#OVARIANCANCER: USING SOCIAL MEDIA TO FACILITATE HEALTH COMMUNICATION

Thesis (Ph.D.)--University of Washington, 2019Ovarian cancer is the fifth leading cause of cancer death among women. Women with a personal or family history of breast and ovarian cancer are encouraged to seek genetic testing, but fewer than 15 to 30% of eligible patients are ever offered genetic testing. Social media may be well positioned to address this area of need. This research seeks to improve our understanding of social media as a platform for public health research and communication, in the context of familial ovarian cancer susceptibility. In Aim 1, I explored how ovarian cancer and ovarian cancer risk is discussed over Twitter, collecting and analyzing tweets to identify structural features of a tweet and describe how social media users publicly exchange and engage with ovarian cancer information over Twitter. In Aim 2, I conducted a series of contextual interviews to describe the online health information-seeking behaviors of internet users at risk for ovarian cancer. Finally, in Aim 3, I evaluated innovative methods for recruiting research participants for an ovarian cancer genetic testing study, using paid targeted advertisements and unpaid posts over Facebook. Findings from this research illustrate what structural components of a social media post may help improve message reach, describe how internet users with a risk of ovarian cancer assess online health information and demonstrate that Facebook is an effective tool for reaching women over the age of 30 with an increased risk of ovarian cancer. These findings offer insight into how public health professionals can leverage social media for the purposes of health communication, and demonstrate that with the help of patient advocates, online communication tools like social media may improve representation in research and health service provision, by widening messaging reach

Science Education in the Early Childhood & Special Education Setting: An Analysis of Science Education Across Lake Washington, Bellevue & Seattle School Districts

Thesis (Master's)--University of Washington, 2012This survey based research illustrates science education in the early childhood setting, specifically across Lake Washington, Seattle and Bellevue Public School Districts, with a lens on programs serving children with special needs. Taking current best practice into consideration, this research compares the amount of time that teachers currently spend teaching their students science across these settings, with recommendations urging educators to expose their students to the scientific inquiry process early and often. Additionally, the results of this survey align with findings regarding teacher self-efficacy in the area of science, demonstrating that educators who have a science background and/or have received professional development opportunities in the area of science, are likely to teach science more often and lead higher quality lessons. The survey results also demonstrate that the provision of curriculum and training opportunities are indicative of a community that supports science education, and therefore predictive of the amount and quality of science education that students in an early childhood setting receive

An Accessible Communication System for Population-Based Genetic Testing: Development and Usability Study

BackgroundGenetic testing uptake is low, despite the well-established connection between pathogenic variants in certain cancer-linked susceptibility genes and ovarian cancer risk. Given that most major insurers cover genetic testing for those with a family history suggestive of hereditary cancer, the issue may lie in access to genetic testing. Remotely accessible web-based communication systems may improve awareness, and uptake, of genetic testing services. ObjectiveThis study aims to present the development and formative evaluation of the multistep web-based communication system required to support the implementation of, and access to, genetic testing. MethodsWhile designing the multistep web-based communication system, we considered various barriers and facilitators to genetic testing, guided by dimensions of accessibility. In addition to conducting usability testing, we performed ongoing assessments focusing on the function of the web-based system and participant response rates, with the goal of continuing to make modifications to the web-based communication system as it is in use. ResultsThe combined approach of usability testing and expert user experience consultation resulted in several modifications to the multistep web-based communication system, including changes that related to imagery and content, web accessibility, and general organization of the web-based system. All recommendations were made with the goal of improving the overall accessibility of the web-based communication system. ConclusionsA multistep web-based communication system appears to be an effective way to address many potential barriers to access, which may otherwise make genetic testing difficult for at-risk individuals to participate in. Importantly, some dimensions of access were easy to assess before study recruitment, but other aspects of the communication system required ongoing assessment during the implementation process of the Making Genetic Testing Accessible study

Using Social Media to Facilitate Communication About Women’s Testing: Tool Validation Study

BackgroundStrong participant recruitment practices are critical to public health research but are difficult to achieve. Traditional recruitment practices are often time consuming, costly, and fail to adequately target difficult-to-reach populations. Social media platforms such as Facebook are well-positioned to address this area of need, enabling researchers to leverage existing social networks and deliver targeted information. The MAGENTA (Making Genetic Testing Accessible) study aimed to improve the availability of genetic testing for hereditary cancer susceptibility in at-risk individuals through the use of a web-based communication system along with social media advertisements to improve reach. ObjectiveThis paper is aimed to evaluate the effectiveness of Facebook as an outreach tool for targeting women aged ≥30 years for recruitment in the MAGENTA study. MethodsWe designed and implemented paid and unpaid social media posts with ongoing assessment as a primary means of research participant recruitment in collaboration with patient advocates. Facebook analytics were used to assess the effectiveness of paid and unpaid outreach efforts. ResultsOver the course of the reported recruitment period, Facebook materials had a reach of 407,769 people and 57,248 (14.04%) instances of engagement, indicating that approximately 14.04% of people who saw information about the study on Facebook engaged with the content. Paid advertisements had a total reach of 373,682. Among those reached, just <15% (54,117/373,682, 14.48%) engaged with the page content. Unpaid posts published on the MAGENTA Facebook page resulted in a total of 34,087 reach and 3131 instances of engagement, indicating that around 9.19% (3131/34,087) of people who saw unpaid posts engaged. Women aged ≥65 years reported the best response rate, with approximately 43.95% (15,124/34,410) of reaches translating to engagement. Among the participants who completed the eligibility questionnaire, 27.44% (3837/13,983) had heard about the study through social media or another webpage. ConclusionsFacebook is a useful way of enhancing clinical trial recruitment of women aged ≥30 years who have a potentially increased risk for ovarian cancer by promoting news stories over social media, collaborating with patient advocacy groups, and running paid and unpaid campaigns. Trial RegistrationClinicalTrials.gov NCT02993068; https://clinicaltrials.gov/ct2/show/NCT0299306

Novel Models of Genetic Education and Testing for Pancreatic Cancer Interception: Preliminary Results from the GENERATE Study

Up to 10% of patients with pancreatic ductal adenocarcinoma (PDAC) carry underlying germline pathogenic variants in cancer susceptibility genes. The GENetic Education Risk Assessment and TEsting (GENERATE) study aimed to evaluate novel methods of genetic education and testing in relatives of patients with PDAC. Eligible individuals had a family history of PDAC and a relative with a germline pathogenic variant in APC, ATM, BRCA1, BRCA2, CDKN2A, EPCAM, MLH1, MSH2, MSH6, PALB2, PMS2, STK11, or TP53 genes. Participants were recruited at six academic cancer centers and through social media campaigns and patient advocacy efforts. Enrollment occurred via the study website (https://GENERATEstudy.org) and all participation, including collecting a saliva sample for genetic testing, could be done from home. Participants were randomized to one of two remote methods that delivered genetic education about the risks of inherited PDAC and strategies for surveillance. The primary outcome of the study was uptake of genetic testing. From 5/8/2019 to 5/6/2020, 49 participants were randomized to each of the intervention arms. Overall, 90 of 98 (92%) of randomized participants completed genetic testing. The most frequently detected pathogenic variants included those in BRCA2 (N = 15, 17%), ATM (N = 11, 12%), and CDKN2A (N = 4, 4%). Participation in the study remained steady throughout the onset of the Coronavirus disease (COVID-19) pandemic. Preliminary data from the GENERATE study indicate success of remote alternatives to traditional cascade testing, with genetic testing rates over 90% and a high rate of identification of germline pathogenic variant carriers who would be ideal candidates for PDAC interception approaches. PREVENTION RELEVANCE: Preliminary data from the GENERATE study indicate success of remote alternatives for pancreatic cancer genetic testing and education, with genetic testing uptake rates over 90% and a high rate of identification of germline pathogenic variant carriers who would be ideal candidates for pancreatic cancer interception