Data Acquisition, Data Management and Subject Tracking in an RCT: Promoting Breast Cancer Screening in Non-Adherent Women

As part of the mini-symposium entitled Data Acquisition, Data Management, and Subject Tracking in Clinical and Translational Research: Seeking Solutions to Persistent Challenges, Dr. Luckmann\u27s presentation focuses on common challenges arising from his clinical research experience in the development and implementation of complex data systems for clinical studies

Evidence-Based Resources for Public Health Project

Introduction Evidence-Based Medicine (EBM) for clinical medicine involves using the best evidence to care for individual patients. Evidence-based public health (EBPH) involves using the best evidence to develop public health policies and intervention programs. There are various EBM resources available to help clinicians sort through the vast amount of medical literature to find the best evidence for their practice needs, yet few resources are available to assist public health practitioners find high quality information relevant to their practice needs. Purpose This project is identifying and cataloging existing electronic evidence-based resources in public health and assessing possible models for effectively and efficiently delivering current, evidence-based practices identified in the journal literature to public health practitioners. This resource will assist federal, state and local health department personnel in identifying evidence-based practices. Links to existing resources are being organized for easy access and searching on a website. Methodology To inform the processes of identifying resources we first developed a working definition of the field of public health. We examined public health associations, government health agencies, national health objectives, and other public health sources to identify the knowledge domains of public health (e.g. epidemiology, maternal and child health). We then sought to identify journals, databases, and other resources containing content relevant to these domains and subdomains. To guide the process of selecting journals we used sources from the CDC Information Center, the Healthy People 2010 Information Access Project, MLA’s Core Public Health Journals Project, and ISI’s Journal Citation Reports. The selected journals were matched with the identified public health knowledge domains and subdomains. We then systematically identified existing public health and clinical medical models for organizing, summarizing, synthesizing, and disseminating evidence-based knowledge in the public health and medical fields. These ranged from electronic journal search services to comprehensive knowledge bases that select, summarize and critique health literature in specific domains. Results Results to date include a project website (http://library.umassmed.edu/ebpph); lists of public health journals and bibliographic databases; a chart of public health sources used to identify 17 knowledge domains, and 143 subdomains of public health; a table of public health journals matched with each knowledge domain and subdomain; and an annotated listing of medical and public health models of literature summarization, synthesis and dissemination. Discussion/Conclusion We believe that our methodology for identifying domain-specific evidence-based resources was effective and efficient in accomplishing the project goal. Our methodology for identifying information resources related to a specific knowledge can be used to enhance collection development in a specific discipline. Many different sophisticated approaches are being used by government, non-profit and for-profit organizations in the United States to summarize, synthesize, organize and disseminate evidence-based health information, primarily to clinical medical practitioners. Study of the structure, content, and usability of these existing models may offer important lessons for developing new and improved models aimed at serving a similar purpose for public health practitioners. In the next year of the project we will be exploring through focus groups with public health practitioners the feasibility, usability and acceptability of several models for providing evidence-based information. Support The Evidence-Based Practice for Public Health Project is funded through a cooperative agreement with the Centers for Disease Control and Prevention Information Center and the Association of Teachers of Preventive Medicine. Presented at the 2003 Medical Library Association Annual Meeting, San Diego, CA

Improving Access to Credible and Relevant Information for Public Health Professionals: A Qualitative Study of Information Needs in Communicable Disease Control

In order to understand the information needs and the current and ideal approaches to information access in one major area of public health, semi-structured key informant interviews were conducted with 12 communicable disease control public health professionals in Massachusetts at their worksite. Examples of the types of information they commonly accessed and how it was accessed were solicited and/or observed where feasible. The interviews were transcribed and analyzed thematically. Information needs ranged from breaking news (e.g. epidemiology of emerging disease outbreaks) and untested programmatic ideas (e.g. how to handle prevention and treatment of West Nile Virus and SARS) to the need for published evidence-based information about better known diseases (e.g. tuberculosis and HIV/AIDS). Current preferences for information delivery mechanisms varied according to the type of information sought. Information about emerging diseases and programmatic interventions to address these were more often obtained from email alert systems and from informal local and national networks of colleagues via telephone, teleconference or special interest listservs. Information about more well-known diseases was often obtained via websites, general or specific journal search engines, or from listservs providing citations to new or updated sources of information about these diseases. Informants identified improvements to the existing information access and delivery systems that could meet their needs more effectively. This session will review areas for improvements identified by informants and suggest models that can be implemented to help public health professionals access credible and relevant information. Oral presentation at the 2004 American Public Health Association Annual Meeting, Washington, DC

Enhancing evidence-based information access to inform public health practice

It is clear from the trend towards evidence-based practices in many fields that public health (PH) practice can be better informed if credible information about effective practices is accessible. Comparing sources of evidence-based information in clinical medicine to what is available for PH, we found fewer examples of readily accessible sources in PH. This project was conceived to identify enhancements to evidence-based information accessing needs of PH professionals. A qualitative study identified how PH professionals currently access information and what enhancements they need. Nineteen individual interviews were conducted across two state health department bureaus – communicable disease control and community health promotion. Follow-up focus groups were conducted to gather additional data on preferences for information accessing models and features. An information maturity continuum emerged ranging from fast-breaking news about emerging health threats to evidence-based practice guidelines. Needs within this continuum varied somewhat across bureaus, but both groups expressed needs for improved information access such as better organizing/filtering of information, access to systematic reviews and/or summaries as well as full text of articles, one portal access with a good search engine, and broader access to best practice information. Both groups identified a need for PH-specific filters to create more efficient access to relevant information either delivered to their desktops via listservs or sought via search engines. Informants stated a preference for making enhancements to systems with which they were already familiar such as PubMed. Oral presentation at the 133rd Annual Meeting of the American Public Health Association; Abstract 108127, Session 5134. Philadelphia, PA

Design and methods for a randomized clinical trial comparing three outreach efforts to improve screening mammography adherence

<p>Abstract</p> <p>Background</p> <p>Despite the demonstrated need to increase screening mammography utilization and strong evidence that mail and telephone outreach to women can increase screening, most managed care organizations have not adopted comprehensive outreach programs. The uncertainty about optimum strategies and cost effectiveness have retarded widespread acceptance. While 70% of women report getting a mammogram within the prior 2 years, repeat mammography rates are less than 50%. This 5-year study is conducted though a Central Massachusetts healthcare plan and affiliated clinic. All womenhave adequate health insurance to cover the test.</p> <p>Methods/Design</p> <p>This randomized study compares 3 arms: reminder letter alone; reminder letter plus reminder call; reminder letter plus a second reminder and booklet plus a counselor call. All calls provide women with the opportunity to schedule a mammogram in a reasonable time. The invention period will span 4 years and include repeat attempts. The counselor arm is designed to educate, motivate and counsel women in an effort to alleviate PCP burden.</p> <p>All women who have been in the healthcare plan for 24 months and who have a current primary care provider (PCP) and who are aged 51-84 are randomized to 1 of 3 arms. Interventions are limited to women who become ≥18 months from a prior mammogram. Women and their physicians may opt out of the intervention study.</p> <p>Measurement of completed mammograms will use plan billing records and clinic electronic records. The primary outcome is the proportion of women continuously enrolled for ≥24 months who have had ≥1 mammogram in the last 24 months. Secondary outcomes include the number of women who need repeat interventions. The cost effectiveness analysis will measure all costs from the provider perspective.</p> <p>Discussion</p> <p>So far, 18,509 women aged 51-84 have been enrolled into our tracking database and were randomized into one of three arms. At baseline, 5,223 women were eligible for an intervention. We anticipate that the outcome will provide firm data about the maximal effectiveness as well as the cost effectiveness of the interventions both for increasing the mammography rate and the repeat mammography rate.</p> <p>Trial registration</p> <p><url>http://clinicaltrials.gov/</url><a href="http://www.clinicaltrials.gov/ct2/show/NCT01332032">NCT01332032</a></p

Christianity as Public Religion::A Justification for using a Christian Sociological Approach for Studying the Social Scientific Aspects of Sport

The vast majority of social scientific studies of sport have been secular in nature and/or have tended to ignore the importance of studying the religious aspects of sport. In light of this, Shilling and Mellor (2014) have sought to encourage sociologists of sport not to divorce the ‘religious’ and the ‘sacred’ from their studies. In response to this call, the goal of the current essay is to explore how the conception of Christianity as ‘public religion’ can be utilised to help justify the use of a Christian sociological approach for studying the social scientific aspects of sport. After making a case for Christianity as public religion, we conclude that many of the sociological issues inherent in modern sport are an indirect result of its increasing secularisation and argue that this justifies the need for a Christian sociological approach. We encourage researchers to use the Bible, the tools of Christian theology and sociological concepts together, so to inform analyses of modern sport from a Christian perspective

Review: advice from doctors and nurses, behavioural interventions, nicotine replacement treatment, and several pharmacological treatments increase smoking cessation rates

Review of article: Lancaster T, Stead L, Silagy C, et al, for the Cochrane Tobacco Addiction Review Group. Effectiveness of interventions to help people stop smoking: findings from the Cochrane Library. BMJ 2000 Aug 5;321:355–8

Design of a handheld electronic pain, treatment and activity diary

Effective tools for recording and analyzing data on patients\u27 pain experience, use of pain treatments, and physical function are needed to improve communication between providers and patients with noncancer chronic pain. A handheld electronic diary (HED) that can be used throughout the day may provide more useful and accurate information about pain, treatments, and function than available paper and on-line diaries that are designed to be used once daily, weekly or less often. Based on user-specified requirements we designed and built a prototype HED with 7 modules. Diary queries are followed by multiple choice responses customized to the patients\u27 expected responses. Usability testing confirmed user comprehension and acceptability of the queries, response sets, and interface