Behavioral and Social Science最新文献

{"title":"Abstract B16: Potential challenges and strategies for working with community cancer advocates in a rural population","authors":"Katelyn Schifano","doi":"10.1158/1538-7755.DISP17-B16","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-B16","url":null,"abstract":"Introduction: The Breast Health Research Champion (BHRC) program was developed in order to train breast health advocates in the community on breast health basics, clinical trials, and biospecimen donations. Data collection is underway for the 4th cohort, and focuses on the rural area of Lawrenceville, Virginia. Lawrenceville is a part of Brunswick County, which is a large county encompassing 569 square miles and a population of 16,500 persons. This is the second cohort involving rural communities. When working with small, tight-knit communities, we have encountered some challenges and have developed methods/strategies to address them. Methods: From experiences in a past rural cohort, several adaptations were made in the program in order to ensure success. These minor adaptations were developed in conjunction with community facilitators from the target area. Conversations were held throughout the facilitator training sessions, encouraging facilitators to problem-solve potential issues in order to assist in preparing for the program. Although the changes are small, it is thought that the adjustments made created a more engaged, sustainable relationship between researchers, community partners, and community members. Summary: The community partner identified two women from different geographic areas in the large county of Brunswick. This served multiple purposes; it helped reduce the burden on any one community member, and it increased the areas that participants were recruited from. The recruitment from various areas was critical as it provided a greater impact of the key messages of the program going out into the community. Particularly in the rural areas, we have found that communication from a community facilitator as opposed to research staff is crucial for engaging individuals. Participants were more likely to attend sessions and continued education when contacted by the community facilitator. The facilitators also identified alternate options to engage participants who were unable to travel or attend a session. iPads were used to record videos from education sessions in order to facilitate their understanding. Internet connectivity is not readily available in this area; however, the community partner was able to provide space for additional viewing sessions with Internet access. Another challenge we encountered was a lack of healthy foods available for the sessions. Facilitators worked with local community members to plan menus and prepare healthy food options for the sessions. Conclusion: Engaging communities in research involves flexibility and a multifaceted approach. When preparing for community-involved research, make sure community members understand that challenges will be encountered, but research staff are there to troubleshoot issues that arise. Open and honest communication with community partners about past challenges and listening to their suggestions for improvements are crucial for successful engagement in rural communities. The","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115331531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract B17: Effects of promotores-led small-group education on colorectal cancer knowledge among underserved Hispanics","authors":"K. Briant, Janeth I. Sanchez, Monica Escareño, Virginia J. Gonzalez, B. Thompson","doi":"10.1158/1538-7755.DISP17-B17","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-B17","url":null,"abstract":"Background: Great strides in cancer prevention and early detection have led to a decrease in colorectal cancer (CRC) incidence and mortality (Zauber, 2015). Nevertheless, CRC continues to be a leading cause of cancer-related deaths among men and women aged 50 and older in the US and Washington State (WA) (ACS, 2013; WA DOH, 2013). CRC disparities also continue to persist with regard to access to timely and effective cancer education and screening among minority and underserved populations (CDC, 2013; Tammana, 2014). The lower Yakima Valley of WA is a very rural, poor, and medically underserved area where a high proportion of Hispanics reside. Data from the Behavioral Risk Factor Surveillance System demonstrate that CRC screening rates in Yakima (79.87%), Franklin (75.03%), and Benton counties (79.46%) are lower than the WA screening rate (81.25%) (WA DOH, 2014). Thus, CRC screening promotion efforts in the lower Yakima Valley are of high importance. In this study, we used promotores to deliver the Colorectal Cancer 101 curriculum at “home health parties.” The aim of this study was to assess changes in CRC knowledge and intent to screen for CRC among Hispanics in the Yakima Valley. Methods: A pre- and post-test study design was used to assess changes in knowledge, attitudes, and beliefs around CRC and screening at baseline and at 3-month follow-up after receipt of a promotores-led home-based educational intervention. We recruited participants at local community events, through flyers, and snowball sampling. CRC home health parties were conducted in English and Spanish by bilingual-trained promotores between March and September 2012. Results: A total of 129 participants completed a pre/post assessment. Majority of participants were Hispanic (98.4%), female (73.4%), and had less than a high school education (86.0%). Although 72.1% had a regular doctor and 95.3% had a regular health clinic, only 50% reported having health insurance. Preliminary results show that at baseline, less than 40% of the participants reported having a physician recommend and discuss CRC screening, while 54.4% indicated thinking about going to a physician or clinic to receive CRC screening. Overall, 62% of the respondents stated having heard of the stool test, 55% had received a stool test in the past, and 63% reported considering obtaining a stool test within the next three months. Approximately 62% had heard of a colonoscopy or sigmoidoscopy; 37.4% had received such a test in the past and 36% were considering obtaining a colonoscopy or sigmoidoscopy within the next three months. At baseline, participants reported intent to discuss CRC screening with others (family members = 34.4%; friends = 40.3%). Conclusion: We hypothesize that using promotores to deliver CRC information: 1) is a culturally relevant way to increase knowledge about CRC and awareness of CRC screening, and 2) will result in increased intention to talk to others about CRC. Pre/post-test comparisons regarding C","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116034958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract C23: Patterns of employment and income losses among adults with differing levels of wealth following a cancer diagnosis","authors":"Margaret G. Tebbs, S. Nikpay, Emily H. Castellanos","doi":"10.1158/1538-7755.DISP17-C23","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-C23","url":null,"abstract":"Background: Cancer survivors often face economic hardships resulting from employment changes and rising out-of-pocket health care expenses. Financial strain among cancer survivors is associated with worse clinical outcomes and poorer quality of life. The protective factors against employment and income losses among cancer survivors are not well established. Objectives: To assess the economic impact of cancer diagnosis among survivors with varying degrees of financial leverage; to determine the relationship between marital status and economic outcomes following diagnosis. Methods: This study used data from the 1985 to 2013 waves of the Panel Study of Income Dynamics, a nationally representative, longitudinal survey of economic circumstances. Data are collected through annual (prior to 1999) and biennial (after 1999) household interviews. Health information, including a history of cancer, was added to the survey in 1999 and our analytic sample included 1,235 cancer survivors. Individuals were stratified based on marital status and wealth status ( $110,000) prior to a cancer diagnosis. Wealth-stratified means and medians for employment status, hours worked, individual earnings, and total family income were calculated 2 years prior to diagnosis as well as 1 and 2 years after diagnosis. Results: Employment status changes one year after diagnosis were similar among the three wealth groups, each dropping by 8% (low wealth p=0.09, medium and high wealth p $110,000 saw the sharpest declines in yearly earnings, with the mean decreasing by $5,959 (p Conclusions: Factors such as marital status and higher wealth status appear to be protective against losses of income or employment, allowing households to compensate for financial stress. In contrast, low-wealth individuals with less financial leverage return to work sooner than their higher-wealth counterparts. Racial and ethnic differences associated with lower wealth may contribute to disparities in survival outcomes. Citation Format: Margaret Tebbs, Sayeh Nikpay, Emily H. Castellanos. Patterns of employment and income losses among adults with differing levels of wealth following a cancer diagnosis [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C23.","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"447 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116562836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract C18: [Advocate Abstract:] The job or work of being a cancer patient: How to advocate for yourself and a loved one","authors":"R. H. Gelb","doi":"10.1158/1538-7755.DISP17-C18","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-C18","url":null,"abstract":"The Job or Work of Being a Cancer Patient is the most important job a cancer patient will ever have; their life depends on it! The Job or Work entails learning how to acquire complicated scientific cancer information, becoming skilled at communicating, negotiating and problem-solving with a family, health care providers, insurance and pharmaceutical companies, government agencies and other cancer patients. Personal Advocacy: is about taking charge of your disease/illness and your life; includes learning how to do research on your cancer diagnosis in order to gather information about the disease/illness. Personal observations: importance of Developing a Relationship with your physicians where you are comfortable and able to have conversations about the following: a. Medical narrative: domain of diagnosis, treatment and cures, i.e., of symptoms, tests, diet, and medications; but equally important. b. Be able to identify Illness Beliefs and the role they play in a cancer patient9s management of their illness; understand the difference between c. Constraining Illness Beliefs, beliefs that negatively impact and limit the cancer patient9s management of his/her disease and illness. Citation Format: Richard H. Gelb. [Advocate Abstract:] The job or work of being a cancer patient: How to advocate for yourself and a loved one [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C18.","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127551958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract C27: Socioeconomic status and racial differences in utilization of inpatient versus outpatient hysterectomy","authors":"Z. Bahrani-Mostafavi, L. Huber, S. Shahbazi, Pourya Naderi-Yeganeh","doi":"10.1158/1538-7755.DISP17-C27","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-C27","url":null,"abstract":"Introduction: Hysterectomy is the second most common surgical procedure performed among reproductive aged women. The primary reason for hysterectomy among women 35-54 years is uterine fibroids; for older women the most common reasons are uterine prolapse or most gynecologic (GYN) cancers. According to the National Center for Health Statistics, an estimated 600,000 hysterectomies are performed annually in the U.S. with an annual cost of $5 billion, which makes hysterectomy a major public health concern. Moreover, hysterectomy is costly, with mean total patient costs of $30,000-45,000--depending on hysterectomy type, operative time, and the length of stay. The objective of this study is to identify the patient-level predictors of hysterectomy surgical approaches (inpatient [IP] vs. outpatient [OP]). Methods: We used 2010-2012 Florida State Inpatient Database (SID) and State Ambulatory Surgery Database (SASD) of the Healthcare Cost and Utilization Project. Using ICD-9 and CPT coding systems, we restricted our study population (n=111,241) to those women who had hysterectomy procedures. Hysterectomies (IP and OP) were also stratified by type of procedure including abdominal (ABH), vaginal (VAH), and laparoscopic (LAH). Patient-level factors associated with the use of IP and OP hysterectomy were identified by chi-square test. Logistic regression analyses were used to identify independent predictors of hysterectomy surgical approaches. Statistical analysis was conducted using SAS Version 9.4. Results: The study population included women who underwent an IP or OP hysterectomy. About 70% of patients had IP hysterectomy, among which ABH was the most common procedure (47.02%). Among IP hysterectomy cases, higher percentage of patients was between 40-65 years of age (66.27%), white (61.95%), had private insurance (56.10%), and belonged to the lowest-income-level families (32.54%). The most common procedure among OP hysterectomy cases was LAH (87.70%). Among OP hysterectomy cases, higher percentage of patients was between 40-65 years of age (73.31%), white (70.30%), had private insurance (74.82%), and belonged to the third quartile of income level (32.85%). Logistics regression results indicate that Hispanic race, levels of income, older age, and pay categories (any other than Medicare, Medicaid, and private insurance) are statistically significant factors (p Conclusions: We found that ABH is the common hysterectomy type among patients who underwent an IP hysterectomy, while LAH is the common procedure for IP hysterectomies. The majority of hysterectomy patients (both IP and OP) were white, older adults, and those with private insurance. However, IP patients were from lowest-income-level families while OP patients were belonged to higher-income-level families. The findings suggest that OP facilities, although more available and affordable, are not commonly used by Medicare/Medicaid holders or by non-white women. Findings from this study highlight the importan","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126571332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract C20: Financial strain in people struggling with health care costs","authors":"S. Humble, A. McQueen, Marquita W. Lewis, J. Hunleth, Natasan McCray, Amanda A. Lee, Miquela Ibrao, A. James","doi":"10.1158/1538-7755.DISP17-C20","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-C20","url":null,"abstract":"Background: Financial distress and financial strain have received increasing attention in the health disparities literature. This is partly because the costs of some illnesses, such as cancer, can lead to “financial toxicity.” It is also because some health care costs, from screening/diagnosis to treatment, are unaffordable to many patients. Cost concerns are a commonly mentioned barrier to adherence, but affordability and financial strain have remained underexamined in the public health and medical literatures. As a result, there are no standard measurement strategies. In an ongoing study, we aim to disentangle elements of financial strain, develop a comprehensive assessment of strain, and then examine how strain affects health care choices including adherence to medical recommendations. Methods: We reviewed the literature to compile measures of financial strain and financial distress. We then conducted 26 cognitive interviews to pretest the questions with community members. We sought to develop a set of items that were sensitive to respondents9 life contexts (e.g., avoid questions about vacations). Survey questions were iteratively deleted and revised based on participant feedback. Participants9 responses indicated that some financial experiences were not captured, so we added questions to address the omissions. Then, we recruited participants through newspaper ads and a Federally Qualified Health Center for the final interviewer-administered questionnaire. Data were collected on tablets for direct input into REDCap. To describe financial strain, we conducted descriptive analyses. Results: Our analysis is based on the first 169 survey participants (51% female; 82% African American; mean age = 56) in our ongoing study. Few (9%) had private insurance, 15% had no insurance, and 22% were uninsured but enrolled in a local health care coverage program. We asked about a range of financial strains. Many participants (63%) had outstanding medical bills (34% of whom owed > $5000). In the past year, many (>50%) had a bill that was past due, had paid the minimum on a utility bill, or paid a utility bill late in the last year; fewer had their utilities (20%) or phone (40%) cut off. Participants commonly reported that in the last year, they very often (31%) or fairly often (33%) did not have enough money for the things they needed. In particular, 30% said they could not currently afford a suitable place to stay, 64% could not afford suitable clothing, and 76% could not afford an adequate car or other form of transportation. About half of respondents said they sometimes, most of the time, or always ran out of food by the end of the month. Unexpected expenses were a concern for participants: nearly half said they did not have enough money to pay for a minor emergency, and 40% had “no confidence” that they could pay for an emergency of $300. Some had people they could go to if they were “short on funds,” but just as many said others asked them for money. Financ","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127925701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract B22: Trends in mammography utilization at a safety net breast cancer screening center","authors":"B. Oppong, Holly S. Greenwald, C. Dash, K. Makambi, Tesha Coleman, L. Adams-Campbell","doi":"10.1158/1538-7755.DISP17-B22","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-B22","url":null,"abstract":"Background: Breast cancer screening uptake patterns vary based on race and ethnicity, insurance status, socioeconomic status, and age. Among uninsured and resource-poor populations, community-based safety net clinics have emerged as important providers of these breast cancer screening services. The Capital Breast Care Center (CBCC) was established in 2004 to deliver breast and cervical cancer screening to all women in the District of Columbia (DC) metropolitan region. CBCC serves a large Black and Hispanic population with representation of many diverse ethnic groups within these racial categories. Here, we examine the population of women presenting to CBCC for screening mammograms from 2010 to 2016, evaluating patterns of changes in utilization of the services along sociodemographic and economic lines among the women. Methods: Prospectively collected demographic data were abstracted from the electronic medical records including age, race, menopausal status, insurance status, highest education attainment, and screening outcome. Percentages of women who sought mammography screening were computed for each year by categories of selected characteristics. Time trends in screening were tested with the Cochran-Armitage trend test. Results: From 2010 to 2016, 8448 women were screened at CBCC with 106 diagnoses of breast cancer. African-American and Hispanic women accounted for about 90%. Trends in the racial/ethnic composition of the women screened shifted, with African American women decreasing while the proportion of Latina patients increased (p-value Conclusion: In this analysis of asymptomatic women presenting for breast cancer screening, over a 7-year period there were significant trends in an increase in Hispanic women, those residing in Virginia, and those screened using the NBCCEDP. These analyses of the population of women selecting CBCC for mammography screening may reflect both local and national demographic shifts. Assessment of patient trends can improve preventative/public health efforts and intervention services offered at community clinics. Citation Format: Bridget A. Oppong, Holly Greenwald, Chiranjeev Dash, Kepher Makambi, Tesha Coleman, Lucile Adams-Campbell. Trends in mammography utilization at a safety net breast cancer screening center [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B22.","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132856538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract C04: Impact of a Minority Prostate Cancer (MiCaP) Research Digest in translating scientific discovery into public health and community applications","authors":"F. Odedina, K. Walsh-Childers, M. Young, G. Dagne, Janice L. Krieger, E. Kaninjing, N. Askins","doi":"10.1158/1538-7755.DISP17-C04","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-C04","url":null,"abstract":"Background and Objective: Although prostate cancer (CaP) mortality and morbidity have declined since the 1990s, Black men (BM) are still disproportionately affected by CaP. It will take a concerted and inventive effort to address the burden of CaP in BM. A unique approach that is of significant interest to our team is increased access to life-changing, scientific CaP discoveries for BM, especially those with implications for primary and secondary preventive interventions. The primary objective of this study was to develop a research dissemination program, the Minority Prostate Cancer (MiCaP) Research Digest, which will spread information about CaP scientific discoveries, evidence-based interventions, and open clinical trials instantly among BM. We hypothesized that knowledge, attitude, perceived behavioral control, cues to action, and risk-reduction and prevention behaviors will be higher among the users of the MiCaP Research Digest compared to nonusers. Methodology: The development of the MiCaP Research Digest was guided by valid behavioral and health communication models and based on an understanding of the scientific information needs of BM. The targeted population was BM between the ages of 35 and 70 years. The research setting was in Florida. We employed focus groups and individual interviews to plan and select the strategy, channel, and material for the digest. Subsequently, the communication strategy statement was used to develop message concepts and materials. A cross-sectional pre- post study design was employed to establish the efficacy of the Digest among 33 BM. Results: The Digest comprised a one-page public abstract and a 7-minute video that includes: (1) Digest Minute sound bite by the author; (2) 4-minute discussion with the author taking questions from a CaP advocate and a peer scientist; (3) Digest Minute recap by the scientist and advocate; and (4) a clinical trial opportunity session. The first volume focused on “Prostate tumor gene expression in Black men.” Majority of the 33 participants who previewed the Digest were native-born BM, between 60 and 69 years, had college degrees, were married, and had full-time employment. Based on McNemar9s test results of pre- and post-assessments, there was significant improvement in the knowledge and self-efficacy of participants. In rating the Digest, 100% of participants were satisfied with it, 96% rated the digest information as satisfactory, 87% rated it as better than expected, and 97% rated the quality as high. Participants9 written feedback was also very positive. Conclusion: Although many biomedical research projects are funded through public dollars, oftentimes the scientific discoveries from the projects are inaccessible for the public. This is especially disconcerting when such discoveries can have immediate impact on a disease that disproportionately affects a specific population, Black men (BM). The MiCaP Research Digest provides a vehicle for BM to access high-impact CaP scien","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131533519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract A20: Hispanic patient navigation: An intervention to increase clinical trial participation","authors":"Carla Strom, K. Weaver, J. Ruiz, K. Winkfield","doi":"10.1158/1538-7755.DISP17-A20","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-A20","url":null,"abstract":"Background: Hispanics are the fastest-growing population in North Carolina and have unique health care needs related to culture and language. To meet their needs and address the historically low participation in cancer clinical trials, we developed a bilingual Hispanic Clinical Trial Navigator (HCTN) position to support Hispanic adult and pediatric patients treated at Wake Forest Baptist Comprehensive Cancer Center (WFBCCC). The HCTN is a novel approach to integrate culturally and linguistically competent navigation with support around clinical trial decision making. The purpose of this analysis was to evaluate the services provided during the program9s first year and its impact on clinical trial participation. Methods: Retrospective data from 11/1/2015 to 10/31/2016 were obtained from a navigation database, WFBCCC cancer registry, and clinical trial system. Data are reported in the aggregate, and clinical trial participation rates were compared to data prior to the hiring of the HCTN (11/1/2014-10/31/2015). Results: There were 108 pediatric and adult patients navigated during the first year; 55 breast screening/diagnostic and 53 cancer treatment. The majority of patients were female (87%) with a mean age of 45 years. The most common diagnoses among treatment patients were breast (47%), hematologic (34%), and gastrointestinal (6%) malignancies. Major patient barriers identified include treatment logistics/transportation (87%), financial/insurance (70%) information/education (55%), and continuity of care (53%). In addition to education and referrals, the HCTN was able to remove potential barriers to trial participation through transportation assistance (31%), meal vouchers (21%), and parking validation (40%). In the year prior to the HCTN there were 88 newly diagnosed Hispanic patients with a clinical trial participation rate of 20% in treatment/non-treatment intervention studies. With HCTN navigation, clinical trial participation among Hispanic patients navigated was 34%. Conclusions: Our data indicate an initial success in increasing Hispanic participation in cancer clinical trials utilizing an HCTN. Navigation is now available in a majority of community cancer centers and is used as an opportunity to provide culturally and linguistically appropriate patient support around cancer and clinical trials. Placing HCTNs in cancer treatment settings could be a cost-effective and efficient method of providing navigation, while also facilitating state-of-the-art care through clinical trials. Opportunities exist for additional studies of navigation to increase clinical trial participation in underserved populations. Citation Format: Carla Strom, Kathryn E. Weaver, Jimmy Ruiz, Karen M. Winkfield. Hispanic patient navigation: An intervention to increase clinical trial participation [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; At","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133886153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract A23: Interim Recruitment Outcomes in an NCORP-Based Patient Navigation Trial for African Americans with Early Stage Lung Cancer","authors":"M. Ford, D. C. Bryant, Kathleen B. Cartmell, Katherine R. Sterba, Dana R. Burshell, E. Hill, A. D. Toma, K. Knight, K. Weaver, E. Calhoun, N. Esnaola","doi":"10.1158/1538-7755.DISP17-A23","DOIUrl":"https://doi.org/10.1158/1538-7755.DISP17-A23","url":null,"abstract":"Background: Enrollment of early-stage lung cancer patients to randomized trials has historically been challenging. The STARS Trial enrolled 36 of 1,030 intended patients from 28 sites, while the ROSEL Trial recruited 22 of 960 intended patients from 10 sites. Unfortunately, evidence shows African Americans with early-stage non-small cell lung cancer (NSCLC) are significantly less likely than their European American counterparts to undergo resection and may also be less likely to participate in lung cancer trials as well. Purpose: The purpose of this research is to describe interim recruitment results from an NIMHD-funded, NCI NCORP-based patient navigation trial conducted with African Americans with early-stage, probable/proven NSCLC. Design: The protocol-driven, barriers-focused patient navigation intervention is being conducted in the context of a two-arm cluster-randomized trial testing the effectiveness of the intervention in increasing rates of lung-directed curative-intent therapy (surgery and SBRT) in African Americans with Stage I-II NSCLC. The two study arms consist of the protocol-driven, intensive navigation intervention vs. usual care. The trial includes 24 study sites in 13 U.S. states. Specific activities to enhance recruitment in the present trial include reaching out to referring physicians (e.g., primary care, pulmonologists, radiologists) to increase referrals of African American patients to the participating NCORP sites, and partnering with the leaders of community-engagement activities at the sites to raise community-level awareness of the trial. Results/Conclusions: To date, 90 African American patients have been recruited and the trial is now on target to meet its expected accrual goal of 200 patients. The majority of potential participants were ineligible due to receipt of surgical resection or radiation therapy prior to enrollment (27%), not having been told that they had probable/proven NSCLC prior to study contact (32%), or a previous history of lung cancer (10%). Only 13 potential participants have refused trial participation. The median age of the 90 participants is 66 years (range 51-86 years). Most are unmarried (64%) and have a high school diploma or less (73%). Only 10 of the participants (24%) have no comorbidities. The number of enrolled-to-date African American participants in this ongoing trial exceeds the total number of participants recruited to the STARS Trial or to the ROSEL Trial. Citation Format: Marvella E. Ford, Debbie C. Bryant. Kathleen B. Cartmell, Katherine Sterba, Dana R. Burshell, Elizabeth G. Hill, Allan De Toma, Kendrea D. Knight, Kathryn Weaver Elizabeth Calhoun, Nestor F. Esnaola. Interim Recruitment Outcomes in an NCORP-Based Patient Navigation Trial for African Americans with Early Stage Lung Cancer [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philad","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"503 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131477925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}