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  • 1
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2015
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 24, No. 10_Supplement ( 2015-10-01), p. A61-A61
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 24, No. 10_Supplement ( 2015-10-01), p. A61-A61
    Abstract: Introduction: The population of breast cancer survivors continues to grow due to improved medical treatments and education. Yet there is a lack of comprehensive survivorship care planning to manage overall health following cancer treatment. The Institute of Medicine (IOM) recommends psychosocial components be included in survivorship care plans to address long-term psychological distress. African Americans in particular experience disproportionate levels of psychosocial distress in breast cancer survivorship. Thus the goal of this study was to understand the psychosocial needs, resources, and cultural influences during the transition from treatment to survivorship from the perspectives of both the oncology professionals and survivors themselves. Methods: Twenty-nine, semi-structured one-on-one interviews were conducted in Washington State by African-American community advocates as part of a larger on-going study. Twelve oncology professionals (OPs) and 17 female African-American breast cancer survivors (BCSs) were interviewed. Open-ended interview guides were tailored for BCSs and OPs respectively. Interviews were transcribed, coded, and analyzed using principles of constant comparison grounded theory, in which concepts were identified and themes derived from interview data. Interviews were approximately 45 minutes in duration and participants received $40 compensation for their time. Results: Similar to previous literature, psychosocial needs identified by both BCSs and OPs included fear of recurrence, emotional and financial distress, and support issues. However, the role of daily stressors and microaggressions described by many BCSs were not widely identified by OPs. BCSs also indicated a need for more empathetic interactions from OPs during medical visits. A major gap identified between the BCSs and OPs was found in the source of psychosocial information provided to BCSs. Nearly half of the BCSs indicated psychosocial support was received from community-based programs (spiritual and secular) whereas many OPs believed support was provided as part of clinical services at their institution. However, several OPs did state that there are numerous community resources available to survivors. Many professionals stated that a structured protocol is not in place to help survivors identify available services and some specifically identified the need to include psychosocial factors in the survivorship care plan. A few OPs suggested that follow-up appointments with survivors 3-, 6- and 12-months after cancer treatment may reduce feelings of isolation and lack of support. With regard to cultural factors that may impact the transition to survivorship, many of the BCSs noted they did not openly share their cancer experience with others, family/friends or professionals, which they indicated is an African-American cultural trait; specifically, the desire to appear as a “strong” woman. Some OPs also mentioned this aspect of the African-American culture as a possible barrier to communication about psychosocial well-being during medical visits. Some survivors conveyed interest in mentoring future BCSs stating a need for African Americans to support each other, but did not specifically describe how this support would differ from other sources of support. OPs discussed historical injustices as a potential source of mistrust within African American breast cancer survivors. Conclusion: While there are many areas of overlap between BCSs and OPs regarding psychosocial needs of African-American BCSs, there remain gaps of primarily social and institutional systemic barriers to care. Study limitations and some recommendations to meet the psychosocial needs of African American breast cancer survivors have emerged from the interviews and are discussed. Citation Format: Swati Somuri, Rachel M. Ceballos, Sarah H. Hohl, Rachel M. Malen, Bridgette Hempstead, Jacci Thompson-Dodd. Perspectives on transitioning from cancer treatment to breast cancer survivorship. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A61.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2015
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    detail.hit.zdb_id: 1153420-5
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  • 2
    In: BMC Health Services Research, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-08-23)
    Abstract: The United States Preventive Services Task Force (USPSTF) lists 32 grade A or B recommended preventive services for non-pregnant United States (US) adults, including colorectal cancer screening (CRC). Little guidance is given on how to implement these services with consistency and fidelity in primary care. Given limited patient visit time and competing demands, primary care providers (PCPs) tend to prioritize a small subset of these recommendations. Completion rates of some of these services, including CRC screening, are suboptimal. Expanding delivery of preventive services to other healthcare providers, where possible, can improve access and uptake, particularly in medically underserved areas or populations. Fecal immunochemical testing (FIT) (at-home, stool-based testing) for CRC screening can be distributed and resulted without PCP involvement. Pharmacists have long delivered preventive services (e.g., influenza vaccination) and may be a good option for expanding CRC screening delivery using FIT, but it is not clear how PCPs would perceive this expansion. Methods We used semi-structured interviews with PCPs in North Carolina and Washington state to assess perceptions and recommendations for a potential pharmacy-based FIT distribution program (PharmFIT™). Transcripts were coded and analyzed using a hybrid inductive-deductive content analysis guided by the Consolidated Framework for Implementation Research (CFIR) to elucidate potential multi-level facilitators of and barriers to implementation of PharmFIT™. Results We completed 30 interviews with PCPs in North Carolina (N = 12) and Washington state (N = 18). PCPs in both states were largely accepting of PharmFIT™, with several important considerations. First, PCPs felt that pharmacists should receive appropriate training for identifying patients eligible and due for FIT screening. Second, a clear understanding of responsibility for tracking tests, communication, and, particularly, follow-up of positive test results should be established and followed. Finally, clear electronic workflows should be established for relay of test result information between the pharmacy and the primary care clinic. Conclusion If the conditions are met regarding pharmacist training, follow-up for positive FITs, and transfer of documentation, PCPs are likely to support PharmFIT™ as a way for their patients to obtain and complete CRC screening using FIT.
    Type of Medium: Online Resource
    ISSN: 1472-6963
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2050434-2
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  • 3
    In: Journal of Psychosocial Oncology, Informa UK Limited, Vol. 39, No. 1 ( 2021-01-02), p. 35-53
    Type of Medium: Online Resource
    ISSN: 0734-7332 , 1540-7586
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2021
    detail.hit.zdb_id: 2091285-7
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  • 4
    In: Journal of Cancer Education, Springer Science and Business Media LLC, Vol. 30, No. 3 ( 2015-9), p. 447-452
    Type of Medium: Online Resource
    ISSN: 0885-8195 , 1543-0154
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2015
    detail.hit.zdb_id: 2049313-7
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  • 5
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2015
    In:  Supportive Care in Cancer Vol. 23, No. 7 ( 2015-7), p. 2145-2155
    In: Supportive Care in Cancer, Springer Science and Business Media LLC, Vol. 23, No. 7 ( 2015-7), p. 2145-2155
    Type of Medium: Online Resource
    ISSN: 0941-4355 , 1433-7339
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2015
    detail.hit.zdb_id: 1463166-0
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  • 6
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2014
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 23, No. 11_Supplement ( 2014-11-01), p. A09-A09
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 23, No. 11_Supplement ( 2014-11-01), p. A09-A09
    Abstract: Introduction: While survivor care planning is currently the focus of much research, the process of communication between providers and patients, as well as, perceptions of the patient experience during the time of transition from patient to survivor, is not well understood. While this period of transition can be one of joy and hope, emotional distress can occur for patients as they face fears of recurrence and reduced oversight of their cancer status. For African-American patients this period may include unique concerns that should be more closely investigated. To address this, the current study explored the needs, barriers, and facilitators present during the period of transition from the perspective of both oncology professionals (OP) and African-American breast cancer survivors (AA-BCS). Methods: African-American community advocates with extensive skill in elicitation conducted 29 semi-structured one-on-one interviews. Twelve OPs (e.g. social workers, nurses, oncologists) and 17 female AA-BCSs were interviewed. The interview guides were tailored for BCSs and OPs respectively, and aimed to: 1) elicit perspectives about medical and psychosocial information presented to patients 2) understand the cognitive and emotional experience of AA-BCSs as they receive medical and psychosocial information about post-treatment cancer survivorship and 3) identify perceived barriers, facilitators, and goals toward providing necessary information and emotional support to AA-BCS in particular. Interviews were transcribed, coded, and analyzed using principles of constant comparison grounded theory, in which concepts were identified and themes derived from interview data. Results: Many AA-BCSs reported feeling confident in their medical care but some noted concerns, such as, reluctance to ask questions of OPs and perceived micro-aggressions in the medical environment. Overall, AA-BCSs and OPs reported similar medical information being presented to patients (e.g., post-treatment care, medication side effects, and logistical considerations), but gaps were noted in both groups with regard to communication of psychosocial and financial resources. For instance, BCSs reported the majority of psychosocial information and social support needs were met through community-based not hospital-based programs. OPs, specifically, recognized there are often “gaps in patient handoffs” highlighting the need for more cross-communication between OPs providing dissimilar specialties. Medically, however, most AA-BCSs perceived their care as equivalent to that received by patients from other ethnicities. Few OPs identified differences in medical or cultural needs of many African-Americans, but a small number noted AA-BCSs may have more difficulty asking questions of OPs and would benefit from patient advocacy. While a limited number of OPs identified issues such as skin discoloration due to radiation, a lack of images that represented the African-American community during reconstructive surgery, the effect of historical insults on interaction with medical professionals, and the presence of more aggressive breast cancer among younger African-Americans, many OPs identified a need for more cross-cultural training. Many OPs, however, did mention observing higher rates of external social support, spirituality, and resilience among AA-BCSs, which was echoed by the AA-BCSs themselves. The benefit of compassionate communication was also identified by OPs and AA-BCSs as an important contributor to overcoming potential barriers during this period of transition. Conclusion: The results of this study suggest, medically, AA-BCSs were generally satisfied with their care, but the presence of perceived micro-aggressions and reluctance to ask questions of OPs should be further explored. OPs acknowledged the need for more cross-cultural training, but appeared reluctant to discuss perceived differences in the needs or experience of AA-BCSs. These and other issues will be presented. Citation Format: Rachel M. Ceballos, Sarah D. Hohl, Bridgette Hempstead, Jacci Thompson-Dodd, Rachel C. Malen. Perceptions of oncology professionals and African American breast cancer survivors on the experience of transitioning from breast cancer patient to survivor. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A09. doi:10.1158/1538-7755.DISP13-A09
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2014
    detail.hit.zdb_id: 2036781-8
    detail.hit.zdb_id: 1153420-5
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  • 7
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2014
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 23, No. 11_Supplement ( 2014-11-01), p. B86-B86
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 23, No. 11_Supplement ( 2014-11-01), p. B86-B86
    Abstract: Purpose. The diagnostic and therapeutic delays African American women experience following an abnormal mammogram are well-documented and may partially contribute to racial disparities in late stage diagnosis and survival. Previous literature has suggested inadequate provider-patient communication may contribute to delayed care and subsequent attitudes and behaviors regarding breast cancer care. Nevertheless, little research has characterized the specific communication needs African American women have following an abnormal mammogram experience. Objective. We describe themes regarding positive and challenging healthcare experiences following an abnormal mammogram result among a small sample of African American women. Methods. Through multiple clinics and community advocates, we recruited a convenience sample of 30 African American women who had received an abnormal mammogram within the previous four years. Qualitative, semi-structured interviews focused on challenging and positive aspects of healthcare interactions following the abnormal mammogram experience (e.g., “What were some ways you felt the doctor and staff supported you?”). Data were analyzed using principles of grounded theory. Results. Several salient themes concerning health communication emerged from our exploratory study. African American women often emphasized their confidence in their ability to act on health information during the abnormal mammogram experience (“When you do the follow-up, you get to ask”). Staff responses to proactive approaches were negative and positive for different women. Negative social interactions with staff included perceived disrespect (“I was actually disappointed with the receptionist…she had a little attitude”) and healthcare distrust concerning withheld information (“I would call them on the phone and…fuss at them about different things that I had found out that were not true or that were available that they did not tell me.”). African American women with positive experiences noted direct communication (“They didn't try to hide anything. They were out front.”; “I feel the doctor supported me by telling me exactly what she was doing.”) and detailed information (“They told me what they were going to do. They told me how to prepare.”). Additionally, women noted the importance of personalism. Women who were less satisfied with follow-up care noted lack of empathy (“They were robots…They're like a tape recording. It's not individualized or personal.”). Conversely, satisfied women mentioned familiarity with patients (“Well they knew my history, so that really made me feel comfortable”) and empathy (“I have doctors who care. They are concerned about this, so they want me to follow-up”; “They talked to you, comforted you.”). Conclusions: Our findings parallel a broader body of literature concerning inadequate patient-provider interactions and culturally specific communication needs of African American populations. The current study further suggests the importance of providing African Americans an active role during care, including direct, professional, and comprehensive communicative styles. Interpersonal support and “whole patient” approaches are also highly valued for this patient population. Emergent themes from this study have direct implications for clinicians and future interventions to increase early breast cancer detection for African American women. Citation Format: Yamile Molina, Sarah H. Hohl, Bridgette Hempstead, Jacci Thompson-Dodd, Rachel C. Malen, Beti Thompson, Rachel M. Ceballos. “The doctor supported me by telling me exactly what she was doing”: Health care experiences of African American women following an abnormal mammogram. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B86. doi:10.1158/1538-7755.DISP13-B86
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2014
    detail.hit.zdb_id: 2036781-8
    detail.hit.zdb_id: 1153420-5
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  • 8
    Online Resource
    Online Resource
    SAGE Publications ; 2014
    In:  Journal of Empirical Research on Human Research Ethics Vol. 9, No. 4 ( 2014-10), p. 10-21
    In: Journal of Empirical Research on Human Research Ethics, SAGE Publications, Vol. 9, No. 4 ( 2014-10), p. 10-21
    Type of Medium: Online Resource
    ISSN: 1556-2646 , 1556-2654
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
    detail.hit.zdb_id: 2263068-5
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  • 9
    In: Cancer Causes & Control, Springer Science and Business Media LLC, Vol. 33, No. 8 ( 2022-08), p. 1095-1105
    Type of Medium: Online Resource
    ISSN: 0957-5243 , 1573-7225
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1496544-6
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  • 10
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2010
    In:  Journal of Cancer Survivorship Vol. 4, No. 4 ( 2010-12), p. 372-380
    In: Journal of Cancer Survivorship, Springer Science and Business Media LLC, Vol. 4, No. 4 ( 2010-12), p. 372-380
    Type of Medium: Online Resource
    ISSN: 1932-2259 , 1932-2267
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2010
    detail.hit.zdb_id: 2388888-X
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