Organizational Characteristics and Smoking Cessation Support in Community-Based Lung Cancer Screening Programs.

An evidence-based approach to navigation, shared decision making, and tobacco cessation education, tailored to lung cancer screening, is needed nationwide at imaging centers to achieve maximal mortality reductions from lung cancer screening.

The OaSiS trial: A hybrid type II, national cluster randomized trial to implement smoking cessation during CT screening for lung cancer.

Introduction: When the Centers for Medicare and Medicaid Services announced coverage for low dose CT lung cancer screening, they also mandated that imaging centers offer smoking cessation services. We designed the Optimizing Lung Screening (OaSiS) trial to evaluate strategies to implement the Public Health Service Guidelines for Treating Tobacco Use and Dependence during CT screening for lung cancer.

Methods And Design: OaSiS was implemented using a pragmatic effectiveness-implementation hybrid design in 26 imaging clinics across the United States affiliated with the National Cancer Institute's National Community Oncology Research Program (NCORP).

The Effects of Health Disparities on Perceptions About Lung Cancer Screening (LCS): Survey Results of a Patient Sample.

Lung cancer screening (LCS) is currently advocated in a subset of current or former smokers with a thirty pack-year smoking history or higher. Studies report that few patients meeting the criteria for screening are undergoing LCS. We conducted a survey to assess if barriers to LCS (race, ethnicity, and socioeconomic status) affect the perceptions about LCS that could influence screening uptake.

Do free clinics reduce unnecessary emergency department visits? The Virginian experience.

As part of the safety net, free clinics (FCs) increase access to preventive and primary care for the uninsured. This study compared a group of uninsured FC users and a group of uninsured non-FC users to explore the impact of FC enrollment on the pattern of ED visits, as characterized by (1) level of complexity of care received at the ED, and (2) avoidable vs. unavoidable as classified by an existing clinical algorithm.

Screening colonoscopy among colorectal cancer survivors insured by Medicaid.

Objectives: The objectives of this research study are to describe the proportion of Medicaid-insured colorectal cancer survivors who had a colonoscopy between 3 and 18 months after surgery of the colon or rectum and to determine if patient, health services, and community characteristics are associated with colonoscopy follow-up after treatment.

Methods: A retrospective cohort study among 1044 Medicaid-insured individuals diagnosed with local or regional colorectal cancer was conducted. Multivariable logistic regression analyses assessed patient, hospital, and community characteristics associated with colonoscopy.

A randomized controlled trial of a culturally congruent intervention to increase condom use and HIV testing among heterosexually active immigrant Latino men.

This randomized controlled trial tested the efficacy of an HIV prevention intervention to increase condom use and HIV testing among Spanish-speaking, heterosexually active immigrant Latino men. A community-based participatory research partnership developed the intervention and selected the study design. Following baseline data collection, 142 immigrant Latino men were randomized to the HIV prevention intervention or the cancer education intervention.

Selected community characteristics and underage drinking.

This study assessed the relationship between community characteristics and alcohol use among 6,636 youth, aged from 14 to 20, in 2004. After adjusting for individual-level characteristics, youth from communities with a greater proportion of grandparents as caregivers, larger numbers of married couple families, and higher employment rates were significantly less likely to report past 30-day alcohol use. Youth from communities with higher median household income were significantly more likely to report past 30-day alcohol use.

Implementing smokeless tobacco instruction into medical student education: addressing the gap.

Background: Despite the unique health and epidemiological aspects of smokeless tobacco use, medical education regarding this topic is virtually lacking.

Description: The purpose of this study is to develop a comprehensive tobacco curriculum that includes smokeless tobacco education. A thorough review of the literature was carried out to develop includes 8 modules in basic and clinical sciences that are evaluated by pretest/posttest increases in knowledge as well as standardized patient encounters and process evaluation.

Contextual factors and health risk behaviors associated with date fighting among high school students.

Over 2,000 North Carolina high school students completed surveys measuring community risk and protective factors and individual health risk behaviors including dating violence perpetration and victimization. Females reported more date fighting perpetration than males (8.8% to 4.

Lay health advisor interventions among Hispanics/Latinos: a qualitative systematic review.

Background: With an expanding Hispanic/Latino community in the United States, practitioners and researchers working to promote health and prevent disease have relied on lay health advisor (LHA) models to address a variety of health issues. The primary goal of this systematic review was to explore how LHA approaches have been used and evaluated within Hispanic/Latino communities in the U.S.

Improving colorectal cancer screening by using community volunteers: results of the Carolinas cancer education and screening (CARES) project.

Background: The goal of the Carolinas Cancer Education and Screening (CARES) Project was to improve colorectal cancer (CRC) screening among low-income women in subsidized housing communities in 11 cities in North and South Carolina who were traditionally underserved by cancer control efforts.

Methods: Cross-sectional samples were randomly selected from housing authority lists at 5 timepoints in this nonrandomized community-based intervention study. Face-to-face interviews focused on CRC knowledge, beliefs, barriers to screening, and screening behaviors.

Evaluation of the Quality of Life in Adult Cancer Survivors (QLACS) scale for long-term cancer survivors in a sample of breast cancer survivors.

Background: This paper evaluates psychometric properties of a recently developed measure focusing on the health-related quality of life (HRQL) of long-term cancer survivors, the Quality of Life in Adult Survivors scale (QLACS), in a sample of breast cancer survivors. This represents an important area of study, given the large number of breast cancer patients surviving many years post diagnosis.

Methods: Analyses are based on an 8-year follow-up of a sample of breast cancer survivors who participated in an earlier study conducted in 1995.

Randomized trial of an intervention to improve mammography utilization among a triracial rural population of women.

Introduction: Mammography is underused by certain groups of women, in particular poor and minority women. We developed a lay health advisor (LHA) intervention based on behavioral theories and tested whether it improved mammography attendance in Robeson County, NC, a rural, low-income, triracial (white, Native American, African American) population.

Methods: A total of 851 women who had not had a mammogram within the past year were randomly assigned to the LHA intervention (n = 433) or to a comparison arm (n = 418) during 1998-2002.

Survival disadvantage among Medicaid-insured breast cancer patients treated with breast conserving surgery without radiation therapy.

Background: Clinical studies indicate that breast cancer patients treated with breast conserving surgery (BCS) without radiotherapy (RT) have a greater risk of recurrence and mortality compared to those receiving BCS plus RT. However, this relationship has been underdeveloped among low-income women in the community who may face barriers in accessing adjuvant treatment and post-treatment surveillance. It is possible that the prognostic significance of omission of RT in clinical trials underestimates the significance of risk in the community.

Physical activity, insulin sensitivity, and hypertension among US adults: findings from the Insulin Resistance Atherosclerosis Study.

Although regular physical activity is associated with less hypertension and improved insulin sensitivity, there is debate regarding the role of insulin sensitivity in hypertension. Thus, in this cross-sectional study, the authors investigated whether physical activity and insulin sensitivity were associated with hypertension. The sample consisted of 1,599 persons aged 40-69 years who participated in the Insulin Resistance Atherosclerosis Study.

CAPRELA (Cancer Prevention for Latinas): findings of a pilot study in Winston-Salem, Forsyth County.

Objective: To evaluate knowledge and attitudes that affect cervical and breast cancer screening among uninsured Hispanic women.

Study Design: Cross-sectional, descriptive study of uninsured Latino women in Forsyth County, North Carolina.

Data Sources/study Setting: A convenience sample of Hispanic women who immigrated to the United States within the last ten years, primarily from Mexico (N = 70).

Creation of a grant support service within a Women's Health Center of Excellence: experiences and lessons learned.

Purpose: The Research Support Core (RSC) began in the Women's Health Center of Excellence at Wake Forest University Health Sciences to (1) augment the institution's capacity to win grants in women's health and (2) assist women faculty in obtaining extramural funding.

Methods: The RSC began in July 2002 with a director, a research associate/scientific editor, and a budget specialist (total 0.7 full-time equivalents [FTE]).

Enforcing the minimum drinking age: state, local and agency characteristics associated with compliance checks and Cops in Shops programs.

Aims: To identify state, local and organizational characteristics associated with local law enforcement agencies' implementation of two dramatically different approaches to enforcement of underage drinking laws: compliance checks and Cops in Shops programs. Compliance checks use underage decoys to attempt to purchase alcohol from retail merchants, while Cops in Shops programs deploy undercover law enforcement officers in alcohol outlets to detect and cite persons under the age of 21 who attempt to purchase alcohol.

Design: Cross-sectional telephone interview conducted as part of the Tobacco Enforcement Study (TES), which examined enforcement of laws related to youth access to tobacco.

Training and evaluating tobacco-specific standardized patient instructors.

Background And Objectives: A comprehensive training program to develop tobacco-specific standardized patient instructors (SPIs) was implemented and evaluated at Wake Forest University.

Methods: Descriptive statistics were used to assess SPIs' experience with the training program and medical students' perceptions of the SPI-student interaction. Two standardized scales, used to assess student performance on counseling (Tobacco Intervention Risk Factor Interview Scale [TIRFIS]) and cultural competency (Tobacco Beliefs Management Scale-Tobacco Cultural Concerns Scale [TBMS-TCCS]), were tested for internal and interrater reliability and sensitivity to varied student performance.

A qualitative exploration of the cancer experience among long-term survivors: comparisons by cancer type, ethnicity, gender, and age.

Background: To elucidate meanings ascribed to the cancer experience by long-term survivors.

Methods: Semi-structured interviews were conducted with 58 cancer survivors (>15 years post-diagnosis). Respondents described how cancer affected their quality of life (QOL) generally and in 17 domains.

Adults' approval and adolescents' alcohol use.

Purpose: To compare adults' approval of adolescents' alcohol use among white, black, and Latino youth and to evaluate the effects of approval on most recent alcohol consumption, past 30-day use and binge drinking.

Methods: A cross-sectional telephone survey of N = 6245 adolescents from 242 communities was conducted as part of the National Evaluation of the Enforcing Underage Drinking Laws Program. The survey assessed perceived availability of alcohol, underage alcohol use, and problems related to underage drinking.

Racial differences in knowledge, attitudes, and cancer screening practices among a triracial rural population.

Background: Low-income, minority, and rural women face a greater burden with regard to cancer-related morbidity and mortality and are usually underrepresented in cancer control research. The Robeson County Outreach, Screening and Education Project sought to increase mammography use among low-income, minority, and rural women age > 40 years. The current article reports on racial disparities and barriers to screening, especially those related to knowledge, attitudes, and behaviors.

Adolescent sexual victimization, use of alcohol and other substances, and other health risk behaviors.

Purpose: To examine the relationship between substance use, other health risk behaviors, and sexual victimization among adolescent females.

Methods: A cross-sectional telephone survey of 16-20-year-olds, including 647 female "ever drinkers" (1999) and 1236 female "never drinkers" and "ever drinkers" (2000) from 17 states, was conducted as part of the National Evaluation of the Enforcing Underage Drinking Laws Program. The survey assessed underage alcohol use, sexual victimization, and other risky behaviors.

An exploration of patients' trust in physicians in training.

Several characteristics associated with patient trust are identified. To determine the level of trust patients from disadvantaged circumstances have in their primary care resident physician, and to determine patient and physician characteristics that predict trust, we administered a survey to randomly selected primary care patients of an academic medical center staffed by internal medicine residents after a visit to their primary care provider. Participants were adults.

Reliability of a Smoking Cessation Risk Factor Interview Scale (SCRFIS) for use with standardized patient instructors.

Background: This study evaluated internal consistency and inter-rater reliability of the smoking cessation risk factor interview scale (SCRFIS).

Methods: Encounters from 16 patient instructors and 414 medical students were used for analyses: Cronbach's alpha and item-to-total correlations measured internal consistency; one-way analysis of variance evaluated comparability of scores across multiple raters, t-tests measured gender bias, and regression analyses compared student counseling skills across three curricula.

Results: The total scale was reliable, there was minimal gender bias, and student counseling skills remained relatively constant over time.