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  • 1
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2012
    In:  Cancer Research Vol. 72, No. 8_Supplement ( 2012-04-15), p. 648-648
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 72, No. 8_Supplement ( 2012-04-15), p. 648-648
    Abstract: Purpose: The lack of accurate prospective tobacco assessments in cancer patients limits the ability to provide tobacco cessation and to accurately evaluate the true impact of tobacco use on cancer treatment outcomes. The purpose of this study was to evaluate tobacco use assessment in patients enrolled in actively accruing cancer clinical trials. Methods: Protocols and forms for 155 actively accruing trials in the NCI's Clinical Trials Cooperative Group program were evaluated for detailed tobacco use assessment at enrollment and through follow-up using a structured coding instrument. Results: Of the 155 clinical trials reviewed, the mean accrual start date was 2008.6 (range 2003-2011), 74.1% were phase III trials, and the total potential accrual population was 106,985 patients. Any form of tobacco use (i.e., cigarette, pipe, cigar, smokeless tobacco, or unspecified “tobacco”) was assessed in 29% of trials (46% of total patient accrual) at enrollment. Current cigarette use at enrollment was assessed in 21.9% of trials and former cigarette use was assessed in 21.3% of trials. Only 4.5% of trials assessed any form of tobacco use during follow-up. Secondhand smoke exposure was captured in 2.6% of trials at enrollment and only 1 trial during follow-up. None of the trials assessed nicotine dependence or interest in quitting at any point during enrollment or treatment. Tobacco assessment varied by type of cancer with a higher proportion of patients being assessed in lung or head and neck cancer trials. Conclusion: Most actively accruing cooperative group clinical trials do not assess tobacco use. Failure to incorporate standardized tobacco assessments into funded national clinical trials will continue to limit the ability to provide evidence based cessation support and will limit the ability to accurately understand the precise impact of tobacco use on cancer treatment outcomes. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 648. doi:1538-7445.AM2012-648
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2012
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  • 2
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2017
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 26, No. 2_Supplement ( 2017-02-01), p. C91-C91
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 26, No. 2_Supplement ( 2017-02-01), p. C91-C91
    Abstract: Background: Human Papillomavirus (HPV) vaccine completion rates in the U.S. are low. Provider recommendation is the most important predictor of vaccine initiation and completion. We sought to understand current practices, perceptions, and likelihood of recommending HPV vaccines among doctors in rural eastern North Carolina. Methods: We distributed a brief 12-item survey to 90 practicing physicians and residents across two community health clinics in eastern North Carolina in March 2015 (44% response rate). The survey asked questions about the likelihood of recommending vaccines to girls and boys of varying ages, comfort in STI discussions, and reasons for not recommending HPV vaccines. Results: Doctors are significantly more likely (p & lt;0.0001) to recommend HPV vaccines to 9-11 year old girls as compared to boys the same age. No significant differences were found for other age groups. Close to half of doctors in our sample (45%) reported to be slightly comfortable, neutral, or not comfortable talking with adolescents about STIs. Doctors who reported being very comfortable in talking with adolescents about STIs were 3.9 times (p & lt;0.05; 1.029-14.996) more likely to recommend the vaccine to 9-11-year-old boys as compared to doctors who reported less comfort. No significant differences were found comfort in talking with adolescents about STIs for girls in the same age group. Conclusion: Results provide a better understanding about specific practices and perceptions regarding HPV vaccines among doctors that may influence their recommendation practices. Our data suggests a need for provider training regarding HPV vaccine recommendation and patient-provider STI communication strategies. Citation Format: Shawna O'Rorke, Essie torres, Alice Richman. Understanding practices, perceptions, and likelihood of recommending the HPV vaccine among doctors in rural eastern North Carolina. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C91.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2017
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    detail.hit.zdb_id: 1153420-5
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  • 3
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2016
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 25, No. 3_Supplement ( 2016-03-01), p. A34-A34
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 25, No. 3_Supplement ( 2016-03-01), p. A34-A34
    Abstract: Background: Although breast cancer mortality rates have been steadily decreasing over time, Black and Latina women continue to have the highest death rate and shortest survival of any racial and ethnic groups in the United States for breast cancers. Most scholars agree, however, that the major cause of this disparity is more likely to be diagnosed with late (vs. early) stage breast cancers that are less responsive to treatment. This disparity in cancer-stage-at-diagnosis reflects Black and Latina women's lower prevalence of breast cancer screening that could detect cancers at earlier, curable stages. Pitt and Edgecombe Counties, located in a rural disadvantaged part of Eastern North Carolina (ENC), maintain breast cancer disparities among its minority women as compared to their white counterparts. Breast cancer incidence among minority women is lower compared to white women for both counties, however the mortality rate for minority women is twice as high compared to their white counterparts (42.4 vs. 21.9 respectively) in Pitt county and slightly higher in Edgecombe county (37.3 vs. 36.7 respectively). Pitt County also has the highest breast cancer mortality rate among minority women and Edgecombe has the fifth highest in Eastern NC. Furthermore, minority women are diagnosed at later stages of the disease, with the rate of diagnosis at stage 4 being almost three times higher than white women in Pitt County and significantly higher in Edgecombe County. This community-based breast health intervention (The Pitt County Breast Wellness Initiative-Education) works to reduce these health disparities in breast cancer mortality through provision of education and navigation to early detection and access to screening for uninsured and underinsured Black and Latina women in Edgecombe and Pitt Counties in NC. Methods: The Pitt County Breast Wellness Initiative-Education provides culturally tailored breast cancer education and navigation to age-appropriate screening services for uninsured/underinsured Black and Latina women age 25 and older in Pitt and Edgecombe Counties, North Carolina. Using a lay health model (adapted from North Carolina Breast Cancer Screening Program Training Curriculum), we trained eight community members on breast health, breast cancer, and being an effective breast health educator. The education component includes a brief 10-minute presentation on breast health, breast cancer, and guidelines for age-appropriate breast cancer screening services. The navigation component includes assistance with the following: (1) Breast Health Assessment Tool and BCCCP applications, (2) scheduling appointments/accessing age-appropriate breast screening services, (3) interpretation, and (4) transportation. Since our program initiation in April 2015, we have educated 85 women and navigated 47 to age-appropriate breast cancer screening services in Pitt and Edgecombe counties. Results: Among the 47 navigated women to age-appropriate screening, 78% (n=37) were 40 years of age or older, 82% (n=39) reported being uninsured, 32% (n=15) reported no previous clinical breast exam, and 38% (n=18) reported no previous mammogram. Among those who reported a having a previous mammogram, many were 2 years or more over due for their yearly mammogram. We use pre-/post-surveys to determine an increase in knowledge and awareness regarding breast health, breast cancer, and guidelines for age-appropriate breast cancer screening services. Up-to-date results from program participants will be reported during the presentation. Conclusion: Specifically, using a LHA community-based model allows this program to serve as a cultural mediation between underserved communities in Pitt and Edgecombe counties and health care service systems and reduces structural barriers in accessing screening services and diagnostic follow-up. Strong collaborative community partnerships will streamline the process of accessing care in an effort to ensure seamless transition within the continuum of breast cancer care. Citation Format: Essie T. Torres, Alice R. Richman. Using a community-based breast health intervention to reduce structural barriers in accessing breast cancer screening services among underserved rural Latina and black women in Eastern North Carolina. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A34.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2016
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    detail.hit.zdb_id: 1153420-5
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  • 4
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2017
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 26, No. 2_Supplement ( 2017-02-01), p. A74-A74
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 26, No. 2_Supplement ( 2017-02-01), p. A74-A74
    Abstract: Background: In recent years, the use of oral chemotherapeutic agents (OCAs) to treat cancer have increased greatly and is expected to continue to increase. According to the World Health Organization, non- adherence with OCAs is the most modifiable factor that can compromise treatment outcomes. WHO estimated that only about 50% of patients take their medications as prescribed, however, adherence varies with compliance rates as low as 16%. The objective of this study is to understand cancer care providers' (oncologists, oncology nurse navigators, and oncologist pharmacists) perspectives regarding challenges patients who are on Oral Chemotherapeutic Agents (OCAs) have adhering to their treatment plans as well as facilitators to adherence. Methods: We conducted 2 focus groups (N= 9) and 2 interviews (N=2), January and February 2016, with 11 cancer care providers practicing in a regional Cancer Center in eastern North Carolina (ENC). The cancer care providers were asked to share their experiences with medication adherence of OCAs among their patient population, and discuss individual-level and structural-level factors that might influence sub-optimal adherence among this population. Participants were also asked about effective strategies they use to help their patients with their medication adherence. Results: The results from this study helped identify and understand the unique factors that contribute to non-adherence to OCAs among the cancer patient population served in ENC. The barriers to adherence to OCAs occur at different levels: policy level (i.e. drug costs and insurance related issues), interpersonal level (i.e. social support, provider communication, and complexity of the regimen), and individual level (i.e. patient related characteristics: education level, health literacy level, anxiety level, and older age). The facilitators identified as increasing adherence to OCAs are: multiple levels of education and reinforcement (i.e. face-to-face, using patient portal system, and repetition of information by cancer care team), social support networks, reminder systems, and nurse navigation program. Cancer care providers reported that utilizing multiple strategies were the most effective in increasing medication adherence among their patient population. Conclusion: This study has identified some modifiable barriers that can help increase medication adherence at multiple levels. The next phase of this study will use results from the formative research phase (identified barriers and facilitators) to develop a tailored nurse coaching intervention component that will significantly improve medication adherence among patients who are at high-risk for non-adherence. Supported in part by a research grant from Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp. The opinions expressed in this abstract are those of the authors and do not necessarily represent those of Merck Sharp & Dohme Corp. Citation Format: Essie Torres, Alice Richman, Shawna O'Rorke, Paige Field, Lauren Carlston. Cancer Care Providers' Perspectives on Medication Adherence for Cancer Patients on Oral Chemotherapeutic Agents: A Qualitative Assessment. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A74.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2017
    detail.hit.zdb_id: 2036781-8
    detail.hit.zdb_id: 1153420-5
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  • 5
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2018
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 27, No. 7_Supplement ( 2018-07-01), p. B04-B04
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 27, No. 7_Supplement ( 2018-07-01), p. B04-B04
    Abstract: Introduction: Although vaccination against cancer is a significant breakthrough, uptake is low. HPV-vaccination rates among girls, ages 13-17, are less than ideal; nationwide, only 63% initiated and only 42% completed the 3-shot series in 2015. These rates are significantly lower among girls who are ethnic minorities, live in poverty, and live in rural areas. The initiation rate in rural North Carolina (NC) counties (17%) is half that for the state as a whole (66%), and is even lower (11%) in the few eastern NC counties studied to date. This study presents data that examine HPV knowledge among parents and their children, and if higher knowledge concordance rates influenced greater HPV uptake among adolescents. Methods: The study was conducted in two rural clinics in eastern North Carolina. Study participants included female and male English- and Spanish-speaking parents and their children (ages 9-17), who were uninsured or Medicaid-insured. Data from this study is from a larger study that assessed if electronic reminders increased HPV vaccine series completion among adolescents and HPV knowledge among parents of adolescents in eastern North Carolina. Parents and their adolescent child completed a baseline survey that was administered during enrollment after the child received the first HPV dose and it assessed their HPV knowledge, and factors that might influence HPV vaccination uptake. Shot records were obtained for all adolescent participants throughout the 2-year study. The final sample included 257 parent-child dyads. Results: Mean parental and child age was 38 and 12, respectively. Most identified as Black (60%) or Hispanic (28%), followed by White (10%). Completion rates for intervention and control groups were similar for HPV dose 2 (65% vs. 65%) and HPV dose 3 (35% vs. 30%), respectively. Those who reported provider recommendation of the vaccine were 1.8 times more likely to complete the series. In addition to doctor recommendation, we found that parents who thought that HPV can cause cancer in women were more likely to complete the 3-dose series. Parent knowledge about the relationship between HPV and cancer in women was low for this sample at baseline. Similarly, parents whose main reason for getting their child a HPV vaccine was to protect their child from HPV were more likely to complete the second dose of the vaccine. Up-to-date results will be reported during the presentation. Conclusion: This finding lends itself to the need for education among parents about the relationship of HPV and cancer. These results have implications for selecting communication strategies to reduce HPV-related health disparities. Citation Format: Essie Torres, Alice Richman, Qiang Wu. Communication about HPV: Shared knowledge and HPV vaccine uptake among parents and adolescents in rural eastern North Carolina [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B04.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2018
    detail.hit.zdb_id: 2036781-8
    detail.hit.zdb_id: 1153420-5
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  • 6
    In: Journal of Health Care for the Poor and Underserved, Project MUSE, Vol. 30, No. 4 ( 2019), p. 1499-1517
    Type of Medium: Online Resource
    ISSN: 1548-6869
    Language: English
    Publisher: Project MUSE
    Publication Date: 2019
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  • 7
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2016
    In:  Journal of Cancer Education Vol. 31, No. 2 ( 2016-6), p. 314-321
    In: Journal of Cancer Education, Springer Science and Business Media LLC, Vol. 31, No. 2 ( 2016-6), p. 314-321
    Type of Medium: Online Resource
    ISSN: 0885-8195 , 1543-0154
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2016
    detail.hit.zdb_id: 2049313-7
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  • 8
    Online Resource
    Online Resource
    MDPI AG ; 2017
    In:  International Journal of Environmental Research and Public Health Vol. 14, No. 7 ( 2017-06-30), p. 711-
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 14, No. 7 ( 2017-06-30), p. 711-
    Abstract: Many noted difficulties of farmworker life result in increased risk for stress and depression. To date, limited research has focused primarily on seasonal farmworkers; much of the prior research examines migrant farmworkers or both groups collectively. This study aims to: (1) describe levels of stress and depression among a sample of seasonal farmworkers; and (2) identify if covariates (age, gender, marital status, education level, years of residency, problems obtaining healthcare due to documentation, language barriers, transportation, costs, medical insurance, and stress level) are significant predictors of depressive symptoms. Survey data were collected from 150 Latino seasonal farmworkers. A hierarchical binary logistic regression was conducted to identify significant covariates. The results indicated that the only statistically significant covariates were health insurance coverage (p = 0.025) and stress (p = 0.008). Those farmworkers without health insurance were 1.8 times more likely than those with health insurance to possess depressive symptoms, while those demonstrating higher stress levels were over 7 times more likely to demonstrate symptoms of depression. The implications of the results are discussed in the manuscript.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    Language: English
    Publisher: MDPI AG
    Publication Date: 2017
    detail.hit.zdb_id: 2175195-X
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  • 9
    Online Resource
    Online Resource
    Informa UK Limited ; 2021
    In:  The American Journal of Family Therapy Vol. 49, No. 4 ( 2021-08-08), p. 392-408
    In: The American Journal of Family Therapy, Informa UK Limited, Vol. 49, No. 4 ( 2021-08-08), p. 392-408
    Type of Medium: Online Resource
    ISSN: 0192-6187 , 1521-0383
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2021
    detail.hit.zdb_id: 2489543-X
    detail.hit.zdb_id: 2489546-5
    detail.hit.zdb_id: 2001825-3
    SSG: 5,2
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  • 10
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2020
    In:  Journal of Community Health Vol. 45, No. 6 ( 2020-12), p. 1205-1210
    In: Journal of Community Health, Springer Science and Business Media LLC, Vol. 45, No. 6 ( 2020-12), p. 1205-1210
    Type of Medium: Online Resource
    ISSN: 0094-5145 , 1573-3610
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2016765-9
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