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Miller S.M.,Temple University | Hui S.K.A.,Temple University | Wen K.-Y.,Temple University | Scarpato J.,Temple University | And 3 more authors.
Patient Education and Counseling | Year: 2013

Objective: The present study explored the impact of a tailored telephone counseling intervention on increasing follow-up adherence after an abnormal Pap smear result among low-income, minority women, which may reduce cervical cancer disparity. Methods: Participants (N= 211) were randomly assigned to receive: (1) a telephone reminder that included an assessment of barriers to adherence, as well as counseling tailored to the barriers elicited; (2) telephone reminder and barriers assessment, followed by a mailed home tailored barriers print brochure; or (3) enhanced standard care comprising telephone reminder and barriers assessment. Assessments were obtained at initial contact and 1-week later, as well as at 6- and 12-months after the initial colposcopy. Results: The telephone counseling group showed greater adherence to follow-up recommendations than did the combined other two groups (p< 0.05). For the initial colposcopy, tailored telephone barriers counseling was more effective among women with a high school education or less. Conclusion: Tailored telephone barriers counseling improves adherence to initial colposcopy, as well as to longer-term medical follow-up, among low-income, inner-city women. Practice Implications: Dissemination of barriers counseling into ongoing telephone reminder calls and contacts may decrease disparities in cancer outcomes, especially among women with less than post-secondary education. © 2013 Elsevier Ireland Ltd.

Buzaglo J.S.,Research and Training Institute | Miller S.M.,Fox Chase Cancer Center | Kendall J.,Southwestern Simmons Cancer Center | Stanton A.L.,University of California at Los Angeles | And 5 more authors.
Journal of Cancer Survivorship | Year: 2013

Introduction: The NCI developed the print-based educational brochure, Facing Forward, to fill a gap in helping cancer patients meet the challenges of transitioning from active treatment to survivorship; however, little research has been conducted on its efficacy. Purpose: The aims of this study were to evaluate the efficacy of Facing Forward in promoting the uptake of recommended behaviors (e. g., ways to manage physical changes) and to explore its usability. Methods: At the last treatment appointment, early-stage breast, prostate, colorectal, and thoracic cancer patients (N = 340) recruited from community clinical oncology practices and an academic medical center completed a baseline assessment and were randomized to receive either Facing Forward (n = 175) or an attention control booklet about the NCI's Cancer Information Service (n = 165). Patients completed follow-up assessments at 8 weeks and 6 months post-baseline. Results: The reported uptake of recommended stress management behaviors was greater among intervention than control participants at both 8 weeks post-baseline (p = 0. 016) and 6 months post-baseline (p = 0. 017). At 8 weeks post-baseline, the intervention control group difference was greater among African-American than Caucasian participants (p < 0.03) and significant only among the former (p < 0.003); attendance at a cancer support group was also greater among the intervention than control group participants (p < 0.02). There were no significant intervention control group differences in the reported uptake of recommended behaviors in three other categories (p > 0.025). Intervention participants rated Facing Forward as understandable and helpful and indicated a high level of intention to try the behaviors recommended. Conclusions: Facing Forward can enhance early-stage survivors' reported ability to manage stress and increase support group use during the reentry period. Implications for Cancer Survivors: Facing Forward can help survivors meet the challenges of the reentry period. © 2012 Springer Science+Business Media New York.

Karlinski M.,Institute of Psychiatry and Neurology | Kobayashi A.,Institute of Psychiatry and Neurology | Czlonkowska A.,Institute of Psychiatry and Neurology | Czlonkowska A.,Medical University of Warsaw | And 19 more authors.
Stroke | Year: 2015

Background and Purpose-According to the European license, alteplase can be given no sooner than 3 months after previous stroke. However, it is not known whether past history of stroke influences the effect of treatment. Our aim was to evaluate safety and functional outcome after intravenous thrombolysis administered in everyday practice to patients with previous stroke ≤3 months compared with those with first-ever stroke. Methods-We analyzed consecutive cases treated with alteplase between October 2003 and July 2014 contributed to the Safe Implementation of Thrombolysis for Stroke-Eastern Europe registry from 12 countries. Odds ratios were calculated using unadjusted and adjusted logistic regression. Results-Of 13 007 patients, 11 221 (86%) had no history of stroke and 249 (2%) experienced previous stroke ≤3 months before admission. Patients with previous stroke ≤3 months had a higher proportion of hypertension and hyperlipidemia. There were no significant differences in outcome, including symptomatic intracerebral hemorrhage according to European Cooperative Acute Stroke Study (unadjusted odds ratio 1.27, 95% confidence interval: 0.74-2.15), and being alive and independent at 3 months (odds ratio 0.81, 95% confidence interval: 0.61-1.09). Conclusions-Patients currently treated with alteplase, despite a history of previous stroke ≤3 months, do not seem to achieve worse outcome than those with first-ever stroke. Although careful patient selection was probably of major importance, our findings provide reassurance that this group of patients may safely benefit from thrombolysis and should not be arbitrarily excluded as a whole. Further studies are needed to identify the shortest safe time lapse from the previous event to treatment with alteplase. © 2015 American Heart Association, Inc.

Manne S.,Rutgers Cancer Institute of New Jersey | Kashy D.,Michigan State University | Albrecht T.,Barbara Ann Karmanos Cancer Institute | Wong Y.-N.,Fox Chase Cancer Center | And 15 more authors.
European Journal of Cancer Care | Year: 2015

Patient participation in cancer clinical trials is low. Little is known about attitudinal barriers to participation, particularly among patients who may be offered a trial during an imminent initial oncology consult. The aims of the present study were to confirm the presence of proposed subscales of a recently developed cancer clinical trial attitudinal barriers measure, describe the most common cancer clinical trials attitudinal barriers, and evaluate socio-demographic, medical and financial factors associated with attitudinal barriers. A total of 1256 patients completed a survey assessing demographic factors, perceived financial burden, prior trial participation and attitudinal barriers to clinical trials participation. Results of a factor analysis did not confirm the presence of the proposed four attitudinal barriers subscale/factors. Rather, a single factor represented the best fit to the data. The most highly-rated barriers were fear of side-effects, worry about health insurance and efficacy concerns. Results suggested that less educated patients, patients with non-metastatic disease, patients with no previous oncology clinical trial participation, and patients reporting greater perceived financial burden from cancer care were associated with higher barriers. These patients may need extra attention in terms of decisional support. Overall, patients with fewer personal resources (education, financial issues) report more attitudinal barriers and should be targeted for additional decisional support. © 2014 John Wiley & Sons Ltd.

Lepore S.J.,Temple University | Buzaglo J.S.,Research and Training Institute | Lieberman M.A.,University of California at San Francisco | Golant M.,Research and Training Institute | Davey A.,Temple University
BMC Cancer | Year: 2011

Background: The Internet can increase access to psychosocial care for breast cancer survivors through online support groups. This study will test a novel prosocial online group that emphasizes both opportunities for getting and giving help. Based on the helper therapy principle, it is hypothesized that the addition of structured helping opportunities and coaching on how to help others online will increase the psychological benefits of a standard online group.Methods/Design: A two-armed randomized controlled trial with pretest and posttest. Non-metastatic breast cancer survivors with elevated psychological distress will be randomized to either a standard facilitated online group or to a prosocial facilitated online group, which combines online exchanges of support with structured helping opportunities (blogging, breast cancer outreach) and coaching on how best to give support to others. Validated and reliable measures will be administered to women approximately one month before and after the interventions. Self-esteem, positive affect, and sense of belonging will be tested as potential mediators of the primary outcomes of depressive/anxious symptoms and sense of purpose in life.Discussion: This study will test an innovative approach to maximizing the psychological benefits of cancer online support groups. The theory-based prosocial online support group intervention model is sustainable, because it can be implemented by private non-profit or other organizations, such as cancer centers, which mostly offer face-to-face support groups with limited patient reach.Trial Registration: ClinicalTrials.gov: NCT01396174. © 2011 Lepore et al; licensee BioMed Central Ltd.

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