Increasing Adherence to Adjuvant Hormone Therapy Among Patients With Breast Cancer: A Smart Phone App-Based Pilot Study.

Purpose: This study tested the feasibility and efficacy of using a text-based intervention to increase initiation, decrease discontinuation, and improve adherence as prescribed to adjuvant hormone therapy (AHT) among hyphenate post-menopausal breast cancer survivors.

Methods: The 3-month intervention consisted of daily text message reminders to take medication, coupled with a dynamic (eg, feedback on progress) tailored intervention using weekly interactive surveys delivered by a smartphone app. Five clinic sites within the Alliance for Clinical Trials in Oncology participated.

Hispanic breast cancer patients' symptom experience and patient-physician communication during chemotherapy.

Objective: Patient-clinician communication difficulties are a major barrier to effective symptom management during chemotherapy especially among non-English-speaking and minority patients. This study sought to examine how information is exchanged between patients and clinicians during chemotherapy treatment regarding pain, depression, fatigue, and nausea experienced among the most prevalent non-English-speaking group in the USA, Hispanic breast cancer survivors.

Methods: Hispanic breast cancer patients and clinicians participated in focus groups to examine Hispanic breast cancer survivors' experience and patient-physician communication of symptoms during chemotherapy.

A social-contextual investigation of smoking among rural women: multi-level factors associated with smoking status and considerations for cessation.

Introduction: The social-contextual model of tobacco control and the potential mechanisms of the maintenance or cessation of smoking behavior among disadvantaged women, including rural residents, have yet to be comprehensively studied. The purpose of this study was to determine the association between selected individual, interpersonal, workplace, and neighborhood characteristics and smoking status among women in Appalachia, a US region whose residents experience a disproportionate prevalence of tobacco-related health disparities. These findings may assist in efforts to design and test scientifically valid tobacco control interventions for this and other disadvantaged populations.

Social Networks and Smoking in Rural Women: Intervention Implications.

Objectives: We characterized the social network characteristics of women in Ohio Appalachia according to smoking status.

Methods: Women ≥18 years of age were recruited from 3 Ohio Appalachian counties to complete a cross-sectional survey. Sociodemographic and smoking-related information was collected by face-to-face interview.

Effect of patient navigation on satisfaction with cancer-related care.

Purpose: Despite growing popularity of patient navigation (PN) as a means to improve cancer care quality and reduce cancer-related disparities, there are few well-designed controlled trials assessing the impact of PN on patient outcomes like satisfaction with care. The present controlled study examined effect of PN on satisfaction with cancer-related care.

Methods: Patients who presented with a symptom or abnormal screening test (n = 1788) or definitive diagnosis (n = 445) of breast, cervical, colorectal, or prostate cancer from eight Patient Navigator Research Program sites were included in one of two groups: intervention (PN) or comparison (usual care or usual care plus cancer educational materials).

Testing Interventions to Motivate and Educate (TIME): A multi-level intervention to improve colorectal cancer screening.

Objective: To test the effectiveness of a colorectal cancer (CRC) screening intervention directed at three levels (clinic, provider, patient) in a primary care setting.

Method: We conducted a group randomized trial (Clinical Trials registration no. NCT01568151) among 10 primary care clinics in Columbus, Ohio that were randomized to a study condition (intervention or usual care).

Outcomes of a health coaching intervention delivered by medical students for older adults with uncontrolled type 2 diabetes.

Effective strategies are needed to address the health behaviors of older patients with diabetes. One approach is health coaching, the practice of health education and health promotion through a structured partnership designed to enhance well-being and facilitate the achievement of individuals' health-related goals. The aim of this study was to describe the development of a pilot health coaching curriculum, investigate its effects on geriatric patient outcomes, and examine qualitative feedback by older patients and medical students to the curriculum.

Effects of Patient Navigation on Patient Satisfaction Outcomes.

Patient navigation (PN) may reduce cancer health disparities. Few studies have investigated the effects of PN on patient-reported satisfaction with care or assessed patients' satisfaction with navigators. The objectives of this study are to test the effects of PN on patient satisfaction with cancer care, assess patients' satisfaction with navigators, and examine the impact of barriers to care on satisfaction for persons with abnormal cancer-related screening tests or symptoms.

Improving symptom communication through personal digital assistants: the CHAT (Communicating Health Assisted by Technology) project.

Background: Communication problems impede effective symptom management during chemotherapy. The primary aim of this pilot randomized controlled trial was to test the effects of a personal digital assistant-delivered communication intervention on pain, depression, and fatigue symptoms among breast cancer patients undergoing chemotherapy. Secondary aims included assessment of 1) study feasibility, 2) patient and clinician responses to study participation, and 3) intervention effects on health-related quality of life (HRQoL) and communication self-efficacy.

Effect of a web-based curriculum on primary care practice: basic skin cancer triage trial.

Background And Objectives: Primary care physicians (PCPs) are uniquely positioned to detect melanoma. Effective educational interventions targeted at PCPs may improve early melanoma detection. A previous in-person Basic Skin Cancer Triage (BSCT) 2-hour course demonstrated significant short-term improvement in provider practices, attitudes, ability, confidence, and knowledge.

Do better-rated navigators improve patient satisfaction with cancer-related care?

Patient navigation has emerged as a promising strategy for addressing racial-ethnic and socioeconomic disparities in cancer-related care. However, little is known about the impact of patients' perception of the quality of navigation on patient outcomes. We examined the impact of better-rated navigators on patients' satisfaction with cancer-related care.

The Ohio Patient Navigation Research Program: does the American Cancer Society patient navigation model improve time to resolution in patients with abnormal screening tests?

Background: Patient navigation (PN) has been suggested as a way to reduce cancer health disparities; however, many models of PN exist and most have not been carefully evaluated. The goal of this study was to test the Ohio American Cancer Society model of PN as it relates to reducing time to diagnostic resolution among persons with abnormal breast, cervical, or colorectal cancer screening tests or symptoms.

Methods: A total of 862 patients from 18 clinics participated in this group-randomized trial.

Psychometric development and reliability analysis of a patient satisfaction with interpersonal relationship with navigator measure: a multi-site patient navigation research program study.

Background: Patient navigation (PN) is a method for addressing racial-ethnic and socioeconomically based disparities in cancer-related care. Patient navigators provide logistic and emotional support to underserved patients to facilitate successful completion of diagnostic and treatment care. Yet, little is known about patient satisfaction with the relationship with a navigator due to a dearth of instruments measuring satisfaction.

Trust and distrust among Appalachian women regarding cervical cancer screening: a qualitative study.

Objective: To explore Appalachian women's perceptions of trust and distrust of healthcare providers and the medical care system as they relate to views about cervical cancer and screening.

Methods: Thirty-six Ohio Appalachia female residents participated in community focus groups conducted by trained facilitators. Discussion topics included factors related to cervical cancer, and the issues of trust and distrust in medical care.

Structural and reliability analysis of a patient satisfaction with cancer-related care measure: a multisite patient navigation research program study.

Background: Patient satisfaction is an important outcome measure of quality of cancer care and 1 of the 4 core study outcomes of the National Cancer Institute (NCI)-sponsored Patient Navigation Research Program to reduce race/ethnicity-based disparities in cancer care. There is no existing patient satisfaction measure that spans the spectrum of cancer-related care. The objective of this study was to develop a Patient Satisfaction With Cancer Care measure that is relevant to patients receiving diagnostic/therapeutic cancer-related care.

Patients' question-asking behavior during primary care visits: a report from the AAFP National Research Network.

Purpose: The Ask Me 3 (AM3) health communication program encourages patients to ask specific questions during office visits with the intention of improving understanding of their health conditions and adherence to treatment recommendations. This study evaluated whether implementing AM3 improves patients' question-asking behavior and increases adherence to prescription medications and lifestyle recommendations.

Methods: This randomized trial involved 20 practices from the American Academy of Family Physicians National Research Network that were assigned to an AM3 intervention group or a control group.

Development Of An Educational Video To Improve Patient Knowledge And Communication With Their Healthcare Providers About Colorectal Cancer Screening.

BACKGROUND: Low rates of colorectal cancer (CRC) screening persist due to individual, provider and system level barriers. PURPOSE: To develop and obtain initial feedback about a CRC screening educational video from community members and medical professionals. METHODS: Focus groups of patients were conducted prior to the development of an educational video and focus groups of patients provided initial feedback about the developed CRC screening educational video.

Psychosocial predictors of adherence to risk-appropriate cervical cancer screening guidelines: a cross sectional study of women in Ohio Appalachia participating in the Community Awareness Resources and Education (CARE) project.

Objective: We describe factors, in the context of the Social Determinants of Health model, associated with receiving Pap smears within risk-appropriate guidelines (i.e., guidelines that specify screening intervals based upon a woman's individual risk of developing cervical cancer).

The impact of patients' participation on physicians' patient-centered communication.

Objective: The goal of this study is to add to a small, but growing body of research exploring how patients' communication style affects physicians' communication. In particular, we examine how patients' active participation (e.g.

Acceptance of the HPV vaccine among women, parents, community leaders, and healthcare providers in Ohio Appalachia.

To assess HPV vaccine acceptability, focus groups of women (18-26 years), parents, community leaders, and healthcare providers were conducted throughout Ohio Appalachia. Themes that emerged among the 23 focus groups (n=114) about the HPV vaccine were: barriers (general health and vaccine specific), lack of knowledge (cervical cancer and HPV), cultural attitudes, and suggestions for educational materials and programs. Important Appalachian attitudes included strong family ties, privacy, conservative views, and lack of trust of outsiders to the region.

Determinants of colorectal cancer screening in primary care.

Background: Colorectal cancer (CRC) is serious, yet a minority of US adults receive within-guideline screening exams.

Methods: A random selection of patients attending clinics in 3 different settings completed a survey on CRC-related barriers, knowledge, and beliefs.

Results: Participants with fewer barriers, better knowledge, and more positive beliefs toward screening were significantly more likely to be within screening guidelines.

Enhancing behavioral science education at the Ohio State University College of Medicine.

The social and behavioral sciences play key roles in patient health outcomes. Given this reality, successful development of social and behavioral science curricula in medical education is critically important to the quality of patients' lives and the effectiveness of health care delivery systems. The Institute of Medicine, in a recent report, recommended that medical schools enhance their curricula in these areas and identified four institutions as "exemplars" of social and behavioral science education.

Development of an instrument to measure seniors' patient safety health beliefs: the Seniors Empowerment and Advocacy in Patient Safety (SEAPS) survey.

Objective: To develop a survey to measure seniors' embracement of ambulatory patient safety self-advocacy behaviors, the Senior Empowerment and Advocacy in Patient Safety (SEAPS) survey.

Methods: Content was developed by review of published recommendations combined with interviews and focus groups with community members; items were generated for subscales based on the health belief model (HBM). Psychometric characteristics were assessed by cluster and correlation analyses on a pilot test of 143 community dwelling seniors; the ability of the subscales and demographic variables to predict reported behavior was investigated by multiple regression.

A pilot study of home treatment of deep vein thrombosis with subcutaneous once-daily enoxaparin plus warfarin.

Objective: To evaluate patient satisfaction, effectiveness, and safety of at-home treatment of acute deep vein thrombosis (DVT) with subcutaneous enoxaparin dosed at 1.5 mg/kg once daily plus oral warfarin.

Methods: Patients with acute DVT and no more than 1 previous episode of DVT received enoxaparin plus oral warfarin until their international normalized ratio (INR) was >2 on 2 consecutive days.