27 results on '"Cotter, Megan"'
Search Results
2. Implementation of a Lung Cancer Screening Program in Two Federally Qualified Health Centers
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Watson, Lesley, Cotter, Megan M., Shafer, Shauna, Neloms, Kara, Smith, Robert A., and Sharpe, Katherine
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- 2021
3. Using the consolidated framework for implementation research to understand safety net health system efforts to increase colorectal cancer screening rates
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Kegler, Michelle C., Beasley, Derrick D., Liang, Shuting, Cotter, Megan, Phillips, Emily, Hermstad, April, Williams, Rentonia, Martinez, Jeremy, and Riehman, Kara
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- 2018
4. Clinical impact of whole-genome sequencing in patients with early-onset dementia
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Huq, Aamira J, primary, Thompson, Bryony, additional, Bennett, Mark F, additional, Bournazos, Adam, additional, Bommireddipalli, Shobhana, additional, Gorelik, Alexandra, additional, Schultz, Joshua, additional, Sexton, Adrienne, additional, Purvis, Rebecca, additional, West, Kirsty, additional, Cotter, Megan, additional, Valente, Giulia, additional, Hughes, Andrew, additional, Riaz, Moeen, additional, Walsh, Maie, additional, Farrand, Sarah, additional, Loi, Samantha M, additional, Kilpatrick, Trevor, additional, Brodtmann, Amy, additional, Darby, David, additional, Eratne, Dhamidhu, additional, Walterfang, Mark, additional, Delatycki, Martin Bruce, additional, Storey, Elsdon, additional, Fahey, Michael, additional, Cooper, Sandra, additional, Lacaze, Paul, additional, Masters, Colin L, additional, Velakoulis, Dennis, additional, Bahlo, Melanie, additional, James, Paul A, additional, and Winship, Ingrid, additional
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- 2022
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5. Clinical audit of genetic testing and referral patterns for fragile X and associated conditions
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Cotter, Megan, Archibald, Alison D., McClaren, Belinda J., Burgess, Trent, Francis, David, Hills, Louise, Martyn, Melissa, Oertel, Ralph, Slater, Howard, Cohen, Jonathan, and Metcalfe, Sylvia A.
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- 2016
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6. Changes in breast cancer screening rates among 32 community health centers during the COVID‐19 pandemic
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Fedewa, Stacey A., primary, Cotter, Megan M., additional, Wehling, Kristen A., additional, Wysocki, Karla, additional, Killewald, Richard, additional, and Makaroff, Laura, additional
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- 2021
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7. Familiarity With and Use of Insufficient Evidence Findings From the Community Preventive Services Task Force
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Alston, Anita, primary, Cotter, Megan M., additional, Klabunde, Carrie N., additional, and Neilson, Elizabeth, additional
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- 2021
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8. Successes and challenges of implementing a lung cancer screening program in federally qualified health centers: a qualitative analysis using the Consolidated Framework for Implementation Research
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Allen, Caitlin G, primary, Cotter, Megan M, additional, Smith, Robert A, additional, and Watson, Lesley, additional
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- 2020
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9. State Variation in Low-Dose Computed Tomography Scanning for Lung Cancer Screening in the United States
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Fedewa, Stacey A, primary, Kazerooni, Ella A, additional, Studts, Jamie L, additional, Smith, Robert A, additional, Bandi, Priti, additional, Sauer, Ann Goding, additional, Cotter, Megan, additional, Sineshaw, Helmneh M, additional, Jemal, Ahmedin, additional, and Silvestri, Gerard A, additional
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- 2020
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10. Successes and Challenges of Implementing a Lung Cancer Screening Program in Federally Qualified Health Centers: A Qualitative Analysis Using the Consolidated Framework for Implementation Research
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Allen, Caitlin G., primary, Cotter, Megan M., additional, Smith, Robert A., additional, and Watson, Lesley, additional
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- 2020
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11. Essential Anatomy for Neurology and Psychiatry in the Undergraduate Medical Curriculum
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Harmon, Derek, primary, Harrell, Kelly, additional, Keim, Sarah, additional, Topping, Daniel, additional, Sanky, Charles, additional, Laitman, Jeffrey, additional, Reidenberg, Joy S., additional, Farias, Anna, additional, Lopez, Lisa, additional, Zumwalt, Ann, additional, Mork, Amy, additional, Wineski, Lawrence, additional, Cotter, Megan, additional, Brooks, William, additional, Davies, David, additional, Royer, Danielle, additional, Marzban, Hassan, additional, Notebaert, Andrew, additional, Martindale, Jim, additional, and Hankin, Mark, additional
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- 2020
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12. State Variation in Low-Dose Computed Tomography Scanning for Lung Cancer Screening in the United States.
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Fedewa, Stacey A, Kazerooni, Ella A, Studts, Jamie L, Smith, Robert A, Bandi, Priti, Sauer, Ann Goding, Cotter, Megan, Sineshaw, Helmneh M, Jemal, Ahmedin, and Silvestri, Gerard A
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LUNG cancer ,EARLY detection of cancer ,ADULTS ,TOMOGRAPHY ,CANCER patients - Abstract
Background: Annual lung cancer screening (LCS) with low-dose chest computed tomography in older current and former smokers (ie, eligible adults) has been recommended since 2013. Uptake has been slow and variable across the United States. We estimated the LCS rate and growth at the national and state level between 2016 and 2018.Methods: The American College of Radiology's Lung Cancer Screening Registry was used to capture screening events. Population-based surveys, the US Census, and cancer registry data were used to estimate the number of eligible adults and lung cancer mortality (ie, burden). Lung cancer screening rates (SRs) in eligible adults and screening rate ratios with 95% confidence intervals (CI) were used to measure changes by state and year.Results: Nationally, the SR was steady between 2016 (3.3%, 95% CI = 3.3% to 3.7%) and 2017 (3.4%, 95% CI = 3.4% to 3.9%), increasing to 5.0% (95% CI = 5.0% to 5.7%) in 2018 (2018 vs 2016 SR ratio = 1.52, 95% CI = 1.51 to 1.62). In 2018, several southern states with a high lung-cancer burden (eg, Mississippi, West Virginia, and Arkansas) had relatively low SRs (<4%) among eligible adults, whereas several northeastern states with lower lung cancer burden (eg, Massachusetts, Vermont, and New Hampshire) had the highest SRs (12.8%-15.2%). The exception was Kentucky, which had the nation's highest lung cancer mortality rate and one of the highest SRs (13.7%).Conclusions: Fewer than 1 in 20 eligible adults received LCS nationally, and uptake varied widely across states. LCS rates were not aligned with lung cancer burden across states, except for Kentucky, which has supported comprehensive efforts to implement LCS. [ABSTRACT FROM AUTHOR]- Published
- 2021
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13. Successes and challenges of implementing a lung cancer screening program in federally qualified health centers: a qualitative analysis using the Consolidated Framework for Implementation Research.
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Allen, Caitlin G, Cotter, Megan M, Smith, Robert A, and Watson, Lesley
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In recent years, studies have shown that low-dose computed tomography (LDCT) is a safe and effective way to screen high-risk adults for lung cancer. Despite this, uptake remains low, especially in limited-resource settings. The American Cancer Society (ACS) partnered with two federally qualified health centers and accredited screening facilities on a 2 year pilot project to implement an LDCT screening program. Both sites attempted to develop a referral program and care coordination practices to move patients through the screening continuum and identify critical facilitators and barriers to implementation. Evaluators conducted key informant interviews (N = 46) with clinical and administrative staff, as well as regional ACS staff during annual site visits. The Consolidated Framework for Implementation Research guided our analysis of factors associated with effective implementation and improved screening outcomes. One study site established a sustainable lung screening program, while the other struggled to overcome significant implementation barriers. Increased time spent with patients, disruption to normal workflows, and Medicaid reimbursement policies presented challenges at both sites. Supportive, engaged leaders and knowledgeable champions who provided clear implementation guidance improved staff engagement and were able to train, guide, and motivate staff throughout the intervention. A slow, stepwise implementation process allowed one site's project champions to pilot test new processes and resolve issues before scaling up. This pilot study provides critical insights into the necessary resources and steps for successful lung cancer screening program implementation in underserved settings. Future efforts can build upon these findings and identify and address possible facilitators and barriers to screening program implementation. [ABSTRACT FROM AUTHOR]
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- 2021
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14. Partnering with National Pediatric Associations to promote Tobacco Control in the Philippines
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Ahluwalia, Indu, primary, Dean, Anna, additional, Cotter, Megan, additional, Julie, Gorzkowski, additional, Hemedez-Gonzalez, Rizalina, additional, and Tait, Fan, additional
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- 2019
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15. Abstract 3312: Appropriate follow-up for patients with suspicious lung cancer screening findings: Lessons learned from Federally Qualified Health Centers
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Watson, Lesley, primary, Cotter, Megan M., additional, Smith, Robert A., additional, and Sharpe, Katherine, additional
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- 2019
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16. Informed decision making and psychosocial outcomes in pregnant and nonpregnant women offered population fragile X carrier screening
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Metcalfe, Sylvia A, primary, Martyn, Melissa, additional, Ames, Alice, additional, Anderson, Vicki, additional, Archibald, Alison D, additional, Carter, Rob, additional, Cohen, Jonathan, additional, Cotter, Megan, additional, Dang, William, additional, Delatycki, Martin B, additional, Donath, Susan, additional, Edwards, Samantha, additional, Forbes, Robin, additional, Gavrila, Mioara, additional, Halliday, Jane, additional, Hickerton, Chriselle, additional, Hill, Melissa, additional, Jacobs, Lorilli, additional, Petrou, Vicki, additional, Plunkett, Loren, additional, Sheffield, Leslie, additional, Thornton, Alison, additional, Younie, Sandra, additional, and Emery, Jon D, additional
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- 2017
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17. Proceedings of the 8th Annual Conference on the Science of Dissemination and Implementation
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Chambers, David, Simpson, Lisa, Hill-Briggs, Felicia, Neta, Gila, Vinson, Cynthia, Beidas, Rinad, Marcus, Steven, Aarons, Gregory, Hoagwood, Kimberly, Schoenwald, Sonja, Evans, Arthur, Hurford, Matthew, Rubin, Ronnie, Hadley, Trevor, Barg, Frances, Walsh, Lucia, Adams, Danielle, Mandell, David, Martin, Lindsey, Mignogna, Joseph, Mott, Juliette, Hundt, Natalie, Kauth, Michael, Kunik, Mark, Naik, Aanand, Cully, Jeffrey, McGuire, Alan, White, Dominique, Bartholomew, Tom, McGrew, John, Luther, Lauren, Rollins, Angie, Salyers, Michelle, Cooper, Brittany, Funaiole, Angie, Richards, Julie, Lee, Amy, Lapham, Gwen, Caldeiro, Ryan, Lozano, Paula, Gildred, Tory, Achtmeyer, Carol, Ludman, Evette, Addis, Megan, Marx, Larry, Bradley, Katharine, VanDeinse, Tonya, Wilson, Amy Blank, Stacey, Burgin, Powell, Byron, Bunger, Alicia, Cuddeback, Gary, Barnett, Miya, Stadnick, Nicole, Brookman-Frazee, Lauren, Lau, Anna, Dorsey, Shannon, Pullmann, Michael, Mitchell, Shannon, Schwartz, Robert, Kirk, Arethusa, Dusek, Kristi, Oros, Marla, Hosler, Colleen, Gryczynski, Jan, Barbosa, Carolina, Dunlap, Laura, Lounsbury, David, O’Grady, Kevin, Brown, Barry, Damschroder, Laura, Waltz, Thomas, Ritchie, Mona, Atkins, David, Imel, Zac E., Xiao, Bo, Can, Doğan, Georgiou, Panayiotis, Narayanan, Shrikanth, Berkel, Cady, Gallo, Carlos, Sandler, Irwin, Brown, C. Hendricks, Wolchik, Sharlene, Mauricio, Anne Marie, Mehrotra, Sanjay, Chandurkar, Dharmendra, Bora, Siddhartha, Das, Arup, Tripathi, Anand, Saggurti, Niranjan, Raj, Anita, Hughes, Eric, Jacobs, Brian, Kirkendall, Eric, Loeb, Danielle, Trinkley, Katy, Yang, Michael, Sprowell, Andrew, Nease, Donald, Lyon, Aaron, Lewis, Cara, Boyd, Meredith, Melvin, Abigail, Nicodimos, Semret, Liu, Freda, Jungbluth, Nathanial, Flynn, Allen, Landis-Lewis, Zach, Sales, Anne, Baloh, Jure, Ward, Marcia, Zhu, Xi, Bennett, Ian, Unutzer, Jurgen, Mao, Johnny, Proctor, Enola, Vredevoogd, Mindy, Chan, Ya-Fen, Williams, Nathaniel, Green, Phillip, Bernstein, Steven, Rosner, June-Marie, DeWitt, Michelle, Tetrault, Jeanette, Dziura, James, Hsiao, Allen, Sussman, Scott, O’Connor, Patrick, Toll, Benjamin, Jones, Michael, Gassaway, Julie, Tobin, Jonathan, Zatzick, Douglas, Bradbury, Angela R., Patrick-Miller, Linda, Egleston, Brian, Olopade, Olufunmilayo I., Hall, Michael J., Daly, Mary B., Fleisher, Linda, Grana, Generosa, Ganschow, Pamela, Fetzer, Dominique, Brandt, Amanda, Farengo-Clark, Dana, Forman, Andrea, Gaber, Rikki S., Gulden, Cassandra, Horte, Janice, Long, Jessica, Chambers, Rachelle Lorenz, Lucas, Terra, Madaan, Shreshtha, Mattie, Kristin, McKenna, Danielle, Montgomery, Susan, Nielsen, Sarah, Powers, Jacquelyn, Rainey, Kim, Rybak, Christina, Savage, Michelle, Seelaus, Christina, Stoll, Jessica, Stopfer, Jill, Yao, Shirley, Domchek, Susan, Hahn, Erin, Munoz-Plaza, Corrine, Wang, Jianjin, Delgadillo, Jazmine Garcia, Mittman, Brian, Gould, Michael, Liang, Shuting, Kegler, Michelle C., Cotter, Megan, Phillips, Emily, Hermstad, April, Morton, Rentonia, Beasley, Derrick, Martinez, Jeremy, Riehman, Kara, Gustafson, David, Marsch, Lisa, Mares, Louise, Quanbeck, Andrew, McTavish, Fiona, McDowell, Helene, Brown, Randall, Thomas, Chantelle, Glass, Joseph, Isham, Joseph, Shah, Dhavan, Liebschutz, Jane, Lasser, Karen, Watkins, Katherine, Ober, Allison, Hunter, Sarah, Lamp, Karen, Ewing, Brett, Iwelunmor, Juliet, Gyamfi, Joyce, Blackstone, Sarah, Quakyi, Nana Kofi, Plange-Rhule, Jacob, Ogedegbe, Gbenga, Kumar, Pritika, Van Devanter, Nancy, Nguyen, Nam, Nguyen, Linh, Nguyen, Trang, Phuong, Nguyet, Shelley, Donna, Rudge, Sian, Langlois, Etienne, Tricco, Andrea, Ball, Sherry, Lambert-Kerzner, Anne, Sulc, Christine, Simmons, Carol, Shell-Boyd, Jeneen, Oestreich, Taryn, O’Connor, Ashley, Neely, Emily, McCreight, Marina, Labebue, Amy, DiFiore, Doreen, Brostow, Diana, Ho, P. Michael, Aron, David, Harvey, Jillian, McHugh, Megan, Scanlon, Dennis, Lee, Rebecca, Soltero, Erica, Parker, Nathan, McNeill, Lorna, Ledoux, Tracey, McIsaac, Jessie-Lee, MacLeod, Kate, Ata, Nicole, Jarvis, Sherry, Kirk, Sara, Purtle, Jonathan, Dodson, Elizabeth, Brownson, Ross, Curran, Geoffrey, Pyne, Jeffrey, Ehrhart, Mark, Torres, Elisa, Miech, Edward, Stevens, Kathleen, Hamilton, Alison, Cohen, Deborah, Padgett, Deborah, Morshed, Alexandra, Patel, Rupa, Prusaczyk, Beth, Aron, David C., Gupta, Divya, Hand, Rosa, Abram, Jenica, Wolfram, Taylor, Hastings, Molly, Moreland-Russell, Sarah, Tabak, Rachel, Ramsey, Alex, Baumann, Ana, Kryzer, Emily, Montgomery, Katherine, Lewis, Ericka, Padek, Margaret, Mamaril, Cezar Brian, Mays, Glen, Branham, Keith, Timsina, Lava, Hogg, Rachel, Fagan, Abigail, Shapiro, Valerie, Brown, Eric, Haggerty, Kevin, Hawkins, David, Oesterle, Sabrina, Catalano, Richard, McKay, Virginia, Dolcini, M. Margaret, Hoffer, Lee, Moin, Tannaz, Li, Jinnan, Duru, O. Kenrik, Ettner, Susan, Turk, Norman, Chan, Charles, Keckhafer, Abigail, Luchs, Robert, Ho, Sam, Mangione, Carol, Selby, Peter, Zawertailo, Laurie, Minian, Nadia, Balliunas, Dolly, Dragonetti, Rosa, Hussain, Sarwar, Lecce, Julia, Chinman, Matthew, Acosta, Joie, Ebener, Patricia, Malone, Patrick S., Slaughter, Mary, Freedman, Darcy, Flocke, Susan, Lee, Eunlye, Matlack, Kristen, Trapl, Erika, Ohri-Vachaspati, Punam, Taggart, Morgan, Borawski, Elaine, Parrish, Amanda, Harris, Jeffrey, Kohn, Marlana, Hammerback, Kristen, McMillan, Becca, Hannon, Peggy, Swindle, Taren, Whiteside-Mansell, Leanne, Ward, Wendy, Holt, Cheryl, Santos, Sheri Lou, Tagai, Erin, Scheirer, Mary Ann, Carter, Roxanne, Bowie, Janice, Haider, Muhiuddin, Slade, Jimmie, Wang, Min Qi, Masica, Andrew, Ogola, Gerald, Berryman, Candice, Richter, Kathleen, Shelton, Rachel, Jandorf, Lina, Erwin, Deborah, Truong, Khoa, Javier, Joyce R., Coffey, Dean, Schrager, Sheree M., Palinkas, Lawrence, Miranda, Jeanne, Johnson, Veda, Hutcherson, Valerie, Ellis, Ruth, Kharmats, Anna, Marshall-King, Sandra, LaPradd, Monica, Fonseca-Becker, Fannie, Kepka, Deanna, Bodson, Julia, Warner, Echo, Fowler, Brynn, Shenkman, Elizabeth, Hogan, William, Odedina, Folakami, De Leon, Jessica, Hooper, Monica, Carrasquillo, Olveen, Reams, Renee, Hurt, Myra, Smith, Steven, Szapocznik, Jose, Nelson, David, Mandal, Prabir, and Teufel, James
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Medicine(all) ,Health Policy ,Public Health, Environmental and Occupational Health ,Meeting Abstracts - Abstract
Table of contents A1 Introduction to the 8th Annual Conference on the Science of Dissemination and Implementation: Optimizing Personal and Population Health David Chambers, Lisa Simpson D1 Discussion forum: Population health D&I research Felicia Hill-Briggs D2 Discussion forum: Global health D&I research Gila Neta, Cynthia Vinson D3 Discussion forum: Precision medicine and D&I research David Chambers S1 Predictors of community therapists’ use of therapy techniques in a large public mental health system Rinad Beidas, Steven Marcus, Gregory Aarons, Kimberly Hoagwood, Sonja Schoenwald, Arthur Evans, Matthew Hurford, Ronnie Rubin, Trevor Hadley, Frances Barg, Lucia Walsh, Danielle Adams, David Mandell S2 Implementing brief cognitive behavioral therapy (CBT) in primary care: Clinicians' experiences from the field Lindsey Martin, Joseph Mignogna, Juliette Mott, Natalie Hundt, Michael Kauth, Mark Kunik, Aanand Naik, Jeffrey Cully S3 Clinician competence: Natural variation, factors affecting, and effect on patient outcomes Alan McGuire, Dominique White, Tom Bartholomew, John McGrew, Lauren Luther, Angie Rollins, Michelle Salyers S4 Exploring the multifaceted nature of sustainability in community-based prevention: A mixed-method approach Brittany Cooper, Angie Funaiole S5 Theory informed behavioral health integration in primary care: Mixed methods evaluation of the implementation of routine depression and alcohol screening and assessment Julie Richards, Amy Lee, Gwen Lapham, Ryan Caldeiro, Paula Lozano, Tory Gildred, Carol Achtmeyer, Evette Ludman, Megan Addis, Larry Marx, Katharine Bradley S6 Enhancing the evidence for specialty mental health probation through a hybrid efficacy and implementation study Tonya VanDeinse, Amy Blank Wilson, Burgin Stacey, Byron Powell, Alicia Bunger, Gary Cuddeback S7 Personalizing evidence-based child mental health care within a fiscally mandated policy reform Miya Barnett, Nicole Stadnick, Lauren Brookman-Frazee, Anna Lau S8 Leveraging an existing resource for technical assistance: Community-based supervisors in public mental health Shannon Dorsey, Michael Pullmann S9 SBIRT implementation for adolescents in urban federally qualified health centers: Implementation outcomes Shannon Mitchell, Robert Schwartz, Arethusa Kirk, Kristi Dusek, Marla Oros, Colleen Hosler, Jan Gryczynski, Carolina Barbosa, Laura Dunlap, David Lounsbury, Kevin O'Grady, Barry Brown S10 PANEL: Tailoring Implementation Strategies to Context - Expert recommendations for tailoring strategies to context Laura Damschroder, Thomas Waltz, Byron Powell S11 PANEL: Tailoring Implementation Strategies to Context - Extreme facilitation: Helping challenged healthcare settings implement complex programs Mona Ritchie S12 PANEL: Tailoring Implementation Strategies to Context - Using menu-based choice tasks to obtain expert recommendations for implementing three high-priority practices in the VA Thomas Waltz S13 PANEL: The Use of Technology to Improve Efficient Monitoring of Implementation of Evidence-based Programs - Siri, rate my therapist: Using technology to automate fidelity ratings of motivational interviewing David Atkins, Zac E. Imel, Bo Xiao, Doğan Can, Panayiotis Georgiou, Shrikanth Narayanan S14 PANEL: The Use of Technology to Improve Efficient Monitoring of Implementation of Evidence-based Programs - Identifying indicators of implementation quality for computer-based ratings Cady Berkel, Carlos Gallo, Irwin Sandler, C. Hendricks Brown, Sharlene Wolchik, Anne Marie Mauricio S15 PANEL: The Use of Technology to Improve Efficient Monitoring of Implementation of Evidence-based Programs - Improving implementation of behavioral interventions by monitoring emotion in spoken speech Carlos Gallo, C. Hendricks Brown, Sanjay Mehrotra S16 Scorecards and dashboards to assure data quality of health management information system (HMIS) using R Dharmendra Chandurkar, Siddhartha Bora, Arup Das, Anand Tripathi, Niranjan Saggurti, Anita Raj S17 A big data approach for discovering and implementing patient safety insights Eric Hughes, Brian Jacobs, Eric Kirkendall S18 Improving the efficacy of a depression registry for use in a collaborative care model Danielle Loeb, Katy Trinkley, Michael Yang, Andrew Sprowell, Donald Nease S19 Measurement feedback systems as a strategy to support implementation of measurement-based care in behavioral health Aaron Lyon, Cara Lewis, Meredith Boyd, Abigail Melvin, Semret Nicodimos, Freda Liu, Nathanial Jungbluth S20 PANEL: Implementation Science and Learning Health Systems: Intersections and Commonalities - Common loop assay: Methods of supporting learning collaboratives Allen Flynn S21 PANEL: Implementation Science and Learning Health Systems: Intersections and Commonalities - Innovating audit and feedback using message tailoring models for learning health systems Zach Landis-Lewis S22 PANEL: Implementation Science and Learning Health Systems: Intersections and Commonalities - Implementation science and learning health systems: Connecting the dots Anne Sales S23 Facilitation activities of Critical Access Hospitals during TeamSTEPPS implementation Jure Baloh, Marcia Ward, Xi Zhu S24 Organizational and social context of federally qualified health centers and variation in maternal depression outcomes Ian Bennett, Jurgen Unutzer, Johnny Mao, Enola Proctor, Mindy Vredevoogd, Ya-Fen Chan, Nathaniel Williams, Phillip Green S25 Decision support to enhance treatment of hospitalized smokers: A randomized trial Steven Bernstein, June-Marie Rosner, Michelle DeWitt, Jeanette Tetrault, James Dziura, Allen Hsiao, Scott Sussman, Patrick O’Connor, Benjamin Toll S26 PANEL: Developing Sustainable Strategies for the Implementation of Patient-Centered Care across Diverse US Healthcare Systems - A patient-centered approach to successful community transition after catastrophic injury Michael Jones, Julie Gassaway S27 PANEL: Developing Sustainable Strategies for the Implementation of Patient-Centered Care across Diverse US Healthcare Systems - Conducting PCOR to integrate mental health and cancer screening services in primary care Jonathan Tobin S28 PANEL: Developing Sustainable Strategies for the Implementation of Patient-Centered Care across Diverse US Healthcare Systems - A comparative effectiveness trial of optimal patient-centered care for US trauma care systems Douglas Zatzick S29 Preferences for in-person communication among patients in a multi-center randomized study of in-person versus telephone communication of genetic test results for cancer susceptibility Angela R Bradbury, Linda Patrick-Miller, Brian Egleston, Olufunmilayo I Olopade, Michael J Hall, Mary B Daly, Linda Fleisher, Generosa Grana, Pamela Ganschow, Dominique Fetzer, Amanda Brandt, Dana Farengo-Clark, Andrea Forman, Rikki S Gaber, Cassandra Gulden, Janice Horte, Jessica Long, Rachelle Lorenz Chambers, Terra Lucas, Shreshtha Madaan, Kristin Mattie, Danielle McKenna, Susan Montgomery, Sarah Nielsen, Jacquelyn Powers, Kim Rainey, Christina Rybak, Michelle Savage, Christina Seelaus, Jessica Stoll, Jill Stopfer, Shirley Yao and Susan Domchek S30 Working towards de-implementation: A mixed methods study in breast cancer surveillance care Erin Hahn, Corrine Munoz-Plaza, Jianjin Wang, Jazmine Garcia Delgadillo, Brian Mittman Michael Gould S31Integrating evidence-based practices for increasing cancer screenings in safety-net primary care systems: A multiple case study using the consolidated framework for implementation research Shuting (Lily) Liang, Michelle C. Kegler, Megan Cotter, Emily Phillips, April Hermstad, Rentonia Morton, Derrick Beasley, Jeremy Martinez, Kara Riehman S32 Observations from implementing an mHealth intervention in an FQHC David Gustafson, Lisa Marsch, Louise Mares, Andrew Quanbeck, Fiona McTavish, Helene McDowell, Randall Brown, Chantelle Thomas, Joseph Glass, Joseph Isham, Dhavan Shah S33 A multicomponent intervention to improve primary care provider adherence to chronic opioid therapy guidelines and reduce opioid misuse: A cluster randomized controlled trial protocol Jane Liebschutz, Karen Lasser S34 Implementing collaborative care for substance use disorders in primary care: Preliminary findings from the summit study Katherine Watkins, Allison Ober, Sarah Hunter, Karen Lamp, Brett Ewing S35 Sustaining a task-shifting strategy for blood pressure control in Ghana: A stakeholder analysis Juliet Iwelunmor, Joyce Gyamfi, Sarah Blackstone, Nana Kofi Quakyi, Jacob Plange-Rhule, Gbenga Ogedegbe S36 Contextual adaptation of the consolidated framework for implementation research (CFIR) in a tobacco cessation study in Vietnam Pritika Kumar, Nancy Van Devanter, Nam Nguyen, Linh Nguyen, Trang Nguyen, Nguyet Phuong, Donna Shelley S37 Evidence check: A knowledge brokering approach to systematic reviews for policy Sian Rudge S38 Using Evidence Synthesis to Strengthen Complex Health Systems in Low- and Middle-Income Countries Etienne Langlois S39 Does it matter: timeliness or accuracy of results? The choice of rapid reviews or systematic reviews to inform decision-making Andrea Tricco S40 Evaluation of the veterans choice program using lean six sigma at a VA medical center to identify benefits and overcome obstacles Sherry Ball, Anne Lambert-Kerzner, Christine Sulc, Carol Simmons, Jeneen Shell-Boyd, Taryn Oestreich, Ashley O'Connor, Emily Neely, Marina McCreight, Amy Labebue, Doreen DiFiore, Diana Brostow, P. Michael Ho, David Aron S41 The influence of local context on multi-stakeholder alliance quality improvement activities: A multiple case study Jillian Harvey, Megan McHugh, Dennis Scanlon S42 Increasing physical activity in early care and education: Sustainability via active garden education (SAGE) Rebecca Lee, Erica Soltero, Nathan Parker, Lorna McNeill, Tracey Ledoux S43 Marking a decade of policy implementation: The successes and continuing challenges of a provincial school food and nutrition policy in Canada Jessie-Lee McIsaac, Kate MacLeod, Nicole Ata, Sherry Jarvis, Sara Kirk S44 Use of research evidence among state legislators who prioritize mental health and substance abuse issues Jonathan Purtle, Elizabeth Dodson, Ross Brownson S45 PANEL: Effectiveness-Implementation Hybrid Designs: Clarifications, Refinements, and Additional Guidance Based on a Systematic Review and Reports from the Field - Hybrid type 1 designs Brian Mittman, Geoffrey Curran S46 PANEL: Effectiveness-Implementation Hybrid Designs: Clarifications, Refinements, and Additional Guidance Based on a Systematic Review and Reports from the Field - Hybrid type 2 designs Geoffrey Curran S47 PANEL: Effectiveness-Implementation Hybrid Designs: Clarifications, Refinements, and Additional Guidance Based on a Systematic Review and Reports from the Field - Hybrid type 3 designs Jeffrey Pyne S48 Linking team level implementation leadership and implementation climate to individual level attitudes, behaviors, and implementation outcomes Gregory Aarons, Mark Ehrhart, Elisa Torres S49 Pinpointing the specific elements of local context that matter most to implementation outcomes: Findings from qualitative comparative analysis in the RE-inspire study of VA acute stroke care Edward Miech S50 The GO score: A new context-sensitive instrument to measure group organization level for providing and improving care Edward Miech S51 A research network approach for boosting implementation and improvement Kathleen Stevens, I.S.R.N. Steering Council S52 PANEL: Qualitative methods in D&I Research: Value, rigor and challenge - The value of qualitative methods in implementation research Alison Hamilton S53 PANEL: Qualitative methods in D&I Research: Value, rigor and challenge - Learning evaluation: The role of qualitative methods in dissemination and implementation research Deborah Cohen S54 PANEL: Qualitative methods in D&I Research: Value, rigor and challenge - Qualitative methods in D&I research Deborah Padgett S55 PANEL: Maps & models: The promise of network science for clinical D&I - Hospital network of sharing patients with acute and chronic diseases in California Alexandra Morshed S56 PANEL: Maps & models: The promise of network science for clinical D&I - The use of social network analysis to identify dissemination targets and enhance D&I research study recruitment for pre-exposure prophylaxis for HIV (PrEP) among men who have sex with men Rupa Patel S57 PANEL: Maps & models: The promise of network science for clinical D&I - Network and organizational factors related to the adoption of patient navigation services among rural breast cancer care providers Beth Prusaczyk S58 A theory of de-implementation based on the theory of healthcare professionals’ behavior and intention (THPBI) and the becker model of unlearning David C. Aron, Divya Gupta, Sherry Ball S59 Observation of registered dietitian nutritionist-patient encounters by dietetic interns highlights low awareness and implementation of evidence-based nutrition practice guidelines Rosa Hand, Jenica Abram, Taylor Wolfram S60 Program sustainability action planning: Building capacity for program sustainability using the program sustainability assessment tool Molly Hastings, Sarah Moreland-Russell S61 A review of D&I study designs in published study protocols Rachel Tabak, Alex Ramsey, Ana Baumann, Emily Kryzer, Katherine Montgomery, Ericka Lewis, Margaret Padek, Byron Powell, Ross Brownson S62 PANEL: Geographic variation in the implementation of public health services: Economic, organizational, and network determinants - Model simulation techniques to estimate the cost of implementing foundational public health services Cezar Brian Mamaril, Glen Mays, Keith Branham, Lava Timsina S63 PANEL: Geographic variation in the implementation of public health services: Economic, organizational, and network determinants - Inter-organizational network effects on the implementation of public health services Glen Mays, Rachel Hogg S64 PANEL: Building capacity for implementation and dissemination of the communities that care prevention system at scale to promote evidence-based practices in behavioral health - Implementation fidelity, coalition functioning, and community prevention system transformation using communities that care Abigail Fagan, Valerie Shapiro, Eric Brown S65 PANEL: Building capacity for implementation and dissemination of the communities that care prevention system at scale to promote evidence-based practices in behavioral health - Expanding capacity for implementation of communities that care at scale using a web-based, video-assisted training system Kevin Haggerty, David Hawkins S66 PANEL: Building capacity for implementation and dissemination of the communities that care prevention system at scale to promote evidence-based practices in behavioral health - Effects of communities that care on reducing youth behavioral health problems Sabrina Oesterle, David Hawkins, Richard Catalano S68 When interventions end: the dynamics of intervention de-adoption and replacement Virginia McKay, M. Margaret Dolcini, Lee Hoffer S69 Results from next-d: can a disease specific health plan reduce incident diabetes development among a national sample of working-age adults with pre-diabetes? Tannaz Moin, Jinnan Li, O. Kenrik Duru, Susan Ettner, Norman Turk, Charles Chan, Abigail Keckhafer, Robert Luchs, Sam Ho, Carol Mangione S70 Implementing smoking cessation interventions in primary care settings (STOP): using the interactive systems framework Peter Selby, Laurie Zawertailo, Nadia Minian, Dolly Balliunas, Rosa Dragonetti, Sarwar Hussain, Julia Lecce S71 Testing the Getting To Outcomes implementation support intervention in prevention-oriented, community-based settings Matthew Chinman, Joie Acosta, Patricia Ebener, Patrick S Malone, Mary Slaughter S72 Examining the reach of a multi-component farmers’ market implementation approach among low-income consumers in an urban context Darcy Freedman, Susan Flocke, Eunlye Lee, Kristen Matlack, Erika Trapl, Punam Ohri-Vachaspati, Morgan Taggart, Elaine Borawski S73 Increasing implementation of evidence-based health promotion practices at large workplaces: The CEOs Challenge Amanda Parrish, Jeffrey Harris, Marlana Kohn, Kristen Hammerback, Becca McMillan, Peggy Hannon S74 A qualitative assessment of barriers to nutrition promotion and obesity prevention in childcare Taren Swindle, Geoffrey Curran, Leanne Whiteside-Mansell, Wendy Ward S75 Documenting institutionalization of a health communication intervention in African American churches Cheryl Holt, Sheri Lou Santos, Erin Tagai, Mary Ann Scheirer, Roxanne Carter, Janice Bowie, Muhiuddin Haider, Jimmie Slade, Min Qi Wang S76 Reduction in hospital utilization by underserved patients through use of a community-medical home Andrew Masica, Gerald Ogola, Candice Berryman, Kathleen Richter S77 Sustainability of evidence-based lay health advisor programs in African American communities: A mixed methods investigation of the National Witness Project Rachel Shelton, Lina Jandorf, Deborah Erwin S78 Predicting the long-term uninsured population and analyzing their gaps in physical access to healthcare in South Carolina Khoa Truong S79 Using an evidence-based parenting intervention in churches to prevent behavioral problems among Filipino youth: A randomized pilot study Joyce R. Javier, Dean Coffey, Sheree M. Schrager, Lawrence Palinkas, Jeanne Miranda S80 Sustainability of elementary school-based health centers in three health-disparate southern communities Veda Johnson, Valerie Hutcherson, Ruth Ellis S81 Childhood obesity prevention partnership in Louisville: creative opportunities to engage families in a multifaceted approach to obesity prevention Anna Kharmats, Sandra Marshall-King, Monica LaPradd, Fannie Fonseca-Becker S82 Improvements in cervical cancer prevention found after implementation of evidence-based Latina prevention care management program Deanna Kepka, Julia Bodson, Echo Warner, Brynn Fowler S83 The OneFlorida data trust: Achieving health equity through research & training capacity building Elizabeth Shenkman, William Hogan, Folakami Odedina, Jessica De Leon, Monica Hooper, Olveen Carrasquillo, Renee Reams, Myra Hurt, Steven Smith, Jose Szapocznik, David Nelson, Prabir Mandal S84 Disseminating and sustaining medical-legal partnerships: Shared value and social return on investment James Teufel
- Published
- 2016
18. Abstract B79: Addressing patient barriers to cancer screening in safety net clinics
- Author
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Morton, Rentonia, primary, Cotter, Megan, additional, Riehman, Kara, additional, Liang, Lily Shuting, additional, Kegler, Michelle, additional, Phillips, Emily, additional, Beasley, Derrick, additional, Hermstad, April, additional, and Martinez, Jeremy, additional
- Published
- 2016
- Full Text
- View/download PDF
19. Erratum to: ‘Integrating evidence-based practices for increasing cancer screenings in safety net health systems: a multiple case study using the Consolidated Framework for Implementation Research’
- Author
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Liang, Shuting, primary, Kegler, Michelle C., additional, Cotter, Megan, additional, Phillips, Emily, additional, Beasley, Derrick, additional, Hermstad, April, additional, Morton, Rentonia, additional, Martinez, Jeremy, additional, and Riehman, Kara, additional
- Published
- 2015
- Full Text
- View/download PDF
20. Integrating evidence-based practices for increasing cancer screenings in safety net health systems: a multiple case study using the Consolidated Framework for Implementation Research
- Author
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Liang, Shuting, primary, Kegler, Michelle C., additional, Cotter, Megan, additional, Phillips, Emily, additional, Beasley, Derrick, additional, Hermstad, April, additional, Morton, Rentonia, additional, Martinez, Jeremy, additional, and Riehman, Kara, additional
- Published
- 2015
- Full Text
- View/download PDF
21. Integrating evidence-based practices for increasing cancer screenings in safety net health systems: a multiple case study using the Consolidated Framework for Implementation Research.
- Author
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Shuting Liang, Kegler, Michelle C., Cotter, Megan, Emily, Phillips, Beasley, Derrick, Hermstad, April, Morton, Rentonia, Martinez, Jeremy, Riehman, Kara, and Liang, Shuting
- Subjects
EARLY detection of cancer ,HEALTH services administration ,ADAPTABILITY (Personality) ,COLON cancer ,COMPARATIVE studies ,EXPERIMENTAL design ,HEALTH planning ,RESEARCH methodology ,MEDICAL care ,MEDICAL cooperation ,PRIMARY health care ,RESEARCH ,EVIDENCE-based medicine ,PROFESSIONAL practice ,EVALUATION research ,HEALTH equity - Abstract
Background: Implementing evidence-based practices (EBPs) to increase cancer screenings in safety net primary care systems has great potential for reducing cancer disparities. Yet there is a gap in understanding the factors and mechanisms that influence EBP implementation within these high-priority systems. Guided by the Consolidated Framework for Implementation Research (CFIR), our study aims to fill this gap with a multiple case study of health care safety net systems that were funded by an American Cancer Society (ACS) grants program to increase breast and colorectal cancer screening rates. The initiative funded 68 safety net systems to increase cancer screening through implementation of evidence-based provider and client-oriented strategies.Methods: Data are from a mixed-methods evaluation with nine purposively selected safety net systems. Fifty-two interviews were conducted with project leaders, implementers, and ACS staff. Funded safety net systems were categorized into high-, medium-, and low-performing cases based on the level of EBP implementation. Within- and cross-case analyses were performed to identify CFIR constructs that influenced level of EBP implementation.Results: Of 39 CFIR constructs examined, six distinguished levels of implementation. Two constructs were from the intervention characteristics domain: adaptability and trialability. Three were from the inner setting domain: leadership engagement, tension for change, and access to information and knowledge. Engaging formally appointed internal implementation leaders, from the process domain, also distinguished level of implementation. No constructs from the outer setting or individual characteristics domain differentiated systems by level of implementation.Conclusions: Our study identified a number of influential CFIR constructs and illustrated how they impacted EBP implementation across a variety of safety net systems. Findings may inform future dissemination efforts of EBPs for increasing cancer screening in similar settings. Moreover, our analytic approach is similar to previous case studies using CFIR and hence could facilitate comparisons across studies. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
22. National Evidence-Based Oncology Navigation Metrics: Multisite Exploratory Study to Demonstrate Value and Sustainability of Navigation Programs.
- Author
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Johnston, Danelle, Watson, Lesley, Strusowski, Tricia, Sein, Elaine, Wiatrek, Dawn, Cotter, Megan, Simpson, Kelley, and Glonek, Alex
- Subjects
CANCER patient medical care ,CONFERENCES & conventions ,QUALITY assurance ,EVIDENCE-based nursing ,PATIENT-centered care - Abstract
Background: As evidence guides practice, it is essential for navigation programs to identify core metrics and standardize data collection to demonstrate program outcomes. Evidence supports that there is a need for heterogeneity with navigation measurements.1 Through extensive literature review, 3 main areas of measurements have been defined: Patient Experience, Clinical Outcomes, and Return on Investment metrics.2 To advance the field toward the goal of standardized metrics, a team from the Academy of Oncology Nurse & Patient Navigators (AONN+), the American Cancer Society, and The Chartis Group, Chartis Oncology Solutions Practice, conducted a pilot study to assess the extent to which navigation programs could implement 10 of the 35 AONN+ national evidence-based metrics, with the goal of validating these metrics and establishing benchmarks. The following metrics were included in the study: barriers to care, time to initial treatment, navigation caseload, hospital readmissions, distress screenings, social support referrals, palliative care referrals, learning style preference, navigator competencies, and patient satisfaction with care. Objectives: * Implement and validate navigation metrics * Identify common barriers and challenges to metric measurement, strategies for overcoming them, and measurement best practices and lessons learned * Develop a Navigation Metrics Implementation Tool Kit based on study findings Methods: Using a mixed methods approach, the study team selected 8 sites to collect the metrics over a 6-month period. Metrics data were uploaded into the ONQiQ NAVmetrics cloud-based IT platform to create site-specific dashboards. Prior to study launch, sites also submitted 3 years of historical data on these metrics, as available. The team also collected qualitative data on facilitators and barriers to metrics tracking by observing monthly calls between each site and the study team, pre/post key informant interviews, and documentation of quality improvement (QI) activities. Results: Across 8 sites, a total of 64 navigators participated, averaging 45 hours per week; 59.3% of time on patient-directed interventions and 40.7% on administrative activities; 4462 navigated patients who equate 53% of abstracted cases. Metrics outcomes summary: 88 cases per navigator; 2.2 barriers per patient; 10.4% readmission rate; 42% of patients received distress screening; 0.4 social support referrals per patient; 0.2 palliative care referrals per patient; 0.7 learning styles per patient identified; and 6% of patients completed a satisfaction survey. Barriers and challenges to metrics implementation: IT challenges, electronic medical record data capture and standardization, health system barriers, unstandardized navigation processes or defined scope, and unclear metric definitions. Each study site completed at least 1 QI activity to improve their implementation of the metrics. Most QI activities focused on distress screening and palliative care referrals. Conclusion: Of the 10 metrics, 5 were found to be core metrics that were applicable across sites: navigator competencies, navigation caseload, barriers to care, psychosocial distress screening, and social support referrals. Involving navigators earlier in the care continuum had a positive effect on barrier assessment, diagnosis to treatment, and social support referrals. Programs faced challenges with metrics implementation and struggled to de- fine processes for data capture and reporting. Continued research around navigation metrics will be vitally important to ensure sustainability of navigation programs. [ABSTRACT FROM AUTHOR]
- Published
- 2019
23. Plant Profile: Queen of the Night.
- Author
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Cotter, Megan
- Abstract
Presents information on the rare plant Peniocereus greggii variety transmontanus also known as the Queen of the night. Blooming time of the plant; Number of flushes of flowers that may be produced by the plant from late May to early June; Requirement for the blooming of the plant; Uses of the plant; Effort of botanists at Desert Botanical Garden in Phoenix, Arizona to restore the plant to its natural role in the ecosystem.
- Published
- 2004
24. CPC Publicity Inspires Collaboration to Save Imperiled Goldenrod.
- Author
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Cotter, Megan
- Abstract
Focuses on the recovery projects for the Yadkin River goldenrod in central North Carolina. Characteristics of goldenrod; Effort of the North Carolina Plant Conservation Program to conserve the population of goldenrod in a private land; Amount of funds granted for a study of the cytogenetics of the plant species and other aspects of the biology of the plant; Importance of the results of the study.
- Published
- 2004
25. State Variation in Low-Dose Computed Tomography Scanning for Lung Cancer Screening in the United States.
- Author
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Fedewa SA, Kazerooni EA, Studts JL, Smith RA, Bandi P, Sauer AG, Cotter M, Sineshaw HM, Jemal A, and Silvestri GA
- Subjects
- Adult, Aged, Educational Status, Humans, Mass Screening methods, Tomography, X-Ray Computed methods, United States epidemiology, Early Detection of Cancer, Lung Neoplasms diagnostic imaging, Lung Neoplasms epidemiology
- Abstract
Background: Annual lung cancer screening (LCS) with low-dose chest computed tomography in older current and former smokers (ie, eligible adults) has been recommended since 2013. Uptake has been slow and variable across the United States. We estimated the LCS rate and growth at the national and state level between 2016 and 2018., Methods: The American College of Radiology's Lung Cancer Screening Registry was used to capture screening events. Population-based surveys, the US Census, and cancer registry data were used to estimate the number of eligible adults and lung cancer mortality (ie, burden). Lung cancer screening rates (SRs) in eligible adults and screening rate ratios with 95% confidence intervals (CI) were used to measure changes by state and year., Results: Nationally, the SR was steady between 2016 (3.3%, 95% CI = 3.3% to 3.7%) and 2017 (3.4%, 95% CI = 3.4% to 3.9%), increasing to 5.0% (95% CI = 5.0% to 5.7%) in 2018 (2018 vs 2016 SR ratio = 1.52, 95% CI = 1.51 to 1.62). In 2018, several southern states with a high lung-cancer burden (eg, Mississippi, West Virginia, and Arkansas) had relatively low SRs (<4%) among eligible adults, whereas several northeastern states with lower lung cancer burden (eg, Massachusetts, Vermont, and New Hampshire) had the highest SRs (12.8%-15.2%). The exception was Kentucky, which had the nation's highest lung cancer mortality rate and one of the highest SRs (13.7%)., Conclusions: Fewer than 1 in 20 eligible adults received LCS nationally, and uptake varied widely across states. LCS rates were not aligned with lung cancer burden across states, except for Kentucky, which has supported comprehensive efforts to implement LCS., (© The Author(s) 2020. Published by Oxford University Press.)
- Published
- 2021
- Full Text
- View/download PDF
26. Erratum to: 'Integrating evidence-based practices for increasing cancer screenings in safety net health systems: a multiple case study using the Consolidated Framework for Implementation Research'.
- Author
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Liang S, Kegler MC, Cotter M, Phillips E, Beasley D, Hermstad A, Morton R, Martinez J, and Riehman K
- Published
- 2016
- Full Text
- View/download PDF
27. Integrating evidence-based practices for increasing cancer screenings in safety net health systems: a multiple case study using the Consolidated Framework for Implementation Research.
- Author
-
Liang S, Kegler MC, Cotter M, Emily P, Beasley D, Hermstad A, Morton R, Martinez J, and Riehman K
- Subjects
- Female, Health Status Disparities, Humans, Male, Research Design, United States, Delivery of Health Care methods, Early Detection of Cancer methods, Evidence-Based Practice methods, Health Plan Implementation methods, Primary Health Care methods
- Abstract
Background: Implementing evidence-based practices (EBPs) to increase cancer screenings in safety net primary care systems has great potential for reducing cancer disparities. Yet there is a gap in understanding the factors and mechanisms that influence EBP implementation within these high-priority systems. Guided by the Consolidated Framework for Implementation Research (CFIR), our study aims to fill this gap with a multiple case study of health care safety net systems that were funded by an American Cancer Society (ACS) grants program to increase breast and colorectal cancer screening rates. The initiative funded 68 safety net systems to increase cancer screening through implementation of evidence-based provider and client-oriented strategies., Methods: Data are from a mixed-methods evaluation with nine purposively selected safety net systems. Fifty-two interviews were conducted with project leaders, implementers, and ACS staff. Funded safety net systems were categorized into high-, medium-, and low-performing cases based on the level of EBP implementation. Within- and cross-case analyses were performed to identify CFIR constructs that influenced level of EBP implementation., Results: Of 39 CFIR constructs examined, six distinguished levels of implementation. Two constructs were from the intervention characteristics domain: adaptability and trialability. Three were from the inner setting domain: leadership engagement, tension for change, and access to information and knowledge. Engaging formally appointed internal implementation leaders, from the process domain, also distinguished level of implementation. No constructs from the outer setting or individual characteristics domain differentiated systems by level of implementation., Conclusions: Our study identified a number of influential CFIR constructs and illustrated how they impacted EBP implementation across a variety of safety net systems. Findings may inform future dissemination efforts of EBPs for increasing cancer screening in similar settings. Moreover, our analytic approach is similar to previous case studies using CFIR and hence could facilitate comparisons across studies.
- Published
- 2016
- Full Text
- View/download PDF
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