News Article | October 28, 2016
VA scientists, working with Westat, will conduct the Vietnam Era Health Retrospective Observational Study (VE-HEROeS) for the U.S. Department of Veterans Affairs (VA). The study will help VA determine if the overall health of Vietnam War theater veterans (who served in Vietnam, Cambodia or Laos) and Vietnam era veterans (who served in the military elsewhere in the world in the same time period) is different from that of their counterparts in the general U.S. population who did not serve in the military. Study data will look at the following: Westat will conduct study tasks, including assisting VA researchers on sample design and selection, questionnaire design, data collection, medical record abstraction, and analysis. Westat will contact approximately 300,000 U.S. households to identify potential respondents, and the VA will provide another sample of 43,000 Vietnam War theater and era veterans. The survey will also ask about whether the veteran’s service was exclusively in the deep coastal waters off of Vietnam, called “Blue Water Navy,” and endeavor to describe the current health of this group. In addition, 2,000 individuals will be invited to participate in a medical record review that will confirm specific neurological conditions (Parkinson’s, dementia, stroke, brain injury) and hepatitis C that they reported in their survey. Findings from this study, anticipated in winter 2018, will inform the VA on how to provide high-quality health care, prevention services, and other benefits for this large group of Americans who are now mostly in their late 60s and older. Westat is one of the leading research and statistical survey organizations in the United States. Since 1963, Westat has provided statistical and evaluation research services to Federal and state government agencies and other organizations in the fields of health, education, social services, transportation, housing, the environment and other subjects.
News Article | January 28, 2017
Despite everything that has been said and written about the negative effects of tobacco, new evidence suggests that there are still Americans, including teenagers, who are smoking it. Over the years, tobacco has evolved into a variety of different forms. Presently, it can be classified into three groups: smoked tobacco, smokeless tobacco, and the trendy, e-cigarettes. Smoked tobacco includes the popular menthol and light cigarettes — the most widely used tobacco in the United States — cigars, pipes, bidis (hand-rolled Indian cigarettes wrapped in a tendu or temburni leaf), kreteks or clove cigarettes (contains 60 percent tobacco and 40 percent ground cloves), and hookahs. Smokeless tobacco products, on the other hand, include chewable tobacco (placed between the cheek and gums), snuff (sniffed if dried), dip (a moist and chewable snuff), snus (powder tobacco pouch placed on the upper lip), and dissolvable tobacco products, such as lozenges, orbs, sticks, and strips. Contrary to the popular notion that e-cigarettes are healthy and nicotine-free, these battery-operated smoking instruments (sometimes made to look like cigarettes, pipes, or pens) do have nicotine in them along with other unknown chemicals converted into vapor you still inhale. According to the latest findings of the Population Assessment of Tobacco and Health (PATH) Study, which was published in the New England Journal of Medicine, more than one in four adults (27.6 percent) and almost one in every four teenagers (8.9 percent) use tobacco. This conclusion was drawn from the first batch of PATH Study data, involving 32,320 adults and 13,651 teenagers. The research was done from September 2013 to December 2014. "These findings will serve as the baseline for comparison to future waves of PATH Study data in our effort to understand changes in use of tobacco products over time, including switching among types of products, quitting tobacco, and trajectories of use of multiple products," Karin Kasza, MA, the lead author of the study, explained. The PATH Study, which was initiated back in 2011, is a massive longitudinal study on a national scale aimed at delving deeper into Americans' tobacco use, which is led by statistical survey research corporation, Westat, based in Rockville, Maryland. It was founded under the joint initiative of the National Institutes of Health's National Institute on Drug Abuse (NIDA) and the U.S. Food and Drug Administration's Center for Tobacco Products (USFDA CTP). Based on the Centers for Disease Control and Prevention (CDC) website, smoking causes more than 480,000 deaths each year in the United States — nearly one in five deaths. Smoking has been known to heighten the risks of serious diseases, including coronary heart disease, stroke, tuberculosis, emphysema, asthma, and a whole variety of cancer. It is also connected to infertility, teeth and gum infection, and cataracts (because of the smoke getting into your eyes). In pregnant women, smoking tobacco or mere exposure to second-hand smoke have been found to cause preterm labor, still birth, and birth defects. Smoking has also been linked to degradation of overall health, increased absenteeism from work, and higher healthcare expenses. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.
Casagrande S.S.,Social and Scientific Systems Inc. |
Fradkin J.E.,U.S. National Institute of Diabetes and Digestive and Kidney Diseases |
Saydah S.H.,Centers for Disease Control and Prevention |
Rust K.F.,Westat |
Cowie C.C.,U.S. National Institute of Diabetes and Digestive and Kidney Diseases
Diabetes Care | Year: 2013
OBJECTIVE-To determine the prevalence of people with diabetes who meet hemoglobin A1c (A1C), blood pressure (BP), and LDL cholesterol (ABC) recommendations and their current statin use, factors associated with goal achievement, and changes in the proportion achieving goals between 1988 and 2010. RESEARCH DESIGN AND METHODS-Data were cross-sectional from the National Health and Nutrition Examination Surveys (NHANES) from 1988-1994, 1999-2002, 2003-2006, and 2007-2010. Participants were 4,926 adults aged ≥20 years who self-reported a previous diagnosis of diabetes and completed the household interview and physical examination (n = 1,558 for valid LDL levels). Main outcome measures were A1C, BP, and LDL cholesterol, in accordance with the American Diabetes Association recommendations, and current use of statins. RESULTS-In 2007-2010, 52.5% of people with diabetes achieved A1C <7.0% (,53 mmol/mol), 51.1% achieved BP <130/80 mmHg, 56.2% achieved LDL<100 mg/dL, and 18.8% achieved all three ABCs. These levels of control were significant improvements from 1988 to 1994 (all P < 0.05). Statin use significantly increased between 1988-1994 (4.2%) and 2007-2010 (51.4%, P < 0.01). Compared with non-Hispanic whites, Mexican Americans were less likely to meet A1C and LDL goals (P < 0.03), and non-Hispanic blacks were less likely to meet BP and LDL goals (P < 0.02). Compared with non-Hispanic blacks, Mexican Americans were less likely to meet A1C goals (P < 0.01). Younger individuals were less likely to meet A1C and LDL goals. CONCLUSIONS-Despite significant improvement during the past decade, achieving the ABC goals remains suboptimal among adults with diabetes, particularly in some minority groups. Substantial opportunity exists to further improve diabetes control and, thus, to reduce diabetes-related morbidity and mortality. © 2013 by the American Diabetes Association.
Church T.R.,University of Minnesota |
Black W.C.,Dartmouth Hitchcock Medical Center |
Aberle D.R.,University of California at Los Angeles |
Berg C.D.,U.S. National Cancer Institute |
And 11 more authors.
New England Journal of Medicine | Year: 2013
BACKGROUND: Lung cancer is the largest contributor to mortality from cancer. The National Lung Screening Trial (NLST) showed that screening with low-dose helical computed tomography (CT) rather than with chest radiography reduced mortality from lung cancer. We describe the screening, diagnosis, and limited treatment results from the initial round of screening in the NLST to inform and improve lung-cancer- screening programs. METHODS: At 33 U.S. centers, from August 2002 through April 2004, we enrolled asymptomatic participants, 55 to 74 years of age, with a history of at least 30 pack-years of smoking. The participants were randomly assigned to undergo annual screening, with the use of either low-dose CT or chest radiography, for 3 years. Nodules or other suspicious findings were classified as positive results. This article reports findings from the initial screening examination. RESULTS: A total of 53,439 eligible participants were randomly assigned to a study group (26,715 to low-dose CT and 26,724 to chest radiography); 26,309 participants (98.5%) and 26,035 (97.4%), respectively, underwent screening. A total of 7191 participants (27.3%) in the low-dose CT group and 2387 (9.2%) in the radiography group had a positive screening result; in the respective groups, 6369 participants (90.4%) and 2176 (92.7%) had at least one follow-up diagnostic procedure, including imaging in 5717 (81.1%) and 2010 (85.6%) and surgery in 297 (4.2%) and 121 (5.2%). Lung cancer was diagnosed in 292 participants (1.1%) in the low-dose CT group versus 190 (0.7%) in the radiography group (stage 1 in 158 vs. 70 participants and stage IIB to IV in 120 vs. 112). Sensitivity and specificity were 93.8% and 73.4% for low-dose CT and 73.5% and 91.3% for chest radiography, respectively. CONCLUSIONS: The NLST initial screening results are consistent with the existing literature on screening by means of low-dose CT and chest radiography, suggesting that a reduction in mortality from lung cancer is achievable at U.S. screening centers that have staff experienced in chest CT. Copyright © 2013 Massachusetts Medical Society. All rights reserved.
Karakus M.C.,650 Research Blvd |
Journal of Behavioral Health Services and Research | Year: 2011
The relationship between depression and development of chronic illness among older adults is not well understood. This study uses data from the Health and Retirement Study to evaluate the relationship between depression at baseline and new onset of chronic illnesses including cancer heart problems arthritis and diabetes. Analysis controlling for demographics (age, gender, race, education) health risk indicators (BMI and smoking) functional limitations (gross motor index health limitations for work) and income show that working-age older people (ages 50-62) with depression at baseline are at significantly higher risk to develop diabetes heart problems and arthritis during the 12-year follow-up. No significant association was found between depression and cancer. Prevention efforts aimed at chronic illnesses among the elderly should recognize the mind-body interaction and focus on preventing or alleviating depression. © 2011 National Council for Community Behavioral Healthcare.
Nichols H.B.,University of North Carolina at Chapel Hill |
DeRoo L.A.,University of Bergen |
Scharf D.R.,Westat |
Sandler D.P.,National Health Research Institute
Journal of the National Cancer Institute | Year: 2015
Background: Tamoxifen has been US Food and Drug Administration-approved for primary prevention of breast cancer since 1998 but has not been widely adopted, in part because of increased risk of serious side effects. Little is known about the risk-benefit profiles of women who use chemoprevention outside of a clinical trial. We examined characteristics associated with initiation and discontinuation of tamoxifen for primary prevention of breast cancer within a large cohort of women with a first-degree family history of breast cancer. Methods: This research was conducted within The Sister Study, a cohort of 50 884 US and Puerto Rican women age 35 to 74 years enrolled from 2003 to 2009. Eligible women were breast cancer-free at enrollment and had a sister who had been diagnosed with breast cancer. Participants reported tamoxifen use, ages started and stopped taking tamoxifen, and total duration of use at enrollment. We identified 788 tamoxifen users and 3131 nonusers matched on age and year of enrollment who had no history of contraindicating factors (stroke, transient ischemic attack, cataract, endometrial or uterine cancer). Characteristics associated with tamoxifen initiation were evaluated with multivariable conditional logistic regression. All statistical tests were two-sided. Results: Based on published risk-benefit indices, 20% of women who used tamoxifen had insufficient evidence that the benefits of tamoxifen outweigh the risk of serious side effects. After 4.5 years, 46% of women had discontinued tamoxifen. Conclusions: While the majority of women who used tamoxifen for primary prevention of breast cancer were likely to benefit, substantial discontinuation of tamoxifen before five years and use by women at risk of serious side effects may attenuate benefits for breast cancer prevention.
Colby D.A.,Westat |
Shifren K.,Towson University
Psychology, Health and Medicine | Year: 2013
Fifty one breast cancer patients participated in a cross-sectional study developed to assess the relation between their level of optimism, positive and negative mental health, and their quality of life. Patients were measured with the Life Orientation Test (LOT), the Center for Epidemiological Studies Depression Scale (CES-D), and the Functional Living Index-Cancer (FLIC). T-tests revealed that these breast cancer patients reported more optimism than pessimism, more positive than negative mental health, and the majority of the sample reported doing well on each qualify life domain of the FLIC. As expected, individuals who reported more depressive symptoms also reported less qualify of life. Breast cancer patients who scored lower on pessimism showed more positive mental health, but they showed no relation to negative mental health. Women who scored higher on optimism reported better social and mental functioning on the FLIC than women who scored low on optimism. © 2013 Taylor and Francis Group, LLC.
Medical care | Year: 2012
The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Clinician and Group Adult Visit Survey enables patients to report their experiences with outpatient medical offices. To evaluate the factor structure and reliability of the CAHPS Clinician and Group (CG-CAHPS) Adult Visit Survey. Data from 21,318 patients receiving care in 450 clinical practice sites collected from March 2010 to December 2010 were analyzed from the CG-CAHPS Database. RESEARCH DESIGN AND PARTICIPANTS: Individual level and multilevel confirmatory factor analyses were used to examine CAHPS survey responses at the patient and practice site levels. We also estimated internal consistency reliability and practice site level reliability. Correlations among multi-item composites and correlations between the composites and 2 global rating items were examined. Scores on CG-CAHPS composites assessing Access to Care, Doctor Communication, Courteous/Helpful Staff, and 2 global ratings of whether one would Recommend their Doctor, and an Overall Doctor Rating. Analyses provide support for the hypothesized 3-factor model assessing Access to Care, Doctor Communication, and Courteous/Helpful Staff. In addition, the internal consistency reliabilities were ≥ 0.77 and practice site level reliabilities for sites with >4 clinicians were ≥ 0.75. All composites were positively and significantly correlated with the 2 global rating items, with Doctor Communication having the strongest relationship with the global ratings. The CG-CAHPS Adult Visit Survey has acceptable psychometric properties at the individual level and practice site level. The analyses suggest that the survey items are measuring their intended concepts and yield reliable information.
Evaluation and the Health Professions | Year: 2013
A sample frame is the listing of the units from which a sample is to be selected. When deciding upon a file to serve as a source for a sample frame for a survey, perhaps the most important consideration is the extent to which the target population will be covered by the frame. However, other issues also come into play such as the accuracy of contact and other information appearing on the file as well as its cost. The American Medical Association Masterfile has long been considered the preferred choice for surveys of physicians, although it does have drawbacks. Here we consider two alternative files, discussing their relative advantages and disadvantages. For surveys of physician practices (or other organizations that employ physicians), there have been no files that are obvious choices to serve as the basis for a sample frame. Here we discuss data collection on physician practices from an analytic perspective and consider how sampling physicians to obtain practice level data may be a desirable approach. © The Author(s) 2013.
Sorra J.S.,Westat |
BMC Health Services Research | Year: 2010
Background: The Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture was designed to assess staff views on patient safety culture in hospital settings. The purpose of this study was to examine the multilevel psychometric properties of the survey. Methods: Survey data from 331 U.S. hospitals with 2,267 hospital units and 50,513 respondents were analyzed to examine the psychometric properties of the survey's items and composites. Item factor loadings, intraclass correlations (ICCs), design effects, internal consistency reliabilities, and multilevel confirmatory factor analyses (MCFA) were examined as well as intercorrelations among the survey's composites. Results: Psychometric analyses confirmed the multilevel nature of the data at the individual, unit and hospital levels of analysis. Results provided overall evidence supporting the 12 dimensions and 42 items included in the AHRQ Hospital Survey on Patient Safety Culture as having acceptable psychometric properties at all levels of analysis, with a few exceptions. The Staffing composite fell slightly below cutoffs in a number of areas, but is conceptually important given its impact on patient safety. In addition, one hospital-level model fit indicator for the Supervisor/Manager Expectations & Actions Promoting Patient Safety composite was low (CFI = .82), but all other psychometrics for this scale were good. Average dimension intercorrelations were moderate at .42 at the individual level, .50 at the unit level, and .56 at the hospital level. Conclusions: Psychometric analyses conducted on a very large database of hospitals provided overall support for the patient safety culture dimensions and items included in the AHRQ Hospital Survey on Patient Safety Culture. The survey's items and dimensions overall are psychometrically sound at the individual, unit, and hospital levels of analysis and can be used by researchers and hospitals interested in assessing patient safety culture. Further research is needed to study the criterion-related validity of the survey by analysing the relationship between patient safety culture and patient outcomes and studying how to improve patient safety culture. © 2010 Sorra and Dyer; licensee BioMed Central Ltd.