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4. Characteristics of patient navigation programs in the Cancer Moonshot ACCSIS colorectal cancer screening initiative

Author

Coronado, Gloria D, Ferrari, Renée M, Barnes, Autumn, Castañeda, Sheila F, Cromo, Mark, Davis, Melinda M, Doescher, Mark P, English, Kevin, Hatcher, Jenna, Kim, Karen E, Kobrin, Sarah, Liebovitz, David, Mishra, Shiraz I, Nodora, Jesse N, Norton, Wynne E, Oliveri, Jill M, Reuland, Daniel S, Subramanian, Sujha, Thompson, Jamie H, and Paskett, Electra D

Subjects
Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Cancer, Digestive Diseases, Prevention, Health Services, Clinical Research, Colo-Rectal Cancer, Humans, Patient Navigation, Early Detection of Cancer, Colorectal Neoplasms, Program Evaluation, Mass Screening, Oncology & Carcinogenesis, Oncology and carcinogenesis
Abstract

BackgroundAlthough patient navigation has shown promise for increasing participation in colorectal cancer screening and follow-up, little evidence is available to guide implementation of patient navigation in clinical practice. We characterize 8 patient navigation programs being implemented as part of multi-component interventions of the National Cancer Institute's Cancer Moonshot Accelerating Colorectal Cancer Screening and Follow-Up Through Implementation Science (ACCSIS) initiative.MethodsWe developed a data collection template organized by ACCSIS framework domains. The template was populated by a representative from each of the 8 ACCSIS research projects. We report standardized descriptions of 1) the socio-ecological context in which the navigation program was being conducted, 2) navigation program characteristics, 3) activities undertaken to facilitate program implementation (eg, training), and 4) outcomes used in program evaluation.ResultsACCSIS patient navigation programs varied broadly in their socio-ecological context and settings, the populations they served, and how they were implemented in practice. Six research projects adapted and implemented evidence-based patient navigation programs; the remaining projects developed new programs. Five projects began navigation when patients were due for initial colorectal cancer screening; 3 projects began navigation later in the screening process, when patients were due for follow-up colonoscopy after an abnormal stool-test result. Seven projects relied on existing clinical staff to deliver the navigation; 1 hired a centralized research navigator. All project researchers plan to evaluate the effectiveness and implementation of their programs.ConclusionsOur detailed program descriptions may facilitate cross-project comparisons and guide future implementation and evaluation of patient navigation programs in clinical practice.

Published
2023

6. Evaluation of COVID-19 vaccine implementation in a large safety net health system

Author

Chen, Jennifer C, Gutierrez, Griselda, Kamran, Rachel, Terry, Jill, Telliyan, Armenui, Zaks, Camilo, Carson, Savanna L, Brown, Arleen, and Kim, Karen

Subjects
Health Services and Systems, Nursing, Health Sciences, Vaccine Related, Dissemination and Implementation Research, Infectious Diseases, Coronaviruses, Health Services, Social Determinants of Health, Health Disparities, Emerging Infectious Diseases, Clinical Research, Immunization, Coronaviruses Disparities and At-Risk Populations, 8.1 Organisation and delivery of services, Good Health and Well Being, COVID-19, vaccine, vaccine distribution, implementation, leadership, communication, integrated delivery of health care, equity
Abstract

ObjectivesTo evaluate rapid COVID-19 vaccine clinic implementation from January-April 2021 in the Los Angeles County Department of Health Services (LACDHS), the second-largest US safety net health system. During initial vaccine clinic implementation, LACDHS vaccinated 59,898 outpatients, 69% of whom were Latinx (exceeding the LA County Latinx population of 46%). LACDHS is a unique safety net setting to evaluate rapid vaccine implementation due to system size, geographic breadth, language/racial/ethnic diversity, limited health staffing resources, and socioeconomic complexity of patients.MethodsImplementation factors were assessed through semi-structured interviews of staff from all twelve LACDHS vaccine clinics from August-November 2021 using the Consolidated Framework for Implementation Research (CFIR) and themes analyzed using rapid qualitative analysis.ResultsOf 40 potential participants, 25 health professionals completed an interview (27% clinical providers/medical directors, 23% pharmacist, 15% nursing staff, and 35% other). Qualitative analysis of participant interviews yielded ten narrative themes. Implementation facilitators included bidirectional communication between system leadership and clinics, multidisciplinary leadership and operations teams, expanded use of standing orders, teamwork culture, use of active and passive communication structures, and development of patient-centered engagement strategies. Barriers to implementation included vaccine scarcity, underestimation of resources needed for patient outreach, and numerous process challenges encountered.ConclusionPrevious studies focused on robust advance planning as a facilitator and understaffing and high staff turnover as barriers to implementation in safety net health systems. This study found facilitators that can mitigate lack of advance planning and staffing challenges present during public health emergencies such as the COVID-19 pandemic. The ten identified themes may inform future implementations in safety net health systems.

Published
2023

10. EACTS/STS Guidelines for Diagnosing and Treating Acute and Chronic Syndromes of the Aortic Organ

Author

Czerny, Martin, Grabenwöger, Martin, Berger, Tim, Aboyans, Victor, Della Corte, Alessandro, Chen, Edward P., Desai, Nimesh D., Dumfarth, Julia, Elefteriades, John A., Etz, Christian D., Kim, Karen M., Kreibich, Maximilian, Lescan, Mario, Di Marco, Luca, Martens, Andreas, Mestres, Carlos A., Milojevic, Milan, Nienaber, Christoph A., Piffaretti, Gabriele, Preventza, Ourania, Quintana, Eduard, Rylski, Bartosz, Schlett, Christopher L., Schoenhoff, Florian, Trimarchi, Santi, Tsagakis, Konstantinos, Siepe, Matthias, Estrera, Anthony L., Bavaria, Joseph E., Pacini, Davide, Okita, Yutaka, Evangelista, Arturo, Harrington, Katherine B., Kachroo, Puja, and Hughes, G. Chad

Published
2024
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12. ACC/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2024 Appropriate Use Criteria for Multimodality Imaging in Cardiovascular Evaluation of Patients Undergoing Nonemergent, Noncardiac Surgery

Author

Doherty, John U., Daugherty, Stacie L., Kort, Smadar, London, Martin J., Mehran, Roxana, Merli, Geno J., Schoenhagen, Paul, Soman, Prem, Starling, Randall C., Johnson, Drew M., Dehmer, Gregory J., Bhave, Nicole M., Biederman, Robert W., Bittencourt, Marcio S., Burroughs, Melissa S., Doukky, Rami, Hays, Allison G., Indik, Julia H., Kim, Karen M., Lotfi, Amir S., Macchiavelli, Anthony J., Neuburger, Peter, Patel, Hena, Pellikka, Patricia A., Reece, T. Brett, and Rong, Lisa Q.

Published
2024
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17. An Overview of Cancer in the First 315,000 All of Us Participants

Author

Aschebrook-Kilfoy, Briseis, Zakin, Paul, Craver, Andrew, Shah, Sameep, Kibriya, Muhammad G, Stepniak, Elizabeth, Ramirez, Andrea, Clark, Cheryl, Cohn, Elizabeth, Ohno-Machado, Lucila, Cicek, Mine, Boerwinkle, Eric, Schully, Sheri D, Mockrin, Stephen, Gebo, Kelly, Mayo, Kelsey, Ratsimbazafy, Francis, Sanders, Alan, Shah, Raj C, Argos, Maria, Ho, Joyce, Kim, Karen, Daviglus, Martha, Greenland, Philip, and Ahsan, Habibul

Subjects
Cancer, Good Health and Well Being, Cohort Studies, Electronic Health Records, Humans, Neoplasms, Population Health, Surveys and Questionnaires, All of Us Research Program Investigators, General Science & Technology
Abstract

IntroductionThe NIH All of Us Research Program will have the scale and scope to enable research for a wide range of diseases, including cancer. The program's focus on diversity and inclusion promises a better understanding of the unequal burden of cancer. Preliminary cancer ascertainment in the All of Us cohort from two data sources (self-reported versus electronic health records (EHR)) is considered.Materials and methodsThis work was performed on data collected from the All of Us Research Program's 315,297 enrolled participants to date using the Researcher Workbench, where approved researchers can access and analyze All of Us data on cancer and other diseases. Cancer case ascertainment was performed using data from EHR and self-reported surveys across key factors. Distribution of cancer types and concordance of data sources by cancer site and demographics is analyzed.Results and discussionData collected from 315,297 participants resulted in 13,298 cancer cases detected in the survey (in 89,261 participants), 23,520 cancer cases detected in the EHR (in 203,813 participants), and 7,123 cancer cases detected across both sources (in 62,497 participants). Key differences in survey completion by race/ethnicity impacted the makeup of cohorts when compared to cancer in the EHR and national NCI SEER data.ConclusionsThis study provides key insight into cancer detection in the All of Us Research Program and points to the existing strengths and limitations of All of Us as a platform for cancer research now and in the future.

Published
2022

23. Primary care provider‐led group visits for advance care planning in the safety net

Author

Schickedanz, Heather B, Polzin, Rhonda, Vassar, Stefanie D, Brown, Arleen F, and Kim, Karen J

Subjects
Biomedical and Clinical Sciences, Health Sciences, Psychology, Advance Care Planning, Aged, Culturally Competent Care, Feasibility Studies, Female, Humans, Male, Patient Acceptance of Health Care, Patient Satisfaction, Primary Health Care, Safety-net Providers, Shared Medical Appointments, Medical and Health Sciences, Geriatrics, Biomedical and clinical sciences, Health sciences
Published
2021

25. 2022 ACC/AHA guideline for the diagnosis and management of aortic disease: A report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines

Author

Isselbacher, Eric M., Preventza, Ourania, Hamilton Black, James, III, Augoustides, John G., Beck, Adam W., Bolen, Michael A., Braverman, Alan C., Bray, Bruce E., Brown-Zimmerman, Maya M., Chen, Edward P., Collins, Tyrone J., DeAnda, Abe, Jr., Fanola, Christina L., Girardi, Leonard N., Hicks, Caitlin W., Hui, Dawn S., Schuyler Jones, William, Kalahasti, Vidyasagar, Kim, Karen M., Milewicz, Dianna M., Oderich, Gustavo S., Ogbechie, Laura, Promes, Susan B., Ross, Elsie Gyang, Schermerhorn, Marc L., Singleton Times, Sabrina, Tseng, Elaine E., Wang, Grace J., Woo, Y. Joseph, Faxon, David P., Upchurch, Gilbert R., Jr, Aday, Aaron W., Azizzadeh, Ali, Boisen, Michael, Hawkins, Beau, Kramer, Christopher M., Luc, Jessica G.Y., MacGillivray, Thomas E., Malaisrie, S. Christopher, Osteen, Kathryn, Patel, Himanshu J., Patel, Parag J., Popescu, Wanda M., Rodriguez, Evelio, Sorber, Rebecca, Tsao, Philip S., Santos Volgman, Annabelle, Beckman, Joshua A., Otto, Catherine M., O'Gara, Patrick T., Armbruster, Anastasia, Birtcher, Kim K., de las Fuentes, Lisa, Deswal, Anita, Dixon, Dave L., Gorenek, Bulent, Haynes, Norrisa, Hernandez, Adrian F., Joglar, José A., Jones, W. Schuyler, Mark, Daniel, Mukherjee, Debabrata, Palaniappan, Latha, Piano, Mariann R., Rab, Tanveer, Spatz, Erica S., and Tamis-Holland, Jacqueline E.

Published
2023
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28. ACR Appropriateness Criteria® Thoracoabdominal Aortic Aneurysm or Dissection: Treatment Planning and Follow-Up

Author

Contrella, Benjamin N., Khaja, Minhajuddin S., Majdalany, Bill S., Kim, Charles Y., Kalva, Sanjeeva P., Beck, Adam W., Browne, William F., Clough, Rachel E., Ferencik, Maros, Fleischman, Fernando, Gunn, Andrew J., Hickey, Sean M., Kandathil, Asha, Kim, Karen M., Monroe, Eric J., Ochoa Chaar, Cassius Iyad, Scheidt, Matthew J., Smolock, Amanda R., Steenburg, Scott D., Waite, Kathleen, Pinchot, Jason W., and Steigner, Michael L.

Published
2023
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29. Racial disparities in mitral valve surgery: A statewide analysis

Author

Martin, David, George, Kristopher, Batra, Sanjay, Liakonis, Chris, Dabir, Reza, Shannon, Francis, Robinson, Philip, Delucia, Alphonse, Kaakeh, Bakri, Zehr, Kenton, Mandal, Kaushik, Simonetti, Vincent, Nemeh, Hassan, Alnajjar, Raed, Holmes, Robert, Gandhi, Divyakant, Minanov, Kristijan, Talbott, J.D., Martin, James, Downey, Richard, Collar, Alonson, Lall, Shelly, Pridjian, Ara, Fanning, Justin, Baghelai, Kourish, Pruitt, Andrew, Schwartz, Charles, Kim, Karen, Blakeman, Bradfod, Pienta, Michael J., Theurer, Patricia F., He, Chang, Drake, Daniel, Murphy, Edward, Bolling, Steven F., Romano, Matthew A., Prager, Richard L., Thompson, Michael P., and Ailawadi, Gorav

Published
2023
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32. Improving Shared Decision Making For Asian American Pacific Islander Sexual and Gender Minorities

Author

Bi, Stephanie, Gunter, Kathryn E, López, Fanny Y, Anam, Seeba, Tan, Judy Y, Polin, Danielle J, Jia, Justin L, Xu, Lucy J, Laiteerapong, Neda, Pho, Mai T, Kim, Karen E, and Chin, Marshall H

Subjects
Clinical Research, Mental Health, Health Services, 7.1 Individual care needs, Management of diseases and conditions, Good Health and Well Being, Asian, Decision Making, Shared, Female, Humans, Interviews as Topic, Male, Native Hawaiian or Other Pacific Islander, Patient Participation, Sexual and Gender Minorities, Social Stigma, sexual and gender minorities, lesbian, gay, bisexual, transgender, and queer, Asian American and Pacific Islander, shared decision making, mental health, Public Health and Health Services, Applied Economics, Health Policy & Services
Abstract

BackgroundAsian American Pacific Islander (AAPI) sexual and gender minorities (SGM) face unique challenges in mental health and accessing high-quality health care.ObjectiveThe objective of this study was to identify barriers and facilitators for shared decision making (SDM) between AAPI SGM and providers, especially surrounding mental health.Research designInterviews, focus groups, and surveys.SubjectsAAPI SGM interviewees in Chicago (n=20) and San Francisco (n=20). Two focus groups (n=10) in San Francisco.MeasuresParticipants were asked open-ended questions about their health care experiences and how their identities impacted these encounters. Follow-up probes explored SDM and mental health. Participants were also surveyed about attitudes towards SGM disclosure and preferences about providers. Transcripts were analyzed for themes and a conceptual model was developed.ResultsOur conceptual model elucidates the patient, provider, and encounter-centered factors that feed into SDM for AAPI SGM. Some participants shared the stigma of SGM identities and mental health in their AAPI families. Their AAPI and SGM identities were intertwined in affecting mental health. Some providers inappropriately controlled the visibility of the patient's identities, ignoring or overemphasizing them. Participants varied on whether they preferred a provider of the same race, and how prominently their AAPI and/or SGM identities affected SDM.ConclusionsProviders should understand identity-specific challenges for AAPI SGM to engage in SDM. Providers should self-educate about AAPI and SGM history and intracommunity heterogeneity before the encounter, create a safe environment conducive to patient disclosure of SGM identity, and ask questions about patient priorities for the visit, pronouns, and mental health.

Published
2019

39. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines

Author

Isselbacher, Eric M., Preventza, Ourania, Hamilton Black III, James, Augoustides, John G., Beck, Adam W., Bolen, Michael A., Braverman, Alan C., Bray, Bruce E., Brown-Zimmerman, Maya M., Chen, Edward P., Collins, Tyrone J., DeAnda, Abe, Jr., Fanola, Christina L., Girardi, Leonard N., Hicks, Caitlin W., Hui, Dawn S., Jones, William Schuyler, Kalahasti, Vidyasagar, Kim, Karen M., Milewicz, Dianna M., Oderich, Gustavo S., Ogbechie, Laura, Promes, Susan B., Ross, Elsie Gyang, Schermerhorn, Marc L., Times, Sabrina Singleton, Tseng, Elaine E., Wang, Grace J., and Woo, Y. Joseph

Published
2022
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47. Community-Based Services to Improve Testing and Linkage to Care Among Non-U.S.-Born Persons with Chronic Hepatitis B Virus Infection - Three U.S. Programs, October 2014-September 2017.

Author

Harris, Aaron M, Link-Gelles, Ruth, Kim, Karen, Chandrasekar, Edwin, Wang, Su, Bannister, Nicole, Pong, Perry, Chak, Eric, Chen, Moon S, Bowlus, Christopher, and Nelson, Noele P

Subjects
Humans, Hepatitis B virus, Hepatitis B, Chronic, Hepatitis B Vaccines, Hepatitis B Surface Antigens, Mass Screening, Program Evaluation, Adult, Middle Aged, Community Health Services, Referral and Consultation, United States, Female, Male, Emigrants and Immigrants, Hepatitis B, Chronic, General & Internal Medicine
Abstract

Among an estimated 850,000 to 2.2 million persons with chronic hepatitis B virus (HBV) infection in the United States, 70% are non-U.S.-born (1,2). All patients require linkage to care, and approximately 20%-40% require antiviral treatment (3). Without treatment, one in four persons chronically infected with HBV will die prematurely from liver failure, liver cirrhosis, or hepatocellular carcinoma (4). To mitigate morbidity and mortality, CDC funded a cooperative agreement to develop hepatitis B testing and linkage-to-care programs serving non-U.S.-born persons during October 2014-September 2017. This report describes each program's operational services and partnerships with primary care centers, community-based organizations, and public health departments to recruit non-U.S.-born persons for HBV testing using the hepatitis B surface antigen (HBsAg) and link those whose test results were positive to HBV-directed care (medical visit attendance with monitoring of HBV DNA and liver enzyme tests). Among 10,152 program participants, 757 (7.5%) were HBsAg-positive, indicative of chronic HBV infection; among these, 643 (85%) attended ≥1 medical visit, 587 (78%) received HBV-directed care, and 137 (18%) were prescribed antiviral treatment. Among 273 household contacts of HBsAg-positive persons, 39 (14%) had positive test results for HBsAg. Prevalence of current HBV infection was high in this non-U.S.-born population and among household and sexual contacts of HBV-infected persons. HBV testing and linkage to care can be achieved through partnerships with community organizations, health centers, and public health departments.

Published
2018

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