Browsing by Subject "Health education"

Now showing 1 - 8 of 8
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    A Call to Action to Review the USPSTF's Recommendation for Testicular Self-Examination
    (Sage, 2022) Rovito, Michael J.; Allen, Keri; Nangia, Ajay; Craycraft, Mike; Cary, Clint; Lutz, Michael; Lyon, Timothy; Fadich, Ana; Baird, Bryce; Welch, Morgan Garrett; Alcantara, Alexie; Urology, School of Medicine
    We urge the United States Preventive Services Task Force (USPSTF) to call for a formal review of the evidence regarding testicular self-examination (TSE). Twelve years have since passed since the evidence was last formally analyzed where normally re-reviews occur in 5-year cycles. If they would decide to move forward with this action, we ask for the USPSTF to review their methods for establishing recommendations to optimize their rating system operationalization process. Finally, emerging evidence demonstrates a net positive effect of TSE. This stands in contrast to the assertions of TSE's supposed harm that is prevalent in the literature as well as the rationale behind the USPSTF's "D" rating of TSE.
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    Effect of a School-Based Educational Intervention About the Human Papillomavirus Vaccine on Psychosocial Outcomes Among Adolescents: Analysis of Secondary Outcomes of a Cluster Randomized Trial
    (American Medical Association, 2021-11-01) Davies, Cristyn; Marshall, Helen S.; Zimet, Gregory; McCaffery, Kirsten; Brotherton, Julia M.L.; Kang, Melissa; Garland, Suzanne; Kaldor, John; McGeechan, Kevin; Skinner, S. Rachel; Pediatrics, School of Medicine
    Importance: Delivery of vaccination to adolescents via a school-based program provides an opportunity to promote their involvement in health decision-making, service provision, and self-efficacy (belief in one's ability to perform a certain behavior). Objective: To examine the effect of a human papillomavirus (HPV) vaccination education and logistical intervention on adolescent psychosocial outcomes. Design, setting, and participants: In this cluster randomized trial and process and qualitative evaluation, adolescents aged 12 to 13 years (first year of high school) were recruited at high schools in Western Australia (WA) and South Australia (SA) in 2013 and 2014. Statistical analysis was performed from January 2016 to December 2020. Interventions: The complex intervention consisted of an adolescent intervention to promote knowledge and psychosocial outcomes, shared decisional support tool, and logistical strategies. Main outcomes and measures: Prespecified secondary outcomes were assessed. The HPV Adolescent Vaccination Intervention Questionnaire (HAVIQ) was used to measure changes in adolescent knowledge (6-item subscale), fear and anxiety (6-item subscale), self-efficacy (5-item subscale), and decision-making (8-item subscale). The hypothesis was that the intervention would improve adolescent involvement in vaccine decision-making (measured before dose 1 only), improve vaccine-related self-efficacy, and reduce vaccine-related fear and anxiety (measured before doses 1, 2, and 3). Mean (SD) scores for each subscale were compared between intervention and control students. In the process evaluation, focus groups were conducted. Analyses of the HAVIQ data were conducted from 2016 to 2020. Qualitative analyses of the focus groups were undertaken from 2017 to 2020. Results: The trial included 40 schools (21 intervention and 19 control) across sectors with 6967 adolescents (mean [SD] age, 13.70 [0.45] years). There were 3805 students (1689 girls and 2116 boys) in the intervention group and 3162 students (1471 girls and 1691 boys) in the control group. The overall response rate for the HAVIQ was 55%. In WA, where parental consent was required, the response rate was 35% (1676 of 4751 students); in SA, where parental consent was not required, it was 97% (2166 of 2216 students). The mean (SD) score for decision-making in the intervention group before dose 1 was 3.50 (0.42) of 5 points and 3.40 (0.40) in the control group, a small but significant difference of 0.11 point (95% CI, 0.06 to 0.16 point; P < .001). There was a small difference in favor of the intervention group in reduced vaccination-related anxiety (pre-dose 1 difference, -0.11 point [95% CI, -0.19 to -0.02 point]; pre-dose 2 difference, -0.18 point [95% CI, -0.26 to -0.10 point]; pre-dose 3 difference, -0.18 [95% CI, -0.24 to -0.11]) and increased vaccination self-efficacy (pre-dose 1 difference, 4.0 points; [95% CI, 1.0 to 7.0 points]; pre-dose 2 difference, 4.0 points [95% CI, 2.0 to 6.0 points]; pre-dose 3 difference, 3.0 points [95% CI, 1.0 to 5.0 points]). Focus group data from 111 adolescents in 6 intervention and 5 control schools revealed more confidence and less anxiety with each vaccine dose. Conclusions and relevance: In this cluster randomized trial, there was a small difference in adolescent decisional involvement and vaccine-related confidence and reduced vaccination-related fear and anxiety that was maintained throughout the vaccine course in the intervention vs control groups. Guidelines for vaccination at school should incorporate advice regarding how this outcome can be achieved.
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    An evaluation of the impact of an intercultural service learning experience on the development of transcultural self-efficacy of nursing students
    (2014-11-06) Schmidt, Lynn Marie; McNelis, Angela; Dreifuerst, Kristina Thomas; Horton-Deutsch, Sara; Lay, Kathy
    The increase in diverse populations with unique, culturally specific needs, along with the lack of diverse healthcare providers to deliver culturally competent care, has escalated the need for non-diverse practitioners to gain the knowledge, skills, and attitudes to deliver culturally competent care. Culturally competent care cannot be offered to patients unless nurses understand how cultural values, attitudes, and beliefs impact patients' response to care. Nurses must develop cultural competence to accurately access, develop, and implement effective nursing interventions. The purpose of this exploratory, quasi-experimental, pretest-posttest study was to explore the impact of an intercultural service learning experience (domestic or international) on pre-licensure nursing students' perceived development of transcultural self-efficacy. A convenience sample of senior semester nursing students enrolled in a private, faith-based, baccalaureate degree nursing program in the Midwest United States completed the Transcultural Self-Efficacy Tool (TSET), Cultural Competence Clinical Evaluation Tool-Student Version (CCCET-SV), and reflective journals. All students were immersed in an intercultural service learning experience. Eighteen students traveled domestically and 38 traveled internationally. The data revealed that there was not a statistical difference in TSET scores based on location of the intercultural experience. However, there was a statistically significant difference from pretest to posttest for perceived Cognitive, Practical, and Affective dimensions of transcultural self-efficacy, in change scores (pretest to posttest), and pretest to posttest for pre-licensure BSN students’ perceived clinical competence behaviors (culturally sensitive and professionally appropriate attitudes, values, and beliefs) following an intercultural service learning experience.
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    Kidney Nutrition in the Era of Social Media: Bridging the Gap of Nutrition Education and Kidney Health Literacy by Leveraging Resources of Social Networking
    (Elsevier, 2022) Biruete, Annabel; Kistler, Brandon M.; Kalantar-Zadeh, Kamyar; Moore, Linda W.; Medicine, School of Medicine
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    Lay perceptions of breast cancer in Western Kenya
    (Baishideng Publishing Group, 2015-10-10) Naanyu, Violet; Asirwa, Chite Fredrick; Wachira, Juddy; Busakhala, Naftali; Kisuya, Job; Otieno, Grieven; Keter, Alfred; Mwangi, Anne; Omenge, Orango Elkanah; Inui, Thomas; Department of Medicine, IU School of Medicine
    AIM: To explore lay perceptions of causes, severity, presenting symptoms and treatment of breast cancer. METHODS: In October-November 2012, we recruited men and women (18 years and older) from households and health facilities in three different parts of Western Kenya, chosen for variations in their documented burdens of breast cancer. A standardized and validated tool, the breast cancer awareness measure (BCAM), was administered in face-to-face interviews. Survey domains covered included socio-demographics, opinions about causes, symptoms, severity, and treatment of breast cancer. Descriptive analyses were done on quantitative data while open-ended answers were coded, and emerging themes were integrated into larger categories in a qualitative analysis. The open-ended questions had been added to the standard BCAM for the purposes of learning as much as the investigators could about underlying lay beliefs and perceptions. RESULTS: Most respondents were female, middle-aged (mean age 36.9 years), married, and poorly educated. Misconceptions and lack of knowledge about causes of breast cancer were reported. The following (in order of higher to lower prevalence) were cited as potential causes of the condition: Genetic factors or heredity (n = 193, 12.3%); types of food consumed (n = 187, 11.9%); witchcraft and curses (n = 108, 6.9%); some family planning methods (n = 56, 3.6%); and use of alcohol and tobacco (n = 46, 2.9%). When asked what they thought of breast cancer’s severity, the most popular response was “it is a killer disease” (n = 266, 19.7%) a lethal condition about which little or nothing can be done. While opinions about presenting symptoms and signs of breast cancer were able to be elicited, such as an increase in breast size and painful breasts, early-stage symptoms and signs were not widely recognized. Some respondents (14%) were ignorant of available treatment altogether while others felt breast cancer treatment is both dangerous and expensive. A minority reported alternative medicine as providing relief to patients. CONCLUSION: The impoverished knowledge in these surveys suggests that lay education as well as better screening and treatment should be part of breast cancer control in Kenya.
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    Making National Cancer Institute-Designated Comprehensive Cancer Center Knowledge Accessible to Community Oncologists via an Online Tumor Board: Longitudinal Observational Study
    (JMIR, 2022-05-19) Kalra, Maitri; Henry, Elizabeth; McCann, Kelly; Karuturi, Meghan S.; Bustamante Alvarez, Jean G.; Parkes, Amanda; Wesolowski, Robert; Wei, Mei; Mougalian, Sarah S.; Durm, Gregory; Qin, Angel; Schonewolf, Caitlin; Trivedi, Meghna; Armaghani, Avan J.; Wilson, Frederick H.; Iams, Wade T.; Turk, Anita A.; Vikas, Praveen; Cecchini, Michael; Lubner, Sam; Pathak, Priyadarshini; Spencer, Kristen; Koshkin, Vadim S.; Labriola, Matthew K.; Marshall, Catherine H.; Beckermann, Katy E.; theMednet.org NCI-CCC Tumor Board Program Collaborative Group; Sharifi, Marina N.; Bejjani, Anthony C.; Hotchandani, Varsha; Housri, Samir; Housri, Nadine; Medicine, School of Medicine
    Background: Expert knowledge is often shared among multidisciplinary academic teams at tumor boards (TBs) across the country, but these conversations exist in silos and do not reach the wider oncology community. Objective: Using an oncologist-only question and answer (Q&A) website, we sought to document expert insights from TBs at National Cancer Institute-designated Comprehensive Cancer Centers (NCI-CCCs) to provide educational benefits to the oncology community. Methods: We designed a process with the NCI-CCCs to document and share discussions from the TBs focused on areas of practice variation on theMednet, an interactive Q&A website of over 13,000 US oncologists. The faculty translated the TB discussions into concise, non-case-based Q&As on theMednet. Answers were peer reviewed and disseminated in email newsletters to registered oncologists. Reach and engagement were measured. Following each Q&A, a survey question asked how the TB Q&As impacted the readers' practice. Results: A total of 23 breast, thoracic, gastrointestinal, and genitourinary programs from 16 NCI-CCC sites participated. Between December 2016 and July 2021, the faculty highlighted 368 questions from their TBs. Q&As were viewed 147,661 times by 7381 oncologists at 3515 institutions from all 50 states. A total of 277 (75%) Q&As were viewed every month. Of the 1063 responses to a survey question on how the Q&A affected clinicians' practices, 646 (61%) reported that it confirmed their current practice, 163 (20%) indicated that a Q&A would change their future practice, and 214 (15%) reported learning something new. Conclusions: Through an online Q&A platform, academics at the NCI-CCCs share knowledge outside the walls of academia with oncologists across the United States. Access to up-to-date expert knowledge can reassure clinicians' practices, significantly impact patient care in community practices, and be a source of new knowledge and education.
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    Participation in a Community-Based Women's Health Education Program and At-Risk Child Development in Rural Kenya: Developmental Screening Questionnaire Results Analysis
    (Johns Hopkins Center for Communication Program, 2021-12-21) McHenry, Megan S.; Maldonado, Lauren Y.; Yang, Ziyi; Anusu, Gertrude; Kaluhi, Evelyn; Christoffersen-Deb, Astrid; Songok, Julia J.; Ruhl, Laura J.; Pediatrics, School of Medicine
    Background: Over 43% of children living in low- and middle-income countries are at risk for developmental delays; however, access to protective interventions in these settings is limited. We evaluated the effect of maternal participation in Chamas for Change (Chamas)-a community-based women's health education program during pregnancy and postpartum-and risk of developmental delay among their children in rural Kenya. Methods: We analyzed developmental screening questionnaire (DSQ) data from a cluster randomized controlled trial in Trans Nzoia County, Kenya (ClinicalTrials.gov, NCT03187873). Intervention clusters (Chamas) participated in community health volunteer-led, group-based health lessons twice a month during pregnancy and postpartum; controls had monthly home visits (standard of care). We screened all children born during the trial who were alive at 1-year follow-up. We labeled children with any positive item on the DSQ as "at-risk development." We analyzed data using descriptive statistics and multilevel regression models (α=.05); analyses were intention-to-treat using individual-level data. Results: Between November 2017 and March 2018, we enrolled 1,920 pregnant women to participate in the parent trial. At 1-year follow-up, we screened 1,273 (689 intervention, 584 control) children born during the trial with the DSQ. Intervention mothers had lower education levels and higher poverty likelihood scores than controls (P<.001 and P=.007, respectively). The overall rate of at-risk development was 3.5%. Children in Chamas clusters demonstrated significantly lower rates of at-risk development than controls (2.5% vs. 4.8%, P=.025). Adjusted analyses revealed lower odds for at-risk development in the intervention arm (OR=0.50; 95% confidence interval=0.27, 0.94). Conclusions: Maternal participation in a community-based women's health education program was associated with lower rates of at-risk development compared to the standard of care. Overall, rates of at-risk development were lower than expected for this population, warranting further investigation. Chamas may help protect children from developmental delay in rural Kenya and other resource-limited settings.
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    Prison Health is Community Health: The Indiana Peer Education Program
    (Research Square, 2022-07-06) Janota, Andrea D.; Hibbard, Patrick F.; Meadows, Meghan E.; Cocco, John P.; Carr, Abigail L.; Nichols, Deborah; Chapman, Erika; Maupomé, Gerardo; Duwve, Joan
    Background: Concerning health inequities have been found in incarcerated populations, which likely impact broader community health. This paper evaluates the Indiana Peer Education Program (INPEP ECHO), an initiative that aims to improve health knowledge using the Project ECHO (Extension for Community Healthcare Outcomes) model to train people incarcerated in Indiana prisons (USA) as peer health educators inside prisons. Peer educators undergo a 40-hour training and then facilitate 10-hour long health education workshops inside their facilities over several days. Methods: We assessed the changes observed in pre- and post-session survey responses to estimate the impact this program had on peer educators and those they teach via multivariate regression analysis. We also examined peer educator qualitative data for emergent themes and confirmation of survey findings. Results: Findings from the 10-hour workshops showed improved knowledge scores and post-release behavior intentions. Peer educator surveys indicated increases in knowledge, health attitudes, and self-efficacy scores. Qualitative analysis affirms the latter finding and points toward peer educators acquiring expertise in the content they teach and how to teach it and that positive results likely expand beyond participants to others in prison, their families, and the communities to which they return. Further, peer educators shared they felt new purpose and hope tied to their participation in INPEP ECHO. Although these survey results show positive change in the short term, such improvements have been shown in other research to lead to improved middle- and long-term outcomes. Conclusions: Though preliminary, results indicate this type of public health intervention, training incarcerated individuals as peer educators on health topics, appears to increase important health knowledge and behavior intentions, which will likely lead to improvements in personal and public health outcomes. Results also point toward specific improvements associated with peers providing the education, and not external sources. The skills participants attain, as well, seem to increase their sense of purpose and self-efficacy, which have been shown to precede desistance from crime. While more work is necessary, the high costs associated with treating diseases like hepatitis C point toward an urgent need for programs like INPEP.