Addressing multilevel barriers to clinical trial participation among Black and White men with prostate cancer through the PACCT study.

Background: Cancer clinical trial participation is low and inequitable. Partnering Around Cancer Clinical Trials (PACCT) addressed systemic and interpersonal barriers through an observational study of eligibility and an intervention to improve patient-physician communication and trial invitation rates.

Methods: Physicians at two comprehensive cancer centers and Black and White men with prostate cancer participated.

Demand for and Occurrence of Medication Cost Conversations: A Narrative Review.

High medication prices can create a financial burden for patients and reduce medication initiation. To improve decision making, public policy is supporting development of tools to provide real-time prescription drug prices. We reviewed the literature on medication cost conversations to characterize the context in which these tools may be used.

Within- and between-group heterogeneity in cultural models of emotion among people of European, Asian, and Latino heritage in the United States.

Research on cultural variation in emotion values and beliefs has usually explained this variation in terms of individualism and collectivism, typically comparing European American against East Asian cultural contexts. This study examined emotion model variability across as well as within cultural contexts in a large sample of young adults of Latino heritage along with people of European and East Asian heritage. Using latent class analysis, we characterized and predicted endorsement of emotion models, distinguishing emotion ideals (the emotions one desires) from beliefs about injunctive norms for emotion (the emotions one believes are appropriate).

Development and pilot test of a physician-focused cancer clinical trials communication training intervention.

Objective: We describe the development and pilot test of a physician-focused, web-based training module designed to improve physician communication related to clinical trials in a diverse cancer patient population.

Methods: Researchers and stakeholders developed the training module, which included a video explaining patient-centered communication strategies for discussing trials, and re-enactments of actual clinical interactions. For the pilot test, the module was provided to physician participants in the Partnering Around Cancer Clinical Trials (PACCT) trial at two major urban cancer centers.

Understanding engagement behaviors and rapport building in tobacco cessation telephone counseling: An analysis of audio-recorded counseling calls.

Introduction: Though telephone counseling is a modality commonly used to promote health behavior change, including tobacco cessation, specific counselor and participant behaviors that indicate engagement and therapeutic alliance remain poorly characterized in the literature. We sought to explore smokers' and counselors' engagement and rapport-building behaviors in telephone counseling for smoking cessation and patterns of these behaviors by smokers' psychiatric symptoms.

Methods: The study team transcribed, audio-recorded tobacco cessation counseling calls for the presence of engagement and rapport-building behaviors among recently hospitalized participants enrolled in a smoking cessation randomized controlled trial (RCT).

Evidence-based smoking cessation treatment: a comparison by healthcare system.

Background: A systems-level approach to smoking cessation treatment may optimize healthcare provider adherence to guidelines. Institutions such as the Veterans Health Administration (VHA) are unique in their systematic approach, but comparisons of provider behavior in different healthcare systems are limited.

Methods: We surveyed general medicine providers and specialists in a large academic health center (AHC) and its affiliated VHA in the Mid-South in 2017 to determine the cross-sectional association of healthcare system in which the provider practiced (exposure: AHC versus VHA) with self-reported provision of evidence-based smoking cessation treatment (delivery of counseling plus smoking cessation medication or referral) at least once in the past 12 months (composite outcome).

Willingness to Discuss Clinical Trials Among Black vs White Men With Prostate Cancer.

Importance: Black individuals are underrepresented in cancer clinical trials.

Objective: To examine whether Black and White men with prostate cancer differ in their willingness to discuss clinical trials with their physicians and, if so, whether patient-level barriers statistically mediate racial differences.

Design, Setting, And Participants: This cross-sectional survey study used baseline data from Partnering Around Cancer Clinical Trials, a randomized clinical trial to increase Black individuals' enrollment in prostate cancer clinical trials.

Barriers and facilitators to dissemination and adoption of precision medicine among Hispanics/Latinos.

Background: With the rapid advances in gene technologies in recent years, the potential benefits of precision medicine (PM) may spread unevenly to disadvantaged populations, such as Hispanics/Latinos. The objective of this study was to explore patient-level barriers and facilitators to dissemination and adoption of PM among Hispanics/Latinos, including knowledge and awareness.

Methods: Self-identified Hispanics/Latinos from diverse countries in Latin America (N = 41) participated in the study.

Who emphasizes positivity? An exploration of emotion values in people of Latino, Asian, and European heritage living in the United States.

Emotion values vary within and between individualistic and collectivistic cultural contexts. The form of collectivism prevalent in Latin America emphasizes simpatía, a cultural model that stresses the relational benefits of positivity but also the costs of negativity. This model was predicted to engender a pattern of emotion values distinct from that of the more commonly studied collectivist group, people of Asian heritage (PAH), among whom an emphasis on moderating positive and negative emotions is typically observed, and from people of European heritage (PEH), among whom authenticity in emotions is typically valued.

Smartphone apps for cancer: A content analysis of the digital health marketplace.

Objective: The purpose of this study was to examine the state of smartphone applications for cancer intended for the general public with a focus on interactive features, content sources, and application developer affiliations. The level of health provider involvement in screening or appraising application content was also assessed.

Methods: A total of 123 apps were identified for analysis from two major mobile application marketplaces (Apple iTunes = 40; Google Play = 83).

eHealth Activity among African American and White Cancer Survivors: A New Application of Theory.

eHealth is a promising resource for cancer survivors and may contribute to reducing racial disparities in cancer survivorship. This research applies the Unified Theory of Acceptance and Use of Technology (UTAUT) to examine eHealth activity among African American (AfAm) and White cancer survivors. In a population-based sample of AfAm and White survivors ( = 300), a Poisson regression tested whether UTAUT constructs (facilitating conditions, social influence, perceived ease of use, perceived usefulness) and beliefs about security/trustworthiness of eHealth were associated with the number of eHealth activities respondents had used.

Unpacking Trial Offers and Low Accrual Rates: A Qualitative Analysis of Clinic Visits With Physicians and Patients Potentially Eligible for a Prostate Cancer Clinical Trial.

Purpose: Cancer clinical trial accrual rates are low, and information about contributing factors is needed. We examined video-recorded clinical interactions to identify circumstances under which patients potentially eligible for a trial at a major cancer center were offered a trial.

Methods: We conducted a qualitative directed content analysis of 62 recorded interactions with physicians (n = 13) and patients with intermediate- or high-risk prostate cancer (n = 43).

Growing Disparities in Patient-Provider Messaging: Trend Analysis Before and After Supportive Policy.

Background: Public policy introduced since 2011 has supported provider adoption of electronic medical records (EMRs) and patient-provider messaging, primarily through financial incentives. It is unclear how disparities in patients' use of incentivized electronic health (eHealth) tools, like patient-provider messaging, have changed over time relative to disparities in use of eHealth tools that were not directly incentivized.

Objective: This study examines trends in eHealth disparities before and after the introduction of US federal financial incentives.

Attitudes toward Precision Treatment of Smoking in the Southern Community Cohort Study.

Background: Precision interventions using biological data may enhance smoking treatment, yet are understudied among smokers who are disproportionately burdened by smoking-related disease.

Methods: We surveyed smokers in the NCI-sponsored Southern Community Cohort Study, consisting primarily of African-American, low-income adults. Seven items assessed attitudes toward aspects of precision smoking treatment, from undergoing tests to acting on results.

Ethnic variation in gratitude and well-being.

Gratitude is positively associated with health and well-being. Past studies of gratitude have primarily focused on the distinct cultural context of European Americans. The current studies aimed to extend gratitude research to Latino and East Asian Americans, 2 collectivistic contexts known to differently value positive emotions.

eHealth Engagement as a Response to Negative Healthcare Experiences: Cross-Sectional Survey Analysis.

Background: eHealth provides individuals with new means of accessing health information and communicating with providers through online channels. Prior evidence suggests that patients use eHealth to find information online when they receive care that is low in patient centeredness. However, it is unclear how other problems with the healthcare-delivery system motivate the use of eHealth, how these problems relate to different kinds of eHealth activities, and which populations are most likely to use eHealth when they receive low-quality care.

The influence of affective behavior on impression formation in interactions between black cancer patients and their oncologists.

Objective: Black patients and their physicians tend to form relatively negative impressions of each other, and these may contribute to racial disparities in health outcomes. The current research tested the hypothesis that the interaction between positive and negative affective behavior predicts the most positive impressions in clinic visits between Black patients and their oncologists.

Method: Naïve coders rated patients' and oncologists' positive and negative affective behavior in thin slices from 74 video recorded clinic visits.

Partnering around cancer clinical trials (PACCT): study protocol for a randomized trial of a patient and physician communication intervention to increase minority accrual to prostate cancer clinical trials.

Background: Cancer clinical trials are essential for testing new treatments and represent state-of-the-art cancer treatment, but only a small percentage of patients ever enroll in a trial. Under-enrollment is an even greater problem among minorities, particularly African Americans, representing a racial/ethnic disparity in cancer care. One understudied cause is patient-physician communication, which is often of poor quality during clinical interactions between African-American patients and non-African-American physicians.

The impact of Black cancer patients' race-related beliefs and attitudes on racially-discordant oncology interactions: A field study.

Objective: Both physician and patient race-related beliefs and attitudes are contributors to racial healthcare disparities, but only the former have received substantial research attention. Using data from a study conducted in the Midwestern US from 2012 to 2014, we investigated whether 114 Black cancer patients' existing race-related beliefs and attitudes would predict how they and 18 non-Black physicians (medical oncologists) would respond in subsequent clinical interactions.

Method: At least two days before interacting with an oncologist for initial discussions of treatment options, patients completed measures of perceived past discrimination, general mistrust of physicians, and suspicion of healthcare systems; interactions were video-recorded.

Their Hands Have Lost Their Bones: Exploring Cultural Scripts in Two West African Affect Lexica.

Previous research has indicated the importance of embodiment in West African emotion lexica. The current study aims to explore the pervasiveness of this cultural script through the analysis of the emotional lexica of two West African languages (Ga and Ewe) from Southern Ghana that have been featured minimally in previous emotion research. The analysis indicated that embodiment was an important cultural script in both affective lexica.