Concept mapping sociocultural aspects of cervical cancer prevention among African American women

IntroductionFor African American women in Houston, cervical cancer mortality is disproportionate to their racial and ethnic counterparts. Most notably, lack of human papillomavirus (HPV) screening and vaccination as well as late diagnosis increase cervical cancer mortality. However, cervical cancer is largely preventable. While previous research has identified a few social determinants that are specifically related to cervical cancer (e.g., education, income, neighborhood), there may be a host of additional social and cultural factors that contribute to a lack of preventative behavior.MethodsThe present study used concept mapping to explore sociocultural determinants of cervical cancer prevention beliefs among young African American women. N = 15 African American women, ages 18–25, participated in a group concept mapping session focused on cervical cancer knowledge, beliefs about women’s health, and how their social environment and culture play a role in their conceptualization of cervical cancer prevention.DiscussionFive overarching concepts emerged: (1) Screening, (2) Support System, (3) Cervical Cancer 101 (knowledge), (4) Fatalism, and (5) Ease of Prevention.ConclusionThe present study highlights the use of concept mapping for prevention science, particularly in exploratory studies for understanding cervical cancer screening barriers, avenues for intervention, and public health messaging. We discuss the findings and implications for public health research in cervical cancer prevention tailored for African American women

Group interventions to improve health outcomes : a framework for their design and delivery

Peer reviewedPublisher PD

Barriers to mental health service use and preferences for addressing emotional concerns among lung cancer patients

OBJECTIVE: This study examined barriers to mental health service use and preferences for addressing emotional concerns among lung cancer patients (N=165) at two medical centers in the Midwestern United States. METHODS: Lung cancer patients completed an assessment of anxiety and depressive symptoms, mental health service use, barriers to using these services, and preferences for addressing emotional concerns. RESULTS: Only 45% of distressed patients received mental health care since their lung cancer diagnosis. The most prevalent patient-reported barriers to mental health service use among non-users of these services (n=110) included the desire to independently manage emotional concerns (58%) and inadequate knowledge of services (19%). In addition, 57% of distressed patients who did not access mental health services did not perceive the need for help. Seventy-five percent of respondents (123/164) preferred to talk to a primary care physician if they were to have an emotional concern. Preferences for counseling, psychiatric medication, peer support, spiritual care, or independently managing emotional concerns also were endorsed by many patients (range=40-50%). Older age was associated with a lower likelihood of preferring to see a counselor. CONCLUSIONS: Findings suggest that many distressed lung cancer patients underuse mental health services and do not perceive the need for such services. Efforts to increase appropriate use of services should address patients' desire for autonomy and lack of awareness of services

A randomised controlled trial to evaluate the efficacy of a 6 month dietary and physical activity intervention for prostate cancer patients receiving androgen deprivation therapy

<p>Abstract</p> <p>Background</p> <p>Treatment with Androgen Deprivation Therapy (ADT) for prostate cancer is associated with changes in body composition including increased fat and decreased lean mass; increased fatigue, and a reduction in quality of life. No study to date has evaluated the effect of dietary and physical activity modification on the side-effects related to ADT. The aim of this study is to evaluate the efficacy of a 6-month dietary and physical activity intervention for prostate cancer survivors receiving ADT to minimise the changes in body composition, fatigue and quality of life, typically associated with ADT.</p> <p>Methods</p> <p>Men are recruited to this study if their treatment plan is to receive ADT for at least 6 months. Men who are randomised to the intervention arm receive a home-based tailored intervention to meet the following guidelines a) ≥ 5 servings vegetables and fruits/day; b) 30%-35% of total energy from fat, and < 10% energy from saturated fat/day; c) 10% of energy from polyunsaturated fat/day; d) limited consumption of processed meats; e) 25-35 gm of fibre/day; f) alcoholic drinks ≤ 28 units/week; g) limited intake of foods high in salt and/or sugar. They are also encouraged to include at least 30 minutes of brisk walking, 5 or more days per week. The primary outcomes are change in body composition, fatigue and quality of life scores. Secondary outcomes include dietary intake, physical activity and perceived stress. Baseline information collected includes: socio-economic status, treatment duration, perceived social support and health status, family history of cancer, co-morbidities, medication and supplement use, barriers to change, and readiness to change their health behaviour. Data for the primary and secondary outcomes will be collected at baseline, 3 and 6 months from 47 intervention and 47 control patients.</p> <p>Discussion</p> <p>The results of this study will provide detailed information on diet and physical activity levels in prostate cancer patients treated with ADT and will test the feasibility and efficacy of a diet and physical activity intervention which could provide essential information to develop guidelines for prostate cancer patients to minimise the side effects related to ADT.</p> <p>Trial registration</p> <p>ISRCTN trial number ISCRTN75282423</p

How Can Physical Activity Referral Rates for Breast Cancer Patients be Increased?

Exercise therapy is beneficial for cancer survivors’ biopsychosocial aspects of health (1–3); however, the rates of exercise referrals by the oncology providers (OPs) and supporting teams remain low, causing a paradox. We chose to address this issue in this opinion article. We discuss the possible barriers that make the OPs unable or reluctant to refer more patients to exercise therapy sessions and also briefly address issues of patients’ adherence. Finally, the available exercise therapy infrastructure is discussed as an additional barrier to the therapeutic benefits of exercise. Our rationale is based on the fact that physical activity (PA) can enable wide-reaching benefits for the recovery of cancer patients during and after cancer treatment (4–6). Moreover, and specifically for breast cancer survivors, the recent trials and a systematic review disproved the notion that arm exercise should be avoided (i.e., postoperative progressive arm resistance training does not precipitate or exacerbate lymphedema) (7–9). This further supports the beneficial effects of PA across a range of contexts. In the UK, 1.6 million cancer survivors out of a total of 2 million do not meet the minimum recommended PA guidelines for sustaining an independent and disability-free lifestyle (10). A single-blinded randomized control trial has shown that cancer survivors are more likely to become physically active if they are advised to do so by a health-care professional (11). This highlights the impact OPs have on patients’ life and survival, especially when the treatments involve a life-changing approach, such as increasing PA levels, commitment to exercise training, and adopting a healthier lifestyle. Based on our own knowledge on cancer care practices and on research experience in other patient populations (12), we hypothesized that the main reasons behind the exercise referral paradox for breast cancer survivors in England are (1) lack of time during a consultation to promote PA, (2) OPs and supporting team lack of current knowledge and awareness of the benefits of PA in cancer survivors’ biopsychosocial aspects of health, and (3) the lack of knowledge and confidence from the patients’ side to request an exercise referral from the OPs

Usefulness and engagement with a guided workbook intervention (WorkPlan) to support work related goals among cancer survivors

Background: Returning to work after cancer is associated with improved physical and psychological functioning, but managing this return can be a challenging process. A workbook based intervention (WorkPlan) was developed to support return-to-work among cancer survivors. The aim of this study was to explore how participants using the workbook engaged with the intervention and utilised the content of the intervention in their plan to return-to-work. Methods: As part of a feasibility randomised controlled trial, 23 participants from the intervention group were interviewed 4-weeks post intervention. Interviews focussed on intervention delivery and data was analysed using Framework analysis. Results: Participants revealed a sense of empowerment and changes in their outlook as they transitioned from patient to employee, citing the act of writing as a medium for creating their own return-to-work narrative. Participants found the generation of a return-to-work plan useful for identifying potential problems and solutions, which also served as a tool for aiding discussion with the employer on return-to-work. Additionally, participants reported feeling less uncertain and anxious about returning to work. Timing of the intervention in coordination with ongoing cancer treatments was crucial to perceived effectiveness; participants identified the sole or final treatment as the ideal time to receive the intervention. Conclusions: The self-guided workbook supports people diagnosed with cancer to build their communication and planning skills to successfully manage their return-to-work. Further research could examine how writing plays a role in this process

Atmospheric conditions during the Arctic Clouds in Summer Experiment (ACSE): Contrasting open-water and sea-ice surfaces during melt and freeze-up seasons

The Arctic Clouds in Summer Experiment (ACSE) was conducted during summer and early autumn 2014, providing a detailed view of the seasonal transition from ice melt into freeze-up. Measurements were taken over both ice-free and ice-covered surfaces near the ice edge, offering insight into the role of the surface state in shaping the atmospheric conditions. The initiation of the autumn freeze-up was related to a change in air mass, rather than to changes in solar radiation alone; the lower atmosphere cooled abruptly, leading to a surface heat loss. During melt season, strong surface inversions persisted over the ice, while elevated inversions were more frequent over open water. These differences disappeared during autumn freeze-up, when elevated inversions persisted over both ice-free and ice-covered conditions. These results are in contrast to previous studies that found a well-mixed boundary layer persisting in summer and an increased frequency of surface-based inversions in autumn, suggesting that knowledge derived from measurements taken within the pan-Arctic area and on the central ice pack does not necessarily apply closer to the ice edge. This study offers an insight into the atmospheric processes that occur during a crucial period of the year; understanding and accurately modeling these processes is essential for the improvement of ice-extent predictions and future Arctic climate projections