Cancer Care Delivery Research: Building the Evidence Base to Support Practice Change in Community Oncology

Understanding how health care system structures, processes, and available resources facilitate and/or hinder the delivery of quality cancer care is imperative, especially given the rapidly changing health care landscape. The emerging field of cancer care delivery research (CCDR) focuses on how organizational structures and processes, care delivery models, financing and reimbursement, health technologies, and health care provider and patient knowledge, attitudes, and behaviors influence cancer care quality, cost, and access and ultimately the health outcomes and well-being of patients and survivors. In this article, we describe attributes of CCDR, present examples of studies that illustrate those attributes, and discuss the potential impact of CCDR in addressing disparities in care. We conclude by emphasizing the need for collaborative research that links academic and community-based settings and serves simultaneously to accelerate the translation of CCDR results into practice. The National Cancer Institute recently launched its Community Oncology Research Program, which includes a focus on this area of research

Multisite Randomized Trial of a Single-Session Versus Multisession Literacy-Sensitive Self-Care Intervention for Patients With Heart Failure

Self-care training can reduce hospitalization for heart failure (HF), and more intensive intervention may benefit more vulnerable patients, including those with low literacy

Case Studies in Nutrition in Agriculture

Excerpts from the report Foreword: The purpose of this work is to provide an organizational framework for the preparation of case studies documenting agricultural research and development projects that explicitly address food consumption or nutritional concerns in project objectives, design, implementation, and evaluation. It is assumed that a series of case studies will be prepared over the next few years and that subsequent cases will be prepared by individuals closely associated with the projects described. To that end, this report outlines a conceptual framework for approaching the documentation of agricultural projects that include nutritional goals, proposes a format for case presentation, presents criteria for selection of appropriate projects for treatment as case studies, and suggests a set as of priorities for the inclusion of subsequent cases in order to assure comparability of case studies and an even representation of projects in the completed case study series. Two case studies based on the format developed in this document are also presented here. These are the Adaptive Crops Research and Extension Project and the International Sorghum and Millet Project. These projects represent very different ways of addressing the issues of food consumption and nutrition in agricultural research and development

Income and dietary adequacy in an agricultural community

Although many studies as well as conventional wisdom suggest that increases in income result in improved diet and nutritional status in rural areas of developing countries, several recent studies have failed to demonstrate such a relationship. In this paper the relationships between material wealth and income and dietary strategies are examined for an agricultural community in rural Mexico. A superficial examination focusing on summary indices of dietary adequacy frequently cited in the literature and indices of wealth and income demonstrates a positive relationship between them in this community. However, an examination of the same data emphasizing alternative dietary strategies to achieve nutritional adequacy shows a more complex picture. Increasing income is associated with consumption of purchased foods especially foods of animal origin, and is not associated with the consumption of staple foods produced within the household. Diets dependent on purchased foods do not necessarily meet nutritional needs more adequately than diets which rely on agricultural products and gathered foods. Among the implications of this research are a need for a method of analysis which focuses on alternative nutritional strategies available in particular settings, and a need to reassess the relative importance of income generating activities and subsistence agriculture in areas undergoing agricultural change.