NAU publications by CHER
Faculty & staff publications
NAU faculty and staff have the opportunity to publish their findings and knowledge as authors. CHER has many researchers that have been cited multiple times in major publications for their great work. The Center for Health Equity Research has accumulated all faculty publications into one, easy to navigate database.
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Armin, Julie S; Williamson, Heather J; Rothers, Janet; Lee, Michele S; Baldwin, Julie A JMIR Research Protocols, 12 (e37801), 2023. @article{Armin2023, title = {An adapted cancer screening education program for Native American women with intellectual and developmental disabilities and their caregivers: Protocol for feasibility and acceptability testing}, author = {Julie S Armin and Heather J Williamson and Janet Rothers and Michele S Lee and Julie A Baldwin }, url = {https://www.researchprotocols.org/2023/1/e37801}, doi = {10.2196/37801}, year = {2023}, date = {2023-02-13}, journal = {JMIR Research Protocols}, volume = {12}, number = {e37801}, abstract = {Women with intellectual and developmental disabilities (IDD) do not undergo breast and cervical cancer screening at the same rate as women without IDD. IDDs are diagnosed in childhood, are lifelong, and involve difficulties in adaptive behaviors and intellectual functioning. Native American women also experience disparities in breast and cervical cancer screenings. Despite known disparities, women with IDD are often not included in health promotion programs, and there is a need for evidence-based programming for those with intersectional identities, such as Native American women with IDD. This study aims to assess the feasibility and acceptability of My Health My Choice (MHMC), an adaptation of the Women Be Healthy 2 program. There are 2 parts to the study: adaptation of the Women Be Healthy 2 program and feasibility and acceptability testing of MHMC.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Women with intellectual and developmental disabilities (IDD) do not undergo breast and cervical cancer screening at the same rate as women without IDD. IDDs are diagnosed in childhood, are lifelong, and involve difficulties in adaptive behaviors and intellectual functioning. Native American women also experience disparities in breast and cervical cancer screenings. Despite known disparities, women with IDD are often not included in health promotion programs, and there is a need for evidence-based programming for those with intersectional identities, such as Native American women with IDD. This study aims to assess the feasibility and acceptability of My Health My Choice (MHMC), an adaptation of the Women Be Healthy 2 program. There are 2 parts to the study: adaptation of the Women Be Healthy 2 program and feasibility and acceptability testing of MHMC. |
Jennifer W Bea Taylor Lane, Brenda Charley Etta Yazzie Janet Yellowhair Jennifer Hudson Brian Kinslow Betsy Wertheim Denise Roe Anna Schwartz C J Restoring Balance: A Physical Activity Intervention for Native American Cancer Survivors and Their Familial Support Persons Journal Article Exercise, Sport, and Movement, 1 (2), pp. e00007, 2023. @article{Bea2023, title = {Restoring Balance: A Physical Activity Intervention for Native American Cancer Survivors and Their Familial Support Persons}, author = {Jennifer W Bea, Taylor Lane, Brenda Charley, Etta Yazzie, Janet Yellowhair, Jennifer Hudson, Brian Kinslow, Betsy C Wertheim, Denise J Roe, Anna Schwartz}, url = {https://journals.lww.com/acsm-esm/toc/2023/02000}, doi = {10.1249/ESM.0000000000000007}, year = {2023}, date = {2023-02-01}, journal = {Exercise, Sport, and Movement}, volume = {1}, number = {2}, pages = {e00007}, abstract = {Introduction/Purpose Exercise interventions among Native American cancer survivors are lacking, despite major cancer health disparities in survivorship. The purpose of this study was to evaluate a 12-wk randomized controlled trial (RCT) of culturally tailored exercise on cancer risk biomarkers and quality of life among Native American cancer survivors and family members. Methods Participants were randomized to immediate start versus 6-wk waitlist control at two rural and two urban sites. Participants enrolled in a small feasibility pilot study (only cancer survivors evaluated, n = 18; cohort 1) or larger efficacy pilot study where cancer survivors (n = 38; cohort 2) and familial supporters (n = 25; cohort 3) were evaluated concurrently. Resistance, aerobic, flexibility, and balance exercises were tailored by cultural experts representing 10 tribes. Exercises were supervised on-site 1 d·wk−1 and continued in home-based settings 2–5 d·wk−1. Fat mass, blood pressure, hemoglobin A1c, 6-min walk, sit-to-stand test, and quality of life (Patient-Reported Outcomes Measurement Information System Global Health short form and isolation subscale) were measured. Mixed-effects models evaluated differences between RCT arms from baseline to 6 wk, and 12-wk intervention effects in combined arms. Results There were no consistent differences at 6 wk between randomized groups. Upon combining RCT arms, 6-min walk and sit-to-stand tests improved in all three cohorts by 12 wk (both survivors and familial support persons, P < 0.001); social isolation was reduced in all three cohorts (P ≤ 0.05). Familial support persons additionally improved blood pressure and hemoglobin A1c (P ≤ 0.05). Conclusions Exercise improved cardiorespiratory fitness and physical function among Native American cancer survivors and familial supporters. A longer intervention may influence other important health outcomes among Native American survivors. Additional improvements demonstrated among Native American family members may have a meaningful impact on cancer prevention in this underserved population with shared heritable and environmental risks.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Introduction/Purpose Exercise interventions among Native American cancer survivors are lacking, despite major cancer health disparities in survivorship. The purpose of this study was to evaluate a 12-wk randomized controlled trial (RCT) of culturally tailored exercise on cancer risk biomarkers and quality of life among Native American cancer survivors and family members. Methods Participants were randomized to immediate start versus 6-wk waitlist control at two rural and two urban sites. Participants enrolled in a small feasibility pilot study (only cancer survivors evaluated, n = 18; cohort 1) or larger efficacy pilot study where cancer survivors (n = 38; cohort 2) and familial supporters (n = 25; cohort 3) were evaluated concurrently. Resistance, aerobic, flexibility, and balance exercises were tailored by cultural experts representing 10 tribes. Exercises were supervised on-site 1 d·wk−1 and continued in home-based settings 2–5 d·wk−1. Fat mass, blood pressure, hemoglobin A1c, 6-min walk, sit-to-stand test, and quality of life (Patient-Reported Outcomes Measurement Information System Global Health short form and isolation subscale) were measured. Mixed-effects models evaluated differences between RCT arms from baseline to 6 wk, and 12-wk intervention effects in combined arms. Results There were no consistent differences at 6 wk between randomized groups. Upon combining RCT arms, 6-min walk and sit-to-stand tests improved in all three cohorts by 12 wk (both survivors and familial support persons, P < 0.001); social isolation was reduced in all three cohorts (P ≤ 0.05). Familial support persons additionally improved blood pressure and hemoglobin A1c (P ≤ 0.05). Conclusions Exercise improved cardiorespiratory fitness and physical function among Native American cancer survivors and familial supporters. A longer intervention may influence other important health outcomes among Native American survivors. Additional improvements demonstrated among Native American family members may have a meaningful impact on cancer prevention in this underserved population with shared heritable and environmental risks. |
Bea, Jennifer W; Charley, Brenda; Lane, Taylor; Kinslow, Brian; de Heer, Hendrik 'Dirk'; Yazzie, Etta; Yellowhair, Janet; Hudson, Jennifer; Wertheim, Betsy C; Schwartz, Anna L Sage Journals, 2022. @article{Bea2022, title = {Formative Evaluation and Adaptation of a Navajo Cancer Survivor Physical Activity Intervention to Serve a Broader Native American Cancer Survivor Community}, author = {Jennifer W Bea and Brenda Charley and Taylor Lane and Brian Kinslow and Hendrik 'Dirk' de Heer and Etta Yazzie and Janet Yellowhair and Jennifer Hudson and Betsy C Wertheim and Anna L Schwartz}, doi = {10.1177/15248399221131318}, year = {2022}, date = {2022-11-26}, journal = {Sage Journals}, abstract = {Background Although exercise has been shown to improve cancer survivorship in other communities, cancer exercise studies among Native American communities are rare. We sought to adapt a Navajo-tailored cancer exercise pilot program to serve a broader Native American cancer community. Methods Tribal experts representing 10 different Tribal Nations were engaged in small focus groups (n=2–4) to assess program materials for cultural appropriateness and adaptation to expand tribal inclusiveness. Facilitated by a trained Native American interviewer, focus groups were provided a primer survey and then reviewed intervention materials (protocols, incentives, logo, flyers, etc.). Consensus was reached by the research team on all program adaptations. Results The program name, Restoring Balance, layout, graphics, and symbols were considered culturally appropriate overall. Program exercises and biomarker measurements were viewed as valuable to health improvements in the community. Important color, linguistic, and logistic program modifications were recommended to improve cultural alignment. The order of incentive items was revised to highlight restoration and the logo rotated to align with the four corners of the earth, an important cultural element. Linguistic modifications primarily related to prior traumatic research experiences in Native American communities where data had been taken without adequate community benefit or permission. Program emphasis should be on nurturing, added value and giving. Conclusion and Relevance The methodology used for cultural expert review was successful in eliciting adaptations to expand the tribal inclusiveness of Restoring Balance. Culture, as well as historically traumatic research experiences, among Native American populations must be considered when adapting health promotion programming.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background Although exercise has been shown to improve cancer survivorship in other communities, cancer exercise studies among Native American communities are rare. We sought to adapt a Navajo-tailored cancer exercise pilot program to serve a broader Native American cancer community. Methods Tribal experts representing 10 different Tribal Nations were engaged in small focus groups (n=2–4) to assess program materials for cultural appropriateness and adaptation to expand tribal inclusiveness. Facilitated by a trained Native American interviewer, focus groups were provided a primer survey and then reviewed intervention materials (protocols, incentives, logo, flyers, etc.). Consensus was reached by the research team on all program adaptations. Results The program name, Restoring Balance, layout, graphics, and symbols were considered culturally appropriate overall. Program exercises and biomarker measurements were viewed as valuable to health improvements in the community. Important color, linguistic, and logistic program modifications were recommended to improve cultural alignment. The order of incentive items was revised to highlight restoration and the logo rotated to align with the four corners of the earth, an important cultural element. Linguistic modifications primarily related to prior traumatic research experiences in Native American communities where data had been taken without adequate community benefit or permission. Program emphasis should be on nurturing, added value and giving. Conclusion and Relevance The methodology used for cultural expert review was successful in eliciting adaptations to expand the tribal inclusiveness of Restoring Balance. Culture, as well as historically traumatic research experiences, among Native American populations must be considered when adapting health promotion programming. |
Teufel-Shone, Nicolette I; Goldtooth-Begay, Carol; Begay, Andria B; Lazaro, Ashley; Yellowhair, Janet; Todecheenie, Rolanda; Begay, Delila; Singer, Darlene; Briscoe, Curtis Frontiers in Public Health, 10 , 2022. @article{Teufel-Shone2022, title = {Maintaining the Partnership Between a Tribal Breast and Cervical Cancer Program and a University-Based Cancer Prevention Center During COVID-19 Lock-Down Restrictions-A Case Study}, author = {Nicolette I. Teufel-Shone and Carol Goldtooth-Begay and Andria B. Begay and Ashley Lazaro and Janet Yellowhair and Rolanda Todecheenie and Delila Begay and Darlene Singer and Curtis Briscoe}, editor = {Heather H. Goltz}, doi = {10.3389/fpubh.2022.902253}, year = {2022}, date = {2022-07-13}, issuetitle = {Public Health Education and Promotion}, journal = {Frontiers in Public Health}, volume = {10}, abstract = {To inform women of the Navajo Nation of safety measures implemented to minimize COVID-19 virus exposure during screening and treatment procedures at Navajo Nation based health care facilities, the Navajo Nation Breast and Cervical Cancer Prevention Program (NNBCCPP) and the University-based Partnership for Native American Cancer Prevention Program (NACP) collaborated to develop a podcast to describe the continued availability of services. During the COVID-19 pandemic, women of all ages and ethnicities in the US needing breast and cervical cancer prevention screenings and treatment, have been hesitant to seek services given the advice to avoid crowded spaces and maintain physical distancing. Epidemiological trends indicate that proactive, intensive strategies are needed in Native American communities for early detection and treatment to support early cancer diagnosis and improve cancer survival. The NNBCCPP and Northern Arizona University (NAU) through the National Institute of Health's National Cancer Institute funded NACP had a nascent partnership prior to the onset of COVID-19 pandemic. This partnership relied on face-to-face interaction to allow for informal social interaction, facilitate clear communication and support continued trust building. To adhere to federal, state and tribal recommendations to minimize gatherings and to stay in-place to minimize the spread of the virus, the Navajo Nation and NAU restricted, and in most cases would not approve employee travel for partnership meetings. The plans to develop a podcast necessitated bringing additional members into the collaboration who were unfamiliar to the original partners and due to travel restrictions, required all interactions to be remote. This expanded group met virtually to develop a script, record and edit the podcast. More importantly, group members had to build and maintain trust over months of communicating via a teleconference video platform. This collaborative addressed challenges related to unstable Internet connections and periodic stay-at-home policies; thus, these emerging partners had to modify social and professional communication to respect and accommodate the stress and uncertain circumstances created by the pandemic on the citizens and employees of Navajo Nation. This case study describes strategies used to maintain and respect all members of the partnership.}, keywords = {}, pubstate = {published}, tppubtype = {article} } To inform women of the Navajo Nation of safety measures implemented to minimize COVID-19 virus exposure during screening and treatment procedures at Navajo Nation based health care facilities, the Navajo Nation Breast and Cervical Cancer Prevention Program (NNBCCPP) and the University-based Partnership for Native American Cancer Prevention Program (NACP) collaborated to develop a podcast to describe the continued availability of services. During the COVID-19 pandemic, women of all ages and ethnicities in the US needing breast and cervical cancer prevention screenings and treatment, have been hesitant to seek services given the advice to avoid crowded spaces and maintain physical distancing. Epidemiological trends indicate that proactive, intensive strategies are needed in Native American communities for early detection and treatment to support early cancer diagnosis and improve cancer survival. The NNBCCPP and Northern Arizona University (NAU) through the National Institute of Health's National Cancer Institute funded NACP had a nascent partnership prior to the onset of COVID-19 pandemic. This partnership relied on face-to-face interaction to allow for informal social interaction, facilitate clear communication and support continued trust building. To adhere to federal, state and tribal recommendations to minimize gatherings and to stay in-place to minimize the spread of the virus, the Navajo Nation and NAU restricted, and in most cases would not approve employee travel for partnership meetings. The plans to develop a podcast necessitated bringing additional members into the collaboration who were unfamiliar to the original partners and due to travel restrictions, required all interactions to be remote. This expanded group met virtually to develop a script, record and edit the podcast. More importantly, group members had to build and maintain trust over months of communicating via a teleconference video platform. This collaborative addressed challenges related to unstable Internet connections and periodic stay-at-home policies; thus, these emerging partners had to modify social and professional communication to respect and accommodate the stress and uncertain circumstances created by the pandemic on the citizens and employees of Navajo Nation. This case study describes strategies used to maintain and respect all members of the partnership. |
Schwartz, Anna L; Terry, Christopher M Returning to Sport: Female Athletes Living with and beyond Cancer Journal Article International Journal of Environmental Research and Public Health, 18 (15), 2021. @article{Schwartz2021, title = {Returning to Sport: Female Athletes Living with and beyond Cancer}, author = {Anna L. Schwartz and Christopher M. Terry}, url = {https://doi.org/10.3390/ijerph18158151}, doi = {10.3390/ijerph18158151}, year = {2021}, date = {2021-08-01}, journal = {International Journal of Environmental Research and Public Health}, volume = {18}, number = {15}, abstract = {Many athletes living with and beyond cancer can continue to train and, in some cases, compete during treatment. Following cancer treatment, athletes can return to competitive sport but need to learn to adapt their physical strength and training to the lingering effects of cancer. It is critical for oncology healthcare providers to use the principles of assess, refer and advise to exercise oncology programs that are appropriate for the individual. Managing side effects of treatment is key to being able to train during and immediately following cancer treatment. Keen attention to fatigue is important at any point in the cancer spectrum to avoid overtraining and optimize the effects of training. Resources are introduced for providers to reference and direct patients to information for psychosocial support and instruction. The purpose of this paper is to present exercise considerations during and after cancer treatment for athletic cancer survivors.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Many athletes living with and beyond cancer can continue to train and, in some cases, compete during treatment. Following cancer treatment, athletes can return to competitive sport but need to learn to adapt their physical strength and training to the lingering effects of cancer. It is critical for oncology healthcare providers to use the principles of assess, refer and advise to exercise oncology programs that are appropriate for the individual. Managing side effects of treatment is key to being able to train during and immediately following cancer treatment. Keen attention to fatigue is important at any point in the cancer spectrum to avoid overtraining and optimize the effects of training. Resources are introduced for providers to reference and direct patients to information for psychosocial support and instruction. The purpose of this paper is to present exercise considerations during and after cancer treatment for athletic cancer survivors. |
Schmitz, Kathryn H; Stout, Nicole L; Maitin-Shepard, Melissa; Campbell, Anna; Schwartz, Anna L; Grimmett, Chloe; Meyerhardt, Jeffrey A; Sokolof, Jonas M Moving through cancer: Setting the agenda to make exercise standard in oncology practice Journal Article Cancer, 127 (3), pp. 476-484, 2021, ISBN: 10.1002/cncr.33245. @article{Schmitz2021, title = {Moving through cancer: Setting the agenda to make exercise standard in oncology practice}, author = {Kathryn H Schmitz and Nicole L Stout and Melissa Maitin-Shepard and Anna Campbell and Anna L Schwartz and Chloe Grimmett and Jeffrey A Meyerhardt and Jonas M Sokolof}, url = {https://doi.org/10.1002/cncr.33245}, isbn = {10.1002/cncr.33245}, year = {2021}, date = {2021-02-01}, journal = {Cancer}, volume = {127}, number = {3}, pages = {476-484}, abstract = {International evidence-based guidelines support the prescription of exercise for all individuals living with and beyond cancer. This article describes the agenda of the newly formed Moving Through Cancer initiative, which has a primary objective of making exercise standard practice in oncology by 2029.}, keywords = {}, pubstate = {published}, tppubtype = {article} } International evidence-based guidelines support the prescription of exercise for all individuals living with and beyond cancer. This article describes the agenda of the newly formed Moving Through Cancer initiative, which has a primary objective of making exercise standard practice in oncology by 2029. |
Chief, Carmenlita; Sanderson, Priscilla R; Willeto, Angela A A; Yazzie, Alfred; McKinley, Alexis; Monroy, Fernando P; Harris, Robin B; Oren, Eyal “Nobody Is Talking About It”: Diné (Navajo) Communities Speak About Stomach Cancer and Helicobacter pylori Infections Journal Article Journal of Cancer Education , 2020. @article{Chief2020, title = {“Nobody Is Talking About It”: Diné (Navajo) Communities Speak About Stomach Cancer and Helicobacter pylori Infections}, author = {Carmenlita Chief and Priscilla R. Sanderson and Angela A. A. Willeto and Alfred Yazzie and Alexis McKinley and Fernando P. Monroy and Robin B. Harris and Eyal Oren }, url = {https://doi.org/10.1007/s13187-020-01831-0}, doi = {10.1007/s13187-020-01831-0}, year = {2020}, date = {2020-07-22}, journal = {Journal of Cancer Education }, abstract = {Stomach cancer is the third leading cause of cancer death globally. Helicobacter pylori plays a role in the healthy human gut, but is also associated with multiple chronic diseases, including stomach cancer. Though H. pylori prevalence is declining in parts of the world, it remains high among certain populations. In Arizona, stomach cancer rates are 3–4 times higher among the Navajo Nation population as compared with the non-Hispanic white population. This pilot project assessed adult Diné (Navajo) individuals’ understanding and awareness regarding H. pylori infection and stomach cancer. Focus groups were held in three Diné communities. Data were analyzed thematically using a multi-investigator consensus approach. Participants had limited knowledge of H. pylori infection and stomach cancer and perceived local medical providers as also having limited knowledge on these conditions. Participants described poor health care experiences, structural inequalities, and environmental concerns and associated these with H. pylori infection and stomach cancer. This study highlights the need for additional research and education on current knowledge and perceptions of stomach cancer and H. pylori infections in Navajo Nation.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Stomach cancer is the third leading cause of cancer death globally. Helicobacter pylori plays a role in the healthy human gut, but is also associated with multiple chronic diseases, including stomach cancer. Though H. pylori prevalence is declining in parts of the world, it remains high among certain populations. In Arizona, stomach cancer rates are 3–4 times higher among the Navajo Nation population as compared with the non-Hispanic white population. This pilot project assessed adult Diné (Navajo) individuals’ understanding and awareness regarding H. pylori infection and stomach cancer. Focus groups were held in three Diné communities. Data were analyzed thematically using a multi-investigator consensus approach. Participants had limited knowledge of H. pylori infection and stomach cancer and perceived local medical providers as also having limited knowledge on these conditions. Participants described poor health care experiences, structural inequalities, and environmental concerns and associated these with H. pylori infection and stomach cancer. This study highlights the need for additional research and education on current knowledge and perceptions of stomach cancer and H. pylori infections in Navajo Nation. |
Tyson, Dinorah Martinez; Teran, Enrique; Dao, Lillie Uyen-Loan; Chee, Vanessa; Hernandez, Isabel; Flores, Mercedes; Ortiz, Miguel Reina; Izurieta, Ricardo; Baldwin, Julie A Cancer is in Style: Lifestyle change and the perceived impact of globalization on Andean indigenous communities in Ecuador Journal Article Ethnicity and Health, 2018. @article{Tyson2018, title = {Cancer is in Style: Lifestyle change and the perceived impact of globalization on Andean indigenous communities in Ecuador}, author = {Dinorah Martinez Tyson and Enrique Teran and Lillie Uyen-Loan Dao and Vanessa Chee and Isabel Hernandez and Mercedes Flores and Miguel Reina Ortiz and Ricardo Izurieta and Julie A Baldwin}, url = {https://www.tandfonline.com/doi/abs/10.1080/13557858.2018.1493437?journalCode=ceth20}, doi = {10.1080/13557858.2018.1493437}, year = {2018}, date = {2018-07-04}, journal = {Ethnicity and Health}, abstract = {Introduction: There is a paucity of information on cancer among Indigenous populations in Latin America. Methods: Guided by tenets of community engaged research and syndemic theory, we conducted eight focus groups (n = 59) with Kichwa men and women in the province of Imbabura, Ecuador. Data were analyzed using applied thematic analysis techniques. Results: Cancer emerged as an important health problem and was reported as a growing concern. Kichwa participants in this study attributed the rise in cancer to (1) exposure to chemicals and pesticides, (2) urbanization and development, and (3) the rise of innutritious, westernized diets. Conclusion: Our findings suggest that the Kichwa are attuned to the global phenomena in which traditional diet has been replaced by western, processed foods and fast food, which result in higher levels of chronic diseases such as cancer. More research is needed to understand the cancer burden among Indigenous peoples in Latin America.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Introduction: There is a paucity of information on cancer among Indigenous populations in Latin America. Methods: Guided by tenets of community engaged research and syndemic theory, we conducted eight focus groups (n = 59) with Kichwa men and women in the province of Imbabura, Ecuador. Data were analyzed using applied thematic analysis techniques. Results: Cancer emerged as an important health problem and was reported as a growing concern. Kichwa participants in this study attributed the rise in cancer to (1) exposure to chemicals and pesticides, (2) urbanization and development, and (3) the rise of innutritious, westernized diets. Conclusion: Our findings suggest that the Kichwa are attuned to the global phenomena in which traditional diet has been replaced by western, processed foods and fast food, which result in higher levels of chronic diseases such as cancer. More research is needed to understand the cancer burden among Indigenous peoples in Latin America. |
Arora, Nonie S; Davis, Kelly J; Kirby, Christine; McGuire, Amy L; Green, Robert C; Blumenthal-Barby, J S; Ubel, Peter A Communication challenges for non geneticist physicians relaying clinical genomic results Journal Article Personalized Medicine, 14 (5), pp. 423-431, 2017. @article{Arora2017, title = {Communication challenges for non geneticist physicians relaying clinical genomic results}, author = {Nonie S Arora and Kelly J Davis and Christine Kirby and Amy L McGuire and Robert C Green and J S Blumenthal-Barby and Peter A Ubel}, url = {https://www.futuremedicine.com/doi/abs/10.2217/pme-2017-0008}, year = {2017}, date = {2017-09-15}, journal = {Personalized Medicine}, volume = {14}, number = {5}, pages = {423-431}, abstract = {Aim: Identify the behavioral challenges to the use of genome sequencing (GS) in a clinical setting. Materials & methods: We observed how general internists and nongenetic specialists delivered GS results to patients enrolled in the MedSeq Project. Using transcripts of such disclosure interactions, we made qualitative observations of communication behaviors that could limit the usefulness of GS results until reaching the point of thematic saturation. Results: Findings included confusion regarding genomic terminology, difficulty with the volume or complexity of information and difficulties communicating complex risk information to patients. We observed a broad dismissal of clinical value of GS by some physicians and sometimes ineffective communication regarding health behavior change. Conclusion: Overcoming these behavioral challenges is necessary to make full use of clinical GS results.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Aim: Identify the behavioral challenges to the use of genome sequencing (GS) in a clinical setting. Materials & methods: We observed how general internists and nongenetic specialists delivered GS results to patients enrolled in the MedSeq Project. Using transcripts of such disclosure interactions, we made qualitative observations of communication behaviors that could limit the usefulness of GS results until reaching the point of thematic saturation. Results: Findings included confusion regarding genomic terminology, difficulty with the volume or complexity of information and difficulties communicating complex risk information to patients. We observed a broad dismissal of clinical value of GS by some physicians and sometimes ineffective communication regarding health behavior change. Conclusion: Overcoming these behavioral challenges is necessary to make full use of clinical GS results. |
Hunter, Wynn G; Zafar, Yousuf S; Hesson, Ashley; Davis, Kelly J; Kirby, Christine; Barnett, Jamison A; Ubel, Peter A Discussing health care expenses in the oncology clinic: Analysis of cost conversations in outpatient encounters Journal Article Journal of Oncology Practice, 12 (11), pp. e944-e956, 2017. @article{Hunter2017, title = {Discussing health care expenses in the oncology clinic: Analysis of cost conversations in outpatient encounters}, author = {Wynn G Hunter and Yousuf S Zafar and Ashley Hesson and Kelly J Davis and Christine Kirby and Jamison A Barnett and Peter A Ubel}, url = {http://ascopubs.org/doi/abs/10.1200/JOP.2017.022855}, year = {2017}, date = {2017-08-23}, journal = {Journal of Oncology Practice}, volume = {12}, number = {11}, pages = {e944-e956}, abstract = {Purpose: ASCO identified oncologist-patient conversations about cancer costs as an important component of high-quality care. However, limited data exist characterizing the content of these conversations. We sought to provide novel insight into oncologist-patient cost conversations by determining the content of cost conversations in breast cancer clinic visits. Methods: We performed content analysis of transcribed dialogue from 677 outpatient appointments for breast cancer management. Encounters featured 677 patients with breast cancer visiting 56 oncologists nationwide from 2010 to 2013. Results: Cost conversations were identified in 22% of visits (95% CI, 19 to 25) and had a median duration of 33 seconds (interquartile range, 19 to 62). Fifty-nine percent of cost conversations were initiated by oncologists (95% CI, 51 to 67), who most commonly brought up costs for antineoplastic agents. By contrast, patients …}, keywords = {}, pubstate = {published}, tppubtype = {article} } Purpose: ASCO identified oncologist-patient conversations about cancer costs as an important component of high-quality care. However, limited data exist characterizing the content of these conversations. We sought to provide novel insight into oncologist-patient cost conversations by determining the content of cost conversations in breast cancer clinic visits. Methods: We performed content analysis of transcribed dialogue from 677 outpatient appointments for breast cancer management. Encounters featured 677 patients with breast cancer visiting 56 oncologists nationwide from 2010 to 2013. Results: Cost conversations were identified in 22% of visits (95% CI, 19 to 25) and had a median duration of 33 seconds (interquartile range, 19 to 62). Fifty-nine percent of cost conversations were initiated by oncologists (95% CI, 51 to 67), who most commonly brought up costs for antineoplastic agents. By contrast, patients … |
Ubel, Peter A; Zhang, Cecilia J; Hesson, Ashley; Davis, Kelly J; Kirby, Christine; Barnett, Jamison; Hunter, Wynn G Study of physician and patient communication identifies missed opportunities to help reduce patients' out-of-pocket spending Journal Article Health Affairs, 35 (4), pp. 654-661, 2016. @article{Ubel2016, title = {Study of physician and patient communication identifies missed opportunities to help reduce patients' out-of-pocket spending}, author = {Peter A Ubel and Cecilia J Zhang and Ashley Hesson and Kelly J Davis and Christine Kirby and Jamison Barnett and Wynn G Hunter}, url = {https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2015.1280}, doi = {10.1377/hlthaff.2015.1280}, year = {2016}, date = {2016-04-01}, journal = {Health Affairs}, volume = {35}, number = {4}, pages = {654-661}, abstract = {Some experts contend that requiring patients to pay out of pocket for a portion of their care will bring consumer discipline to health care markets. But are physicians prepared to help patients factor out-of-pocket expenses into medical decisions? In this qualitative study of audiorecorded clinical encounters, we identified physician behaviors that stand in the way of helping patients navigate out-of-pocket spending. Some behaviors reflected a failure to fully engage with patients’ financial concerns, from never acknowledging such concerns to dismissing them too quickly. Other behaviors reflected a failure to resolve uncertainty about out-of-pocket expenses or reliance on temporary solutions without making long-term plans to reduce spending. Many of these failures resulted from systemic barriers to health care spending conversations, such as a lack of price transparency. For consumer health care markets to work as …}, keywords = {}, pubstate = {published}, tppubtype = {article} } Some experts contend that requiring patients to pay out of pocket for a portion of their care will bring consumer discipline to health care markets. But are physicians prepared to help patients factor out-of-pocket expenses into medical decisions? In this qualitative study of audiorecorded clinical encounters, we identified physician behaviors that stand in the way of helping patients navigate out-of-pocket spending. Some behaviors reflected a failure to fully engage with patients’ financial concerns, from never acknowledging such concerns to dismissing them too quickly. Other behaviors reflected a failure to resolve uncertainty about out-of-pocket expenses or reliance on temporary solutions without making long-term plans to reduce spending. Many of these failures resulted from systemic barriers to health care spending conversations, such as a lack of price transparency. For consumer health care markets to work as … |
Teufel-Shone, Nicolette; Cordova-Marks, Felina; Susanyatame, Gloria; Teufel-Shone, Louis; Irwin, Sandra L Documenting Cancer Information Seeking Behavior and Risk Perception in the Hualapai Indian Community to Inform a Community Health Program Journal Article Journal of Community Health, 43 (5), pp. 891-898, 2015. @article{Teufel-Shone2015, title = {Documenting Cancer Information Seeking Behavior and Risk Perception in the Hualapai Indian Community to Inform a Community Health Program}, author = {Nicolette Teufel-Shone and Felina Cordova-Marks and Gloria Susanyatame and Louis Teufel-Shone and Sandra L Irwin}, url = {https://www.ncbi.nlm.nih.gov/pubmed/25791877}, doi = {10.1007/s10900-015-0009-1}, year = {2015}, date = {2015-10-01}, journal = {Journal of Community Health}, volume = {43}, number = {5}, pages = {891-898}, abstract = {Cancer incidence among American Indians (AIs) is low, yet their 5-year relative survival rate is the second lowest of all U.S. populations. Culturally relevant cancer prevention education is key to achieve health equity. This collaborative project of the Hualapai Tribe and University of Arizona modified the National Cancer Institute's 2003 Health Information National Trends Survey (HINTS) to yield a more culturally relevant cancer information survey to document the health seeking behaviors and perceptions of cancer risks and preventability of AI adults residing in the Hualapai Indian community. A team of health care providers, educators and cancer survivors (six native and three non-natives) completed the adaptation. Four trained native surveyors administered the survey using a random household survey design. The Hualapai HINTS was well accepted (<5% refusal rate) and was completed by 205 adults (20.5% of all adult residents). Respondents reported a preference for and a trust in verbal cancer information and communication with health care professionals (77.1% preference; 57.4% trust) and at workshops (75.2% preference; 45.5% trust). Respondents were aware of some health behaviors associated with a reduced cancer risk, e.g., avoid tobacco use and need for screening. Respondents were less well informed about the role of diet and exercise. These findings were used to inform local cancer prevention education efforts and to develop a series of monthly workshops that engaged local health professionals to reinforce and discuss pathways of the primary role of lifestyle related factors, specifically diet and exercise in reducing cancer risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Cancer incidence among American Indians (AIs) is low, yet their 5-year relative survival rate is the second lowest of all U.S. populations. Culturally relevant cancer prevention education is key to achieve health equity. This collaborative project of the Hualapai Tribe and University of Arizona modified the National Cancer Institute's 2003 Health Information National Trends Survey (HINTS) to yield a more culturally relevant cancer information survey to document the health seeking behaviors and perceptions of cancer risks and preventability of AI adults residing in the Hualapai Indian community. A team of health care providers, educators and cancer survivors (six native and three non-natives) completed the adaptation. Four trained native surveyors administered the survey using a random household survey design. The Hualapai HINTS was well accepted (<5% refusal rate) and was completed by 205 adults (20.5% of all adult residents). Respondents reported a preference for and a trust in verbal cancer information and communication with health care professionals (77.1% preference; 57.4% trust) and at workshops (75.2% preference; 45.5% trust). Respondents were aware of some health behaviors associated with a reduced cancer risk, e.g., avoid tobacco use and need for screening. Respondents were less well informed about the role of diet and exercise. These findings were used to inform local cancer prevention education efforts and to develop a series of monthly workshops that engaged local health professionals to reinforce and discuss pathways of the primary role of lifestyle related factors, specifically diet and exercise in reducing cancer risk. |
McGinnis, Kara; Montiel-Ishino, Alejandro F; Standifer, Maisha Kambon; Wathington, Deanna; Goldsmith, Johnetta; Baldwin, Julie A Photonovels: an innovative approach to address health disparities and sustainability Journal Article Journal of Cancer Education, 29 (3), pp. 441-448, 2014. @article{McGinnis2014, title = {Photonovels: an innovative approach to address health disparities and sustainability}, author = {Kara McGinnis and Alejandro F Montiel-Ishino and Maisha Kambon Standifer and Deanna Wathington and Johnetta Goldsmith and Julie A Baldwin}, url = {https://link.springer.com/article/10.1007%2Fs13187-014-0607-0}, doi = {10.1007/s13187-014-0607-0}, year = {2014}, date = {2014-09-01}, journal = {Journal of Cancer Education}, volume = {29}, number = {3}, pages = {441-448}, abstract = {Medically underserved and underrepresented communities have high rates of health disparities. In the greater Tampa Bay area, communities of color are disproportionately affected by chronic diseases such as cancer. In response to these concerns and as part of a lay health advisory program being implemented by the Center for Equal Health, a University of South Florida/H. Lee Moffitt Cancer Center & Research Institute partnership, our group created a photonovel, an educational tool which explains topics using a graphic novel style. The photonovel was designed to educate community members about prostate cancer and was compared to standard cancer educational materials currently used for cancer outreach. We found that our photonovel served as an effective health education tool to address cancer health disparities in medically underserved and underrepresented populations in Tampa Bay.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Medically underserved and underrepresented communities have high rates of health disparities. In the greater Tampa Bay area, communities of color are disproportionately affected by chronic diseases such as cancer. In response to these concerns and as part of a lay health advisory program being implemented by the Center for Equal Health, a University of South Florida/H. Lee Moffitt Cancer Center & Research Institute partnership, our group created a photonovel, an educational tool which explains topics using a graphic novel style. The photonovel was designed to educate community members about prostate cancer and was compared to standard cancer educational materials currently used for cancer outreach. We found that our photonovel served as an effective health education tool to address cancer health disparities in medically underserved and underrepresented populations in Tampa Bay. |
Loi, Claudia Aguado X; Baldwin, Julie A; McDermott, Robert J; McMillan, Susan; Tyson, Dinorah Martinez; Yampolskaya, Svetlana; VandeWeerd, Carla Risk factors associated with increased depressive symptoms among Latinas diagnosed with breast cancer within 5 years of survivorship Journal Article Psycho-oncology, 2 (12), pp. 2779-2788, 2013. @article{Loi2013, title = {Risk factors associated with increased depressive symptoms among Latinas diagnosed with breast cancer within 5 years of survivorship}, author = {Claudia Aguado X Loi and Julie A Baldwin and Robert J McDermott and Susan McMillan and Dinorah Martinez Tyson and Svetlana Yampolskaya and Carla VandeWeerd}, url = {https://www.ncbi.nlm.nih.gov/pubmed/24000126}, doi = {10.1002/pon.3357}, year = {2013}, date = {2013-12-01}, journal = {Psycho-oncology}, volume = {2}, number = {12}, pages = {2779-2788}, abstract = {BACKGROUND: Co-occurring depression in women with cancer can complicate cancer treatment, lead to poor treatment adherence for both conditions, and decrease survival if left untreated. The purpose of this study was to explore risk factors for depression among Latina breast cancer survivors. METHODS: A closed-ended questionnaire was administered by telephone to 68 Latinas diagnosed with breast cancer within the past 5 years. Depression symptoms were measured using the Patient Health Questionaire-9 with the Endicott substitutive criteria applied. The Cognitive Appraisal Health Scale and the Brief COPE were used to measure appraisal and coping. Descriptive statistics, bivariate and multiple linear regression analyses were completed. RESULTS: Approximately 45.6% of women reported depressive symptoms. Multivariate analyses showed that a cognitive appraisal variable (decreased challenge or the potential to overcome), coping variables (increased acceptance, less positive reframing, less active coping, less use of emotional support, substance use and more self-blame), poor body image, less family and peer support to be significantly associated with an increased risk for depression. Intrapersonal variables accounted for the greatest explained variance (69%). CONCLUSIONS: This study identified several risk factors for depression. Study findings highlight the need for intervention programs to help women normalize emotions and thoughts related to cancer and its treatments, and to improve their cognitive abilities to overcome, accept, and positively reframe cancer and other difficult situations women face throughout the cancer continuum. The importance of family and peer support to improve depressive symptoms was also evident.}, keywords = {}, pubstate = {published}, tppubtype = {article} } BACKGROUND: Co-occurring depression in women with cancer can complicate cancer treatment, lead to poor treatment adherence for both conditions, and decrease survival if left untreated. The purpose of this study was to explore risk factors for depression among Latina breast cancer survivors. METHODS: A closed-ended questionnaire was administered by telephone to 68 Latinas diagnosed with breast cancer within the past 5 years. Depression symptoms were measured using the Patient Health Questionaire-9 with the Endicott substitutive criteria applied. The Cognitive Appraisal Health Scale and the Brief COPE were used to measure appraisal and coping. Descriptive statistics, bivariate and multiple linear regression analyses were completed. RESULTS: Approximately 45.6% of women reported depressive symptoms. Multivariate analyses showed that a cognitive appraisal variable (decreased challenge or the potential to overcome), coping variables (increased acceptance, less positive reframing, less active coping, less use of emotional support, substance use and more self-blame), poor body image, less family and peer support to be significantly associated with an increased risk for depression. Intrapersonal variables accounted for the greatest explained variance (69%). CONCLUSIONS: This study identified several risk factors for depression. Study findings highlight the need for intervention programs to help women normalize emotions and thoughts related to cancer and its treatments, and to improve their cognitive abilities to overcome, accept, and positively reframe cancer and other difficult situations women face throughout the cancer continuum. The importance of family and peer support to improve depressive symptoms was also evident. |
2023 |
Armin, Julie S; Williamson, Heather J; Rothers, Janet; Lee, Michele S; Baldwin, Julie A JMIR Research Protocols, 12 (e37801), 2023. @article{Armin2023, title = {An adapted cancer screening education program for Native American women with intellectual and developmental disabilities and their caregivers: Protocol for feasibility and acceptability testing}, author = {Julie S Armin and Heather J Williamson and Janet Rothers and Michele S Lee and Julie A Baldwin }, url = {https://www.researchprotocols.org/2023/1/e37801}, doi = {10.2196/37801}, year = {2023}, date = {2023-02-13}, journal = {JMIR Research Protocols}, volume = {12}, number = {e37801}, abstract = {Women with intellectual and developmental disabilities (IDD) do not undergo breast and cervical cancer screening at the same rate as women without IDD. IDDs are diagnosed in childhood, are lifelong, and involve difficulties in adaptive behaviors and intellectual functioning. Native American women also experience disparities in breast and cervical cancer screenings. Despite known disparities, women with IDD are often not included in health promotion programs, and there is a need for evidence-based programming for those with intersectional identities, such as Native American women with IDD. This study aims to assess the feasibility and acceptability of My Health My Choice (MHMC), an adaptation of the Women Be Healthy 2 program. There are 2 parts to the study: adaptation of the Women Be Healthy 2 program and feasibility and acceptability testing of MHMC.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Women with intellectual and developmental disabilities (IDD) do not undergo breast and cervical cancer screening at the same rate as women without IDD. IDDs are diagnosed in childhood, are lifelong, and involve difficulties in adaptive behaviors and intellectual functioning. Native American women also experience disparities in breast and cervical cancer screenings. Despite known disparities, women with IDD are often not included in health promotion programs, and there is a need for evidence-based programming for those with intersectional identities, such as Native American women with IDD. This study aims to assess the feasibility and acceptability of My Health My Choice (MHMC), an adaptation of the Women Be Healthy 2 program. There are 2 parts to the study: adaptation of the Women Be Healthy 2 program and feasibility and acceptability testing of MHMC. |
Jennifer W Bea Taylor Lane, Brenda Charley Etta Yazzie Janet Yellowhair Jennifer Hudson Brian Kinslow Betsy Wertheim Denise Roe Anna Schwartz C J Restoring Balance: A Physical Activity Intervention for Native American Cancer Survivors and Their Familial Support Persons Journal Article Exercise, Sport, and Movement, 1 (2), pp. e00007, 2023. @article{Bea2023, title = {Restoring Balance: A Physical Activity Intervention for Native American Cancer Survivors and Their Familial Support Persons}, author = {Jennifer W Bea, Taylor Lane, Brenda Charley, Etta Yazzie, Janet Yellowhair, Jennifer Hudson, Brian Kinslow, Betsy C Wertheim, Denise J Roe, Anna Schwartz}, url = {https://journals.lww.com/acsm-esm/toc/2023/02000}, doi = {10.1249/ESM.0000000000000007}, year = {2023}, date = {2023-02-01}, journal = {Exercise, Sport, and Movement}, volume = {1}, number = {2}, pages = {e00007}, abstract = {Introduction/Purpose Exercise interventions among Native American cancer survivors are lacking, despite major cancer health disparities in survivorship. The purpose of this study was to evaluate a 12-wk randomized controlled trial (RCT) of culturally tailored exercise on cancer risk biomarkers and quality of life among Native American cancer survivors and family members. Methods Participants were randomized to immediate start versus 6-wk waitlist control at two rural and two urban sites. Participants enrolled in a small feasibility pilot study (only cancer survivors evaluated, n = 18; cohort 1) or larger efficacy pilot study where cancer survivors (n = 38; cohort 2) and familial supporters (n = 25; cohort 3) were evaluated concurrently. Resistance, aerobic, flexibility, and balance exercises were tailored by cultural experts representing 10 tribes. Exercises were supervised on-site 1 d·wk−1 and continued in home-based settings 2–5 d·wk−1. Fat mass, blood pressure, hemoglobin A1c, 6-min walk, sit-to-stand test, and quality of life (Patient-Reported Outcomes Measurement Information System Global Health short form and isolation subscale) were measured. Mixed-effects models evaluated differences between RCT arms from baseline to 6 wk, and 12-wk intervention effects in combined arms. Results There were no consistent differences at 6 wk between randomized groups. Upon combining RCT arms, 6-min walk and sit-to-stand tests improved in all three cohorts by 12 wk (both survivors and familial support persons, P < 0.001); social isolation was reduced in all three cohorts (P ≤ 0.05). Familial support persons additionally improved blood pressure and hemoglobin A1c (P ≤ 0.05). Conclusions Exercise improved cardiorespiratory fitness and physical function among Native American cancer survivors and familial supporters. A longer intervention may influence other important health outcomes among Native American survivors. Additional improvements demonstrated among Native American family members may have a meaningful impact on cancer prevention in this underserved population with shared heritable and environmental risks.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Introduction/Purpose Exercise interventions among Native American cancer survivors are lacking, despite major cancer health disparities in survivorship. The purpose of this study was to evaluate a 12-wk randomized controlled trial (RCT) of culturally tailored exercise on cancer risk biomarkers and quality of life among Native American cancer survivors and family members. Methods Participants were randomized to immediate start versus 6-wk waitlist control at two rural and two urban sites. Participants enrolled in a small feasibility pilot study (only cancer survivors evaluated, n = 18; cohort 1) or larger efficacy pilot study where cancer survivors (n = 38; cohort 2) and familial supporters (n = 25; cohort 3) were evaluated concurrently. Resistance, aerobic, flexibility, and balance exercises were tailored by cultural experts representing 10 tribes. Exercises were supervised on-site 1 d·wk−1 and continued in home-based settings 2–5 d·wk−1. Fat mass, blood pressure, hemoglobin A1c, 6-min walk, sit-to-stand test, and quality of life (Patient-Reported Outcomes Measurement Information System Global Health short form and isolation subscale) were measured. Mixed-effects models evaluated differences between RCT arms from baseline to 6 wk, and 12-wk intervention effects in combined arms. Results There were no consistent differences at 6 wk between randomized groups. Upon combining RCT arms, 6-min walk and sit-to-stand tests improved in all three cohorts by 12 wk (both survivors and familial support persons, P < 0.001); social isolation was reduced in all three cohorts (P ≤ 0.05). Familial support persons additionally improved blood pressure and hemoglobin A1c (P ≤ 0.05). Conclusions Exercise improved cardiorespiratory fitness and physical function among Native American cancer survivors and familial supporters. A longer intervention may influence other important health outcomes among Native American survivors. Additional improvements demonstrated among Native American family members may have a meaningful impact on cancer prevention in this underserved population with shared heritable and environmental risks. |
2022 |
Bea, Jennifer W; Charley, Brenda; Lane, Taylor; Kinslow, Brian; de Heer, Hendrik 'Dirk'; Yazzie, Etta; Yellowhair, Janet; Hudson, Jennifer; Wertheim, Betsy C; Schwartz, Anna L Sage Journals, 2022. @article{Bea2022, title = {Formative Evaluation and Adaptation of a Navajo Cancer Survivor Physical Activity Intervention to Serve a Broader Native American Cancer Survivor Community}, author = {Jennifer W Bea and Brenda Charley and Taylor Lane and Brian Kinslow and Hendrik 'Dirk' de Heer and Etta Yazzie and Janet Yellowhair and Jennifer Hudson and Betsy C Wertheim and Anna L Schwartz}, doi = {10.1177/15248399221131318}, year = {2022}, date = {2022-11-26}, journal = {Sage Journals}, abstract = {Background Although exercise has been shown to improve cancer survivorship in other communities, cancer exercise studies among Native American communities are rare. We sought to adapt a Navajo-tailored cancer exercise pilot program to serve a broader Native American cancer community. Methods Tribal experts representing 10 different Tribal Nations were engaged in small focus groups (n=2–4) to assess program materials for cultural appropriateness and adaptation to expand tribal inclusiveness. Facilitated by a trained Native American interviewer, focus groups were provided a primer survey and then reviewed intervention materials (protocols, incentives, logo, flyers, etc.). Consensus was reached by the research team on all program adaptations. Results The program name, Restoring Balance, layout, graphics, and symbols were considered culturally appropriate overall. Program exercises and biomarker measurements were viewed as valuable to health improvements in the community. Important color, linguistic, and logistic program modifications were recommended to improve cultural alignment. The order of incentive items was revised to highlight restoration and the logo rotated to align with the four corners of the earth, an important cultural element. Linguistic modifications primarily related to prior traumatic research experiences in Native American communities where data had been taken without adequate community benefit or permission. Program emphasis should be on nurturing, added value and giving. Conclusion and Relevance The methodology used for cultural expert review was successful in eliciting adaptations to expand the tribal inclusiveness of Restoring Balance. Culture, as well as historically traumatic research experiences, among Native American populations must be considered when adapting health promotion programming.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background Although exercise has been shown to improve cancer survivorship in other communities, cancer exercise studies among Native American communities are rare. We sought to adapt a Navajo-tailored cancer exercise pilot program to serve a broader Native American cancer community. Methods Tribal experts representing 10 different Tribal Nations were engaged in small focus groups (n=2–4) to assess program materials for cultural appropriateness and adaptation to expand tribal inclusiveness. Facilitated by a trained Native American interviewer, focus groups were provided a primer survey and then reviewed intervention materials (protocols, incentives, logo, flyers, etc.). Consensus was reached by the research team on all program adaptations. Results The program name, Restoring Balance, layout, graphics, and symbols were considered culturally appropriate overall. Program exercises and biomarker measurements were viewed as valuable to health improvements in the community. Important color, linguistic, and logistic program modifications were recommended to improve cultural alignment. The order of incentive items was revised to highlight restoration and the logo rotated to align with the four corners of the earth, an important cultural element. Linguistic modifications primarily related to prior traumatic research experiences in Native American communities where data had been taken without adequate community benefit or permission. Program emphasis should be on nurturing, added value and giving. Conclusion and Relevance The methodology used for cultural expert review was successful in eliciting adaptations to expand the tribal inclusiveness of Restoring Balance. Culture, as well as historically traumatic research experiences, among Native American populations must be considered when adapting health promotion programming. |
Teufel-Shone, Nicolette I; Goldtooth-Begay, Carol; Begay, Andria B; Lazaro, Ashley; Yellowhair, Janet; Todecheenie, Rolanda; Begay, Delila; Singer, Darlene; Briscoe, Curtis Frontiers in Public Health, 10 , 2022. @article{Teufel-Shone2022, title = {Maintaining the Partnership Between a Tribal Breast and Cervical Cancer Program and a University-Based Cancer Prevention Center During COVID-19 Lock-Down Restrictions-A Case Study}, author = {Nicolette I. Teufel-Shone and Carol Goldtooth-Begay and Andria B. Begay and Ashley Lazaro and Janet Yellowhair and Rolanda Todecheenie and Delila Begay and Darlene Singer and Curtis Briscoe}, editor = {Heather H. Goltz}, doi = {10.3389/fpubh.2022.902253}, year = {2022}, date = {2022-07-13}, issuetitle = {Public Health Education and Promotion}, journal = {Frontiers in Public Health}, volume = {10}, abstract = {To inform women of the Navajo Nation of safety measures implemented to minimize COVID-19 virus exposure during screening and treatment procedures at Navajo Nation based health care facilities, the Navajo Nation Breast and Cervical Cancer Prevention Program (NNBCCPP) and the University-based Partnership for Native American Cancer Prevention Program (NACP) collaborated to develop a podcast to describe the continued availability of services. During the COVID-19 pandemic, women of all ages and ethnicities in the US needing breast and cervical cancer prevention screenings and treatment, have been hesitant to seek services given the advice to avoid crowded spaces and maintain physical distancing. Epidemiological trends indicate that proactive, intensive strategies are needed in Native American communities for early detection and treatment to support early cancer diagnosis and improve cancer survival. The NNBCCPP and Northern Arizona University (NAU) through the National Institute of Health's National Cancer Institute funded NACP had a nascent partnership prior to the onset of COVID-19 pandemic. This partnership relied on face-to-face interaction to allow for informal social interaction, facilitate clear communication and support continued trust building. To adhere to federal, state and tribal recommendations to minimize gatherings and to stay in-place to minimize the spread of the virus, the Navajo Nation and NAU restricted, and in most cases would not approve employee travel for partnership meetings. The plans to develop a podcast necessitated bringing additional members into the collaboration who were unfamiliar to the original partners and due to travel restrictions, required all interactions to be remote. This expanded group met virtually to develop a script, record and edit the podcast. More importantly, group members had to build and maintain trust over months of communicating via a teleconference video platform. This collaborative addressed challenges related to unstable Internet connections and periodic stay-at-home policies; thus, these emerging partners had to modify social and professional communication to respect and accommodate the stress and uncertain circumstances created by the pandemic on the citizens and employees of Navajo Nation. This case study describes strategies used to maintain and respect all members of the partnership.}, keywords = {}, pubstate = {published}, tppubtype = {article} } To inform women of the Navajo Nation of safety measures implemented to minimize COVID-19 virus exposure during screening and treatment procedures at Navajo Nation based health care facilities, the Navajo Nation Breast and Cervical Cancer Prevention Program (NNBCCPP) and the University-based Partnership for Native American Cancer Prevention Program (NACP) collaborated to develop a podcast to describe the continued availability of services. During the COVID-19 pandemic, women of all ages and ethnicities in the US needing breast and cervical cancer prevention screenings and treatment, have been hesitant to seek services given the advice to avoid crowded spaces and maintain physical distancing. Epidemiological trends indicate that proactive, intensive strategies are needed in Native American communities for early detection and treatment to support early cancer diagnosis and improve cancer survival. The NNBCCPP and Northern Arizona University (NAU) through the National Institute of Health's National Cancer Institute funded NACP had a nascent partnership prior to the onset of COVID-19 pandemic. This partnership relied on face-to-face interaction to allow for informal social interaction, facilitate clear communication and support continued trust building. To adhere to federal, state and tribal recommendations to minimize gatherings and to stay in-place to minimize the spread of the virus, the Navajo Nation and NAU restricted, and in most cases would not approve employee travel for partnership meetings. The plans to develop a podcast necessitated bringing additional members into the collaboration who were unfamiliar to the original partners and due to travel restrictions, required all interactions to be remote. This expanded group met virtually to develop a script, record and edit the podcast. More importantly, group members had to build and maintain trust over months of communicating via a teleconference video platform. This collaborative addressed challenges related to unstable Internet connections and periodic stay-at-home policies; thus, these emerging partners had to modify social and professional communication to respect and accommodate the stress and uncertain circumstances created by the pandemic on the citizens and employees of Navajo Nation. This case study describes strategies used to maintain and respect all members of the partnership. |
2021 |
Schwartz, Anna L; Terry, Christopher M Returning to Sport: Female Athletes Living with and beyond Cancer Journal Article International Journal of Environmental Research and Public Health, 18 (15), 2021. @article{Schwartz2021, title = {Returning to Sport: Female Athletes Living with and beyond Cancer}, author = {Anna L. Schwartz and Christopher M. Terry}, url = {https://doi.org/10.3390/ijerph18158151}, doi = {10.3390/ijerph18158151}, year = {2021}, date = {2021-08-01}, journal = {International Journal of Environmental Research and Public Health}, volume = {18}, number = {15}, abstract = {Many athletes living with and beyond cancer can continue to train and, in some cases, compete during treatment. Following cancer treatment, athletes can return to competitive sport but need to learn to adapt their physical strength and training to the lingering effects of cancer. It is critical for oncology healthcare providers to use the principles of assess, refer and advise to exercise oncology programs that are appropriate for the individual. Managing side effects of treatment is key to being able to train during and immediately following cancer treatment. Keen attention to fatigue is important at any point in the cancer spectrum to avoid overtraining and optimize the effects of training. Resources are introduced for providers to reference and direct patients to information for psychosocial support and instruction. The purpose of this paper is to present exercise considerations during and after cancer treatment for athletic cancer survivors.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Many athletes living with and beyond cancer can continue to train and, in some cases, compete during treatment. Following cancer treatment, athletes can return to competitive sport but need to learn to adapt their physical strength and training to the lingering effects of cancer. It is critical for oncology healthcare providers to use the principles of assess, refer and advise to exercise oncology programs that are appropriate for the individual. Managing side effects of treatment is key to being able to train during and immediately following cancer treatment. Keen attention to fatigue is important at any point in the cancer spectrum to avoid overtraining and optimize the effects of training. Resources are introduced for providers to reference and direct patients to information for psychosocial support and instruction. The purpose of this paper is to present exercise considerations during and after cancer treatment for athletic cancer survivors. |
Schmitz, Kathryn H; Stout, Nicole L; Maitin-Shepard, Melissa; Campbell, Anna; Schwartz, Anna L; Grimmett, Chloe; Meyerhardt, Jeffrey A; Sokolof, Jonas M Moving through cancer: Setting the agenda to make exercise standard in oncology practice Journal Article Cancer, 127 (3), pp. 476-484, 2021, ISBN: 10.1002/cncr.33245. @article{Schmitz2021, title = {Moving through cancer: Setting the agenda to make exercise standard in oncology practice}, author = {Kathryn H Schmitz and Nicole L Stout and Melissa Maitin-Shepard and Anna Campbell and Anna L Schwartz and Chloe Grimmett and Jeffrey A Meyerhardt and Jonas M Sokolof}, url = {https://doi.org/10.1002/cncr.33245}, isbn = {10.1002/cncr.33245}, year = {2021}, date = {2021-02-01}, journal = {Cancer}, volume = {127}, number = {3}, pages = {476-484}, abstract = {International evidence-based guidelines support the prescription of exercise for all individuals living with and beyond cancer. This article describes the agenda of the newly formed Moving Through Cancer initiative, which has a primary objective of making exercise standard practice in oncology by 2029.}, keywords = {}, pubstate = {published}, tppubtype = {article} } International evidence-based guidelines support the prescription of exercise for all individuals living with and beyond cancer. This article describes the agenda of the newly formed Moving Through Cancer initiative, which has a primary objective of making exercise standard practice in oncology by 2029. |
2020 |
Chief, Carmenlita; Sanderson, Priscilla R; Willeto, Angela A A; Yazzie, Alfred; McKinley, Alexis; Monroy, Fernando P; Harris, Robin B; Oren, Eyal “Nobody Is Talking About It”: Diné (Navajo) Communities Speak About Stomach Cancer and Helicobacter pylori Infections Journal Article Journal of Cancer Education , 2020. @article{Chief2020, title = {“Nobody Is Talking About It”: Diné (Navajo) Communities Speak About Stomach Cancer and Helicobacter pylori Infections}, author = {Carmenlita Chief and Priscilla R. Sanderson and Angela A. A. Willeto and Alfred Yazzie and Alexis McKinley and Fernando P. Monroy and Robin B. Harris and Eyal Oren }, url = {https://doi.org/10.1007/s13187-020-01831-0}, doi = {10.1007/s13187-020-01831-0}, year = {2020}, date = {2020-07-22}, journal = {Journal of Cancer Education }, abstract = {Stomach cancer is the third leading cause of cancer death globally. Helicobacter pylori plays a role in the healthy human gut, but is also associated with multiple chronic diseases, including stomach cancer. Though H. pylori prevalence is declining in parts of the world, it remains high among certain populations. In Arizona, stomach cancer rates are 3–4 times higher among the Navajo Nation population as compared with the non-Hispanic white population. This pilot project assessed adult Diné (Navajo) individuals’ understanding and awareness regarding H. pylori infection and stomach cancer. Focus groups were held in three Diné communities. Data were analyzed thematically using a multi-investigator consensus approach. Participants had limited knowledge of H. pylori infection and stomach cancer and perceived local medical providers as also having limited knowledge on these conditions. Participants described poor health care experiences, structural inequalities, and environmental concerns and associated these with H. pylori infection and stomach cancer. This study highlights the need for additional research and education on current knowledge and perceptions of stomach cancer and H. pylori infections in Navajo Nation.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Stomach cancer is the third leading cause of cancer death globally. Helicobacter pylori plays a role in the healthy human gut, but is also associated with multiple chronic diseases, including stomach cancer. Though H. pylori prevalence is declining in parts of the world, it remains high among certain populations. In Arizona, stomach cancer rates are 3–4 times higher among the Navajo Nation population as compared with the non-Hispanic white population. This pilot project assessed adult Diné (Navajo) individuals’ understanding and awareness regarding H. pylori infection and stomach cancer. Focus groups were held in three Diné communities. Data were analyzed thematically using a multi-investigator consensus approach. Participants had limited knowledge of H. pylori infection and stomach cancer and perceived local medical providers as also having limited knowledge on these conditions. Participants described poor health care experiences, structural inequalities, and environmental concerns and associated these with H. pylori infection and stomach cancer. This study highlights the need for additional research and education on current knowledge and perceptions of stomach cancer and H. pylori infections in Navajo Nation. |
2018 |
Tyson, Dinorah Martinez; Teran, Enrique; Dao, Lillie Uyen-Loan; Chee, Vanessa; Hernandez, Isabel; Flores, Mercedes; Ortiz, Miguel Reina; Izurieta, Ricardo; Baldwin, Julie A Cancer is in Style: Lifestyle change and the perceived impact of globalization on Andean indigenous communities in Ecuador Journal Article Ethnicity and Health, 2018. @article{Tyson2018, title = {Cancer is in Style: Lifestyle change and the perceived impact of globalization on Andean indigenous communities in Ecuador}, author = {Dinorah Martinez Tyson and Enrique Teran and Lillie Uyen-Loan Dao and Vanessa Chee and Isabel Hernandez and Mercedes Flores and Miguel Reina Ortiz and Ricardo Izurieta and Julie A Baldwin}, url = {https://www.tandfonline.com/doi/abs/10.1080/13557858.2018.1493437?journalCode=ceth20}, doi = {10.1080/13557858.2018.1493437}, year = {2018}, date = {2018-07-04}, journal = {Ethnicity and Health}, abstract = {Introduction: There is a paucity of information on cancer among Indigenous populations in Latin America. Methods: Guided by tenets of community engaged research and syndemic theory, we conducted eight focus groups (n = 59) with Kichwa men and women in the province of Imbabura, Ecuador. Data were analyzed using applied thematic analysis techniques. Results: Cancer emerged as an important health problem and was reported as a growing concern. Kichwa participants in this study attributed the rise in cancer to (1) exposure to chemicals and pesticides, (2) urbanization and development, and (3) the rise of innutritious, westernized diets. Conclusion: Our findings suggest that the Kichwa are attuned to the global phenomena in which traditional diet has been replaced by western, processed foods and fast food, which result in higher levels of chronic diseases such as cancer. More research is needed to understand the cancer burden among Indigenous peoples in Latin America.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Introduction: There is a paucity of information on cancer among Indigenous populations in Latin America. Methods: Guided by tenets of community engaged research and syndemic theory, we conducted eight focus groups (n = 59) with Kichwa men and women in the province of Imbabura, Ecuador. Data were analyzed using applied thematic analysis techniques. Results: Cancer emerged as an important health problem and was reported as a growing concern. Kichwa participants in this study attributed the rise in cancer to (1) exposure to chemicals and pesticides, (2) urbanization and development, and (3) the rise of innutritious, westernized diets. Conclusion: Our findings suggest that the Kichwa are attuned to the global phenomena in which traditional diet has been replaced by western, processed foods and fast food, which result in higher levels of chronic diseases such as cancer. More research is needed to understand the cancer burden among Indigenous peoples in Latin America. |
2017 |
Arora, Nonie S; Davis, Kelly J; Kirby, Christine; McGuire, Amy L; Green, Robert C; Blumenthal-Barby, J S; Ubel, Peter A Communication challenges for non geneticist physicians relaying clinical genomic results Journal Article Personalized Medicine, 14 (5), pp. 423-431, 2017. @article{Arora2017, title = {Communication challenges for non geneticist physicians relaying clinical genomic results}, author = {Nonie S Arora and Kelly J Davis and Christine Kirby and Amy L McGuire and Robert C Green and J S Blumenthal-Barby and Peter A Ubel}, url = {https://www.futuremedicine.com/doi/abs/10.2217/pme-2017-0008}, year = {2017}, date = {2017-09-15}, journal = {Personalized Medicine}, volume = {14}, number = {5}, pages = {423-431}, abstract = {Aim: Identify the behavioral challenges to the use of genome sequencing (GS) in a clinical setting. Materials & methods: We observed how general internists and nongenetic specialists delivered GS results to patients enrolled in the MedSeq Project. Using transcripts of such disclosure interactions, we made qualitative observations of communication behaviors that could limit the usefulness of GS results until reaching the point of thematic saturation. Results: Findings included confusion regarding genomic terminology, difficulty with the volume or complexity of information and difficulties communicating complex risk information to patients. We observed a broad dismissal of clinical value of GS by some physicians and sometimes ineffective communication regarding health behavior change. Conclusion: Overcoming these behavioral challenges is necessary to make full use of clinical GS results.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Aim: Identify the behavioral challenges to the use of genome sequencing (GS) in a clinical setting. Materials & methods: We observed how general internists and nongenetic specialists delivered GS results to patients enrolled in the MedSeq Project. Using transcripts of such disclosure interactions, we made qualitative observations of communication behaviors that could limit the usefulness of GS results until reaching the point of thematic saturation. Results: Findings included confusion regarding genomic terminology, difficulty with the volume or complexity of information and difficulties communicating complex risk information to patients. We observed a broad dismissal of clinical value of GS by some physicians and sometimes ineffective communication regarding health behavior change. Conclusion: Overcoming these behavioral challenges is necessary to make full use of clinical GS results. |
Hunter, Wynn G; Zafar, Yousuf S; Hesson, Ashley; Davis, Kelly J; Kirby, Christine; Barnett, Jamison A; Ubel, Peter A Discussing health care expenses in the oncology clinic: Analysis of cost conversations in outpatient encounters Journal Article Journal of Oncology Practice, 12 (11), pp. e944-e956, 2017. @article{Hunter2017, title = {Discussing health care expenses in the oncology clinic: Analysis of cost conversations in outpatient encounters}, author = {Wynn G Hunter and Yousuf S Zafar and Ashley Hesson and Kelly J Davis and Christine Kirby and Jamison A Barnett and Peter A Ubel}, url = {http://ascopubs.org/doi/abs/10.1200/JOP.2017.022855}, year = {2017}, date = {2017-08-23}, journal = {Journal of Oncology Practice}, volume = {12}, number = {11}, pages = {e944-e956}, abstract = {Purpose: ASCO identified oncologist-patient conversations about cancer costs as an important component of high-quality care. However, limited data exist characterizing the content of these conversations. We sought to provide novel insight into oncologist-patient cost conversations by determining the content of cost conversations in breast cancer clinic visits. Methods: We performed content analysis of transcribed dialogue from 677 outpatient appointments for breast cancer management. Encounters featured 677 patients with breast cancer visiting 56 oncologists nationwide from 2010 to 2013. Results: Cost conversations were identified in 22% of visits (95% CI, 19 to 25) and had a median duration of 33 seconds (interquartile range, 19 to 62). Fifty-nine percent of cost conversations were initiated by oncologists (95% CI, 51 to 67), who most commonly brought up costs for antineoplastic agents. By contrast, patients …}, keywords = {}, pubstate = {published}, tppubtype = {article} } Purpose: ASCO identified oncologist-patient conversations about cancer costs as an important component of high-quality care. However, limited data exist characterizing the content of these conversations. We sought to provide novel insight into oncologist-patient cost conversations by determining the content of cost conversations in breast cancer clinic visits. Methods: We performed content analysis of transcribed dialogue from 677 outpatient appointments for breast cancer management. Encounters featured 677 patients with breast cancer visiting 56 oncologists nationwide from 2010 to 2013. Results: Cost conversations were identified in 22% of visits (95% CI, 19 to 25) and had a median duration of 33 seconds (interquartile range, 19 to 62). Fifty-nine percent of cost conversations were initiated by oncologists (95% CI, 51 to 67), who most commonly brought up costs for antineoplastic agents. By contrast, patients … |
2016 |
Ubel, Peter A; Zhang, Cecilia J; Hesson, Ashley; Davis, Kelly J; Kirby, Christine; Barnett, Jamison; Hunter, Wynn G Study of physician and patient communication identifies missed opportunities to help reduce patients' out-of-pocket spending Journal Article Health Affairs, 35 (4), pp. 654-661, 2016. @article{Ubel2016, title = {Study of physician and patient communication identifies missed opportunities to help reduce patients' out-of-pocket spending}, author = {Peter A Ubel and Cecilia J Zhang and Ashley Hesson and Kelly J Davis and Christine Kirby and Jamison Barnett and Wynn G Hunter}, url = {https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2015.1280}, doi = {10.1377/hlthaff.2015.1280}, year = {2016}, date = {2016-04-01}, journal = {Health Affairs}, volume = {35}, number = {4}, pages = {654-661}, abstract = {Some experts contend that requiring patients to pay out of pocket for a portion of their care will bring consumer discipline to health care markets. But are physicians prepared to help patients factor out-of-pocket expenses into medical decisions? In this qualitative study of audiorecorded clinical encounters, we identified physician behaviors that stand in the way of helping patients navigate out-of-pocket spending. Some behaviors reflected a failure to fully engage with patients’ financial concerns, from never acknowledging such concerns to dismissing them too quickly. Other behaviors reflected a failure to resolve uncertainty about out-of-pocket expenses or reliance on temporary solutions without making long-term plans to reduce spending. Many of these failures resulted from systemic barriers to health care spending conversations, such as a lack of price transparency. For consumer health care markets to work as …}, keywords = {}, pubstate = {published}, tppubtype = {article} } Some experts contend that requiring patients to pay out of pocket for a portion of their care will bring consumer discipline to health care markets. But are physicians prepared to help patients factor out-of-pocket expenses into medical decisions? In this qualitative study of audiorecorded clinical encounters, we identified physician behaviors that stand in the way of helping patients navigate out-of-pocket spending. Some behaviors reflected a failure to fully engage with patients’ financial concerns, from never acknowledging such concerns to dismissing them too quickly. Other behaviors reflected a failure to resolve uncertainty about out-of-pocket expenses or reliance on temporary solutions without making long-term plans to reduce spending. Many of these failures resulted from systemic barriers to health care spending conversations, such as a lack of price transparency. For consumer health care markets to work as … |
2015 |
Teufel-Shone, Nicolette; Cordova-Marks, Felina; Susanyatame, Gloria; Teufel-Shone, Louis; Irwin, Sandra L Documenting Cancer Information Seeking Behavior and Risk Perception in the Hualapai Indian Community to Inform a Community Health Program Journal Article Journal of Community Health, 43 (5), pp. 891-898, 2015. @article{Teufel-Shone2015, title = {Documenting Cancer Information Seeking Behavior and Risk Perception in the Hualapai Indian Community to Inform a Community Health Program}, author = {Nicolette Teufel-Shone and Felina Cordova-Marks and Gloria Susanyatame and Louis Teufel-Shone and Sandra L Irwin}, url = {https://www.ncbi.nlm.nih.gov/pubmed/25791877}, doi = {10.1007/s10900-015-0009-1}, year = {2015}, date = {2015-10-01}, journal = {Journal of Community Health}, volume = {43}, number = {5}, pages = {891-898}, abstract = {Cancer incidence among American Indians (AIs) is low, yet their 5-year relative survival rate is the second lowest of all U.S. populations. Culturally relevant cancer prevention education is key to achieve health equity. This collaborative project of the Hualapai Tribe and University of Arizona modified the National Cancer Institute's 2003 Health Information National Trends Survey (HINTS) to yield a more culturally relevant cancer information survey to document the health seeking behaviors and perceptions of cancer risks and preventability of AI adults residing in the Hualapai Indian community. A team of health care providers, educators and cancer survivors (six native and three non-natives) completed the adaptation. Four trained native surveyors administered the survey using a random household survey design. The Hualapai HINTS was well accepted (<5% refusal rate) and was completed by 205 adults (20.5% of all adult residents). Respondents reported a preference for and a trust in verbal cancer information and communication with health care professionals (77.1% preference; 57.4% trust) and at workshops (75.2% preference; 45.5% trust). Respondents were aware of some health behaviors associated with a reduced cancer risk, e.g., avoid tobacco use and need for screening. Respondents were less well informed about the role of diet and exercise. These findings were used to inform local cancer prevention education efforts and to develop a series of monthly workshops that engaged local health professionals to reinforce and discuss pathways of the primary role of lifestyle related factors, specifically diet and exercise in reducing cancer risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Cancer incidence among American Indians (AIs) is low, yet their 5-year relative survival rate is the second lowest of all U.S. populations. Culturally relevant cancer prevention education is key to achieve health equity. This collaborative project of the Hualapai Tribe and University of Arizona modified the National Cancer Institute's 2003 Health Information National Trends Survey (HINTS) to yield a more culturally relevant cancer information survey to document the health seeking behaviors and perceptions of cancer risks and preventability of AI adults residing in the Hualapai Indian community. A team of health care providers, educators and cancer survivors (six native and three non-natives) completed the adaptation. Four trained native surveyors administered the survey using a random household survey design. The Hualapai HINTS was well accepted (<5% refusal rate) and was completed by 205 adults (20.5% of all adult residents). Respondents reported a preference for and a trust in verbal cancer information and communication with health care professionals (77.1% preference; 57.4% trust) and at workshops (75.2% preference; 45.5% trust). Respondents were aware of some health behaviors associated with a reduced cancer risk, e.g., avoid tobacco use and need for screening. Respondents were less well informed about the role of diet and exercise. These findings were used to inform local cancer prevention education efforts and to develop a series of monthly workshops that engaged local health professionals to reinforce and discuss pathways of the primary role of lifestyle related factors, specifically diet and exercise in reducing cancer risk. |
2014 |
McGinnis, Kara; Montiel-Ishino, Alejandro F; Standifer, Maisha Kambon; Wathington, Deanna; Goldsmith, Johnetta; Baldwin, Julie A Photonovels: an innovative approach to address health disparities and sustainability Journal Article Journal of Cancer Education, 29 (3), pp. 441-448, 2014. @article{McGinnis2014, title = {Photonovels: an innovative approach to address health disparities and sustainability}, author = {Kara McGinnis and Alejandro F Montiel-Ishino and Maisha Kambon Standifer and Deanna Wathington and Johnetta Goldsmith and Julie A Baldwin}, url = {https://link.springer.com/article/10.1007%2Fs13187-014-0607-0}, doi = {10.1007/s13187-014-0607-0}, year = {2014}, date = {2014-09-01}, journal = {Journal of Cancer Education}, volume = {29}, number = {3}, pages = {441-448}, abstract = {Medically underserved and underrepresented communities have high rates of health disparities. In the greater Tampa Bay area, communities of color are disproportionately affected by chronic diseases such as cancer. In response to these concerns and as part of a lay health advisory program being implemented by the Center for Equal Health, a University of South Florida/H. Lee Moffitt Cancer Center & Research Institute partnership, our group created a photonovel, an educational tool which explains topics using a graphic novel style. The photonovel was designed to educate community members about prostate cancer and was compared to standard cancer educational materials currently used for cancer outreach. We found that our photonovel served as an effective health education tool to address cancer health disparities in medically underserved and underrepresented populations in Tampa Bay.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Medically underserved and underrepresented communities have high rates of health disparities. In the greater Tampa Bay area, communities of color are disproportionately affected by chronic diseases such as cancer. In response to these concerns and as part of a lay health advisory program being implemented by the Center for Equal Health, a University of South Florida/H. Lee Moffitt Cancer Center & Research Institute partnership, our group created a photonovel, an educational tool which explains topics using a graphic novel style. The photonovel was designed to educate community members about prostate cancer and was compared to standard cancer educational materials currently used for cancer outreach. We found that our photonovel served as an effective health education tool to address cancer health disparities in medically underserved and underrepresented populations in Tampa Bay. |
2013 |
Loi, Claudia Aguado X; Baldwin, Julie A; McDermott, Robert J; McMillan, Susan; Tyson, Dinorah Martinez; Yampolskaya, Svetlana; VandeWeerd, Carla Risk factors associated with increased depressive symptoms among Latinas diagnosed with breast cancer within 5 years of survivorship Journal Article Psycho-oncology, 2 (12), pp. 2779-2788, 2013. @article{Loi2013, title = {Risk factors associated with increased depressive symptoms among Latinas diagnosed with breast cancer within 5 years of survivorship}, author = {Claudia Aguado X Loi and Julie A Baldwin and Robert J McDermott and Susan McMillan and Dinorah Martinez Tyson and Svetlana Yampolskaya and Carla VandeWeerd}, url = {https://www.ncbi.nlm.nih.gov/pubmed/24000126}, doi = {10.1002/pon.3357}, year = {2013}, date = {2013-12-01}, journal = {Psycho-oncology}, volume = {2}, number = {12}, pages = {2779-2788}, abstract = {BACKGROUND: Co-occurring depression in women with cancer can complicate cancer treatment, lead to poor treatment adherence for both conditions, and decrease survival if left untreated. The purpose of this study was to explore risk factors for depression among Latina breast cancer survivors. METHODS: A closed-ended questionnaire was administered by telephone to 68 Latinas diagnosed with breast cancer within the past 5 years. Depression symptoms were measured using the Patient Health Questionaire-9 with the Endicott substitutive criteria applied. The Cognitive Appraisal Health Scale and the Brief COPE were used to measure appraisal and coping. Descriptive statistics, bivariate and multiple linear regression analyses were completed. RESULTS: Approximately 45.6% of women reported depressive symptoms. Multivariate analyses showed that a cognitive appraisal variable (decreased challenge or the potential to overcome), coping variables (increased acceptance, less positive reframing, less active coping, less use of emotional support, substance use and more self-blame), poor body image, less family and peer support to be significantly associated with an increased risk for depression. Intrapersonal variables accounted for the greatest explained variance (69%). CONCLUSIONS: This study identified several risk factors for depression. Study findings highlight the need for intervention programs to help women normalize emotions and thoughts related to cancer and its treatments, and to improve their cognitive abilities to overcome, accept, and positively reframe cancer and other difficult situations women face throughout the cancer continuum. The importance of family and peer support to improve depressive symptoms was also evident.}, keywords = {}, pubstate = {published}, tppubtype = {article} } BACKGROUND: Co-occurring depression in women with cancer can complicate cancer treatment, lead to poor treatment adherence for both conditions, and decrease survival if left untreated. The purpose of this study was to explore risk factors for depression among Latina breast cancer survivors. METHODS: A closed-ended questionnaire was administered by telephone to 68 Latinas diagnosed with breast cancer within the past 5 years. Depression symptoms were measured using the Patient Health Questionaire-9 with the Endicott substitutive criteria applied. The Cognitive Appraisal Health Scale and the Brief COPE were used to measure appraisal and coping. Descriptive statistics, bivariate and multiple linear regression analyses were completed. RESULTS: Approximately 45.6% of women reported depressive symptoms. Multivariate analyses showed that a cognitive appraisal variable (decreased challenge or the potential to overcome), coping variables (increased acceptance, less positive reframing, less active coping, less use of emotional support, substance use and more self-blame), poor body image, less family and peer support to be significantly associated with an increased risk for depression. Intrapersonal variables accounted for the greatest explained variance (69%). CONCLUSIONS: This study identified several risk factors for depression. Study findings highlight the need for intervention programs to help women normalize emotions and thoughts related to cancer and its treatments, and to improve their cognitive abilities to overcome, accept, and positively reframe cancer and other difficult situations women face throughout the cancer continuum. The importance of family and peer support to improve depressive symptoms was also evident. |