feasibility. There were relatively few differences between rural and non-rural clinicians or associated with other clinician or setting characteristics. There is considerable variability in perceived impact and feasibility of implementation strategies for CPC activities among family medicine clinicians. It is important to assess both feasibility and impact of implementation strategies as well as their generalizability across settings. Our results suggest that optimal strategies to implement evidence-based CPC activities will likely need to be adapted for primary care settings. Future research is needed to replicate these findings and identify practical, implementation partner informed implementation strategies.
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Affiliation(s)
- Russell E Glasgow
- Department of Family Medicine, University of Colorado School of Medicine, 1844 Kona St. Eugene, Aurora, CO, OR 97403-2142, USA.
- Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.
| | - Michaela Brtnikova
- Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - L Miriam Dickinson
- Department of Family Medicine, University of Colorado School of Medicine, 1844 Kona St. Eugene, Aurora, CO, OR 97403-2142, USA
| | - Jennifer K Carroll
- Department of Family Medicine, University of Colorado School of Medicine, 1844 Kona St. Eugene, Aurora, CO, OR 97403-2142, USA
- American Academy of Family Physicians National Research Network, Leawood, KS, USA
| | - Jamie L Studts
- Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- University of Colorado Cancer Center, Aurora, CO, USA
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Farris P, Crist R, Miller S, Shannon J. Rural research capacity: a co-created model for research success. Health Res Policy Syst 2023; 21:76. [PMID: 37488533 PMCID: PMC10364434 DOI: 10.1186/s12961-023-01030-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 07/06/2023] [Indexed: 07/26/2023] Open
Abstract
PURPOSE The United States' National Institutes of Health (NIH) have long challenged academia to improve clinical trial enrollment, especially in underrepresented populations; inclusive of geography, age, disability status, racial and ethnic minorities. It has been shown that rural and urban residents enrolled in clinical trials have similar outcomes, yet, rural healthcare systems struggle to provide opportunities to rural residents to participate in clinical trials when infrastructure is limited or unsupportive of research programs and/or research staffing levels are insufficient. To fully address the barriers to clinical trial access in rural areas, it is not adequate to simply open more trials. Community receptivity of research as well as organizational and community capacity must be considered. This project was determined by the Oregon Health and Science University's Institutional Review Board to be generalizable research across the chosen counties and was approved to operate under a waiver of written consent. Participants received a cash incentive in appreciation for their time and verbally agreed to participate after reviewing a project information sheet. METHODS The research team co-created a community-responsive approach to the receipt, review, and acceptance of clinical trials in a rural community setting. An adapted 5 step Implementation Mapping approach was used to develop a systematic strategy intended to increase the success, and therefore, the number of clinical trials offered in a rural community. RESULTS The research team and participating rural community members pilot-tested the implementation of a co-designed research review strategy, inclusive of a Regional Cultural Landscape and three co-created project submission and feasibility review forms, with a cancer early detection clinical trial. The proposed clinical trial required engagement from primary care and oncology. Utilizing the research review strategy demonstrated strong researcher-community stakeholder communication and negotiation, which resulted in early identification and resolution of potential barriers, hiring a local clinical research coordinator, and timely trial opening. CONCLUSION To the knowledge of the research team, the work described is the first to use a community-engaged approach for creating a clinical trial implementation strategy directly supportive of rural-sitting community stakeholders in receiving, reviewing, and approving cancer-related clinical trials in their community. Participating community members and leaders had the chance to negotiate research protocol changes or considerations directly with researchers interested in conducting a cancer clinical trial in their rural setting.
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Affiliation(s)
- Paige Farris
- Community Outreach and Engagement Program, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, 97239, United States of America
| | - Rachel Crist
- Community Outreach and Engagement Program, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, 97239, United States of America
| | - Sylvia Miller
- Oregon Clinical and Translational Research Institute, Oregon Health and Science University, Portland, OR, 97239, United States of America
| | - Jackilen Shannon
- Division of Oncologic Sciences, Knight Cancer Institute, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, United States of America.
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Khan SZ, Lengyel CG. Challenges in the management of colorectal cancer in low- and middle-income countries. Cancer Treat Res Commun 2023; 35:100705. [PMID: 37060879 DOI: 10.1016/j.ctarc.2023.100705] [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: 02/14/2023] [Revised: 03/05/2023] [Accepted: 04/01/2023] [Indexed: 04/17/2023]
Abstract
AIM This narrative review aims to describe colorectal cancer (CRC) management landscape in low- and middle-income countries (LMICs), presenting the most recent and relevant papers on the topic. As a secondary aim, the authors suggest new ways of improving CRC patient care in LMICs. BACKGROUND Several studies show that the incidence of colon cancer in low- and middle-income countries (LMICs) is rising. In addition to the increasing incidence, lack of early detection and impeded access to optimal multidisciplinary treatment may worsen survival outcomes. CONCLUSION Developing quality diagnostic services in the proper health context is crucial for early diagnosis and successful therapy of CRC patients, and applying a resource-sensitive approach to prioritize essential treatments based on effectiveness and cost-effectiveness is key to overcoming barriers in LMICs, with clinical research collaborations between high-income countries (HICs) and LMICs being a helpful strategy to improve health indicators and prevent the burnout of health workers.
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Affiliation(s)
- Shah Zeb Khan
- Department of Clinical Oncology, Bannu Institute of Nuclear Medicine Oncology and Radiotherapy (BINOR), Bannu, Khyber Pakhtunkhwa, Pakistan.
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Preston MA, Cadet D, Hunley R, Retnam R, Arezo S, Sheppard VB. Health Equity and Colorectal Cancer Awareness: a Community Health Educator Initiative. J Cancer Educ 2023; 38:225-230. [PMID: 34677801 PMCID: PMC8532449 DOI: 10.1007/s13187-021-02102-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/09/2021] [Indexed: 06/13/2023]
Abstract
Disparities in colorectal cancer (CRC) incidence and mortality persist in rural and underserved communities. Our Community Outreach and Engagement (COE) activities are grounded in a bi-directional Community-to-Bench model in which the National Outreach Network Community Health Educator (NON CHE) Screen to Save (S2S) initiative was implemented. In this study, we assessed the impact of the NON CHE S2S in rural and underserved communities. Descriptive and comparative analyses were used to examine the role of the NON CHE S2S on CRC knowledge and CRC screening intent. Data included demographics, current CRC knowledge, awareness, and future CRC health plans. A multivariate linear regression was fit to survey scores for CRC knowledge. The NON CHE S2S engaged 441 participants with 170 surveys completed. The difference in participants' CRC knowledge before and after the NON CHE S2S intervention had an overall mean of 0.92 with a standard deviation of 2.56. At baseline, White participants had significantly higher CRC knowledge scores, correctly answering 1.94 (p = 0.007) more questions on average than Black participants. After the NON CHE S2S intervention, this difference was not statistically significant. Greater than 95% of participants agreed that the NON CHE S2S sessions impacted their intent to get screened for CRC. Equity of access to health information and the health care system can be achieved with precision public health strategies. The COE bi-directional Community-to-Bench model facilitated community connections through the NON CHE and increased awareness of CRC risk reduction, screening, treatment, and research. The NON CHE combined with S2S is a powerful tool to engage communities with the greatest health care needs and positively impact an individual's intent to "get screened" for CRC.
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Affiliation(s)
- Michael A Preston
- Department of Health Behavior and Policy, Office of Health Equity & Disparities Research-Community Outreach & Engagement, Virginia Commonwealth University, PO Box 980149, 830 East Main Street, Richmond, VA, 23298-0149, USA.
| | - Debbie Cadet
- Department of Health Behavior and Policy, Office of Health Equity & Disparities Research-Community Outreach & Engagement, Virginia Commonwealth University, PO Box 980149, 830 East Main Street, Richmond, VA, 23298-0149, USA
| | - Rachel Hunley
- Department of Health Behavior and Policy, Office of Health Equity & Disparities Research-Community Outreach & Engagement, Virginia Commonwealth University, PO Box 980149, 830 East Main Street, Richmond, VA, 23298-0149, USA
| | - Reuben Retnam
- Department of Health Behavior and Policy, Office of Health Equity & Disparities Research-Community Outreach & Engagement, Virginia Commonwealth University, PO Box 980149, 830 East Main Street, Richmond, VA, 23298-0149, USA
| | - Sarah Arezo
- Department of Health Behavior and Policy, Office of Health Equity & Disparities Research-Community Outreach & Engagement, Virginia Commonwealth University, PO Box 980149, 830 East Main Street, Richmond, VA, 23298-0149, USA
| | - Vanessa B Sheppard
- Department of Health Behavior and Policy, Office of Health Equity & Disparities Research-Community Outreach & Engagement, Virginia Commonwealth University, PO Box 980149, 830 East Main Street, Richmond, VA, 23298-0149, USA
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9
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Huang H, Sun PY, Zou KY, He J, Zhang YW. [Current situation and prospect of primary prevention of cancer in China]. Zhonghua Zhong Liu Za Zhi 2022; 44:942-949. [PMID: 36164695 DOI: 10.3760/cma.j.cn112152-20220209-00083] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Cancer is a major public health issue that seriously endangers the public health and social development of China. Future initiatives for cancer prevention and control should continue to adhere to the principle of prioritizing prevention, and comprehensively implement related prevention activities nationwide. This is critical to reducing cancer burden in Chinese residents, especially in the low- and middle-income populations and those living in areas that are less economically developed. In the past several decades, the international community has significantly reduced the incidence of related cancers through primary prevention measures such as tobacco control, improved occupational hygiene, and vaccination. China has also implemented a series of exploratory primary prevention measures among high-risk groups of cancer in specific areas including Xuanwei, Qidong, and Linxian, and achieved encouraging results. However, due to the low level of systematic awareness of cancer risk factors and the lack of awareness and ability of self-health management in Chinese residents, it is urgent to develop novel research tools and methods to further reveal the causes of cancer, and establish innovative mechanisms and systems of primary prevention of cancer at population and individual levels. Based on current status of the transformation of cancer spectrum and the development of digital intelligence, it would be beneficial to establish a smart digital system for primary cancer prevention service that can cover the entire population, integrating authoritative popular science education on primary prevention of cancer, individualized cancer risk assessment, and personalized health management assistant. This will improve primary cancer prevention among the Chinese general population and can help the sustainable development of cancer prevention and control in China.
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Affiliation(s)
- H Huang
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - P Y Sun
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - K Y Zou
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y W Zhang
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Adsul P, Chambers D, Brandt HM, Fernandez ME, Ramanadhan S, Torres E, Leeman J, Baquero B, Fleischer L, Escoffery C, Emmons K, Soler M, Oh A, Korn AR, Wheeler S, Shelton RC. Grounding implementation science in health equity for cancer prevention and control. Implement Sci Commun 2022; 3:56. [PMID: 35659151 PMCID: PMC9164317 DOI: 10.1186/s43058-022-00311-4] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 05/20/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The past decade of research has seen theoretical and methodological advances in both implementation science and health equity research, opening a window of opportunity for facilitating and accelerating cross-disciplinary exchanges across these fields that have largely operated in siloes. In 2019 and 2020, the National Cancer Institute's Consortium for Cancer Implementation Science convened an action group focused on 'health equity and context' to identify opportunities to advance implementation science. In this paper, we present a narrative review and synthesis of the relevant literature at the intersection of health equity and implementation science, highlight identified opportunities (i.e., public goods) by the action group for advancing implementation science in cancer prevention and control, and integrate the two by providing key recommendations for future directions. DISCUSSION In the review and synthesis of the literature, we highlight recent advances in implementation science, relevant to promoting health equity (e.g., theories/models/frameworks, adaptations, implementation strategies, study designs, implementation determinants, and outcomes). We acknowledge the contributions from the broader field of health equity research and discuss opportunities for integration and synergy with implementation science, which include (1) articulating an explicit focus on health equity for conducting and reviewing implementation science; (2) promoting an explicit focus on health equity in the theories, models, and frameworks guiding implementation science; and (3) identifying methods for understanding and documenting influences on the context of implementation that incorporate a focus on equity. To advance the science of implementation with a focus on health equity, we reflect on the essential groundwork needed to promote bi-directional learning between the fields of implementation science and health equity research and recommend (1) building capacity among researchers and research institutions for health equity-focused and community-engaged implementation science; (2) incorporating health equity considerations across all key implementation focus areas (e.g., adaptations, implementation strategies, study design, determinants, and outcomes); and (3) continuing a focus on transdisciplinary opportunities in health equity research and implementation science. We believe that these recommendations can help advance implementation science by incorporating an explicit focus on health equity in the context of cancer prevention and control and beyond.
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Affiliation(s)
- Prajakta Adsul
- Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM USA
| | - David Chambers
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD USA
| | - Heather M. Brandt
- HPV Cancer Prevention Program, St. Jude Children’s Research Hospital, Memphis, TN USA
| | - Maria E. Fernandez
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, USA
| | | | - Essie Torres
- East Carolina University, 2309 Carol Belk Bldg, Greenville, NC 27858 USA
| | | | - Barbara Baquero
- University of Washington, 3980 15th Ave. NE, Seattle, WA 98195 USA
| | | | - Cam Escoffery
- Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322 USA
| | - Karen Emmons
- Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 USA
| | - Montserrat Soler
- Ob/Gyn and Women’s Health Institute, Cleveland Clinic, Cleveland, OH USA
| | - April Oh
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Ariella R. Korn
- Cancer Prevention Fellowship Program, Implementation Science, Office of the Director, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, USA
| | - Stephanie Wheeler
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB #7411, Chapel Hill, NC 27599 USA
| | - Rachel C. Shelton
- Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, 722 W 168th Street, New York, NY 10032 USA
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11
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Amuta-Jimenez AO, Smith GPA, Brown KK. Patterns and Correlates of Cervical Cancer Prevention Among Black Immigrant and African American Women in the USA: the Role of Ethnicity and Culture. J Cancer Educ 2022; 37:798-805. [PMID: 32990933 DOI: 10.1007/s13187-020-01884-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/22/2020] [Indexed: 06/11/2023]
Abstract
Cervical cancer prevention disparities between Black and White women have been researched extensively, but less is known about disparities among Black subpopulations, despite increased risk, distinct cultures, and rapidly increasing numbers of Black immigrant women to the USA. A 74-item survey was used to conduct a cross-sectional descriptive study. Independent sample t tests, logistic multiple regressions, and chi-square tests were used to carry out all comparative analyses. The survey was administered via Psychdata from January 2020 to February 2020. The final sample included 450 eligible participants (African American women [AAW] = 335; Black immigrant women [BIW] from either West, Central, East Africa, or the Caribbean = 115). Compared to AAW, BIW demonstrated much lower knowledge of cervical cancer, AAW were more likely to visit a gynecologist, and to have had a well-woman exam every 3 years or less. A greater percentage of BIW reported not getting Pap smear test because they had no symptoms or because they feared bad results while AAW reported not receiving a Pap smear because it was not convenient, they did not trust any doctor/gynecologist, and lacked access to a gynecologist. Doctor and family advising had a much larger effect on cervical screening among BIW compared to AAW. This study provides evidence of crucial differences in CC knowledge, attitudes, and screening behaviors among BIW and AAW. Funding agencies, program planners and evaluators, and health policymakers are encouraged to require disaggregation of Black women in healthcare research to tease out specific ways interventions can be most effective.
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Affiliation(s)
- Ann Oyare Amuta-Jimenez
- School of Health Promotion and Kinesiology, Texas Woman's University, 304 Administration Drive, Denton, TX, 76204, USA.
| | - Gabrielle P A Smith
- Department of Psychology and Philosophy, Texas Woman's University, 304 Administration Drive, Denton, TX, 76204, USA
| | - Kyrah K Brown
- Department of Kinesiology, University of Texas at Arlington, 500 W. Nedderman Drive, Arlington, TX, 76019, USA
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12
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Klein WMP. Behavioral medicine, cancer control, and NCI: reflections on a fruitful past and auspicious future. Transl Behav Med 2021; 11:2065-2069. [PMID: 34850930 DOI: 10.1093/tbm/ibab131] [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: 11/14/2022] Open
Abstract
Cancer prevention and control has benefited substantially from behavioral medicine research over the last several decades. The National Cancer Institute's (NCI) Division of Cancer Control and Population Sciences, ably led by Barbara Rimer and then Bob Croyle since being established in 1997, has been a primary supporter of this research. NCI has made significant investments in many of the topics featured in this special section and will continue to do so. These include research on basic behavioral processes such as affect as well as optimal approaches to health communication. A key and enduring focus has been the support of behavioral interventions, particularly for tobacco, diet, physical activity, and sun exposure. The success of such interventions will be amplified to the extent that they leverage novel research designs, emerging digital technologies, evidence gleaned from the burgeoning field of implementation science, and lessons learned from greater attention to the impact of health disparities and inequities. Moreover, as the cancer survivor population continues to grow given the rapid development of diagnostic and therapeutic science, it will be even more essential to devote attention to understanding and addressing the health care and other needs of survivors such as cognitive dysfunction and financial toxicity. The field of behavioral medicine should be both applauded for its many contributions to reducing the cancer burden and encouraged to continue developing new research ideas in these critical areas.
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Affiliation(s)
- William M P Klein
- Behavioral Research Program, National Cancer Institute, Bethesda, MD 20892, USA
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13
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Leeman J, Rohweder C, Lee M, Brenner A, Dwyer A, Ko LK, O'Leary MC, Ryan G, Vu T, Ramanadhan S. Aligning implementation science with improvement practice: a call to action. Implement Sci Commun 2021; 2:99. [PMID: 34496978 PMCID: PMC8424169 DOI: 10.1186/s43058-021-00201-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 03/23/2021] [Accepted: 08/25/2021] [Indexed: 12/24/2022] Open
Abstract
Background In several recent articles, authors have called for aligning the fields of implementation and improvement science. In this paper, we call for implementation science to also align with improvement practice. Multiple implementation scholars have highlighted the importance of designing implementation strategies to fit the existing culture, infrastructure, and practice of a healthcare system. Worldwide, healthcare systems are adopting improvement models as their primary approach to improving healthcare delivery and outcomes. The prevalence of improvement models raises the question of how implementation scientists might best align their efforts with healthcare systems’ existing improvement infrastructure and practice. Main body We describe three challenges and five benefits to aligning implementation science and improvement practice. Challenges include (1) use of different models, terminology, and methods, (2) a focus on generalizable versus local knowledge, and (3) limited evidence in support of the effectiveness of improvement tools and methods. We contend that implementation science needs to move beyond these challenges and work toward greater alignment with improvement practice. Aligning with improvement practice would benefit implementation science by (1) strengthening research/practice partnerships, (2) fostering local ownership of implementation, (3) generating practice-based evidence, (4) developing context-specific implementation strategies, and (5) building practice-level capacity to implement interventions and improve care. Each of these potential benefits is illustrated in a case study from the Centers for Disease Control and Prevention’s Cancer Prevention and Control Research Network. Conclusion To effectively integrate evidence-based interventions into routine practice, implementation scientists need to align their efforts with the improvement culture and practice that is driving change within healthcare systems worldwide. This paper provides concrete examples of how researchers have aligned implementation science with improvement practice across five implementation projects. Supplementary Information The online version contains supplementary material available at 10.1186/s43058-021-00201-1.
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Affiliation(s)
- Jennifer Leeman
- School of Nursing, The University of North Carolina at Chapel Hill, CB #7460, Chapel Hill, NC, 27599, USA.
| | - Catherine Rohweder
- Center for Health Promotion & Disease Prevention, The University of North Carolina at Chapel Hill, CB #7424, Carrboro, NC, 27510, USA
| | - Matthew Lee
- Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, 8th Floor, New York, NY, 10016, USA
| | - Alison Brenner
- Department of General Medicine & Clinical Epidemiology, UNC School of Medicine, The University of North Carolina at Chapel Hill, CB #7293, Carrboro, NC, 27510, USA
| | - Andrea Dwyer
- University of Colorado Cancer Center, 13001 East 17th Avenue, Aurora, CO, 80045, USA
| | - Linda K Ko
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, USA.,Department of Cancer Prevention, Fred Hutchinson Cancer Research Center, Hans Rosling Center for Public Health, 3980 15th Avenue NE, 4th Floor, Seattle, WA, 98195, USA
| | - Meghan C O'Leary
- Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, CB #7400, Chapel Hill, NC, 27599, USA
| | - Grace Ryan
- The University of Iowa, 145 N. Riverside Drive, N475 CPHB, Iowa City, IA, 52242, USA
| | - Thuy Vu
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, USA
| | - Shoba Ramanadhan
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
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14
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Bretas G, Renna NL, Bines J. Practical considerations for expediting breast cancer treatment in Brazil. Lancet Reg Health Am 2021; 2:100028. [PMID: 36779036 PMCID: PMC9904000 DOI: 10.1016/j.lana.2021.100028] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/11/2021] [Accepted: 07/12/2021] [Indexed: 12/12/2022]
Abstract
Patients in Brazil continue to present with late-stage breast cancer. Notwithstanding these figures, policies and programs to overcome this long-lasting scenario have had limited results. We enlist the main barriers for advancing breast cancer diagnosis in Brazil, based on the available evidence, and we propose feasible strategies that may serve as a platform to address this major public health challenge.
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Affiliation(s)
- Gustavo Bretas
- Instituto Nacional de Câncer, Rio de Janeiro, Brazil,Grupo Oncoclínicas, Rio de Janeiro, Brazil
| | | | - José Bines
- Instituto Nacional de Câncer, Rio de Janeiro, Brazil,Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil,Corresponding author.
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15
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Sellami M, Bragazzi NL. The effect of sport and physical activity on transport proteins: implications for cancer prevention and control. Adv Protein Chem Struct Biol 2021; 123:17-26. [PMID: 33485483 DOI: 10.1016/bs.apcsb.2020.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register]
Abstract
The present contribution briefly overviews the major biological functions of the plasma membrane and of the transport proteins (transporters), which enable the movement of different molecules and substrates (either charged or uncharged) by passive (facilitated diffusion) or active transport. In particular, transporters are overviewed at the level of the skeletal muscles, which represent a highly complex, heterogeneous, plastic and dynamic tissue and are one of the most abundant tissues in humans, accounting for up to 40% of their total weight and containing up to 50%-75% of all body proteins. Moreover, it is shown how sport and physical activity finely tune and modulate human proteome, especially in terms of structural and functional improvements concerning the density of the transport proteins. These changes are among the factors responsible for the positive outcomes of training, which involve mainly the cardiovascular and the endocrine/metabolic systems. Different kinds of training (strength and endurance) enable to achieve such improvements, even though there seems to exist a dose-relationship intensity-dependent effect, with responses after 6-8 weeks of exercise and disappearing in the chronic period (years of training). Finally, exercise-induced changes at the level of transporters can play a role in terms of cancer prevention and management. Regular physical activity and exercise can, indeed, counteract the side-effects of chemotherapy drugs, including doxorubicin and other anthracycline derivatives, which may impair the functions of cardiac and skeletal muscles, probably modulating the expression of multidrug resistance proteins.
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16
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Abstract
Background Oral cancer is one of the most common non-communicable diseases worldwide. This paper presents an evaluation of the trends and geographical distributions of oral cancers in the Saudi Arabian population. Methods Data from Saudi Cancer Registry reports were used in this analysis, which assessed the period between 1994 and 2015. All cancer cases are recorded in these reports, as well as the age, gender, region and histological cancer sites for each patient. Age-standardised and age-specific incidence rates were calculated in these reports. For the purposes of this paper, only cancers of the lips, tongue and mouth were considered oral cancers. Results Between 1994 and 2015, the Saudi Cancer Registry identified 172,424 cancer cases in total. Of these, 3184 were oral cancer. The mean age-standardised rate of oral cancer for the study period was 2.9 per 100,000 people; for females, it was 1.5, and for males, it was 1.4. The incidence of oral cancer varied by region, with Jazan displaying the highest age-standardised rate and Hail displaying the lowest. A positive correlation was observed between oral cancer incidence and age. Conclusion The overall trend of the age-standardised rate for both sexes remained constant from 1994 to 2015. However, the oral cancer incidence in Saudi Arabia varies by region. Studying this variation in more detail will help to guide awareness programmes in the regions that are most in need.
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Affiliation(s)
- Bandar M Alshehri
- Department of Clinical Laboratory, Faculty of applied Medical Sciences, Najran University, P.O. Box: 1988, Najran, Kingdom of Saudi Arabia.
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17
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Norton WE, Zwarenstein M, Czajkowski S, Kato E, O'Mara A, Shelburne N, Chambers DA, Loudon K. Building internal capacity in pragmatic trials: a workshop for program scientists at the US National Cancer Institute. Trials 2019; 20:779. [PMID: 31881919 PMCID: PMC6935210 DOI: 10.1186/s13063-019-3934-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 11/26/2019] [Indexed: 11/16/2022] Open
Abstract
Background Building capacity in research funding organizations to support the conduct of pragmatic clinical trials is an essential component of advancing biomedical and public health research. To date, efforts to increase the ability to design and carry out pragmatic trials have largely focused on training researchers. To complement these efforts, we developed an interactive workshop tailored to meet the roles and responsibilities of program scientists at the National Cancer Institute—the leading cancer research funding agency in the USA. The objectives of the workshop were to improve the understanding of pragmatic trials and enhance the capacity to distinguish between elements that make a trial more pragmatic or more explanatory among key programmatic staff. To our knowledge, this is the first reported description of such a workshop. Main body The workshop was developed to meet the needs of program scientists as researchers and stewards of research funds, which often includes promoting scientific initiatives, advising prospective applicants, collaborating with grantees, and creating training programs. The workshop consisted of presentations from researchers with expertise in the design and interpretation of trials across the explanatory-pragmatic continuum. Presentations were followed by interactive, small-group exercises to solidify participants’ understanding of the purpose and conduct of these trials, which were tailored to attendees’ areas of expertise across the cancer control continuum and designed to reflect their scope of work as program scientists at NCI. A total of 29 program scientists from the Division of Cancer Control and Population Sciences and the Division of Cancer Prevention participated; 19 completed a post-workshop evaluation. Attendees were very enthusiastic about the workshop: they reported improved knowledge, significant relevance of the material to their work, and increased interest in pragmatic trials across the cancer control continuum. Conclusion Training program scientists at major biomedical research agencies who are responsible for developing funding opportunities and advising grantees is essential for increasing the quality and quantity of pragmatic trials. Together with workshops for other target audiences (e.g., academic researchers), this approach has the potential to shape the future of pragmatic trials and continue to generate more and better actionable evidence to guide decisions that are of critical importance to health care practitioners, policymakers, and patients.
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Affiliation(s)
- Wynne E Norton
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, #3E424, Bethesda, MD, 20850, USA.
| | | | - Susan Czajkowski
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, #3E424, Bethesda, MD, 20850, USA
| | - Elisabeth Kato
- Agency for Healthcare Research and Quality, Rockville, MD, USA
| | - Ann O'Mara
- Independent Contractor, Rockville, MD, USA
| | - Nonniekaye Shelburne
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, #3E424, Bethesda, MD, 20850, USA
| | - David A Chambers
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, #3E424, Bethesda, MD, 20850, USA
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18
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Leeman J, Glanz K, Hannon P, Shannon J. The Cancer Prevention and Control Research Network: Accelerating the implementation of evidence-based cancer prevention and control interventions. Prev Med 2019; 129S:105857. [PMID: 31718801 PMCID: PMC7110411 DOI: 10.1016/j.ypmed.2019.105857] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 09/24/2019] [Indexed: 11/19/2022]
Abstract
This editorial provides a high level overview of the articles included in this supplement.
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Affiliation(s)
- Jennifer Leeman
- University of North Carolina, School of Nursing, 120 N. Medical Drive, Chapel Hill, NC 27599-7460, USA.
| | - Karen Glanz
- University of Pennsylvania, Perelman School of Medicine and School of Nursing, 801 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021, USA
| | - Peggy Hannon
- University of Washington, Department of Health Services, 1959 NE Pacific Street, Magnuson Health Sciences Bldg, Box 357660, Seattle, WA 98195, USA
| | - Jackilen Shannon
- Oregon Health and Science University, School of Public Health, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
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19
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Portilla-Skerrett GM, Díaz-Algorri Y, Soto-Salgado M, Cruz-Correa M. Improvement in Hispanics' CRC Knowledge and Awareness using the Inflatable Caribe Colon. P R Health Sci J 2019; 38:176-180. [PMID: 31536631] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Colorectal cancer (CRC) is the most common cause of cancer death in Puerto Rico (PR). CRC screening rates among PR Hispanics aged ≥ 50 years (57.5%) are below the Healthy People 2020 recommendations (70.5%). Low screening rates can be attributed to lack of education, and beliefs and knowledge about CRC screening procedures. This study evaluated the effectiveness of the Caribe Colon inflatable colon model in two community events as an educational tool to increase CRC knowledge, awareness, and intention to undergo CRC screening. METHODS Participants (aged ≥ 40 years and with no previous CRC history) completed a pre- and post- questionnaire, and took the tour of the Caribe Colon. RESULTS After completing the tour, survey responses (n=154) revealed a significant increase in CRC knowledge and awareness (p<0.0001). Multivariable logistic regression models showed that fear of CRC screening procedures was the primary independent factor for not getting screened after adjusting for age, gender, education, regular visits to a primary care physician, insurance, and history of CRC screening (p=0.006). CONCLUSION Future studies should focus on understanding and reducing barriers to CRC screening including fear. Patients more knowledgeable about CRC screening procedures may have less fear for CRC screening. Furthermore, educational strategies need to be reinforced to reduce fear; this may lead to an increase in CRC screening rates among Hispanics.
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Affiliation(s)
- Gabriela M Portilla-Skerrett
- Faculty of Natural Sciences, University of Puerto Rico Río Piedras Campus, San Juan, PR; San Juan Bautista School of Medicine, Caguas, PR
| | - Yaritza Díaz-Algorri
- Master in Public Health Program, San Juan Bautista School of Medicine, Caguas, PR
| | - Marievelisse Soto-Salgado
- Department of Biochemistry, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, PR; Department of Health Services Administration, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR
| | - Marcia Cruz-Correa
- UPR Comprehensive Cancer Center, Division of Cancer Biology, San Juan, PR; Biochemistry and Surgery, Departments of Medicine, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, PR
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Farrell MM, Gibson KM, Marler A, Given L, Van Kirk Villalobos A, Maynard CD, Bright FS, Kirklin GT, Green TC, Ruhe M, Thorsness J, Weiss S. How the Comprehensive Cancer Control National Partnership shapes the public health workforce. Cancer Causes Control 2018; 29:1205-1220. [PMID: 30523508 DOI: 10.1007/s10552-018-1110-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 11/30/2018] [Indexed: 10/27/2022]
Abstract
This paper explores how, through its extensive network of partners, the Comprehensive Cancer Control National Partnership (National Partnership) has provided a robust array of trainings, learning institutes, webinars, workshops, mentorship programs, and direct technical assistance to comprehensive cancer control programs and coalitions over the past 20 years. Mapping these activities to specific cancer control competencies revealed that the efforts of the National Partnership adequately address the core competencies necessary for an effective workforce and have the potential to increase practitioner capacity to adopt and implement evidence-based cancer control programs. Ensuring the continued availability and uptake of these tools, trainings and partnerships could potentially address gaps and barriers in the public health workforce related to evidence-based practice.
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Affiliation(s)
| | - Kelsy M Gibson
- Centers for Disease Control and Prevention (CDC), Atlanta, USA
| | | | | | | | | | - Frank S Bright
- National Association of Chronic Disease Directors, Decatur, USA
| | | | | | - Melanie Ruhe
- National Association of County and City Health Officials, Washington, DC, USA
| | - Julia Thorsness
- The State of Alaska Comprehensive Cancer Control Program, Anchorage, USA
| | - Stephanie Weiss
- National Association of County and City Health Officials, Washington, DC, USA
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21
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Bednarczyk RA, Chamberlain A, Mathewson K, Salmon DA, Omer SB. Practice-, Provider-, and Patient-level interventions to improve preventive care: Development of the P3 Model. Prev Med Rep 2018; 11:131-138. [PMID: 30003011 PMCID: PMC6040109 DOI: 10.1016/j.pmedr.2018.06.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/28/2018] [Accepted: 06/14/2018] [Indexed: 12/19/2022] Open
Abstract
For adequate provision of preventive services, there is an interplay between activities at the healthcare practice, healthcare provider, and patient levels of the clinical encounter. Commonly used health promotion and behavior theoretical models address some of these three levels, but none fully account for all three. Building off of key components of many existing theoretical models, including the Health Belief Model, Theory of Planned Behavior/Theory of Reasoned Action, Social Cognitive Theory, Social Ecological Model, and the Systems Model of Clinical Preventive Care, we describe the development of the P3 (Practice-, Provider-, and Patient-level) Model for preventive care interventions. The P3 Model accounts for all three levels of the clinical encounter, and the factors that impact these levels, concurrently. This yields a model for preventive care that is applicable and adaptable to different settings, and that provides a framework for the development, implementation, and evaluation of preventive care promotion interventions. The applicability of the P3 Model is shown through two exemplar preventive care programs – immunization and colorectal cancer screening. The P3 Model allows interventions to be developed and evaluated in a modular approach, to allow more practical refinement and optimization of the intervention.
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Affiliation(s)
- Robert A Bednarczyk
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America.,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America.,Cancer Prevention and Control Program, Winship Cancer Institute, Emory University, Atlanta, GA, United States of America.,Emory Vaccine Center, Emory University, Atlanta, GA, United States of America
| | - Allison Chamberlain
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Kara Mathewson
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Daniel A Salmon
- Institute for Vaccine Safety, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
| | - Saad B Omer
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America.,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America.,Emory Vaccine Center, Emory University, Atlanta, GA, United States of America.,Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, United States of America
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22
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Abstract
Because of decreased access and dismal survival rates, strategies need to be developed to increase cancer awareness and facilitate cancer prevention, early detection, and screening activities within American Indian (AI) populations. The purpose of this study was to develop a locally tailored needs assessment to collect cancer prevention, control, and risk factor information and knowledge, attitude, and perceived behavior (hereafter referred to as "needs assessment") data from 500 community members living in 3 geographically diverse settings: the Southeastern USA, the Rocky Mountain region, and the Northern Plains. Needs assessment data helped identify local health priorities and create a pilot cancer prevention and early detection education intervention. There were two versions of common items of the instrument: short (~35 items) and long (55 items), and each partner added items that were recommended by their local AI Advisory Committee. Each partner collaborated with local AI organizations to identify and recruit participants at community venues. During the sessions, facilitators used Power Point® slides and ARS equipment and software to anonymously collect participants' responses. The partners collected needs assessment data from 677 community members over a 4-year period. Cancer education knowledge was low, barriers to accessing timely cancer screening and care services were excessive, tobacco use was excessive, and daily physical activity was insufficient for most participants. ARS was an effective way to collect needs assessment information. During discussions following the data collection, community members requested more cancer education opportunities, access to patient navigation services, and cultural competency training for healthcare providers.
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Affiliation(s)
- Linda Burhansstipanov
- Native American Cancer Research Corporation (NACR), 3022 South Nova Road, Pine, CO, 80470-7830, USA.
| | - Linda U Krebs
- Oncology Consultation, Education & Advocacy Network (OCEAN), 13323 W. Jewell Drive, Lakewood, CO, 80228-4221, USA
| | - Lisa Harjo
- Native American Cancer Research Corporation (NACR), 3022 South Nova Road, Pine, CO, 80470-7830, USA
| | | | - Judith Salmon Kaur
- Native American Programs, Spirit of EAGLES, Mayo Clinic, 200 First Street, Rochester, MN, 55905, USA
| | | | - Dewey Painter
- South East American Indian Council Inc. (SEAIC), 69 Copeland Street, Jacksonville, FL, 32204, USA
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Leyva B, Allen JD, Ospino H, Tom LS, Negrón R, Buesa R, Torres MI. Enhancing capacity among faith-based organizations to implement evidence-based cancer control programs: a community-engaged approach. Transl Behav Med 2017; 7:517-28. [PMID: 28733726 DOI: 10.1007/s13142-017-0513-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Evidence-based interventions (EBIs) to promote cancer control among Latinos have proliferated in recent years, though adoption and implementation of these interventions by faith-based organizations (FBOs) is limited. Capacity building may be one strategy to promote implementation. In this qualitative study, 18 community key informants were interviewed to (a) understand existing capacity for health programming among Catholic parishes, (b) characterize parishes' resource gaps and capacity-building needs implementing cancer control EBIs, and (c) elucidate strategies for delivering capacity-building assistance to parishes to facilitate implementation of EBIs. Semi-structured qualitative interviews were conducted. Key informants concurred about the capacity of Catholic parishes to deliver health programs, and described attributes of parishes that make them strong partners in health promotion initiatives, including a mission to address physical and mental health, outreach to marginalized groups, altruism among members, and existing engagement in health programming. However, resource gaps and capacity building needs were also identified. Specific recommendations participants made about how existing resources might be leveraged to address challenges include to: establish parish wellness committees; provide "hands-on" learning opportunities for parishioners to gain program planning skills; offer continuous, tailored, on-site technical assistance; facilitate relationships between parishes and community resources; and provide financial support for parishes. Leveraging parishes' existing resources and addressing their implementation needs may improve adoption of cancer control EBIs.
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Ramanadhan S, Davis MM, Armstrong R, Baquero B, Ko LK, Leng JC, Salloum RG, Vaughn NA, Brownson RC. Participatory implementation science to increase the impact of evidence-based cancer prevention and control. Cancer Causes Control 2018; 29:363-369. [PMID: 29417296 PMCID: PMC5858707 DOI: 10.1007/s10552-018-1008-1] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [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: 06/29/2017] [Accepted: 01/31/2018] [Indexed: 01/28/2023]
Abstract
It is critical to accelerate the integration of evidence-based programs, practices, and strategies for cancer prevention and control into clinical, community, and public health settings. While it is clear that effective translation of existing knowledge into practice can reduce cancer burden, it is less clear how best to achieve this. This gap is addressed by the rapidly growing field of implementation science. Given that context influences and is influenced by implementation efforts, engaging stakeholders in the co-production of knowledge and solutions offers an opportunity to increase the likelihood that implementation efforts are useful, scalable, and sustainable in real-world settings. We argue that a participatory implementation science approach is critical, as it supports iterative, ongoing engagement between stakeholders and researchers to improve the pathway between research and practice, create system change, and address health disparities and health equity. This article highlights the utility of participatory implementation science for cancer prevention and control research and addresses (a) the spectrum of participatory research approaches that may be of use, (b) benefits of participatory implementation science, and
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Affiliation(s)
- Shoba Ramanadhan
- Center for Community-Based Research, Dana-Farber Cancer Institute, 450 Brookline Ave, LW 601, Boston, MA, 02215, USA.
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
| | - Melinda M Davis
- Oregon Rural Practice-based Research Network, Department of Family Medicine and OHSU-PSU School of Public Health, Oregon Health & Sciences University, 3181 SW Sam Jackson Park Rd, Mail code L222, Portland, OR, 97239-3098, USA
| | - Rebecca Armstrong
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, VIC, 3010, Australia
| | - Barbara Baquero
- Department of Community and Behavioral Health, College of Public Health, University of Iowa Prevention Research Center, University of Iowa, 145 N. Riverside Drive, CPHB N418, Iowa City, IA, 52242, USA
| | - Linda K Ko
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Department of Health Services, University of Washington School of Public Health, 1100 Fairview Ave. N., M3-B232, Seattle, WA, 98109-1024, USA
| | - Jennifer C Leng
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Department of Medicine, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, New York, NY, 10017, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA
| | - Ramzi G Salloum
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, Clinical and Translational Research Building, 2004 Mowry Road, Suite 2243, PO Box 100177, Gainesville, FL, 32610-0177, USA
| | - Nicole A Vaughn
- Department of Health and Exercise Science, School of Health Professions, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA
- Department of Biomedical Sciences, Cooper University Medical School of Rowan University, Camden, NJ, USA
- Department of Family Medicine, Rowan University School of Medicine, Glassboro, NJ, USA
| | - Ross C Brownson
- Prevention Research Center in St. Louis, Brown School, Washington University, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
- Division of Public Health Sciences, Department of Surgery, Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University, St. Louis, MO, USA
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25
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Huang B, Pollock E, Zhu L, Athens JP, Gangnon R, Feuer EJ, Tucker TC. Ranking composite Cancer Burden Indices for geographic regions: point and interval estimates. Cancer Causes Control 2018; 29:279-87. [PMID: 29372360 DOI: 10.1007/s10552-018-1000-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 01/03/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE To develop a composite Cancer Burden Index and produce 95% confidence intervals (CIs) as measures of uncertainties for the index. METHODS The Kentucky Cancer Registry has developed a cancer burden Rank Sum Index (RSI) to guide statewide comprehensive cancer control activities. However, lack of interval estimates for RSI limits its applications. RSI also weights individual measures with little inherent variability equally as ones with large variability. To address these issues, a Modified Sum Index (MSI) was developed to take into account of magnitudes of observed values. A simulation approach was used to generate individual and simultaneous 95% CIs for the rank MSI. An uncertainty measure was also calculated. RESULTS At the Area Development Districts (ADDs) level, the ranks of the RSI and the MSI were almost identical, while larger variation was found at the county level. The widths of the CIs at the ADD level were considerably shorter than those at the county level. CONCLUSION The measures developed for estimating composite cancer burden indices and the simulated CIs provide valuable information to guide cancer prevention and control effort. Caution should be taken when interpreting ranks from small population geographic units where the CIs for the ranks overlap considerably.
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Kreuter MW, McQueen A, Boyum S, Fu Q. Unmet basic needs and health intervention effectiveness in low-income populations. Prev Med 2016; 91:70-75. [PMID: 27496395 PMCID: PMC5050133 DOI: 10.1016/j.ypmed.2016.08.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 04/20/2016] [Accepted: 08/02/2016] [Indexed: 12/29/2022]
Abstract
In the face of unmet basic needs, low SES adults are less likely to obtain needed preventive health services. The study objective was to understand how these hardships may cluster and how the effectiveness of different health-focused interventions might vary across vulnerable population sub-groups with different basic needs profiles. From June 2010-2012, a random sample of low-income adult callers to Missouri 2-1-1 completed a cancer risk assessment and received up to 3 health referrals for needed services (mammography, pap testing, colonoscopy, HPV vaccination, smoking cessation and smoke-free home policies). Participants received either a verbal referral only (N=365), verbal referral+tailored print reminder (N=372), or verbal referral+navigator (N=353). Participants reported their unmet basic needs at baseline and contacts with health referrals at 1-month post-intervention. We examined latent classes of unmet basic needs using SAS. Logistic regression examined the association between latent classes and contacting a health referral, by intervention condition. A 3 class solution best fit the data. For participants with relatively more unmet needs (C2) and those with money needs (C3), the navigator intervention was more effective than the tailored or verbal referral only conditions in leading to health referrals contacts. For participants with fewer unmet basic needs (C1), the tailored intervention was as effective as the navigator intervention. The distribution and nature of unmet basic needs in this sample of low-income adults was heterogeneous, and those with the greatest needs benefitted most from a more intensive navigator intervention in helping them seek needed preventive health services.
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Affiliation(s)
- Matthew W Kreuter
- Washington University, School of Social Work, Campus Box 1196, 1 Brookings Dr., St. Louis, MO 63130, United States.
| | - Amy McQueen
- Washington University, School of Medicine, Campus Box 8005, 4523 Clayton Ave., St. Louis, MO 63110, United States.
| | - Sonia Boyum
- Washington University, School of Social Work, Campus Box 1196, 1 Brookings Dr., St. Louis, MO 63130, United States.
| | - Qiang Fu
- Saint Louis University, College for Public Health and Social Justice, Salus Center Room 480, 3545 Lafayette Ave., St. Louis, MO 63104, United States.
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Thompson VLS, Drake B, James AS, Norfolk M, Goodman M, Ashford L, Jackson S, Witherspoon M, Brewster M, Colditz G. A Community Coalition to Address Cancer Disparities: Transitions, Successes and Challenges. J Cancer Educ 2015; 30:616-22. [PMID: 25351452 PMCID: PMC4416074 DOI: 10.1007/s13187-014-0746-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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: 05/10/2023]
Abstract
Community-based participatory (CBP) strategies are considered important to efforts to eliminate disparities. This paper outlines how the Program for the Elimination of Cancer Disparities (PECaD) uses CBP strategies as a part of a long-term cancer education, prevention, and control strategy in an urban community. Community partnerships have proved to be vital resources to inform PECaD's agenda and the research practice of academic partners. We begin with a description of PECaD governance and partnership structures. The paper then describes programmatic activities and successes, including efforts to monitor clinical trials, deployment of mammography resources, anti-smoking, and prostate and colorectal cancer (CRC) screening education. The influence of changes in funding priorities, preventive screening policy, and community partner development on the partnership process over time is discussed. PECaD community partners have grown and expanded beyond the Program's mission and developed additional partnerships, resulting in a reevaluation of relationships. The impact of these external and internal changes and pressures on the partnerships are noted. The evolution of the evaluation process and what it has revealed about needed improvements in PECaD activities and operations is presented. A summary of the lessons learned and their implications for CBP practice are provided.
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Affiliation(s)
- Vetta L Sanders Thompson
- Public Health Program, Brown School, Washington University, One Brookings Drive, CB 1196, St. Louis, MO, 63130, USA.
| | - Bettina Drake
- Department of Surgery, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
- Siteman Cancer Center, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Aimee S James
- Department of Surgery, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
- Siteman Cancer Center, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Monique Norfolk
- Siteman Cancer Center, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Melody Goodman
- Department of Surgery, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
- Siteman Cancer Center, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Leon Ashford
- PECaD Disparities Elimination Advisory Board, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Sherrill Jackson
- PECaD Disparities Elimination Advisory Board, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Miranda Witherspoon
- PECaD Disparities Elimination Advisory Board, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Mikki Brewster
- PECaD Disparities Elimination Advisory Board, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Graham Colditz
- Department of Surgery, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
- Siteman Cancer Center, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
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Abstract
Traditionally, postdoctoral training programs largely have focused efforts within a single discipline or closely related fields. Yet, addressing the complex questions around cancer prevention and control increasingly requires the ability to work and communicate across disciplines in order to gain a perspective that encompasses the multilevel and multifaceted issues involved with this public health issue. To address this complexity, a transdisciplinary training program was implemented to cultivate the professional and scientific development of the postdoctoral fellows in Washington University in St Louis School of Medicine's Division of Public Health Sciences and NCI-funded centers (Community Networks Program Center and Transdisciplinary Research in Energetics in Cancer Center). Fellows are matched with primary mentors and assemble a multidisciplinary mentoring team. Structured programs support the transition of fellows from disciplinary trainees to independent transdisciplinary scholars and provide exposure to multiple disciplines. This article describes the training program, challenges encountered in implementation, solutions to those problems, and the metrics employed to evaluate the program's success. The goal of the program is to train emerging investigators in the conceptual bases, language, and practices that underlie a transdisciplinary perspective on cancer prevention and control research, to create an infrastructure for continued cross-discipline dialogue and collaboration, and to develop disseminable strategies for such training.
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Affiliation(s)
- Aimee S James
- Division of Public Health Sciences, Department of Surgery, Washington University in Saint Louis, 660 So. Euclid Ave, Box 8100, St Louis, MO, 63110, USA.
| | - Sarah Gehlert
- Division of Public Health Sciences, Department of Surgery, Washington University in Saint Louis, 660 So. Euclid Ave, Box 8100, St Louis, MO, 63110, USA
- The Brown School, Washington University in Saint Louis, Campus Box 1196, One Brookings Drive, St Louis, MO, 63130, USA
| | - Deborah J Bowen
- Department of Bioethics and Humanities, University of Washington, 1107 NE 45th street, Seattle, WA, 98105, USA
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University in Saint Louis, 660 So. Euclid Ave, Box 8100, St Louis, MO, 63110, USA
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29
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Davis SN, Sutton SK, Vadaparampil ST, Meade CD, Rivers BM, Patel MV, Torres-Roca JF, Heysek RV, Spiess P, Pow-Sang J, Jacobsen PB, Gwede CK. Informed decision making among first-degree relatives of prostate cancer survivors: a pilot randomized trial. Contemp Clin Trials 2014; 39:327-34. [PMID: 25465497 DOI: 10.1016/j.cct.2014.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 07/25/2014] [Revised: 10/10/2014] [Accepted: 10/10/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND First degree relatives (FDRs) of men diagnosed with prostate cancer (PCa) are at increased risk for developing the disease, due in part to multiple concurrent risk factors. There is a lack of innovative targeted decision aids to help FDRs make an informed decision about whether or not to undergo PCa screening. PURPOSE This randomized pilot trial evaluated the efficacy of a targeted PCa screening decision aid in unaffected FDRs of PCa survivors. METHODS Seventy-eight Black and White FDRs were randomized to one of two decision aid groups; 39 to a FDR-targeted decision aid and 39 to a general decision aid. The targeted decision aid group received a general PCa decision aid booklet plus a newly developed decision aid DVD targeted specifically for FDRs. PCa screening decision outcomes included knowledge, decisional conflict, distress, and satisfaction with screening decision. Outcomes were assessed at baseline and 4 weeks after baseline. RESULTS There were no differences by intervention group for knowledge, decisional conflict, distress, or satisfaction with screening decision (p>0.05). However, men in both groups had significant increases in knowledge and decreases in decisional conflict (p<0.001). These changes were most pronounced (p<0.05) for younger men compared to older men. CONCLUSION Results suggest that general and targeted information can play an important role in increasing knowledge and decreasing decisional conflict among FDRs. Additional research is needed to identify subgroups of men who benefit the most and better understand the outcomes of a screening decision aid among diverse samples of FDRs.
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Affiliation(s)
- Stacy N Davis
- 1902 Magnolia Drive, MRC-CANCONT, Moffitt Cancer Center, Tampa, FL 33612, United States.
| | - Steven K Sutton
- 1902 Magnolia Drive, MRC-CANCONT, Moffitt Cancer Center, Tampa, FL 33612, United States; Department of Oncologic Sciences, University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd., MDC 44, Tampa, FL 33612, United States.
| | - Susan T Vadaparampil
- 1902 Magnolia Drive, MRC-CANCONT, Moffitt Cancer Center, Tampa, FL 33612, United States; Department of Oncologic Sciences, University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd., MDC 44, Tampa, FL 33612, United States.
| | - Cathy D Meade
- 1902 Magnolia Drive, MRC-CANCONT, Moffitt Cancer Center, Tampa, FL 33612, United States; Department of Oncologic Sciences, University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd., MDC 44, Tampa, FL 33612, United States.
| | - Brian M Rivers
- 1902 Magnolia Drive, MRC-CANCONT, Moffitt Cancer Center, Tampa, FL 33612, United States; Department of Oncologic Sciences, University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd., MDC 44, Tampa, FL 33612, United States.
| | - Mitul V Patel
- 1902 Magnolia Drive, MRC-CANCONT, Moffitt Cancer Center, Tampa, FL 33612, United States.
| | - Javier F Torres-Roca
- 1902 Magnolia Drive, MRC-CANCONT, Moffitt Cancer Center, Tampa, FL 33612, United States; Department of Oncologic Sciences, University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd., MDC 44, Tampa, FL 33612, United States.
| | - Randy V Heysek
- 1902 Magnolia Drive, MRC-CANCONT, Moffitt Cancer Center, Tampa, FL 33612, United States; Department of Oncologic Sciences, University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd., MDC 44, Tampa, FL 33612, United States.
| | - Philippe Spiess
- 1902 Magnolia Drive, MRC-CANCONT, Moffitt Cancer Center, Tampa, FL 33612, United States; Department of Oncologic Sciences, University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd., MDC 44, Tampa, FL 33612, United States.
| | - Julio Pow-Sang
- 1902 Magnolia Drive, MRC-CANCONT, Moffitt Cancer Center, Tampa, FL 33612, United States; Department of Oncologic Sciences, University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd., MDC 44, Tampa, FL 33612, United States.
| | - Paul B Jacobsen
- 1902 Magnolia Drive, MRC-CANCONT, Moffitt Cancer Center, Tampa, FL 33612, United States; Department of Oncologic Sciences, University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd., MDC 44, Tampa, FL 33612, United States.
| | - Clement K Gwede
- 1902 Magnolia Drive, MRC-CANCONT, Moffitt Cancer Center, Tampa, FL 33612, United States; Department of Oncologic Sciences, University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd., MDC 44, Tampa, FL 33612, United States.
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