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Multicenter study of human papillomavirus and the human papillomavirus vaccine: Knowledge and attitudes among people of African descent

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Infectious Diseases in Obstetrics and Gynecology 2013年第1期2013卷 1-8页

作者： Blackman, Elizabeth Thurman, Natalie Halliday, Darron Butler, Raleigh Francis, Dorita Joseph, Madeline Thompson, Jahzreel Akers, Aletha Andraos-Selim, Cecile Bondzi, Cornelius Taioli, Emanuela Hagan, Kourtney L. Jones, Erin A. Jones, Jade Moss, Cierra M. Smith, Ar'Lena C. Ashing, Kimlin Tam Ragin, Camille C. Cancer Prevention and Control Program Fox Chase Cancer Center 333 Cottman Avenue Philadelphia PA 19111 United States African Caribbean Cancer Consortium United States Department of Epidemiology University of Pittsburgh Graduate School of Public Health Pittsburgh PA United States Department of Obstetrics and Gynecology Princess Margaret Hospital Nassau Bahamas Department of Family Medicine Princess Margaret Hospital Nassau Bahamas Division of Gynecologic Specialties Department of Obstetrics Gynecology and Reproductive Sciences University of Pittsburgh Pittsburgh PA United States Department of Biological Sciences Hampton University Hampton VA United States North Shore Long Island Jewish Health System Feinstein Institute for Medical Research Manhasset NY 350 Community Drive United States Division of Cancer Prevention and Population Science University of Pittsburgh Cancer Institute Pittsburgh PA United States Center of Community Alliance for Research and Education Department of Population Science City of Hope Medical Center Duarte CA United States

Objective. To compare knowledge and attitudes of human papillomavirus (HPV) and the vaccine between different cultures of African descent. Methods. A cross-sectional survey of 555 African-Americans and Afro-Caribbeans residing in the US and the Bahamas (BHM) was conducted. Results. General knowledge about HPV and the HPV vaccine differed between the two countries significantly. Bahamian respondents were less likely to have higher numbers of correct knowledge answers when compared to Americans (Adjusted Odds Ratio [Adj. OR] 0.47, 95% Confidence Interval [CI] 0.30-0.75). Older age, regardless of location, was also associated with answering fewer questions correctly (Adj. OR 0.61, 95% CI 0.40-0.92). Attitudes related to HPV vaccination were similar between the US and BHM, but nearly 80% of BHM respondents felt that children should not be able to receive the vaccine without parental consent compared to 57% of American respondents. Conclusions. Grave lack of knowledge, safety and cost concerns, and influence of parental restrictions may negatively impact vaccine uptake among African-American and Afro-Caribbean persons. Interventions to increase the vaccine uptake in the Caribbean must include medical provider and parental involvement. Effective strategies for education and increasing vaccine uptake in BHM are crucial for decreasing cervical cancer burden in the Caribbean. © 2013 Elizabeth Blackman et al.

关键词： TRANSMISSION of papillomavirus diseases ATTITUDES toward health HUMAN Papillomavirus vaccination CROSS-sectional method HEALTH of African Americans THERAPEUTIC use

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Multilevel research and the challenges of implementing genomic medicine

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Journal of the National cancer Institute - Monographs 2012年第44期2012卷 112-120页

作者： Khoury, Muin J. Coates, Ralph J. Fennell, Mary L. Glasgow, Russell E. Scheuner, Maren T. Schully, Sheri D. Williams, Marc S. Clauser, Steven B. Office of Public Health Genomics Centers for Disease Control and Prevention Atlanta GA United States Epidemiology and Genomics Research Program Division of Cancer Control and Population Sciences National Cancer Institute Bethesda MD United States Implementation Science Team Division of Cancer Control and Population Sciences National Cancer Institute Bethesda MD United States Applied Research Program Division of Cancer Control and Population Sciences National Cancer Institute Bethesda MD United States Department of Sociology Department of Health Services Policy and Practice Brown University Providence RI United States Veterans Administration Greater Los Angeles Healthcare System Los Angeles CA United States Clinical Genetics Institute Intermountain Healthcare Salt Lake City UT United States

Advances in genomics and related fields promise a new era of personalized medicine in the cancer care continuum. Nevertheless, there are fundamental challenges in integrating genomic medicine into cancer practice. We explore how multilevel research can contribute to implementation of genomic medicine. We first review the rapidly developing scientific discoveries in this field and the paucity of current applications that are ready for implementation in clinical and public health programs. We then define a multidisciplinary translational research agenda for successful integration of genomic medicine into policy and practice and consider challenges for successful implementation. We illustrate the agenda using the example of Lynch syndrome testing in newly diagnosed cases of colorectal cancer and cascade testing in relatives. We synthesize existing information in a framework for future multilevel research for integrating genomic medicine into the cancer care continuum. © The Author 2012. Published by Oxford University Press. All rights reserved.

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Introduction: Understanding and influencing multilevel factors across the cancer care continuum

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Journal of the National cancer Institute - Monographs 2012年第44期2012卷 2-10页

作者： Taplin, Stephen H. Price, Rebecca Anhang Edwards, Heather M. Foster, Mary K. Breslau, Erica S. Chollette, Veronica Das, Irene Prabhu Clauser, Steven B. Fennell, Mary L. Zapka, Jane Applied Research Program Division of Cancer Control and Population Sciences National Cancer Institute Bethesda MD United States Behavioral Research Program Division of Cancer Control and Population Sciences National Cancer Institute Bethesda MD United States RAND Corporation Frederick MD United States Clinical Monitoring Research Program SAIC-Frederick Inc. NCI-Frederick Frederick MD United States Department of Sociology Brown University Providence RI United States Earl G Graves School of Business and Management Morgan State University Baltimore MD United States Department of Medicine Division of Biostatistics and Epidemiology Medical University of South Carolina Charleston SC United States

Health care in the United States is notoriously expensive while often failing to deliver the care recommended in published guidelines. There is, therefore, a need to consider our approach to health-care delivery. cancer care is a good example for consideration because it spans the continuum of health-care issues from primary prevention through long-term survival and end-of-life care. In this monograph, we emphasize that health-care delivery occurs in a multilevel system that includes organizations, teams, and individuals. To achieve health-care delivery consistent with the Institute of Medicine's six quality aims (safety, effectiveness, timeliness, efficiency, patient-centeredness, and equity), we must influence multiple levels of that multilevel system. The notion that multiple levels of contextual influence affect behaviors through interdependent interactions is a well-established ecological view. This view has been used to analyze health-care delivery and health disparities. However, experience considering multilevel interventions in health care is much less robust. This monograph includes 13 chapters relevant to expanding the foundation of research for multilevel interventions in health-care delivery. Subjects include clinical cases of multilevel thinking in health-care delivery, the state of knowledge regarding multilevel interventions, study design and measurement considerations, methods for combining interventions, time as a consideration in the evaluation of effects, measurement of effects, simulations, application of multilevel thinking to health-care systems and disparities, and implementation of the Affordable Care Act of 2010. Our goal is to outline an agenda to proceed with multilevel intervention research, not because it guarantees improvement in our current approach to health care, but because ignoring the complexity of the multilevel environment in which care occurs has not achieved the desired improvements in care quality outlined by the Institute o

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Multilevel factors affecting quality: Examples from the cancer care continuum

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Journal of the National cancer Institute - Monographs 2012年第44期2012卷 11-19页

作者： Zapka, Jane Taplin, Stephen H. Ganz, Patricia Grunfeld, Eva Sterba, Katherine Department of Medicine Division of Biostatistics and Epidemiology Medical University of South Carolina Charleston SC United States Behavioral Research Program Division of Cancer Control and Population Sciences National Cancer Institute Bethesda MD United States School of Public Health David Geffen School of Medicine University of California Los Angeles Los Angeles CA United States Jonsson Comprehensive Cancer Center University of California Los Angeles Los Angeles CA United States Ontario Institute for Cancer Research University of Toronto Toronto ON Canada Department of Family and Community Medicine University of Toronto Toronto ON Canada

The complex environmental context must be considered as we move forward to improve cancer care and, ultimately, patient and population outcomes. The cancer care continuum represents several care types, each of which includes multiple technical and communication steps and interfaces among patients, providers, and organizations. We use two case scenarios to 1) illustrate the variability, diversity, and interaction of factors from multiple levels that affect care quality and 2) discuss research implications and provide hypothetical examples of multilevel interventions. Each scenario includes a targeted literature review to illustrate contextual influences upon care and sets the stage for theory-informed interventions. The screening case highlights access issues in older women, and the survivorship case illustrates the multiple transition challenges faced by patients, families, and organizations. Example interventions show the potential gains of implementing intervention strategies that work synergistically at multiple levels. While research examining multilevel intervention is a priority, it presents numerous study design, measurement, and analytic challenges. Published by Oxford University Press 2012.

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Central adiposity and subclinical cardiovascular disease in police officers

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ISRN obesity 2013年第1期2013卷 895687页

作者： Penelope Baughman Desta Fekedulegn Michael E Andrew Parveen Nedra Joseph Joan M Dorn John M Violanti Cecil M Burchfiel Epidemic Intelligence Service Centers for Disease Control and Prevention Atlanta GA 30333 USA Biostatistics and Epidemiology Branch Health Effects Laboratory Division National Institute for Occupational Safety and Health Centers for Disease Control and Prevention Morgantown WV 26505 USA. The University of Chicago Comprehensive Cancer Center The University of Chicago Chicago IL 60637 USA. Department of Social and Preventive Medicine School of Public Health and Health Professions The State University of New York at Buffalo Buffalo NY 14214 USA.

Given the associations between obesity and cardiovascular disease (CVD), we evaluated a related but less well-established association between waist circumference and brachial artery reactivity (BAR), a functional measurement of subclinical CVD, where lower levels indicate dysfunction. Regression models examined trends in mean BAR across waist circumference tertiles in police officers, a high-stress occupational group with increased risk for CVD. Mean BAR decreased across increasing waist tertiles among men, but not women, and this association was stronger among officers who consumed more alcohol. Larger waist circumference may be associated with lower BAR, providing an opportunity for intervention prior to disease development.

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Regional, provider, and economic factors associated with the choice of active surveillance in the treatment of men with localized prostate cancer

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Journal of the National cancer Institute - Monographs 2012年第45期2012卷 213-220页

作者： Hamilton, Ann S. Wu, Xiao-Cheng Lipscomb, Joseph Fleming, Steven T. Lo, Mary Wang, Dian Goodman, Michael Ho, Alex Owen, Jean B. Rao, Chandrika German, Robert R. Keck School of Medicine University of Southern California Los Angeles CA United States Epidemiology Program School of Public Health LSU Health Sciences Center New Orleans LA United States Department of Health Policy and Management Rollins School of Public Health Emory University Atlanta GA United States Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA United States College of Public Health University of Kentucky Lexington KY United States Department of Radiation Oncology Medical College of Wisconsin Milwaukee WI United States Clinical Research Center American College of Radiology Philadelphia PA United States North Carolina Central Cancer Registry State Center for Health Statistics Raleigh NC United States Division of Cancer Prevention and Control Centers for Disease Control and Prevention Atlanta GA United States

Data on initial treatment of 8232 cases of localized prostate cancer diagnosed in 2004 were obtained by medical record abstraction (including hospital and outpatient locations) from seven state cancer registries participating in the Centers for Disease control and prevention's Breast and Prostate cancer Data Quality and Patterns of Care Study. Distinction was made between men receiving no therapy with no monitoring plan (no therapy/no plan [NT/NP]) and those receiving active surveillance (AS). Overall, 8.6% received NT/NP and 4.7% received AS. Older age at diagnosis, lower clinical risk group, and certain registry locations were significant predictors of use of both AS and NT/NP. AS was also related to having more severe comorbidities, whereas nonwhite race was predicted receiving NT/NP. Men receiving AS lived in areas with a higher number of urologists per 100 000 men than those receiving NT/NP. In summary, physician and clinical factors were stronger predictors of AS, whereas demographic and regional factors were related to receiving NT/NP. Physicians appear reluctant to recommend AS for younger patients with no comorbidities. © The Author 2012. Published by Oxford University Press. All rights reserved.

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Implementation and spread of interventions into the multilevel context of routine practice and policy: Implications for the cancer care continuum

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Journal of the National cancer Institute - Monographs 2012年第44期2012卷 86-99页

作者： Yano, Elizabeth M. Green, Lawrence W. Glanz, Karen Ayanian, John Z. Mittman, Brian S. Chollette, Veronica Rubenstein, Lisa V. Veterans Health Administration Health Services Research Development Center of Excellence for the Study of Healthcare Provider Behavior Sepulveda CA United States Department of Health Services VA Greater Los Angeles Healthcare System University of California Los Angeles School of Public Health Los Angeles CA United States Department of Epidemiology and Biostatistics School of Medicine University of California San Francisco San Francisco CA United States Comprehensive Cancer Center and Center for Tobacco Research and Education University of California San Francisco San Francisco CA United States Perelman School of Medicine University of Pennsylvania Philadelphia PA United States Department of Health Care Policy Harvard Medical School Boston MA United States Division of General Medicine Brigham and Women's Hospital Boston MA United States Center for Implementation Research and Practice Support (CIPRS) Sepulveda CA United States Behavioral Research Program Division of Cancer Control and Population Sciences National Cancer Institute Rockville MD United States David Geffen University of California Los Angeles School of Medicine Los Angeles CA United States RAND Health Santa Monica CA United States

The promise of widespread implementation of efficacious interventions across the cancer continuum into routine practice and policy has yet to be realized. Multilevel influences, such as communities and families surrounding patients or health-care policies and organizations surrounding provider teams, may determine whether effective interventions are successfully implemented. Greater recognition of the importance of these influences in advancing (or hindering) the impact of single-level interventions has motivated the design and testing of multilevel interventions designed to address them. However, implementing research evidence from single- or multilevel interventions into sustainable routine practice and policy presents substantive challenges. Furthermore, relatively few multilevel interventions have been conducted along the cancer care continuum, and fewer still have been implemented, disseminated, or sustained in practice. The purpose of this chapter is, therefore, to illustrate and examine the concepts underlying the implementation and spread of multilevel interventions into routine practice and policy. We accomplish this goal by using a series of cancer and noncancer examples that have been successfully implemented and, in some cases, spread widely. Key concepts across these examples include the importance of phased implementation, recognizing the need for pilot testing, explicit engagement of key stakeholders within and between each intervention level;visible and consistent leadership and organizational support, including financial and human resources;better understanding of the policy context, fiscal climate, and incentives underlying implementation;explication of handoffs from researchers to accountable individuals within and across levels;ample integration of multilevel theories guiding implementation and evaluation;and strategies for long-term monitoring and sustainability.

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Correlates of cervical cancer screening among Vietnamese American women

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Infectious Diseases in Obstetrics and Gynecology 2012年第1期2012卷 617234页

作者： Ma, Grace X. Fang, Carolyn Y. Feng, Ziding Tan, Yin Gao, Wanzhen Ge, Shaokui Nguyen, Cuc Department of Public Health College of Health Professions Temple University Philadelphia PA 19122 1301 Cecil B Moore Avenue 913 Ritter Annex United States Center for Asian Health College of Health Professions Temple University Philadelphia PA 19122 1415 N. Broad Street United States Fox Chase Cancer Center Cancer Prevention and Control Program Philadelphia PA 19111 333 Cottman Avenue United States Department of Biostatistics Fred Hutchinson Cancer Research Center University of Washington Seattle WA 98109 P.O. Box 19024 United States Asian Community Health Coalition Unit A Philadelphia PA 19123 1106 Buttonwood Street United States Vietnamese Women Association of Eastern Region Marlton NJ 08053 3 Coventry Circle East United States

Objective. Vietnamese American women are at the greatest risk for cervical cancer but have the lowest cervical cancer screening rates. This study was to determine whether demographic and acculturation, healthcare access, and knowledge and beliefs are associated with a prior history of cervical cancer screening among Vietnamese women. Methods. Vietnamese women (n = 1450) from 30 Vietnamese community-based organizations located in Pennsylvania and New Jersey participated in the study and completed baseline assessments. Logistic regression analyses were performed. Results. Overall levels of knowledge about cervical cancer screening and human papillomavirus (HPV) are low. Factors in knowledge, attitude, and beliefs domains were significantly associated with Pap test behavior. In multivariate analyses, physician recommendation for screening and having health insurance were positively associated with prior screening. Conclusion. Understanding the factors that are associated with cervical cancer screening will inform the development of culturally appropriate intervention strategies that would potentially lead to increasing cervical cancer screening rates among Vietnamese women. © 2012 Grace X. Ma et al.

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Potentially functional polymorphisms in ESR1 and breast cancer risk: a meta-analysis

Potentially functional polymorphisms in ESR1 and breast canc...

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第一届国家癌症中心学术年会

作者： Ni Li Jing Dong Zhibin Hu Hongbing Shen Min Dai National Office of Cancer Prevention and Control Cancer Hospital/Institute Chinese Academy of Medical Sciences17 PanjiayuannanliChaoyang District100021 BeijingChina Department of Epidemiology and BiostatisticsCancer CenterNanjing Medical University210029 NanjingChina

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What has made the population of Japan healthy?

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The Lancet 2011年第9796期378卷 1094-1105页

作者： Ikeda, Nayu Saito, Eiko Kondo, Naoki Inoue, Manami Ikeda, Shunya Satoh, Toshihiko Wada, Koji Stickley, Andrew Katanoda, Kota Mizoue, Tetsuya Noda, Mitsuhiko Iso, Hiroyasu Fujino, Yoshihisa Sobue, Tomotaka Tsugane, Shoichiro Naghavi, Mohsen Ezzati, Majid Shibuya, Kenji Department of Global Health Policy Graduate School of Medicine University of Tokyo Bunkyo-ku Tokyo 113-0033 7-3-1 Hongo Japan Department of Health Sciences Interdisciplinary Graduate School of Medicine and Engineering University of Yamanashi Yamanashi Japan Epidemiology and Prevention Division Research Centre for Cancer Prevention and Screening National Cancer Centre Tokyo Japan International University of Health Welfare Graduate School Tokyo Japan Kitasato Clinical Research Centre Kitasato University School of Medicine Sagamihara Japan Department of Preventive Medicine and Public Health Kitasato University School of Medicine Sagamihara Japan Surveillance Division Centre for Cancer Control and Information Services National Cancer Centre Tokyo Japan Department of Epidemiology and International Health National Centre for Global Health and Medicine Tokyo Japan Department of Diabetes and Metabolic Medicine National Centre for Global Health and Medicine Tokyo Japan Department of Social and Environmental Medicine Osaka University Graduate School of Medicine Osaka Japan Department of Preventive Medicine and Community Health University of Occupational and Environmental Health Fukuoka Japan Institute for Health Metrics and Evaluation University of Washington Seattle WA United States Department of Epidemiology and Biostatistics School of Public Health Imperial College London London United Kingdom

People in Japan have the longest life expectancy at birth in the world. Here, we compile the best available evidence about population health in Japan to investigate what has made the Japanese people healthy in the past 50 years. The Japanese population achieved longevity in a fairly short time through a rapid reduction in mortality rates for communicable diseases from the 1950s to the early 1960s, followed by a large reduction in stroke mortality rates. Japan had moderate mortality rates for non-communicable diseases, with the exception of stroke, in the 1950s. The improvement in population health continued after the mid-1960s through the implementation of primary and secondary preventive community public health measures for adult mortality from non-communicable diseases and an increased use of advanced medical technologies through the universal insurance scheme. Reduction in health inequalities with improved average population health was partly attributable to equal educational opportunities and financial access to care. With the achievement of success during the health transition since World War 2, Japan now needs to tackle major health challenges that are emanating from a rapidly ageing population, causes that are not amenable to health technologies, and the effects of increasing social disparities to sustain the improvement in population health. © 2011 Elsevier Ltd.

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