Use of Semi-Structured Interviews to Explore Competing Demands in a Prostate Cancer Prevention Intervention Clinical Trial (PCPICT)

In this paper we report on findings from the first known study using qualitative methods to explore factors influencing physicians’ participation in an ongoing federally-funded prostate cancer chemoprevention clinical trial. We sought to identify ways to improve collaboration between researchers and physicians and enhance the success of future projects and employed purposive sampling to recruit physician/investigators who were involved or invited to participate in the trial. Using the data from open-ended semi-structured interviews, we examined patterns in their languaging and created themes. We found that individual and structural factors served as barriers and facilitators to participation. Willingness and desire to participate in the trial (individual factors) were not always enough to result in actual participation due to practice environment (structural) constraints. Our research provides a better understanding of the complex intersection of factors in this setting and through our findings we extend the theory of competing demands into the arena of prostate cancer prevention clinical trials, moving the science towards solutions to current challenges in recruitment to this type of trial

"It gave me an excuse to get out into society again": Decreasing Veteran Isolation through a Community Agricultural Peer Support Model

Background: Reintegration is known to be a difficult time for Veterans. Peer support programs offer a good strategy for military and Veterans, particularly as it relates to reintegration.  We review an innovative, peer support program implemented at a Veteran run community agricultural initiative (CAI).Methods: This project was a case-study evaluation using a mixed methods design including participant observations; qualitative interviews with a total of 34 CAI members and affiliates; and administered surveys to a total of 67 CAI members and affiliates.Findings: Survey results suggested that CAI participation contributed to improvements in communication, forming bonds, and developing new friendships with Veterans, non-Veterans, family members, and strangers, as well as increased involvement in community events. Interviews revealed that the CAI’s informal peer-support culture and intentional normalization of sharing stories helped promote recovery and reintegration.Conclusions: The CAI continues to refine its peer support model. The organization is overcoming common barriers by leveraging community partnerships to bring Veterans into the fold and expanding their peer support model to Veteran organizations with similar missions. This will ultimately lead to a culture of peer support across agencies and spread the reach of the CAI’s mission for Veterans.</p

Cultural Factors and Concepts of Pollution: Colorectal Cancer and Health Behaviors among Ashkenazi Jewish Women

The colorectal cancer (CRC) incidence in Ashkenazi Jews has been found to be highest of any ethnic group in the world (Feldman, 2001). It is currently unclear how culture and religion influence health behaviors of U.S. Ashkenazi Jews, as well as what other socio-cultural factors influence AJ women\u27s attitudes towards CRC risk and screening practices. This study aimed at exploring and describing the cultural and religious influences on health behaviors and beliefs related to CRC in Ashkenazi Jewish women. Research participants included seven key informants (rabbis) and forty-two Ashkenazi Jewish women ages 50 and up. Methods included in-depth, qualitative interviews and focus groups. The study also utilized a demographic survey which included questions about baseline knowledge of colorectal cancer in Ashkenazi Jews, and a ten-item American Cancer Society\u27s Questionnaire on Experiences with and Attitude toward CRC Screening. Participants were recruited from Tampa synagogues and community using non-probabilistic sampling. Results revealed only 5% of participants were aware of the increased prevalence of colorectal cancer in Ashkenazi Jews; still, most participants (88%) were up to date on colorectal cancer screening. Judaic purity laws did not resonate with many participants, and for those who did follow them, they did not take a view of bodily functions as being impure. A consistent description of a \u27Jewish way\u27 of looking at health emerged, involving both the push for education, which increases knowledge about and access to healthcare, as well as the core Jewish tenet of the infinite value of life. No significant differences were found among the screening practices of the three self-identified denominations, and only breast and cervical cancer screening were found to be significantly different between those who have ever had a CRC screening and those who have not. Recommendations highlight the need for future research in this area including larger samples, further exploring core Jewish tenets as related to health behaviors in this population, partnering with the Jewish community for interventions, and addressing ways to better track CRC incidence, mortality and screening in this population in order to raise awareness

Multisite Agricultural Veterans Affairs Farming and Recovery Mental Health Services (VA FARMS) Pilot Program: Protocol for a Responsive Mixed Methods Evaluation Study

BackgroundVeterans Affairs Farming and Recovery Mental Health Services (VA FARMS) is an innovative pilot program to provide supportive resources for veterans with interests in agricultural vocations. Implemented at 10 pilot sites, VA FARMS will provide mental health services and resources for veterans while supporting training in gardening and agriculture. As each pilot site project has unique goals, outreach strategies, and implementation efforts based on the local environment and veteran population, evaluating the pilot program provides a unique challenge for evaluators. This paper describes the protocol to evaluate VA FARMS, which was specifically designed to enable site variation by providing both site-specific and cross-site understanding of site implementation processes and outcomes. ObjectiveThe objectives of this paper are to (1) describe the protocol used for evaluating VA FARMS, as an innovative Department of Veterans Affairs (VA) agriculturally based, mental health, and employment pilot program serving veterans at 10 pilot sites across the Veterans Health Administration enterprise; and (2) provide guidance to other evaluators assessing innovative programs. MethodsThis evaluation uses the context, inputs, process, product (CIPP) model, which evaluates a program’s content and implementation to identify strengths and areas for improvement. Data collection will use a concurrent mixed methods approach. Quantitative data collection will involve quarterly program surveys, as well as three individual veteran participant surveys administered upon the veteran’s entrance and exit of the pilot program and 3 months postexit. Quantitative data will include baseline descriptive statistics and follow-up statistics on veteran health care utilization, health care status, and agriculture employment status. Qualitative data collection will include participant observation at each pilot site, and interviews with participants, staff, and community stakeholders. Qualitative data will provide insights about pilot program implementation processes, veterans’ experiences, and short-term participation outcomes. ResultsEvaluation efforts began in December 2018 and are ongoing. Between October 2018 and September 2020, 494 veterans had enrolled in VA FARMS and 1326 veterans were reached through program activities such as demonstrations, informational presentations, and town-hall discussions. A total of 1623 community members and 655 VA employees were similarly reached by VA FARMS programming during that time. Data were collected between October 2018 and September 2020 in the form of 336 veteran surveys, 30 veteran interviews, 27 staff interviews, and 11 community partner interviews. Data analysis is expected to be completed by October 2022. ConclusionsThis evaluation protocol will provide guidance to other evaluators assessing innovative programs. In its application to the VA FARMS pilot, the evaluation aims to add to existing literature on nature-based therapies and the rehabilitation outcomes of agricultural training programs for veterans. Results will provide programmatic insights on the implementation of pilot programs, along with needed improvements and modifications for the future expansion of VA FARMS and other veteran-focused agricultural programs. International Registered Report Identifier (IRRID)DERR1-10.2196/4049