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  • 1
    Online Resource
    Online Resource
    Implementing the Comprehensive Unit-Based Safety Program (CUSP) to Improve Patient Safety in an Academic Primary Care Practice
    Elsevier BV ; 2017
    In:  The Joint Commission Journal on Quality and Patient Safety Vol. 43, No. 11 ( 2017-11), p. 591-597
    Details
    In: The Joint Commission Journal on Quality and Patient Safety, Elsevier BV, Vol. 43, No. 11 ( 2017-11), p. 591-597
    Type of Medium: Online Resource
    ISSN: 1553-7250
    URL: Article
    DOI: 10.1016/j.jcjq.2017.06.006
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2017
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  • 2
    Online Resource
    Online Resource
    Clinical Care Providers’ Perspectives on Body Size and Weight Management Among Long-Term Cancer Survivors
    SAGE Publications ; 2015
    In:  Integrative Cancer Therapies Vol. 14, No. 3 ( 2015-05), p. 240-248
    Details
    In: Integrative Cancer Therapies, SAGE Publications, Vol. 14, No. 3 ( 2015-05), p. 240-248
    Abstract: Objective. To examine clinical care providers’ perspectives on cancer survivors’ body size and weight management. Study Design. In-depth, semi-structured, qualitative interviews. Methods. Interviews were conducted with 33 providers (eg. oncologists, surgeons, primary care providers, nurses, dietitians) across academic and community clinical settings. They were transcribed, coded, and analyzed thematically using constant comparative analysis. Results. Providers conceptualized weight in relation to acute treatment, cancer outcomes, or overall health/comorbidities. These patterns were reflected in their reported framing of weight discussions, although providers indicated that they counsel patients on weight to varying extents. Perspectives differed based on professional roles and patient populations. Providers reported that survivors are motivated to lose weight, particularly due to comorbidity concerns, but face numerous barriers to doing so. Conclusion. Providers described survivor-level and capacity-level factors influencing survivors’ weight management. Differences by provider type highlighted the role of provider knowledge, attitudes, and beliefs in clinical encounters. Opportunities for research and intervention include developing and disseminating evidence-based clinical resources for weight management among cancer survivors, addressing capacity barriers, and exploring communication strategies at interpersonal and population levels.
    Type of Medium: Online Resource
    ISSN: 1534-7354 , 1552-695X
    URL: Article
    DOI: 10.1177/1534735415572882
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2101248-9
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  • 3
    Online Resource
    Online Resource
    Improving cancer care for underserved populations in an academic and community practice setting: protocol for a community health worker pilot navigation programme
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 12 ( 2022-12), p. e067270-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 12 ( 2022-12), p. e067270-
    Abstract: Delaying cancer treatment following diagnosis impacts health outcomes, including increasing patient distress and odds of mortality. Interventions to promote timely healthcare engagement may decrease patient-reported stress and improve quality of life. Community health workers (CHWs) represent an enabling resource for reducing delays in attending initial oncology treatment visits. As part of an ongoing programme evaluation coordinated by the Merck Foundation, we will implement a pilot navigation programme comprising CHW-conducted needs assessments for supporting patients and their caregivers. We aim to investigate (1) the programme’s influence on patients’ healthcare utilisation within the period between their first diagnosis and initial treatment visit and (2) the logistic feasibility and acceptability of programme implementation. Methods and analysis We will employ a hybrid implementation design to introduce the CHW navigation programme at the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center. CHW team members will use a consecutive sampling approach. Participants will complete the Problem-Checklist, Chronic Illness Distress Scale and the Satisfaction with Life Domains instruments. CHWs will provide tailored guidance by sharing information available on the Johns Hopkins Electronic Resource databases. The investigators will evaluate patients’ time to initial oncology treatment and healthcare utilisation by reviewing electronic medical records at 3 and 6 months postintervention. Bivariate analyses will be completed to evaluate the relationships between receiving the programme and all outcome measures. Ethics and dissemination This study’s protocol was approved by the Johns Hopkins School of Medicine’s institutional review board (IRB00160610). Informed consent will be obtained by phone by the CHW navigator. Dissemination planning is ongoing through regular meetings between members of the investigator team and public members of two community advisory groups. Study plans include collaborating with other experts from the Johns Hopkins Institute for Clinical and Translational Research and the Johns Hopkins Center for Health Equity for ideating dissemination strategies.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2022-067270
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
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  • 4
    Online Resource
    Online Resource
    The Johns Hopkins Primary Care for Cancer Survivor Clinic: lessons learned in our first 4 years
    Springer Science and Business Media LLC ; 2020
    In:  Journal of Cancer Survivorship Vol. 14, No. 1 ( 2020-02), p. 19-25
    Details
    In: Journal of Cancer Survivorship, Springer Science and Business Media LLC, Vol. 14, No. 1 ( 2020-02), p. 19-25
    Type of Medium: Online Resource
    ISSN: 1932-2259 , 1932-2267
    URL: Article
    DOI: 10.1007/s11764-019-00816-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2388888-X
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  • 5
    Online Resource
    Online Resource
    Relationship Between Physiological Load, Body Composition, And Performance Across Season In Female Soccer Athletes : 2086 Board #99 June 1 3 30 PM - 5 00 PM
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Medicine & Science in Sports & Exercise Vol. 49, No. 5S ( 2017-05), p. 574-
    Details
    In: Medicine & Science in Sports & Exercise, Ovid Technologies (Wolters Kluwer Health), Vol. 49, No. 5S ( 2017-05), p. 574-
    Type of Medium: Online Resource
    ISSN: 0195-9131
    URL: Article
    DOI: 10.1249/01.mss.0000518493.30749.9b
    RVK:
    ZX 1000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2031167-9
    SSG: 31
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  • 6
    Online Resource
    Online Resource
    Screening for lung cancer
    Elsevier BV ; 2017
    In:  Seminars in Oncology Vol. 44, No. 1 ( 2017-02), p. 74-82
    Details
    In: Seminars in Oncology, Elsevier BV, Vol. 44, No. 1 ( 2017-02), p. 74-82
    Type of Medium: Online Resource
    ISSN: 0093-7754
    URL: Article
    DOI: 10.1053/j.seminoncol.2017.02.003
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2017
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  • 7
    Online Resource
    Online Resource
    Making it work: Breast cancer survivorship care at Johns Hopkins.
    American Society of Clinical Oncology (ASCO) ; 2012
    In:  Journal of Clinical Oncology Vol. 30, No. 27_suppl ( 2012-09-20), p. 61-61
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 27_suppl ( 2012-09-20), p. 61-61
    Abstract: 61 Background: Breast cancer survivor numbers are increasing due to population aging and improved treatment outcomes but many of their long-term health care needs are unmet. Integrated follow-up care strategies that enhance care coordination, education, and access to survivorship resources are needed to provide patients with evidence-based care that addresses medical and psychosocial needs after cancer treatment. Methods: In 2008, we established the Johns Hopkins Breast Cancer Survivorship Program with representation from the Schools of Nursing, Public Health, and Medicine to address the needs of patients completing initial cancer treatment and transitioning to long-term follow-up. Patient educational resources were created within an interactive website ( http://bit.ly/hZfzFi ) including 〉 35 patient/provider educational video clips, blogs and social media. Activities including provider educational events, educational folders, and trainee curriculum additions have been ongoing. Starting May 2011, Hopkins patients were offered a one-time transition visit with a nurse practitioner focusing on individualized treatment summary/survivorship care plan activities (e.g., cancer screening/surveillance, medical intervention, psychosocial support, and care coordination with non-cancer providers). Results: Our website is averaging 3,000 hits monthly. We have participated in 22 provider/trainee formal educational presentations. In the pilot phase of these transition visits (n=40), age/race breakdown of participants were representative of our breast cancer population (median age 51, range 34-69; 17% African Americans). Our post-visit survey (n=37), 97% found the survivorship visit beneficial and all reported that this one-time consultation helped with transitioning away from treatment. Conclusions: A multidisciplinary patient-centered approach to breast cancer survivorship allowed us to develop comprehensive clinical and educational service models to benefit patients and their cancer/non-cancer providers. This program aims to enhance education, overcome the fragmentation of the health care system, and improve overall health and wellness of breast cancer survivors as they transition to long-term survivorship.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/jco.2012.30.27_suppl.61
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2012
    detail.hit.zdb_id: 2005181-5
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  • 8
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    Implementation of a novel primary care-centered clinic for survivorship care.
    American Society of Clinical Oncology (ASCO) ; 2017
    In:  Journal of Clinical Oncology Vol. 35, No. 5_suppl ( 2017-02-10), p. 41-41
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 5_suppl ( 2017-02-10), p. 41-41
    Abstract: 41 Background: Patients often face challenges in transitioning to the survivorship stage of cancer care and coordinating with primary care. Prior research has highlighted the uncertainty in who provides survivorship care, leaving patients “lost in transition”. Integrating primary care providers (PCP) into cancer care offers one potential solution. Expanding traditional PCP roles to participating throughout the cancer continuum and familiarizing PCPs with cancer patients’ needs can address this gap. We describe an innovative model of incorporating PCPs to delivering primary care to cancer survivors at a large academic institution. Methods: As one part of a plan to address an identified need for improving survivorship care for cancer patients at Johns Hopkins, PCPs and cancer survivorship care experts developed the Primary Care for Cancer Survivors clinic (PCCS) in 11/2015. The clinic receives referrals from the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center and patients are seen for either a one-time consultation or can transition their primary care to the clinic. We also are creating a database of internal and external referrals to meet the specific needs identified by patients. We descriptively analyzed the utilization of PCCS from 11/2015 through 9/2016. Results: A total of 35 patients have been seen at PCCS. The average age of patients was 56.8 (SD 12.4) and 32 were female and 3 were male. 24 patients identified as white, 8 black, 1 Asian, and 2 others. Most patients transitioned their PC to the clinic (n = 30). The majority of patients had breast (n = 19) and colorectal cancer (n = 5); 10 patients had metastatic disease (3 have deceased). Commonly, referrals were made to physical therapy, including pelvic rehabilitation and lymphedema management, and nutrition counseling. Conclusions: Patients with a wide variety of cancers and at all stages of disease were seen for survivorship care in the PCCS clinic. Integrating nutrition care, psychosocial support, exercise programs, and palliative care were key early factors in meeting patients’ needs. Continuing to assess and meet survivors’ individual needs and build referral networks are important next steps in the development of the clinic.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2017.35.5_suppl.41
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2017
    detail.hit.zdb_id: 2005181-5
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  • 9
    Online Resource
    Online Resource
    Prostate cancer survivorship care plans: What we are failing to tell men after treatment?
    American Society of Clinical Oncology (ASCO) ; 2020
    In:  Journal of Clinical Oncology Vol. 38, No. 6_suppl ( 2020-02-20), p. 311-311
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 6_suppl ( 2020-02-20), p. 311-311
    Abstract: 311 Background: Survivorship care plans (SCPs) present essential information about cancer treatment and follow-up recommendations for cancer survivors. We describe the completeness of prostate cancer SCPs and evaluate guideline concordance of follow-up recommendations. Methods: We analyzed 125 prostate cancer SCPs from an academic and community cancer center, abstracting demographics, cancer/treatment details and follow-up recommendations. Follow-up recommendations were compared to national guidelines. Results: Content provided in 〉 90% of SCPs included cancer TNM stage; PSA at diagnosis; radiation treatment details (98% of men received radiation); and PSA monitoring recommendations. Potential treatment-specific side effects were listed for 69% of men who had surgery, 78% for androgen deprivation therapy (ADT) and 97% for radiation. The presence of post-treatment symptoms were noted in 67% of plans – several ADT-related side effects (e.g., bone thinning, cognitive changes, muscle atrophy) were noted for 0/21 men who completed all ADT. Guidelines recommend an annual digital rectal exam (DRE) with no physical exam otherwise specified. No SCPs specified DRE, but all 68 SCPs at the community site recommended at least annual follow-up visits with urology, radiation oncology, and primary care. Only 5/57 SCPs at the academic site specified follow-up visits (radiation oncology every 6 months). Guidelines recommend PSA testing every 6-12 months (optional 3 months if high risk) for 5 years, then annually; while duration was not specified in any SCPs, if applied to the first 5 years, 91% of SCP recommendations were guideline concordant, 7% suggested oversurveillance, and 2% were incomplete. In men who received ADT, guidelines recommend assessing bone density (by imaging or FRAX score), and goal testosterone level. Of 80 men who completed or had ongoing ADT, 2% were recommended for bone density imaging (0 had FRAX scores) and 19% for testosterone levels. Conclusions: SCP content is more complete for demographic and treatment summary information with gaps in addressing treatment effects and follow-up recommendations beyond PSA testing. These findings highlight the need to improve the quality of information in SCPs. Clinical trial information: NCT03035773.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2020.38.6_suppl.311
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
    detail.hit.zdb_id: 2005181-5
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  • 10
    Online Resource
    Online Resource
    Diabetes Mellitus and Breast Cancer Outcomes: A Systematic Review and Meta-Analysis
    American Society of Clinical Oncology (ASCO) ; 2011
    In:  Journal of Clinical Oncology Vol. 29, No. 1 ( 2011-01-01), p. 40-46
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 29, No. 1 ( 2011-01-01), p. 40-46
    Abstract: The goal of this study was to perform a systematic review and meta-analysis to examine the effect of pre-existing diabetes on breast cancer–related outcomes. Methods We searched EMBASE and MEDLINE databases from inception through July 1, 2009, using search terms related to diabetes mellitus, cancer, and prognostic outcome. Studies were included if they reported a prognostic outcome by diabetes status, evaluated a cancer population, and contained original data published in the English language. We performed a meta-analysis of pre-existing diabetes and its effect on all-cause mortality in patients with breast cancer and qualitatively summarized other prognostic outcomes. Results Of 8,828 titles identified, eight articles met inclusion/exclusion criteria and described outcomes in patients with breast cancer and diabetes. Pre-existing diabetes was significantly associated with all-cause mortality in six of seven studies. In a meta-analysis, patients with breast cancer and diabetes had a significantly higher all-cause mortality risk (pooled hazard ratio [HR], 1.49; 95% CI, 1.35 to 1.65) compared with their nondiabetic counterparts. Three of four studies found pre-existing diabetes to be associated with more advanced stage at presentation. Diabetes was also associated with altered regimens for breast cancer treatment and increased toxicity from chemotherapy. Conclusion Compared with their nondiabetic counterparts, patients with breast cancer and pre-existing diabetes have a greater risk of death and tend to present at later stages and receive altered treatment regimens. Studies are needed to investigate pathophysiologic interactions between diabetes and breast cancer and determine whether improvements in diabetes care can reduce mortality in patients with breast cancer.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2009.27.3011
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2011
    detail.hit.zdb_id: 2005181-5
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