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7. How underserved breast cancer patients use and benefit from eHealth programs: implications for closing the digital divide

Author

Shaw, Bret, Gustafson, David H., Hawkins, Robert, McTavish, Fiona, McDowell, Helene, Pingree, Suzanne, and Ballard, Denise

Subjects
Online health care information services -- Usage, Online health care information services -- Research, Online health care service, Psychology and mental health, Social sciences
Abstract

This article consolidates insights from 15 years of research examining how the medically underserved use and benefit from an eHealth program, the Comprehensive Health Enhancement Support System (CHESS). The authors outline results from early feasibility tests to determine if the underserved would use CHESS. Distinctive behaviors of underserved populations who have used CHESS are reported with a focus on how online health information and computer-mediated support groups are used. The article then reports on how the underserved benefit from using CHESS. Best practice recommendations for recruitment and training the underserved are offered, and implications for closing the digital divide are discussed. Keywords: eHealth; breast cancer; Internet; Interactive Cancer Communication System; CHESS

Published
2006

8. Trajectories of social resource use among informal lung cancer caregivers.

Author

Litzelman, Kristin, Reblin, Maija, McDowell, Helene E., and DuBenske, Lori L.

Subjects
LUNG cancer, CAREGIVERS, GENERALIZED estimating equations, SUPPORT groups, SOCIAL support, TREATMENT of lung tumors, SOCIAL participation, SELF-evaluation, LUNG tumors, BURDEN of care, PSYCHOLOGICAL tests, PSYCHOLOGY of caregivers, QUALITY of life, RESEARCH funding
Abstract

Background: Social support is a key component in maintaining cancer caregiver well-being, and many resources exist to facilitate caregivers' use of social support (eg, cancer support groups). This study sought to determine how informal cancer caregivers use social resources over the course of caregiving.Methods: The data are from the Comprehensive Health Enhancement Support System study of informal caregivers (n = 202) of patients with recently diagnosed lung cancer. Caregivers self-reported their sociodemographic and caregiving characteristics and social resource use over 6 months. Generalized additive models were used to assess social resource use over time, and generalized estimating equation logistic regression models were used to assess the correlates of social resource use.Results: Nearly two-thirds of caregivers reported any social resource use. The most prevalent social resources were faith-based groups (38%) and social clubs (30%). Only 1 in 4 caregivers participated in a formal resource such as counseling (11%) or a cancer support group (6%). Social resource use was lowest immediately after the diagnosis and increased over time. Formal resource use exhibited a nonlinear association with time such that formal resource use peaked approximately 9 to 10 months after the cancer diagnosis. Caregivers were more likely to report social resource use if the patient also reported social engagement.Conclusions: This study has found that many cancer caregivers do not use social resources, although social resource use increases over time after the cancer diagnosis. Because of the association between social engagement and well-being, this information may inform future research and interventions to improve outcomes for cancer caregivers and their families. [ABSTRACT FROM AUTHOR]

Published
2020
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9. Proceedings of the 8th Annual Conference on the Science of Dissemination and Implementation

Author

Chambers, David, Simpson, Lisa, Hill-Briggs, Felicia, Neta, Gila, Vinson, Cynthia, Beidas, Rinad, Marcus, Steven, Aarons, Gregory, Hoagwood, Kimberly, Schoenwald, Sonja, Evans, Arthur, Hurford, Matthew, Rubin, Ronnie, Hadley, Trevor, Barg, Frances, Walsh, Lucia, Adams, Danielle, Mandell, David, Martin, Lindsey, Mignogna, Joseph, Mott, Juliette, Hundt, Natalie, Kauth, Michael, Kunik, Mark, Naik, Aanand, Cully, Jeffrey, McGuire, Alan, White, Dominique, Bartholomew, Tom, McGrew, John, Luther, Lauren, Rollins, Angie, Salyers, Michelle, Cooper, Brittany, Funaiole, Angie, Richards, Julie, Lee, Amy, Lapham, Gwen, Caldeiro, Ryan, Lozano, Paula, Gildred, Tory, Achtmeyer, Carol, Ludman, Evette, Addis, Megan, Marx, Larry, Bradley, Katharine, VanDeinse, Tonya, Wilson, Amy Blank, Stacey, Burgin, Powell, Byron, Bunger, Alicia, Cuddeback, Gary, Barnett, Miya, Stadnick, Nicole, Brookman-Frazee, Lauren, Lau, Anna, Dorsey, Shannon, Pullmann, Michael, Mitchell, Shannon, Schwartz, Robert, Kirk, Arethusa, Dusek, Kristi, Oros, Marla, Hosler, Colleen, Gryczynski, Jan, Barbosa, Carolina, Dunlap, Laura, Lounsbury, David, O’Grady, Kevin, Brown, Barry, Damschroder, Laura, Waltz, Thomas, Ritchie, Mona, Atkins, David, Imel, Zac E., Xiao, Bo, Can, Doğan, Georgiou, Panayiotis, Narayanan, Shrikanth, Berkel, Cady, Gallo, Carlos, Sandler, Irwin, Brown, C. Hendricks, Wolchik, Sharlene, Mauricio, Anne Marie, Mehrotra, Sanjay, Chandurkar, Dharmendra, Bora, Siddhartha, Das, Arup, Tripathi, Anand, Saggurti, Niranjan, Raj, Anita, Hughes, Eric, Jacobs, Brian, Kirkendall, Eric, Loeb, Danielle, Trinkley, Katy, Yang, Michael, Sprowell, Andrew, Nease, Donald, Lyon, Aaron, Lewis, Cara, Boyd, Meredith, Melvin, Abigail, Nicodimos, Semret, Liu, Freda, Jungbluth, Nathanial, Flynn, Allen, Landis-Lewis, Zach, Sales, Anne, Baloh, Jure, Ward, Marcia, Zhu, Xi, Bennett, Ian, Unutzer, Jurgen, Mao, Johnny, Proctor, Enola, Vredevoogd, Mindy, Chan, Ya-Fen, Williams, Nathaniel, Green, Phillip, Bernstein, Steven, Rosner, June-Marie, DeWitt, Michelle, Tetrault, Jeanette, Dziura, James, Hsiao, Allen, Sussman, Scott, O’Connor, Patrick, Toll, Benjamin, Jones, Michael, Gassaway, Julie, Tobin, Jonathan, Zatzick, Douglas, Bradbury, Angela R., Patrick-Miller, Linda, Egleston, Brian, Olopade, Olufunmilayo I., Hall, Michael J., Daly, Mary B., Fleisher, Linda, Grana, Generosa, Ganschow, Pamela, Fetzer, Dominique, Brandt, Amanda, Farengo-Clark, Dana, Forman, Andrea, Gaber, Rikki S., Gulden, Cassandra, Horte, Janice, Long, Jessica, Chambers, Rachelle Lorenz, Lucas, Terra, Madaan, Shreshtha, Mattie, Kristin, McKenna, Danielle, Montgomery, Susan, Nielsen, Sarah, Powers, Jacquelyn, Rainey, Kim, Rybak, Christina, Savage, Michelle, Seelaus, Christina, Stoll, Jessica, Stopfer, Jill, Yao, Shirley, Domchek, Susan, Hahn, Erin, Munoz-Plaza, Corrine, Wang, Jianjin, Delgadillo, Jazmine Garcia, Mittman, Brian, Gould, Michael, Liang, Shuting, Kegler, Michelle C., Cotter, Megan, Phillips, Emily, Hermstad, April, Morton, Rentonia, Beasley, Derrick, Martinez, Jeremy, Riehman, Kara, Gustafson, David, Marsch, Lisa, Mares, Louise, Quanbeck, Andrew, McTavish, Fiona, McDowell, Helene, Brown, Randall, Thomas, Chantelle, Glass, Joseph, Isham, Joseph, Shah, Dhavan, Liebschutz, Jane, Lasser, Karen, Watkins, Katherine, Ober, Allison, Hunter, Sarah, Lamp, Karen, Ewing, Brett, Iwelunmor, Juliet, Gyamfi, Joyce, Blackstone, Sarah, Quakyi, Nana Kofi, Plange-Rhule, Jacob, Ogedegbe, Gbenga, Kumar, Pritika, Van Devanter, Nancy, Nguyen, Nam, Nguyen, Linh, Nguyen, Trang, Phuong, Nguyet, Shelley, Donna, Rudge, Sian, Langlois, Etienne, Tricco, Andrea, Ball, Sherry, Lambert-Kerzner, Anne, Sulc, Christine, Simmons, Carol, Shell-Boyd, Jeneen, Oestreich, Taryn, O’Connor, Ashley, Neely, Emily, McCreight, Marina, Labebue, Amy, DiFiore, Doreen, Brostow, Diana, Ho, P. Michael, Aron, David, Harvey, Jillian, McHugh, Megan, Scanlon, Dennis, Lee, Rebecca, Soltero, Erica, Parker, Nathan, McNeill, Lorna, Ledoux, Tracey, McIsaac, Jessie-Lee, MacLeod, Kate, Ata, Nicole, Jarvis, Sherry, Kirk, Sara, Purtle, Jonathan, Dodson, Elizabeth, Brownson, Ross, Curran, Geoffrey, Pyne, Jeffrey, Ehrhart, Mark, Torres, Elisa, Miech, Edward, Stevens, Kathleen, Hamilton, Alison, Cohen, Deborah, Padgett, Deborah, Morshed, Alexandra, Patel, Rupa, Prusaczyk, Beth, Aron, David C., Gupta, Divya, Hand, Rosa, Abram, Jenica, Wolfram, Taylor, Hastings, Molly, Moreland-Russell, Sarah, Tabak, Rachel, Ramsey, Alex, Baumann, Ana, Kryzer, Emily, Montgomery, Katherine, Lewis, Ericka, Padek, Margaret, Mamaril, Cezar Brian, Mays, Glen, Branham, Keith, Timsina, Lava, Hogg, Rachel, Fagan, Abigail, Shapiro, Valerie, Brown, Eric, Haggerty, Kevin, Hawkins, David, Oesterle, Sabrina, Catalano, Richard, McKay, Virginia, Dolcini, M. Margaret, Hoffer, Lee, Moin, Tannaz, Li, Jinnan, Duru, O. Kenrik, Ettner, Susan, Turk, Norman, Chan, Charles, Keckhafer, Abigail, Luchs, Robert, Ho, Sam, Mangione, Carol, Selby, Peter, Zawertailo, Laurie, Minian, Nadia, Balliunas, Dolly, Dragonetti, Rosa, Hussain, Sarwar, Lecce, Julia, Chinman, Matthew, Acosta, Joie, Ebener, Patricia, Malone, Patrick S., Slaughter, Mary, Freedman, Darcy, Flocke, Susan, Lee, Eunlye, Matlack, Kristen, Trapl, Erika, Ohri-Vachaspati, Punam, Taggart, Morgan, Borawski, Elaine, Parrish, Amanda, Harris, Jeffrey, Kohn, Marlana, Hammerback, Kristen, McMillan, Becca, Hannon, Peggy, Swindle, Taren, Whiteside-Mansell, Leanne, Ward, Wendy, Holt, Cheryl, Santos, Sheri Lou, Tagai, Erin, Scheirer, Mary Ann, Carter, Roxanne, Bowie, Janice, Haider, Muhiuddin, Slade, Jimmie, Wang, Min Qi, Masica, Andrew, Ogola, Gerald, Berryman, Candice, Richter, Kathleen, Shelton, Rachel, Jandorf, Lina, Erwin, Deborah, Truong, Khoa, Javier, Joyce R., Coffey, Dean, Schrager, Sheree M., Palinkas, Lawrence, Miranda, Jeanne, Johnson, Veda, Hutcherson, Valerie, Ellis, Ruth, Kharmats, Anna, Marshall-King, Sandra, LaPradd, Monica, Fonseca-Becker, Fannie, Kepka, Deanna, Bodson, Julia, Warner, Echo, Fowler, Brynn, Shenkman, Elizabeth, Hogan, William, Odedina, Folakami, De Leon, Jessica, Hooper, Monica, Carrasquillo, Olveen, Reams, Renee, Hurt, Myra, Smith, Steven, Szapocznik, Jose, Nelson, David, Mandal, Prabir, and Teufel, James

Subjects
Medicine(all), Health Policy, Public Health, Environmental and Occupational Health, Meeting Abstracts
Abstract

Table of contents A1 Introduction to the 8th Annual Conference on the Science of Dissemination and Implementation: Optimizing Personal and Population Health David Chambers, Lisa Simpson D1 Discussion forum: Population health D&I research Felicia Hill-Briggs D2 Discussion forum: Global health D&I research Gila Neta, Cynthia Vinson D3 Discussion forum: Precision medicine and D&I research David Chambers S1 Predictors of community therapists’ use of therapy techniques in a large public mental health system Rinad Beidas, Steven Marcus, Gregory Aarons, Kimberly Hoagwood, Sonja Schoenwald, Arthur Evans, Matthew Hurford, Ronnie Rubin, Trevor Hadley, Frances Barg, Lucia Walsh, Danielle Adams, David Mandell S2 Implementing brief cognitive behavioral therapy (CBT) in primary care: Clinicians' experiences from the field Lindsey Martin, Joseph Mignogna, Juliette Mott, Natalie Hundt, Michael Kauth, Mark Kunik, Aanand Naik, Jeffrey Cully S3 Clinician competence: Natural variation, factors affecting, and effect on patient outcomes Alan McGuire, Dominique White, Tom Bartholomew, John McGrew, Lauren Luther, Angie Rollins, Michelle Salyers S4 Exploring the multifaceted nature of sustainability in community-based prevention: A mixed-method approach Brittany Cooper, Angie Funaiole S5 Theory informed behavioral health integration in primary care: Mixed methods evaluation of the implementation of routine depression and alcohol screening and assessment Julie Richards, Amy Lee, Gwen Lapham, Ryan Caldeiro, Paula Lozano, Tory Gildred, Carol Achtmeyer, Evette Ludman, Megan Addis, Larry Marx, Katharine Bradley S6 Enhancing the evidence for specialty mental health probation through a hybrid efficacy and implementation study Tonya VanDeinse, Amy Blank Wilson, Burgin Stacey, Byron Powell, Alicia Bunger, Gary Cuddeback S7 Personalizing evidence-based child mental health care within a fiscally mandated policy reform Miya Barnett, Nicole Stadnick, Lauren Brookman-Frazee, Anna Lau S8 Leveraging an existing resource for technical assistance: Community-based supervisors in public mental health Shannon Dorsey, Michael Pullmann S9 SBIRT implementation for adolescents in urban federally qualified health centers: Implementation outcomes Shannon Mitchell, Robert Schwartz, Arethusa Kirk, Kristi Dusek, Marla Oros, Colleen Hosler, Jan Gryczynski, Carolina Barbosa, Laura Dunlap, David Lounsbury, Kevin O'Grady, Barry Brown S10 PANEL: Tailoring Implementation Strategies to Context - Expert recommendations for tailoring strategies to context Laura Damschroder, Thomas Waltz, Byron Powell S11 PANEL: Tailoring Implementation Strategies to Context - Extreme facilitation: Helping challenged healthcare settings implement complex programs Mona Ritchie S12 PANEL: Tailoring Implementation Strategies to Context - Using menu-based choice tasks to obtain expert recommendations for implementing three high-priority practices in the VA Thomas Waltz S13 PANEL: The Use of Technology to Improve Efficient Monitoring of Implementation of Evidence-based Programs - Siri, rate my therapist: Using technology to automate fidelity ratings of motivational interviewing David Atkins, Zac E. Imel, Bo Xiao, Doğan Can, Panayiotis Georgiou, Shrikanth Narayanan S14 PANEL: The Use of Technology to Improve Efficient Monitoring of Implementation of Evidence-based Programs - Identifying indicators of implementation quality for computer-based ratings Cady Berkel, Carlos Gallo, Irwin Sandler, C. Hendricks Brown, Sharlene Wolchik, Anne Marie Mauricio S15 PANEL: The Use of Technology to Improve Efficient Monitoring of Implementation of Evidence-based Programs - Improving implementation of behavioral interventions by monitoring emotion in spoken speech Carlos Gallo, C. Hendricks Brown, Sanjay Mehrotra S16 Scorecards and dashboards to assure data quality of health management information system (HMIS) using R Dharmendra Chandurkar, Siddhartha Bora, Arup Das, Anand Tripathi, Niranjan Saggurti, Anita Raj S17 A big data approach for discovering and implementing patient safety insights Eric Hughes, Brian Jacobs, Eric Kirkendall S18 Improving the efficacy of a depression registry for use in a collaborative care model Danielle Loeb, Katy Trinkley, Michael Yang, Andrew Sprowell, Donald Nease S19 Measurement feedback systems as a strategy to support implementation of measurement-based care in behavioral health Aaron Lyon, Cara Lewis, Meredith Boyd, Abigail Melvin, Semret Nicodimos, Freda Liu, Nathanial Jungbluth S20 PANEL: Implementation Science and Learning Health Systems: Intersections and Commonalities - Common loop assay: Methods of supporting learning collaboratives Allen Flynn S21 PANEL: Implementation Science and Learning Health Systems: Intersections and Commonalities - Innovating audit and feedback using message tailoring models for learning health systems Zach Landis-Lewis S22 PANEL: Implementation Science and Learning Health Systems: Intersections and Commonalities - Implementation science and learning health systems: Connecting the dots Anne Sales S23 Facilitation activities of Critical Access Hospitals during TeamSTEPPS implementation Jure Baloh, Marcia Ward, Xi Zhu S24 Organizational and social context of federally qualified health centers and variation in maternal depression outcomes Ian Bennett, Jurgen Unutzer, Johnny Mao, Enola Proctor, Mindy Vredevoogd, Ya-Fen Chan, Nathaniel Williams, Phillip Green S25 Decision support to enhance treatment of hospitalized smokers: A randomized trial Steven Bernstein, June-Marie Rosner, Michelle DeWitt, Jeanette Tetrault, James Dziura, Allen Hsiao, Scott Sussman, Patrick O’Connor, Benjamin Toll S26 PANEL: Developing Sustainable Strategies for the Implementation of Patient-Centered Care across Diverse US Healthcare Systems - A patient-centered approach to successful community transition after catastrophic injury Michael Jones, Julie Gassaway S27 PANEL: Developing Sustainable Strategies for the Implementation of Patient-Centered Care across Diverse US Healthcare Systems - Conducting PCOR to integrate mental health and cancer screening services in primary care Jonathan Tobin S28 PANEL: Developing Sustainable Strategies for the Implementation of Patient-Centered Care across Diverse US Healthcare Systems - A comparative effectiveness trial of optimal patient-centered care for US trauma care systems Douglas Zatzick S29 Preferences for in-person communication among patients in a multi-center randomized study of in-person versus telephone communication of genetic test results for cancer susceptibility Angela R Bradbury, Linda Patrick-Miller, Brian Egleston, Olufunmilayo I Olopade, Michael J Hall, Mary B Daly, Linda Fleisher, Generosa Grana, Pamela Ganschow, Dominique Fetzer, Amanda Brandt, Dana Farengo-Clark, Andrea Forman, Rikki S Gaber, Cassandra Gulden, Janice Horte, Jessica Long, Rachelle Lorenz Chambers, Terra Lucas, Shreshtha Madaan, Kristin Mattie, Danielle McKenna, Susan Montgomery, Sarah Nielsen, Jacquelyn Powers, Kim Rainey, Christina Rybak, Michelle Savage, Christina Seelaus, Jessica Stoll, Jill Stopfer, Shirley Yao and Susan Domchek S30 Working towards de-implementation: A mixed methods study in breast cancer surveillance care Erin Hahn, Corrine Munoz-Plaza, Jianjin Wang, Jazmine Garcia Delgadillo, Brian Mittman Michael Gould S31Integrating evidence-based practices for increasing cancer screenings in safety-net primary care systems: A multiple case study using the consolidated framework for implementation research Shuting (Lily) Liang, Michelle C. Kegler, Megan Cotter, Emily Phillips, April Hermstad, Rentonia Morton, Derrick Beasley, Jeremy Martinez, Kara Riehman S32 Observations from implementing an mHealth intervention in an FQHC David Gustafson, Lisa Marsch, Louise Mares, Andrew Quanbeck, Fiona McTavish, Helene McDowell, Randall Brown, Chantelle Thomas, Joseph Glass, Joseph Isham, Dhavan Shah S33 A multicomponent intervention to improve primary care provider adherence to chronic opioid therapy guidelines and reduce opioid misuse: A cluster randomized controlled trial protocol Jane Liebschutz, Karen Lasser S34 Implementing collaborative care for substance use disorders in primary care: Preliminary findings from the summit study Katherine Watkins, Allison Ober, Sarah Hunter, Karen Lamp, Brett Ewing S35 Sustaining a task-shifting strategy for blood pressure control in Ghana: A stakeholder analysis Juliet Iwelunmor, Joyce Gyamfi, Sarah Blackstone, Nana Kofi Quakyi, Jacob Plange-Rhule, Gbenga Ogedegbe S36 Contextual adaptation of the consolidated framework for implementation research (CFIR) in a tobacco cessation study in Vietnam Pritika Kumar, Nancy Van Devanter, Nam Nguyen, Linh Nguyen, Trang Nguyen, Nguyet Phuong, Donna Shelley S37 Evidence check: A knowledge brokering approach to systematic reviews for policy Sian Rudge S38 Using Evidence Synthesis to Strengthen Complex Health Systems in Low- and Middle-Income Countries Etienne Langlois S39 Does it matter: timeliness or accuracy of results? The choice of rapid reviews or systematic reviews to inform decision-making Andrea Tricco S40 Evaluation of the veterans choice program using lean six sigma at a VA medical center to identify benefits and overcome obstacles Sherry Ball, Anne Lambert-Kerzner, Christine Sulc, Carol Simmons, Jeneen Shell-Boyd, Taryn Oestreich, Ashley O'Connor, Emily Neely, Marina McCreight, Amy Labebue, Doreen DiFiore, Diana Brostow, P. Michael Ho, David Aron S41 The influence of local context on multi-stakeholder alliance quality improvement activities: A multiple case study Jillian Harvey, Megan McHugh, Dennis Scanlon S42 Increasing physical activity in early care and education: Sustainability via active garden education (SAGE) Rebecca Lee, Erica Soltero, Nathan Parker, Lorna McNeill, Tracey Ledoux S43 Marking a decade of policy implementation: The successes and continuing challenges of a provincial school food and nutrition policy in Canada Jessie-Lee McIsaac, Kate MacLeod, Nicole Ata, Sherry Jarvis, Sara Kirk S44 Use of research evidence among state legislators who prioritize mental health and substance abuse issues Jonathan Purtle, Elizabeth Dodson, Ross Brownson S45 PANEL: Effectiveness-Implementation Hybrid Designs: Clarifications, Refinements, and Additional Guidance Based on a Systematic Review and Reports from the Field - Hybrid type 1 designs Brian Mittman, Geoffrey Curran S46 PANEL: Effectiveness-Implementation Hybrid Designs: Clarifications, Refinements, and Additional Guidance Based on a Systematic Review and Reports from the Field - Hybrid type 2 designs Geoffrey Curran S47 PANEL: Effectiveness-Implementation Hybrid Designs: Clarifications, Refinements, and Additional Guidance Based on a Systematic Review and Reports from the Field - Hybrid type 3 designs Jeffrey Pyne S48 Linking team level implementation leadership and implementation climate to individual level attitudes, behaviors, and implementation outcomes Gregory Aarons, Mark Ehrhart, Elisa Torres S49 Pinpointing the specific elements of local context that matter most to implementation outcomes: Findings from qualitative comparative analysis in the RE-inspire study of VA acute stroke care Edward Miech S50 The GO score: A new context-sensitive instrument to measure group organization level for providing and improving care Edward Miech S51 A research network approach for boosting implementation and improvement Kathleen Stevens, I.S.R.N. Steering Council S52 PANEL: Qualitative methods in D&I Research: Value, rigor and challenge - The value of qualitative methods in implementation research Alison Hamilton S53 PANEL: Qualitative methods in D&I Research: Value, rigor and challenge - Learning evaluation: The role of qualitative methods in dissemination and implementation research Deborah Cohen S54 PANEL: Qualitative methods in D&I Research: Value, rigor and challenge - Qualitative methods in D&I research Deborah Padgett S55 PANEL: Maps & models: The promise of network science for clinical D&I - Hospital network of sharing patients with acute and chronic diseases in California Alexandra Morshed S56 PANEL: Maps & models: The promise of network science for clinical D&I - The use of social network analysis to identify dissemination targets and enhance D&I research study recruitment for pre-exposure prophylaxis for HIV (PrEP) among men who have sex with men Rupa Patel S57 PANEL: Maps & models: The promise of network science for clinical D&I - Network and organizational factors related to the adoption of patient navigation services among rural breast cancer care providers Beth Prusaczyk S58 A theory of de-implementation based on the theory of healthcare professionals’ behavior and intention (THPBI) and the becker model of unlearning David C. Aron, Divya Gupta, Sherry Ball S59 Observation of registered dietitian nutritionist-patient encounters by dietetic interns highlights low awareness and implementation of evidence-based nutrition practice guidelines Rosa Hand, Jenica Abram, Taylor Wolfram S60 Program sustainability action planning: Building capacity for program sustainability using the program sustainability assessment tool Molly Hastings, Sarah Moreland-Russell S61 A review of D&I study designs in published study protocols Rachel Tabak, Alex Ramsey, Ana Baumann, Emily Kryzer, Katherine Montgomery, Ericka Lewis, Margaret Padek, Byron Powell, Ross Brownson S62 PANEL: Geographic variation in the implementation of public health services: Economic, organizational, and network determinants - Model simulation techniques to estimate the cost of implementing foundational public health services Cezar Brian Mamaril, Glen Mays, Keith Branham, Lava Timsina S63 PANEL: Geographic variation in the implementation of public health services: Economic, organizational, and network determinants - Inter-organizational network effects on the implementation of public health services Glen Mays, Rachel Hogg S64 PANEL: Building capacity for implementation and dissemination of the communities that care prevention system at scale to promote evidence-based practices in behavioral health - Implementation fidelity, coalition functioning, and community prevention system transformation using communities that care Abigail Fagan, Valerie Shapiro, Eric Brown S65 PANEL: Building capacity for implementation and dissemination of the communities that care prevention system at scale to promote evidence-based practices in behavioral health - Expanding capacity for implementation of communities that care at scale using a web-based, video-assisted training system Kevin Haggerty, David Hawkins S66 PANEL: Building capacity for implementation and dissemination of the communities that care prevention system at scale to promote evidence-based practices in behavioral health - Effects of communities that care on reducing youth behavioral health problems Sabrina Oesterle, David Hawkins, Richard Catalano S68 When interventions end: the dynamics of intervention de-adoption and replacement Virginia McKay, M. Margaret Dolcini, Lee Hoffer S69 Results from next-d: can a disease specific health plan reduce incident diabetes development among a national sample of working-age adults with pre-diabetes? Tannaz Moin, Jinnan Li, O. Kenrik Duru, Susan Ettner, Norman Turk, Charles Chan, Abigail Keckhafer, Robert Luchs, Sam Ho, Carol Mangione S70 Implementing smoking cessation interventions in primary care settings (STOP): using the interactive systems framework Peter Selby, Laurie Zawertailo, Nadia Minian, Dolly Balliunas, Rosa Dragonetti, Sarwar Hussain, Julia Lecce S71 Testing the Getting To Outcomes implementation support intervention in prevention-oriented, community-based settings Matthew Chinman, Joie Acosta, Patricia Ebener, Patrick S Malone, Mary Slaughter S72 Examining the reach of a multi-component farmers’ market implementation approach among low-income consumers in an urban context Darcy Freedman, Susan Flocke, Eunlye Lee, Kristen Matlack, Erika Trapl, Punam Ohri-Vachaspati, Morgan Taggart, Elaine Borawski S73 Increasing implementation of evidence-based health promotion practices at large workplaces: The CEOs Challenge Amanda Parrish, Jeffrey Harris, Marlana Kohn, Kristen Hammerback, Becca McMillan, Peggy Hannon S74 A qualitative assessment of barriers to nutrition promotion and obesity prevention in childcare Taren Swindle, Geoffrey Curran, Leanne Whiteside-Mansell, Wendy Ward S75 Documenting institutionalization of a health communication intervention in African American churches Cheryl Holt, Sheri Lou Santos, Erin Tagai, Mary Ann Scheirer, Roxanne Carter, Janice Bowie, Muhiuddin Haider, Jimmie Slade, Min Qi Wang S76 Reduction in hospital utilization by underserved patients through use of a community-medical home Andrew Masica, Gerald Ogola, Candice Berryman, Kathleen Richter S77 Sustainability of evidence-based lay health advisor programs in African American communities: A mixed methods investigation of the National Witness Project Rachel Shelton, Lina Jandorf, Deborah Erwin S78 Predicting the long-term uninsured population and analyzing their gaps in physical access to healthcare in South Carolina Khoa Truong S79 Using an evidence-based parenting intervention in churches to prevent behavioral problems among Filipino youth: A randomized pilot study Joyce R. Javier, Dean Coffey, Sheree M. Schrager, Lawrence Palinkas, Jeanne Miranda S80 Sustainability of elementary school-based health centers in three health-disparate southern communities Veda Johnson, Valerie Hutcherson, Ruth Ellis S81 Childhood obesity prevention partnership in Louisville: creative opportunities to engage families in a multifaceted approach to obesity prevention Anna Kharmats, Sandra Marshall-King, Monica LaPradd, Fannie Fonseca-Becker S82 Improvements in cervical cancer prevention found after implementation of evidence-based Latina prevention care management program Deanna Kepka, Julia Bodson, Echo Warner, Brynn Fowler S83 The OneFlorida data trust: Achieving health equity through research & training capacity building Elizabeth Shenkman, William Hogan, Folakami Odedina, Jessica De Leon, Monica Hooper, Olveen Carrasquillo, Renee Reams, Myra Hurt, Steven Smith, Jose Szapocznik, David Nelson, Prabir Mandal S84 Disseminating and sustaining medical-legal partnerships: Shared value and social return on investment James Teufel

Published
2016

10. Implementing an mHealth system for substance use disorders in primary care: a mixed methods study of clinicians' initial expectations and first year experiences.

Author

Mares, Marie-Louise, Gustafson, David H., Glass, Joseph E., Quanbeck, Andrew, McDowell, Helene, McTavish, Fiona, Atwood, Amy K., Marsch, Lisa A., Thomas, Chantelle, Shah, Dhavan, Brown, Randall, Isham, Andrew, Nealon, Mary Jane, and Ward, Victoria

Subjects
SUBSTANCE abuse treatment, DRUG abuse, SMARTPHONES, CLINICAL trials, MEDICAL research, RANDOMIZED controlled trials
Abstract

Background: Millions of Americans need but don't receive treatment for substance use, and evidence suggests that addiction-focused interventions on smart phones could support their recovery. There is little research on implementation of addiction-related interventions in primary care, particularly in Federally Qualified Health Centers (FQHCs) that provide primary care to underserved populations. We used mixed methods to examine three FQHCs' implementation of Seva, a smart-phone app that offers patients online support/discussion, health-tracking, and tools for coping with cravings, and offers clinicians information about patients' health tracking and relapses. We examined (a) clinicians' initial perspectives about implementing Seva, and (b) the first year of implementation at Site 1. Methods: Prior to staggered implementation at three FQHCs (Midwest city in WI vs. rural town in MT vs. metropolitan NY), interviews, meetings, and focus groups were conducted with 53 clinicians to identify core themes of initial expectations about implementation. One year into implementation at Site 1, clinicians there were re-interviewed. Their reports were supplemented by quantitative data on clinician and patient use of Seva. Results: Clinicians anticipated that Seva could help patients and make behavioral health appointments more efficient, but they were skeptical that physicians would engage with Seva (given high caseloads), and they were uncertain whether patients would use Seva. They were concerned about legal obligations for monitoring patients' interactions online, including possible "cries for help" or inappropriate interactions. One year later at Site 1, behavioral health care providers, rather than physicians, had incorporated Seva into patient care, primarily by discussing it during appointments. Given workflow/load concerns, only a few key clinicians monitored health tracking/relapses and prompted outreach when needed; two researchers monitored the discussion board and alerted the clinic as needed. Clinician turnover/leave complicated this approach. Contrary to clinicians' initial concerns, patients showed sustained, mutually supportive use of Seva, with few instances of misuse. Conclusions: Results suggest the value of (a) focusing implementation on behavioral health care providers rather than physicians, (b) assigning a few individuals (not necessarily clinicians) to monitor health tracking, relapses, and the discussion board, (c) anticipating turnover/leave and having designated replacements. Patients showed sustained, positive use of Seva. [ABSTRACT FROM AUTHOR]

Published
2016
Full Text
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11. Creating a Dynamic, Tailored Online Health Education and Support Program for Women with Breast Cancer: A Case Study of the CHESS Program.

Author

Hawkins, Robert, Pingree, Suzanne, Shaw, Bret, Gustafson, David, Gatzke, Kelly, McDowell, Helene, and Tryon-Petith, Charmaine

Subjects
HEALTH education, SOCIAL support, BREAST cancer, INFORMATION resources management, HEALTH
Abstract

The article describes the process used to develop and integrate a tailored health information system for an existing online health education and support system for women with breast cancer called the Comprehensive Health Enhancement Support System (CHESS) "Living with Breast Cancer" program. The foundational steps of formative research involved identifying general informational needs associated with key breast cancer events or experiences followed by differentiating individual characteristics that distinguish between informational needs. The next steps included creating a tailoring framework and then mapping the existing content of CHESS to these differentiating characteristics and treatment stages, and developing decision rules to trigger tailored content to users based on data they input into the system. Finally, low fidelity prototyping sessions were conducted to determine the most appropriate format for users to update variables informing CHESS tailoring, to identify the optimal degree of subtlety appropriate to deliver tailored content, and to learn how tailoring methods affect general navigation and usability. The objective of this case study is to help other eHealth developers learn from the insights we've gained from our extensive regimen of formative research focused on how to develop an online tailored information system for women with breast cancer.

Published
2005

12. The role of the family environment and computer-mediated social support on breast cancer patients' coping strategies.

Author

Yoo, Woohyun, Shah, Dhavan V, Shaw, Bret R, Kim, Eunkyung, Smaglik, Paul, Roberts, Linda J, Hawkins, Robert P, Pingree, Suzanne, McDowell, Helene, and Gustafson, David H

Abstract

Despite the importance of family environment and computer-mediated social support (CMSS) for women with breast cancer, little is known about the interplay of these sources of care and assistance on patients' coping strategies. To understand this relation, the authors examined the effect of family environment as a predictor of the use of CMSS groups as well as a moderator of the relation between group participation and forms of coping. Data were collected from 111 patients in CMSS groups in the Comprehensive Health Enhancement Support System "Living with Breast Cancer" intervention. Results indicate that family environment plays a crucial role in (a) predicting breast cancer patient's participation in CMSS groups and (b) moderating the effects of use of CMSS groups on breast cancer patients' coping strategies such as problem-focused coping and emotion-focused coping. [ABSTRACT FROM AUTHOR]

Published
2014
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13. Integrating addiction treatment into primary care using mobile health technology: protocol for an implementation research study.

Author

Quanbeck, Andrew R., Gustafson, David H., Marsch, Lisa A., McTavish, Fiona, Brown, Randall T., Mares, Marie-Louise, Johnson, Roberta, Glass, Joseph E., Atwood, Amy K., and McDowell, Helene

Subjects
ADDICTIONS, MEDICAL care, MOBILE health, ALCOHOL, PATIENTS
Abstract

Background Healthcare reform in the United States is encouraging Federally Qualified Health Centers and other primary-care practices to integrate treatment for addiction and other behavioral health conditions into their practices. The potential of mobile health technologies to manage addiction and comorbidities such as HIV in these settings is substantial but largely untested. This paper describes a protocol to evaluate the implementation of an E-Health integrated communication technology delivered via mobile phones, called Seva, into primary-care settings. Seva is an evidence-based system of addiction treatment and recovery support for patients and real-time caseload monitoring for clinicians. Methods/Design Our implementation strategy uses three models of organizational change: the Program Planning Model to promote acceptance and sustainability, the NIATx quality improvement model to create a welcoming environment for change, and Rogers's diffusion of innovations research, which facilitates adaptations of innovations to maximize their adoption potential. We will implement Seva and conduct an intensive, mixed-methods assessment at three diverse Federally Qualified Healthcare Centers in the United States. Our non-concurrent multiple-baseline design includes three periods — pretest (ending in four months of implementation preparation), active Seva implementation, and maintenance — with implementation staggered at six-month intervals across sites. The first site will serve as a pilot clinic. We will track the timing of intervention elements and assess study outcomes within each dimension of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework, including effects on clinicians, patients, and practices. Our mixedmethods approach will include quantitative (e.g., interrupted time-series analysis of treatment attendance, with clinics as the unit of analysis) and qualitative (e.g., staff interviews regarding adaptations to implementation protocol) methods, and assessment of implementation costs. Discussion If implementation is successful, the field will have a proven technology that helps Federally Qualified Health Centers and affiliated organizations provide addiction treatment and recovery support, as well as a proven strategy for implementing the technology. Seva also has the potential to improve core elements of addiction treatment, such as referral and treatment processes. A mobile technology for addiction treatment and accompanying implementation model could provide a cost-effective means to improve the lives of patients with drug and alcohol problems. Trial registration ClinicalTrials.gov (NCT01963234). [ABSTRACT FROM AUTHOR]

Published
2014
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14. Predictors and Effects of Training on an Online Health Education and Support System for Women with Breast Cancer.

Author

McDowell, Helene, Eunkyung Kim, Shaw, Bret R., Jeong Yeob Han, and Gumieny, Lauren

Subjects
BREAST cancer, CANCER patients, CANCER education, PATIENT education, HEALTH education, COMPUTER assisted instruction
Abstract

Many breast cancer patients currently turn to Internet-based education and support to help them cope with their illness. This study explores the role of training in influencing how patients use a particular Interactive Cancer Communication System (ICCS) over time and also examines what pre-test characteristics predict which people are most likely to opt in or out of training in the first place. With use of pre-test survey and unobtrusive individual records of ICCS system use data (N = 216), nonparametric tests revealed that only having a later stage of cancer predicted whether or not patients participated in training. Results indicated that participating in training was a significant predictor of higher levels of using the CHESS system. In particular, the repeated measures analysis of covariance found the significant interaction as well as main effect of group (i.e., training vs. no training) and time (i.e., individual's CHESS usages at different times) in interactive and information CHESS services, suggesting that 1) the training group has a higher level of usage than the no training group, 2) both of the groups' usage decreased over time, and 3) these joint patterns hold over time. Practical guidelines for future ICCS campaign implementation are discussed. [ABSTRACT FROM AUTHOR]

Published
2010
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15. Reducing the Digital Divide for Low-income Women With Breast Cancer: A Feasibility Study of a Population-Based Intervention.

Author

Gustafson, DavidH., McTavish, FionaM., Stengle, William, Ballard, Denise, Jones, Ellen, Julesberg, Karen, McDowell, Helene, Landucci, Gina, and Hawkins, Robert

Subjects
BREAST cancer, CANCER patients, WOMEN, MEDICAL care, INFORMATION services, FEASIBILITY studies, QUALITY of life
Abstract

A fundamental challenge to helping underserved women and their families cope with breast cancer is providing them with easily accessible, reliable health care information and support. This is especially true for low-income families living in rural areas where resources are few and frequently distant as well as low-income families in urban areas where access to information and support can he complex and overwhelming. The Internet is one mechanism that has tremendous potential to help these families cope with breast cancer. This article describes a feasibility test of the potential for the National Cancer Institute's (NCI's) Cancer Information Service (CIS) to provide access to an Internet-based system that has been shown to improve quality of life for underserved breast cancer patients. The test was conducted in rural Wisconsin (low socioeconomic status [SES] Caucasian women) and in Detroit, Michigan (low SES African American women), and compares the effectiveness of several different dissemination strategies. Using these results we propose a model for how CIS telephone and partnership program services could efficiently disseminate such information and support systems. In doing so we believe that important steps can be taken to close the digital divide that separates low-income families from the resources they need to effectively face cancer. This is the first of two articles coming from this study. A companion article reports on an evaluation of the use and impact of this system on the women who were given access to it. [ABSTRACT FROM AUTHOR]

Published
2005
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16. Use and Impact of eHealth System by Low-income Women With Breast Cancer.

Author

Gustafson, DavidH., McTavish, FionaM., Stengle, William, Ballard, Denise, Hawkins, Robert, Shaw, BretR., Jones, Ellen, Julèsberg, Karen, McDowell, Helene, Chen, Wei Chih, Volrathongchai, Kanittha, and Landucci, Gina

Subjects
FEASIBILITY studies, BREAST cancer, WOMEN, INCOME, MEDICAL care, CLINICAL trials, INFORMATION services, SOCIAL support
Abstract

This article is the second of a two-part series reporting on a population-based study intended to use an eHealth system to examine the feasibility of reaching underserved women with breast cancer (Gustafson, McTavish et al., Reducing the digital divide for low-income women with breast cancer, 2004; Madison Center for Health Systems Research and Analysis, University of Wisconsin; Comprehensive Health Enhancement Support System [CHESS]) and determine how they use the system and what impact it had on them. Participants included women recently diagnosed with breast cancer whose income was at or below 250% of poverty level and were living in rural Wisconsin (n = 144: all Caucasian) or Detroit (n = 85; all African American). Because this was a population-based study all 229 participants received CHESS. A comparison group of patients (n = 51) with similar demographics was drawn from a separate recently completed randomized clinical trial. Use rates (e.g., frequency and length of use as well as type of use) as well as impact on several dimensions of quality of life and participation in health care are reported. Low-income subjects in this study logged on and spent more time on CHESS than more affluent women in a previous study. Urban African Americans used information and analysis services more and communication services less than rural Caucasians. When all low-income women from this study are combined and compared with a low-income control group from another stud),, the CHESS group was superior to that control group in 4 of 8 outcome variables at both statistically and practically significant levels (social support, negative emotions, participation in health care, and information competence). When African Americans and Caucasians are separated the control group's sample size becomes 30 and 21 thus reducing power. Statistical significance is retained, however, in all four outcomes for Caucasians and in two of four for African Americans. Practical significance is retained for all four outcomes. We conclude that an eHealth system like CHESS will be used extensively and have a positive impact on low-income women with breast cancer. [ABSTRACT FROM AUTHOR]

Published
2005
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