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Guidance on the use of complex systems models for economic evaluations of public health interventions

HEALTH ECONOMICS 2023年第7期32卷 1603-1625页

作者： Breeze, Penny R. Squires, Hazel Ennis, Kate Meier, Petra Hayes, Kate Lomax, Nik Shiell, Alan Kee, Frank de Vocht, Frank O'Flaherty, Martin Gilbert, Nigel Purshouse, Robin Robinson, Stewart Dodd, Peter J. Strong, Mark Paisley, Suzy Smith, Richard Briggs, Andrew Shahab, Lion Occhipinti, Jo-An Lawson, Kenny Bayley, Thomas Smith, Robert Boyd, Jennifer Kadirkamanathan, Visakan Cookson, Richard Hernandez-Alava, Monica Jackson, Christopher H. Karapici, Amanda Sassi, Franco Scarborough, Peter Siebert, Uwe Silverman, Eric Vale, Luke Walsh, Cathal Brennan, Alan School of Health and Related Research University of Sheffield Sheffield UK British Medical Journal Technology Appraisal Group London UK MRC/CSO Social and Public Health Sciences Unit University of Glasgow Scotland UK School of Geography University of Leeds Leeds UK Department of Public Health LaTrobe University Melbourne Australia Centre for Public Health Queen's University Belfast Belfast UK Population Health Sciences Bristol Medical School University of Bristol Bristol UK NIHR Applied Research Collaboration West (ARC West) Bristol UK Department of Public Health Policy and Systems University of Liverpool Liverpool UK CRESS University of Surrey Guildford UK Department of Automatic Control and Systems Engineering University of Sheffield Sheffield UK Business School University of Newcastle Newcastle UK Lumanity-HEOR South Yorkshire Sheffield UK College of Medicine and Health University of Exeter Exeter UK London School of Hygiene & Tropical Medicine London UK Department of Behavioural Science and Health UCL London UK Brain and Mind Centre University of Sydney New South Wales Camperdown Australia United Kingdom Health Security Agency Birmingham UK MRC/CSO Social and Public Health Sciences Unit University of Glasgow Glasgow UK Centre for Health Economics University of York Heslington UK MRC Biostatistics Unit University of Cambridge Cambridge UK NIHR SPHR London School of Hygiene and Tropical Medicine London UK Centre for Health Economics & Policy Innovation Imperial College Business School London UK Nuffield Department of Population Health University of Oxford Oxfordshire Oxford UK Department of Public Health Health Services Research and Health Technology Assessment UMIT TIROL - University for Health Sciences and Technology Hall in Tirol Tyrol Austria Division of Health Technology Assessment and Bioinformatics ONCOTYROL - Center for Personalized Cancer Medicine Innsbruck Austria Center for Health Decision Science Departments of Epidemio

To help health economic modelers respond to demands for greater use of complex systems models in public health. To propose identifiable features of such models and support researchers to plan public health modeling projects using these models. A working group of experts in complex systems modeling and economic evaluation was brought together to develop and jointly write guidance for the use of complex systems models for health economic analysis. The content of workshops was informed by a scoping review. A public health complex systems model for economic evaluation is defined as a quantitative, dynamic, non-linear model that incorporates feedback and interactions among model elements, in order to capture emergent outcomes and estimate health, economic and potentially other consequences to inform public policies. The guidance covers: when complex systems modeling is needed;principles for designing a complex systems model;and how to choose an appropriate modeling technique. This paper provides a definition to identify and characterize complex systems models for economic evaluations and proposes guidance on key aspects of the process for health economics analysis. This document will support the development of complex systems models, with impact on public health systems policy and decision making.

关键词： complex systems economic modeling public health

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Baseline markers of inflammation, lipids, glucose, and Dietary Inflammatory Index scores do not differ between adults willing to participate in an intensive inflammation reduction intervention and those who do not

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Nutrition and Health 2019年第1期25卷 9-19页

作者： Crimarco, Anthony Turner-McGrievy, Gabrielle M Wirth, Michael D Shivappa, Nitin Dunn, Caroline Vyas, Shraddha Mandes, Trisha Hurley, Thomas G West, Delia Hébert, James R Department of Health Promotion Education and Behavior Arnold School of Public Health University of South Carolina BC United States Department of Epidemiology and Biostatistics Arnold School of Public Health University of South Carolina BC United States Cancer Prevention and Control Program Arnold School of Public Health University of South Carolina BC United States Connecting Health Innovations LLC BC United States Department of Exercise Science Arnold School of Public Health University of South Carolina BC United States

Background: Chronic inflammation is associated with numerous chronic diseases and can be managed with diet. Aim: The purpose of this study was to examine differences in baseline characteristics and plasma inflammation levels between two groups of participants that participated in an intensive, lifestyle intervention or a remotely delivered intervention. This work also assessed the association between Dietary Inflammatory Index (DII)^® scores and participants’ inflammatory and metabolic biomarkers at baseline. Method: Ninety-five participants (61 intervention, 34 control) chose to enroll in either a 12-month intervention consisting of a face-to-face nutrition, physical activity, and stress management intervention or a remotely-delivered intervention (control group) focusing on general cancer prevention. The intervention group met at the University of South Carolina for classes and the control group had materials emailed to them. A quantile regression was used to compare participants’ high-sensitivity C-reactive protein and interleukin-6 levels. Multiple linear regression was used to determine the association between DII scores and biomarkers. Results: There were significant differences in age, body mass index, body fat percentage, and blood pressure between groups, but there were no differences in levels of inflammatory biomarkers. Values of interleukin-6 at the 90th percentile of its distribution were 8.31 pg/ml higher among those in DII quartile 4 compared with quartile 1 (p = 0.02). All other outcomes were not significant. Conclusion: Given similar levels of inflammatory biomarkers, participants opting for the control group would also have benefited from a more intensive lifestyle intervention focusing on reducing inflammation. © The Author(s) 2018.

关键词： Dietary Inflammatory Index Inflammation self-selection trial stress vegetarian diet

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Changing life expectancy in European countries 1990–2021: a subanalysis of causes and risk factors from the Global Burden of Disease Study 2021

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The Lancet Public Health 2025年第3期10卷 e172-e188页

作者： Steel, Nicholas Bauer-Staeb, Clarissa Maria Mercedes Ford, John A. Abbafati, Cristiana Abdalla, Mohammed Altigani Abdelkader, Atef Abdi, Parsa Zuñiga, Roberto Ariel Abeldaño Abiodun, Olugbenga Olusola Abolhassani, Hassan Abu-Gharbieh, Eman Abukhadijah, Hana J. Abu-Zaid, Ahmed Addo, Isaac Yeboah Addolorato, Giovanni Adekanmbi, Victor Adetunji, Juliana Bunmi Adeyeoluwa, Temitayo Esther Agardh, Emilie E. Agyemang-Duah, Williams Ahmad, Danish Ahmed, Ayman Ahmed, Syed Anees Akinosoglou, Karolina Akkaif, Mohammed Ahmed Al Awaidy, Salah Al Hasan, Syed Mahfuz Al Zaabi, Omar Ali Mohammed Aldridge, Robert W. Algammal, Abdelazeem M. Al-Gheethi, Adel Ali Saeed Ali, Abid Ali, Mohammed Usman Ali, Syed Shujait Ali, Waad Alicandro, Gianfranco Alif, Sheikh Mohammad Al-Jumaily, Adel Allebeck, Peter Alrawashdeh, Ahmad Al-Rifai, Rami H. Alsabri, Mohammed A. Alshahrani, Najim Z. Aluh, Deborah Oyine Al-Wardat, Mohammad Al-Zyoud, Walid A. Amiri, Sohrab Anderlini, Deanna Andrei, Catalina Liliana Anil, Abhishek Anvari, Saeid Anyasodor, Anayochukwu Edward Appiah, Seth Christopher Yaw Aquilano, Michele Arabloo, Jalal Arafat, Mosab Areda, Demelash Aremu, Abdulfatai Armani, Keivan Armocida, Benedetta Ärnlöv, Johan Asaduzzaman, Muhammad Astell-Burt, Thomas Aujayeb, Avinash Ausloos, Marcel Azadnajafabad, Sina Aziz, Shahkaar Azzam, Ahmed Y. Babu, Giridhara Rathnaiah Badache, Andreea Corina Badiye, Ashish D. Bahramian, Saeed Baig, Atif Amin Baker, Jennifer L. Bansal, Hansi Bärnighausen, Till Winfried Barone, Mark Thomaz Ugliara Barrow, Amadou Barteit, Sandra Bashir, Shahid Bashiru, Hameed Akande Basso, João Diogo Bastan, Mohammad-Mahdi Basu, Sanjay Batra, Kavita Bauckneht, Matteo Baune, Bernhard T. Beghi, Massimiliano Beiranvand, Maryam Béjot, Yannick Bell, Michelle L. Bello, Olorunjuwon Omolaja Belo, Luis Beloukas, Apostolos Beneke, Alice A. Bettencourt, Paulo J.G. Bhagavathula, Akshaya Srikanth Bhala, Neeraj Bhaskar, Sonu Bisulli, Francesca Bjørge, Tone Bodunrin, Aadam Olalekan Carvajal, Alejandro Botero Bouaoud, Souad Brayne, Carol Brenner, H Department of Primary Care and Public Health University of East Anglia Norwich United Kingdom Office for Health Improvement and Disparities Department of Health and Social Care London United Kingdom Department of Legal and Economic Studies La Sapienza University Rome Italy Rome Italy Hull York Medical School University of Hull Hull United Kingdom Department of Mathematics and Sciences Ajman University Ajman United Arab Emirates Department of Medicine Memorial University St. John's NL Canada Postgraduate Department University of Sierra Sur Miahuatlan de Porfirio Diaz Mexico Yhteiskuntadatatieteen keskus (Centre for Social Data Science) Helsinki Finland Department of Internal Medicine Federal Medical Centre Abuja Nigeria Research Center for Immunodeficiencies Tehran University of Medical Sciences Tehran Iran Department of Medical Biochemistry and Biophysics Karolinska Institutet (Karolinska Institute) Stockholm Sweden Department of Clinical Sciences University of Sharjah Sharjah United Arab Emirates Department of Biopharmaceutics and Clinical Pharmacy University of Jordan Amman Jordan Medical Research Center Hamad Medical Corporation Doha Qatar Department of Biochemistry and Molecular Medicine Alfaisal University Riyadh Saudi Arabia College of Graduate Health Sciences University of Tennessee Memphis TN United States School of Medicine Sydney NSW Australia Centre for Social Research in Health University of New South Wales Sydney NSW Australia Internal Medicine and Alcohol Related Disease Unit Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy Department of Medical and Surgical Sciences Università Cattolica di Roma (Catholic University of Rome) Rome Italy Department of Obstetrics and Gynecology University of Texas Medical Branch Galveston TX United States Department of Biochemistry Osun State University Osogbo Nigeria Department of Pharmacology and Therapeutics University of Medical Sciences Ondo Ondo Nigeria Department of Veteri

Background: Decades of steady improvements in life expectancy in Europe slowed down from around 2011, well before the COVID-19 pandemic, for reasons which remain disputed. We aimed to assess how changes in risk factors and cause-specific death rates in different European countries related to changes in life expectancy in those countries before and during the COVID-19 pandemic. Methods: We used data and methods from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 to compare changes in life expectancy at birth, causes of death, and population exposure to risk factors in 16 European Economic Area countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, the Netherlands, Norway, Portugal, Spain, and Sweden) and the four UK nations (England, Northern Ireland, Scotland, and Wales) for three time periods: 1990–2011, 2011–19, and 2019–21. Changes in life expectancy and causes of death were estimated with an established life expectancy cause-specific decomposition method, and compared with summary exposure values of risk factors for the major causes of death influencing life expectancy. Findings: All countries showed mean annual improvements in life expectancy in both 1990–2011 (overall mean 0·23 years [95% uncertainty interval [UI] 0·23 to 0·24]) and 2011–19 (overall mean 0·15 years [0·13 to 0·16]). The rate of improvement was lower in 2011–19 than in 1990–2011 in all countries except for Norway, where the mean annual increase in life expectancy rose from 0·21 years (95% UI 0·20 to 0·22) in 1990–2011 to 0·23 years (0·21 to 0·26) in 2011–19 (difference of 0·03 years). In other countries, the difference in mean annual improvement between these periods ranged from –0·01 years in Iceland (0·19 years [95% UI 0·16 to 0·21] vs 0·18 years [0·09 to 0·26]), to –0·18 years in England (0·25 years [0·24 to 0·25] vs 0·07 years [0·06 to 0·08]). In 2019–21, there was an overall decrease in mean annual life expectancy a

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Calcium intake and genetic variants in the calcium sensing receptor in relation to colorectal cancer mortality: an international consortium study of 18,952 patients

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BJC reports 2024年第1期2卷 63页

作者： Evertine Wesselink William Gauderman Sonja I Berndt Hermann Brenner Daniel D Buchanan Peter T Campbell Andrew T Chan Jenny Chang-Claude Michelle Cotterchoi Marc J Gunter Michael Hoffmeister Amit D Joshi Christina C Newton Rish K Pai Andrew J Pellatt Amanda I Phipps Mingyang Song Caroline Y Um Bethany van Guelpen Emily White Ulrike Peters Fränzel J B van Duijnhoven Division of Human Nutrition and Health Wageningen University & Research Wageningen The Netherlands. Division of Biostatistics Department of Population and Public Health Sciences Keck School of Medicine University of Southern California Los Angeles CA USA. Division of Cancer Epidemiology and Genetics National Cancer Institute National Institutes of Health Bethesda MD USA. Division of Clinical Epidemiology and Aging Research German Cancer Research Center (DKFZ) Heidelberg Germany. Division of Preventive Oncology German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg Germany. German Cancer Consortium (DKTK) German Cancer Research Center (DKFZ) Heidelberg Germany. Colorectal Oncogenomics Group Department of Clinical Pathology Melbourne Medical School The University of Melbourne Parkville VIC Australia. University of Melbourne Centre for Cancer Research The University of Melbourne Parkville VIC Australia. Genomic Medicine and Family Cancer Clinic The Royal Melbourne Hospital Parkville VIC Australia. Department of Epidemiology and Population Health Albert Einstein College of Medicine Bronx NY USA. Division of Gastroenterology Massachusetts General Hospital and Harvard Medical School Boston MA USA. Channing Division of Network Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA USA. Clinical and Translational Epidemiology Unit Massachusetts General Hospital and Harvard Medical School Boston MA USA. Broad Institute of Harvard and MIT Cambridge MA USA. Department of Epidemiology Harvard T.H. Chan School of Public Health Harvard University Boston MA USA. Division of Cancer Epidemiology German Cancer Research Center (DKFZ) Heidelberg Germany. University Medical Centre Hamburg-Eppendorf University Cancer Centre Hamburg (UCCH) Hamburg Germany. Prevention and Cancer Control Cancer Care Ontario Toronto ON Canada. Dalla Lana School of Public Health University of Toronto Toronto ON Canada. Nutrition and Metab

Background:Research on calcium intake as well as variants in the calcium sensor receptor ( gene and their interaction in relation to CRC survival is still limited. Methods:Data from 18,952 CRC patients, were included. Associations between primarily pre-diagnostic dietary ( = 13.085), supplemental ( = 11,837), total calcium intake ( = 5970) as well as 325 single nucleotide polymorphisms (SNPs) of the gene ( = 15,734) in relation to CRC-specific and all-cause mortality were assessed using Cox proportional hazard models. Also interactions between calcium intake and variants in the gene were assessed. Results:During a median follow-up of 4.8 years (IQR 2.4-8.4), 6801 deaths occurred, of which 4194 related to CRC. For all-cause mortality, no associations were observed for the highest compared to the lowest sex- and study-specific quartile of dietary (HR 1.00, 95%CI 0.92-1.09), supplemental (HR 0.97, 95%CI 0.89-1.06) and total calcium intake (HR 0.99, 95%CI 0.88-1.11). No associations with CRC-specific mortality were observed either. Interactions were observed between supplemental calcium intake and several SNPs of the gene. Conclusion:Calcium intake was not associated with all-cause or CRC-specific mortality in CRC patients. The association between supplemental calcium intake and all-cause and CRC-specific mortality may be modified by genetic variants in the gene.

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Correction to: The dietary inflammatory index is associated with anti and pro‑inflammatory adipokines in Brazilian schoolchildren

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European journal of nutrition 2021年第5期60卷 2851-2853页

作者： Lara Gomes Suhett H H M Hermsdorff Sarah Aparecida Vieira Ribeiro Mariana De Santis Filgueiras Nitin Shivappa James R Hébert Juliana Farias de Novaes Department of Nutrition and Health Universidade Federal de Viçosa (UFV) Av. P.H. Rolfs s/n Campus Universitário Viçosa Minas Gerais 36570-000 Brazil. nutrilarasuhett@***. Department of Nutrition and Health Universidade Federal de Viçosa (UFV) Av. P.H. Rolfs s/n Campus Universitário Viçosa Minas Gerais 36570-000 Brazil. Department of Epidemiology and Biostatistics Arnold School of Public Health University of South Carolina Columbia SC USA. Statewide Cancer Prevention and Control Program (CPCP) Arnold School of Public Health University of South Carolina 915 Greene Street Columbia SC 29208 USA. Department of Nutrition Connecting Health Innovations (CHI) 1417 Gregg Street Columbia SC 29201 USA.

A correction to this paper has been published: https://***/10.1007/s00394-021-02544-w

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Show me the roads and give me a road map: Development of a patient conversation tool to improve lung cancer treatment decision-making

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PEC Innovation 2022年 1卷 100094-100094页

作者： Golden, Sara E. Disher, Natalie Dieckmann, Nathan F. Eden, Karen B. Matlock, Daniel Vranas, Kelly C. Slatore, Christopher G. Sullivan, Donald R. Center to Improve Veteran Involvement in Care VA Portland Health Care System (VAPORHCS) Portland OR United States School of Nursing Oregon Health and Science University (OHSU) Portland OR United States Division of Psychology School of Medicine OHSU Portland OR United States Department of Medical Informatics and Clinic Epidemiology OHSU Portland OR United States Division of Geriatric Medicine University of Colorado School of Medicine Aurora CO United States Eastern Colorado Geriatric Research Education and Clinical Center Denver CO United States Section of Pulmonary and Critical Care Medicine VAPORHCS Portland OR United States Division of Pulmonary Allergy and Critical Care Medicine OHSU Portland OR United States Cancer Prevention and Control Program Knight Cancer Institute OHSU Portland OR United States

Objective: Evidence-based decision support resources do not exist for persons with lung cancer. We sought to develop and refine a treatment decision support, or conversation tool, to improve shared decision-making (SDM). Methods: We conducted a multi-site study among patients with stage I-IV non-small cell lung cancer (NSCLC) who completed or had ongoing lung cancer treatment using semi-structured, cognitive qualitative interviews to assess participant understanding of content. We used an integrated approach of deductive and inductive thematic analysis. Results: Twenty-seven patients with NSCLC participated. Participants with prior cancer experiences or those with family members with prior cancer experiences reported better preparedness for cancer treatment decision-making. All participants agreed the conversation tool would be helpful to clarify their thinking about values, comparisons, and goals of treatment, and to help patients communicate more effectively with their clinicians. Conclusion: Participants reported that the tool may empower them with confidence and agency to actively participate in cancer treatment SDM. The conversation tool was acceptable, comprehensible, and usable. Next steps will test effectiveness on patient-centered and decisional outcomes. Innovation: A personalized conversation tool using consequence tables and core SDM components is novel in that it can encourage a tailored, conversational dynamic and includes patient-centered values along with traditional decisional outcomes. © 2022

关键词： Decision support techniques Lung neoplasm Qualitative research

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STREAMLINE: AN AUTOMATED MACHINE LEARNING PIPELINE FOR BIOMEDICINE APPLIED TO EXAMINE THE UTILITY OF PHOTOGRAPHY-BASED PHENOTYPES FOR OSA PREDICTION ACROSS INTERNATIONAL SLEEP CENTERS

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arXiv 2023年

作者： Urbanowicz, Ryan J. Bandhey, Harsh Keenan, Brendan T. Maislin, Greg Hwang, Sy Mowery, Danielle L. Lynch, Shannon M. Mazzotti, Diego R. Han, Fang Li, Qing Yun Penzel, Thomas Tufik, Sergio Bittencourt, Lia Gislason, Thorarinn de Chazal, Philip Singh, Bhajan McArdle, Nigel Chen, Ning-Hung Pack, Allan Schwab, Richard J. Cistulli, Peter A. Magalang, Ulysses J. Department of Computational Biomedicine Cedars Sinai Medical Center Los AngelesCA United States Division of Sleep Medicine Department of Medicine University of Pennsylvania PhiladelphiaPA United States Institute for Biomedical Informatics University of Pennsylvania PhiladelphiaPA United States Department of Biostatistics Epidemiology and Informatics University of Pennsylvania PhiladelphiaPA United States Cancer Prevention and Control Program Fox Chase Cancer Center PhiladelphiaPA United States Division of Medical Informatics Department of Internal Medicine University of Kansas LawrenceKS United States Division of Pulmonary Critical Care and Sleep Medicine Department of Internal Medicine University of Kansas LawrenceKS United States Division of Sleep Medicine Peking University People’s Hospital Beijing China Department of Respiratory and Critical Care Medicine Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China Interdisciplinary Center of Sleep Medicine Charite University Hospital Berlin Germany Department of Psychobiology Federal University of Sao Paulo Sao Paulo Brazil Department of Sleep Medicine Landspitali University Hospital Reykjavik Iceland University of Iceland Faculty of Medicine Reykjavik Iceland Charles Perkins Center Faculty of Engineering University of Sydney Sydney Australia Department of Pulmonary Physiology and Sleep Medicine Sir Charles Gairdner Hospital Nedlands Australia University of Western Australia Crawley Australia Department of Pulmonary and Critical Care Medicine Sleep Center Linkou Chang Gung Memorial Hospital Taoyuan Taiwan Charles Perkins Centre Faculty of Medicine and Health University of Sydney Royal North Shore Hospital Sydney Australia Division of Pulmonary Critical Care and Sleep Medicine Department of Medicine Ohio State University Wexner Medical Center ColumbusOH United States 700 N. San Vicente Blvd. Pacific Design Center Suite G541E Los AngelesCA90069 United States

Objective: While machine learning (ML) includes a valuable array of tools for analyzing biomedical data with multivariate and complex underlying associations, significant time and expertise is required to assemble effective, rigorous, comparable, reproducible, and unbiased pipelines. Automated ML (AutoML) tools seek to facilitate ML application by automating a subset of analysis pipeline elements. In this study we develop and validate a Simple, Transparent, End-to-end Automated Machine Learning Pipeline (STREAMLINE) and apply it to investigate the added utility of photography-based phenotypes for predicting obstructive sleep apnea (OSA);a common and underdiagnosed condition associated with a variety of health, economic, and safety consequences. Methods: STREAMLINE is designed to tackle biomedical binary classification tasks while (1) avoiding common mistakes, (2) accommodating complex associations and common data challenges, and (3) allowing scalability, reproducibility, and model interpretation. It automates the majority of established, generalizable, and reliably automatable aspects of an ML analysis pipeline while incorporating cutting edge algorithms and providing opportunities for human-in-the-loop customization. We present a broadly refactored and extended release of STREAMLINE, validating and benchmarking performance across simulated and real-world datasets. Then we applied STREAMLINE to evaluate the utility of demographics (DEM), self-reported comorbidities (DX), symptoms (SYM), and photography-based craniofacial (CF) and intraoral (IO) anatomy measures in predicting ‘any OSA’ or ‘moderate/severe OSA’ using 3,111 participants from Sleep Apnea Global Interdisciplinary Consortium (SAGIC). Results: Benchmarking analyses validated the efficacy of STREAMLINE across data simulations with increasingly complex patterns of association including epistatic interactions and genetic heterogeneity. OSA analyses identified a significant increase in ROC-AUC when adding CF t

关键词： Machine learning

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Highly processed foods intake is positively associated with pro-inflammatory potential of diet: cross-sectional analysis from the Moli-sani Study

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Nutrition, Metabolism and Cardiovascular Diseases 2021年第11期31卷 3253-3253页

作者： C. Mignogna S. Costanzo E. Ruggiero N. Shivappa J.R. Hebert S. Esposito A. Di Castelnuovo M. Persichillo C. Cerletti M.B. Donati G. De Gaetano L. Iacoviello M. Bonaccio Dep. Medicine and Surgery Research Center in Epidemiology and Preventive Medicine EPIMED University of Insubria Varese Italy Dep. Epidemiology and Prevention IRCCS NEUROMED Pozzilli Italy Cancer Prevention and Control Program Dep. Epidemiology and Biostatistics Arnold School of Public Health University of South Carolina Columbia US Dep. Nutrition Connecting Health Innovations LLC Columbia US Mediterranea Cardiocentro Napoli Italy

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Randomized trial of a community-based, culturally tailored intervention: High engagement among Latina breast cancer survivors

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cancer 2025年第11期131卷 e35842页

作者： Katarina E AuBuchon Claudia J Campos Galván Ysabel Duron Ivis Sampayo Migdalia Torres Alejandra Hurtado-de-Mendoza Charlene Kuo Christina Rush Maria Gloria Elliott Jennie Santiago Olympia Cepeda Laura A Logie Astrid Jimenez George Luta Kristi D Graves Cancer Prevention and Control Program Department of Oncology Lombardi Comprehensive Cancer Center Georgetown University Washington District of Columbia USA. Community Outreach and Engagement George Washington University Washington District of Columbia USA. Latino Cancer Institute San Jose California USA. LatinaSHARE New York New York USA. Red Door Community (formerly Gilda's Club New York City) New York New York USA. Department of Behavioral and Community Health School of Public Health University of Maryland Baltimore Maryland USA. Department of Psychiatry Massachusetts General Hospital Center for Health Outcomes and Interdisciplinary Research Harvard University Boston Massachusetts USA. Nueva Vida Inc Alexandria Virginia USA. Department of Biostatistics Bioinformatics and Biomathematics Georgetown University Washington District of Columbia USA.

BACKGROUND:A preliminary randomized controlled trial was conducted to evaluate the impact of a culturally tailored, group-based intervention for Latina breast cancer survivors (BCSs) and their caregivers on survivors' quality of life (QOL) compared to usual care services provided by community-based organizations. METHODS:This study randomized 136 Latina BCSs and 136 caregivers in Washington, DC; New York, New York; and San Jose, California to an eight-session culturally tailored coping and communication intervention (n = 70 dyads) or usual care support services via community-based organizations (n = 66 dyads). QOL domains (anxiety, depression, fatigue, physical functioning, and social functioning) were measured at baseline, immediately post-intervention, and 6 months post-intervention. RESULTS:Among the 70 dyads in the intervention, 71.4% (n = 50) attended five or more of the eight sessions, which demonstrated high engagement; 82% of participants were retained at 6 months. Results indicated clinically significant improvements in Latina BCSs' reports of anxiety and fatigue at 6 months postintervention compared to BCSs in usual care; however, after adjustment for multiple comparisons, results were not statistically significant. CONCLUSIONS:A culturally tailored, group-based intervention for Latina BCSs and their caregivers led to clinically relevant but not statistically significant improvements in survivors' anxiety and fatigue compared to usual services provided by community-based organizations. Interventions conducted in partnership with community-based organizations yield high engagement and retention; these types of collaborative approaches to psychosocial services have the potential to positively affect Latina BCSs' QOL.

关键词： Latina breast cancer caregiving community‐based research intervention survivorship

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Authors' Response

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Journal of the American College of Radiology : JACR 2022年第3期19卷 404-405页

作者： Erin A Hirsch Anna E Barón Betsy Risendal Jamie L Studts Melissa L New Stephen P Malkoski Division of Medical Oncology School of Medicine University of Colorado Anschutz Medical Campus Aurora Colorado. Electronic address: Erin.Hirsch@cuanschutz.edu. Department of Biostatistics and Informatics Colorado School of Public Health University of Colorado Anschutz Medical Campus Aurora Colorado. Department of Community and Behavioral Health Colorado School of Public Health University of Colorado Anschutz Medical Campus Aurora Colorado. Division of Medical Oncology and Cancer Prevention and Control Program University of Colorado Anschutz Medical Campus Aurora Colorado. Pulmonary Section Rocky Mountain Regional VA Medical Center Aurora Colorado and Division of Pulmonary Sciences and Critical Care Medicine University of Colorado Anschutz Medical Campus Aurora Colorado. Division of Pulmonary Sciences and Critical Care Medicine University of Colorado Anschutz Medical Campus Aurora Colorado Department of Medicine University of Washington WWAMI-Spokane Spokane Washington and Sound Critical Care Sacred Heart Medical Center Spokane Washington.

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