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Article ; Online: A statewide program providing colorectal cancer screening to the uninsured of South Carolina.

Eberth, Jan M / Thibault, Annie / Caldwell, Renay / Josey, Michele J / Qiang, Beidi / Peña, Edsel / LaFrance, Delecia / Berger, Franklin G

Cancer

2018 Volume 124, Issue 9, Page(s) 1912–1920

Abstract: ... residents of South Carolina through established, statewide partnerships and patient navigation. Herein ... in South Carolina. Screening is performed by board-certified gastroenterologists. Descriptive statistics and ...

Abstract	Background: Cancer screening rates are lowest in those without insurance or a regular provider. Since 2008, the Colorectal Cancer Prevention Network (CCPN) has provided open access colonoscopy to uninsured residents of South Carolina through established, statewide partnerships and patient navigation. Herein, we describe the structure, implementation, and clinical outcomes of this program. Methods: The CCPN provides access to colonoscopy screening at no cost to uninsured, asymptomatic patients aged 50-64 years (African Americans age 45-64 years are eligible) who live at or below 150% of the poverty line and seek medical care in free medical clinics, federally qualified health centers, or hospital-based indigent practices in South Carolina. Screening is performed by board-certified gastroenterologists. Descriptive statistics and regression analysis are used to describe the population screened, and to assess compliance rates and colonoscopy quality metrics. Results: Out of >4000 patients referred to the program, 1854 were deemed eligible, 1144 attended an in-person navigation visit, and 1030 completed a colonoscopy; 909 were included in the final sample. Nearly 90% of participants exhibited good-to-excellent bowel preparation. An overall cecal intubation rate of 99% was measured. The polyp detection rate and adenoma detection rate were 63% and 36%, respectively, with male sex and urban residence positively associated with adenoma detection. Over 13% of participants had an advanced polyp, and 1% had a cancer diagnosis or surgical intervention. Conclusion: The CCPN program is characterized by strong collaboration with clinicians statewide, low no-show rates, and high colonoscopy quality. Future work will assess the effectiveness of the navigation approach and will explore the mechanisms driving higher adenoma detection in urban participants. Cancer 2018;124:1912-20. © 2018 American Cancer Society.
MeSH term(s)	Asymptomatic Diseases ; Colonoscopy/statistics & numerical data ; Colorectal Neoplasms/diagnostic imaging ; Colorectal Neoplasms/epidemiology ; Early Detection of Cancer/statistics & numerical data ; Female ; Health Services Accessibility/statistics & numerical data ; Humans ; Male ; Mass Screening/statistics & numerical data ; Medically Uninsured/statistics & numerical data ; Middle Aged ; No-Show Patients/statistics & numerical data ; Patient Navigation/statistics & numerical data ; Poverty/statistics & numerical data ; Program Evaluation ; Rural Population/statistics & numerical data ; Sex Factors ; South Carolina/epidemiology ; State Health Plans/statistics & numerical data ; Urban Population/statistics & numerical data
Language	English
Publishing date	2018-02-07
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1429-1
ISSN	1097-0142 ; 0008-543X ; 1934-662X
ISSN (online)	1097-0142
ISSN	0008-543X ; 1934-662X
DOI	10.1002/cncr.31250
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Article ; Online: Perspectives from the Field: HIV Testing and Linkage to Care in North Carolina.

Sullivan, Kristen A / Berger, Miriam B / Quinlivan, Evelyn Byrd / Parnell, Heather E / Sampson, Lynne A / Clymore, Jacquelyn M / Wilkin, Aimee M

Journal of the International Association of Providers of AIDS Care

2016 Volume 15, Issue 6, Page(s) 477–485

Abstract: ... These issues are explored in North Carolina (NC), with potential applicability to other Southern states ...

Abstract	Background: HIV testing and linkage to care are critical first steps along the care continuum. Targeted efforts are needed in the South to achieve the goals of the National HIV/AIDS Strategy, and qualitative examination of testing and linkage to care from the perspective of professionals in the field can provide nuanced insight into the strengths and limitations of a care system to inform improvement efforts. These issues are explored in North Carolina (NC), with potential applicability to other Southern states. Methods: Twenty-one interviews were conducted with professionals in the HIV prevention and care systems in NC. Interviews were analyzed for emergent themes. Results: Individuals' access barriers, aspects of clinics and clinical care, challenges for community-based organizations, stigma, and the role of the NC Department of Health and Human Services were identified as themes affecting testing and linkage. Discussion: These findings can inform efforts to address HIV testing and linkage to care in NC. This approach may provide beneficial insight for other systems of care.
Language	English
Publishing date	2016-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2709037-1
ISSN	2325-9582 ; 2325-9574
ISSN (online)	2325-9582
ISSN	2325-9574
DOI	10.1177/2325957415617830
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Article: Implementation of the North Carolina HIV Bridge Counseling Program to Facilitate Linkage and Reengagement in Care for Individuals Infected with HIV/AIDS.

Swygard, H / Seña, Arlene C / Mobley, V / Clymore, J / Sampson, L / Glenn, K / Keller, J E / Donovan, J / Berger, M B / Durr, A / Klein, E / Sullivan, K A / Quinlivan, E B

North Carolina medical journal

2018 Volume 79, Issue 4, Page(s) 210–217

Abstract: ... ...

Abstract	BACKGROUND
MeSH term(s)	Counseling ; HIV Infections/prevention & control ; HIV Infections/psychology ; Health Plan Implementation ; Health Services Accessibility ; Humans ; North Carolina ; Patient Acceptance of Health Care ; Patient Compliance ; Referral and Consultation
Language	English
Publishing date	2018-07-11
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	422795-5
ISSN	0029-2559
ISSN	0029-2559
DOI	10.18043/ncm.79.4.210
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Article ; Online: Barriers and Facilitators to Retaining and Reengaging HIV Clients in Care: A Case Study of North Carolina.

Berger, Miriam B / Sullivan, Kristen A / Parnell, Heather E / Keller, Jennifer / Pollard, Alice / Cox, Mary E / Clymore, Jacquelyn M / Quinlivan, Evelyn Byrd

Journal of the International Association of Providers of AIDS Care

2016 Volume 15, Issue 6, Page(s) 486–493

Abstract: ... care engagement, a qualitative case study was conducted in North Carolina to examine the barriers and ...

Abstract	Retention in HIV care is critical to decrease disease-related mortality and morbidity and achieve national benchmarks. However, a myriad of barriers and facilitators impact retention in care; these can be understood within the social-ecological model. To elucidate the unique factors that impact consistent HIV care engagement, a qualitative case study was conducted in North Carolina to examine the barriers and facilitators to retain and reengage HIV clients in care. HIV professionals (n = 21) from a variety of health care settings across the state participated in interviews that were transcribed and analyzed for emergent themes. Respondents described barriers to care at all levels within the HIV prevention and care system including intrapersonal, interpersonal, institutional, community, and public policy. Participants also described recent statewide initiatives with the potential to improve care engagement. Results from this study may assist other states with similar challenges to identify needed programs and priorities to optimize client retention in HIV care.
Language	English
Publishing date	2016-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2709037-1
ISSN	2325-9582 ; 2325-9574
ISSN (online)	2325-9582
ISSN	2325-9574
DOI	10.1177/2325957415616491
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Article ; Online: Race and Prevalence of Large Bowel Polyps Among the Low-Income and Uninsured in South Carolina.

Wallace, Kristin / Brandt, Heather M / Bearden, James D / Blankenship, Bridgette F / Caldwell, Renay / Dunn, James / Hegedus, Patricia / Hoffman, Brenda J / Marsh, Courtney H / Marsh, William H / Melvin, Cathy L / Seabrook, March E / Sterba, Ronald E / Stinson, Mary Lou / Thibault, Annie / Berger, Franklin G / Alberg, Anthony J

Digestive diseases and sciences

2015 Volume 61, Issue 1, Page(s) 265–272

Abstract: Background: Compared to whites, blacks have higher colorectal cancer incidence and mortality rates and are at greater risk for early-onset disease. The reasons for this racial disparity are poorly understood, but one contributing factor could be ... ...

Abstract	Background: Compared to whites, blacks have higher colorectal cancer incidence and mortality rates and are at greater risk for early-onset disease. The reasons for this racial disparity are poorly understood, but one contributing factor could be differences in access to high-quality screening and medical care. Aims: The present study was carried out to assess whether a racial difference in prevalence of large bowel polyps persists within a poor and uninsured population (n = 233, 124 blacks, 91 whites, 18 other) undergoing screening colonoscopy. Methods: Eligible patients were uninsured, asymptomatic, had no personal history of colorectal neoplasia, and were between the ages 45-64 years (blacks) or 50-64 years (whites, other). We examined the prevalence of any adenoma (conventional, serrated) and then difference in adenoma/polyp type by race and age categories. Results: Prevalence for ≥1 adenoma was 37 % (95 % CI 31-43 %) for all races combined and 36 % in blacks <50 years, 38 % in blacks ≥50 years, and 35 % in whites. When stratified by race, blacks had a higher prevalence of large conventional proximal neoplasia (8 %) compared to whites (2 %) (p value = 0.06) but a lower prevalence of any serrated-like (blacks 18 %, whites 32 %; p value = 0.02) and sessile serrated adenomas/polyps (blacks 2 %, whites 8 % Chi-square p value; p = 0.05). Conclusions: Within this uninsured population, the overall prevalence of adenomas was high and nearly equal by race, but the racial differences observed between serrated and conventional polyp types emphasize the importance of taking polyp type into account in future research on this topic.
MeSH term(s)	Adenomatous Polyps/diagnosis ; Adenomatous Polyps/economics ; Adenomatous Polyps/ethnology ; Black or African American ; Colonic Neoplasms/diagnosis ; Colonic Neoplasms/economics ; Colonic Neoplasms/ethnology ; Colonic Polyps/diagnosis ; Colonic Polyps/economics ; Colonic Polyps/ethnology ; Colonoscopy ; Female ; Health Status Disparities ; Healthcare Disparities/economics ; Healthcare Disparities/ethnology ; Humans ; Male ; Medically Uninsured/ethnology ; Middle Aged ; Poverty/economics ; Poverty/ethnology ; Predictive Value of Tests ; Prevalence ; Risk Factors ; South Carolina/epidemiology ; White People
Language	English
Publishing date	2015-09-19
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	304250-9
ISSN	1573-2568 ; 0163-2116
ISSN (online)	1573-2568
ISSN	0163-2116
DOI	10.1007/s10620-015-3862-y
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Article ; Online: Optimal colorectal cancer screening in states' low-income, uninsured populations—the case of South Carolina.

van der Steen, Alex / Knudsen, Amy B / van Hees, Frank / Walter, Gailya P / Berger, Franklin G / Daguise, Virginie G / Kuntz, Karen M / Zauber, Ann G / van Ballegooijen, Marjolein / Lansdorp-Vogelaar, Iris

Health services research

2014 Volume 50, Issue 3, Page(s) 768–789

Abstract: ... immunochemical testing (FIT).: Data sources/study setting: South Carolina's low-income, uninsured population ... program using colonoscopy versus a program using annual FIT in South Carolina's low-income, uninsured ...

Abstract	Objective: To determine whether, given a limited budget, a state's low-income uninsured population would have greater benefit from a colorectal cancer (CRC) screening program using colonoscopy or fecal immunochemical testing (FIT). Data sources/study setting: South Carolina's low-income, uninsured population. Study design: Comparative effectiveness analysis using microsimulation modeling to estimate the number of individuals screened, CRC cases prevented, CRC deaths prevented, and life-years gained from a screening program using colonoscopy versus a program using annual FIT in South Carolina's low-income, uninsured population. This analysis assumed an annual budget of $1 million and a budget availability of 2 years as a base case. Principal findings: The annual FIT screening program resulted in nearly eight times more individuals being screened, and more important, approximately four times as many CRC deaths prevented and life-years gained than the colonoscopy screening program. Our results were robust for assumptions concerning economic perspective and the target population, and they may therefore be generalized to other states and populations. Conclusions: A FIT screening program will prevent more CRC deaths than a colonoscopy-based program when a state's budget for CRC screening supports screening of only a fraction of the target population.
MeSH term(s)	African Americans ; Age Factors ; Colonoscopy/economics ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/ethnology ; Colorectal Neoplasms/prevention & control ; Computer Simulation ; Cost-Benefit Analysis ; Costs and Cost Analysis ; Early Detection of Cancer/economics ; Early Detection of Cancer/methods ; European Continental Ancestry Group ; Feces ; Humans ; Immunoassay/economics ; Immunoassay/methods ; Medically Uninsured/statistics & numerical data ; Middle Aged ; Patient Compliance ; Poverty ; Sex Factors ; South Carolina
Language	English
Publishing date	2014-10-16
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	410435-3
ISSN	1475-6773 ; 0017-9124
ISSN (online)	1475-6773
ISSN	0017-9124
DOI	10.1111/1475-6773.12246
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Article: Breast cancer disparities in South Carolina: early detection, special programs, and descriptive epidemiology.

Adams, Swann Arp / Hebert, James R / Bolick-Aldrich, Susan / Daguise, Virginie G / Mosley, Catishia M / Modayil, Mary V / Berger, Sondra H / Teas, Jane / Mitas, Michael / Cunningham, Joan E / Steck, Susan E / Burch, James / Butler, William M / Horner, Marie-Josephe D / Brandt, Heather M

Journal of the South Carolina Medical Association (1975)

2007 Volume 102, Issue 7, Page(s) 231–239

Abstract: ... American women in South Carolina. The relationship between tumor grade and the estrogen ... disparities is completely unknown. The South Carolina Cancer Disparities Community Network (SCCDCN) has ... with their church congregation. A replication of such a program in South Carolina has great potential ...

Abstract	A discrepancy exists between mortality and incidence rates between African-American and European-American women in South Carolina. The relationship between tumor grade and the estrogen/ progesterone receptor status is different in African-American and European-American women. African-American women with breast cancer should be encouraged to participate in clinical trials, with the goal of identifying biological factors that might facilitate the detection of tumors at an earlier stage and the development of more effective therapies. The most important of our goals is to design studies to reduce the incidence of the disease and interventions to improve survival and quality of life. The importance of participation in research cannot be overstated. Reproductive factors such as early pregnancy and multiple pregnancies are strongly related to breast cancer risk, however, promotion of these factors as a "prevention strategy," clearly does not lead to cogent, comprehensive public health messages. Data from ecological and migrant studies point clearly to other factors that may be important such as diet. Additional research around primary prevention strategies is needed. In addition, yearly mammograms (secondary prevention) are recommended for women over 50 years old or those with relatives who have developed breast cancer. The Best Chance Network, as a provider of screenings to low-income, uninsured women, has helped to narrow the racial gap in screening that otherwise might exist (see Figures 3 and 4) to a large extent. The determination for timing of surgery after diagnosis needs additional consideration. For example, factors such as effective screening in younger women, timing of screening and surgery in relationship to the ovulatory cycle, and season of screening and surgery may have a great impact on outcomes and may offer some insight into the process of carcinogenesis and therapeutic efficacy. Research into this area is so novel that the impact on possible ethnic disparities is completely unknown. The South Carolina Cancer Disparities Community Network (SCCDCN) has identified the following areas as potential research foci: Identification of small media interventions as an effective strategy to motivate targeted populations, especially those least likely to seek screening for breast cancer and those least likely to participate in research programs (African-Americans). Utilization of breast cancer survivors, self-identified as community natural helpers, can share their experiences with their church congregation. A replication of such a program in South Carolina has great potential because of the strong presence of the church, especially in rural parts of the state. Programs that closely integrate religion with screening women for breast cancer are promising in this state. Development of a mammography registry whereby information on all mammography procedures would be collected within a single database system (much like a central cancer registry). This would aid in identifying population groups that could be targeted for special programs and in the examination and exploration of the most appropriate modalities of detection. Such a resource could also be a useful tool to encourage screening. Thus, this focus area has the potential to benefit epidemiologic and health promotion research on many different levels. Additional breast cancer screening methods should not be overlooked as a potential research focus. Mammography is not the only valid screening method for breast cancer. Magnetic resonance imaging has shown some promise for screening among women with a genetic predisposition for cancer. Another promising avenue is thermography. Because detection rates may depend on age, ethnicity, and breast mammographic characteristics, women for whom regular screening methods do not detect their cancers (e.g. older age, African-American ethnicity, dense breasts) must be identified and other screening methods promoted within these populations. The above-mentioned mammography registry would support this type of research.
MeSH term(s)	Black or African American/statistics & numerical data ; Breast Neoplasms/epidemiology ; Breast Neoplasms/ethnology ; Breast Neoplasms/prevention & control ; Community Networks ; Female ; Health Services Accessibility ; Humans ; Incidence ; Mass Screening ; Preventive Medicine ; Socioeconomic Factors ; South Carolina/epidemiology ; White People/statistics & numerical data
Language	English
Publishing date	2007-02-20
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S. ; Review
ZDB-ID	603510-3
ISSN	0038-3139
ISSN	0038-3139
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Article ; Online: Reperfusion of acute myocardial infarction in North Carolina emergency departments (RACE): study design.

Jollis, James G / Mehta, Rajendra H / Roettig, Mayme Lou / Berger, Peter B / Babb, Joseph D / Granger, Christopher B

American heart journal

2006 Volume 152, Issue 5, Page(s) 851.e1–11

Abstract: ... of patients with STEMI in 5 geographic regions in North Carolina. The RACE project was created by an alliance ...

Abstract	Despite the accumulation of almost 2 decades of data in support of rapid reperfusion therapy for ST-segment elevation myocardial infarction (STEMI), the United States healthcare system still faces serious challenges in providing reperfusion to all eligible patients in a timely fashion. American College of Cardiology/American Heart Association guidelines call for systematic interventions aimed at improving both the proportion of patients receiving reperfusion and the timeliness of treatment. We designed a project (RACE) that incorporates standardized protocols and integrated systems for treatment and timely transfer (when appropriate) of patients with STEMI in 5 geographic regions in North Carolina. The RACE project was created by an alliance between national and regional professional societies, a local payer, the pharmaceutical, and healthcare providers, including emergency medical services, emergency medicine, cardiology, and hospital administrations. The main outcomes of interest are rates of reperfusion and time to treatment. Collected data will also provide important insights into barriers to timely reperfusion. The goal of the RACE project is to provide a model for improving the care of patients with STEMI by identifying those features associated with significant improvement, as well as those imposing significant barriers to appropriate therapy.
MeSH term(s)	Angioplasty, Balloon, Coronary ; Emergency Medical Services/organization & administration ; Emergency Service, Hospital/organization & administration ; Fibrinolytic Agents/therapeutic use ; Health Services Accessibility/organization & administration ; Health Services Accessibility/standards ; Humans ; Myocardial Infarction/therapy ; North Carolina ; Regional Medical Programs ; Research Design ; Time Factors ; United States
Chemical Substances	Fibrinolytic Agents
Language	English
Publishing date	2006-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80026-0
ISSN	1097-6744 ; 0002-8703
ISSN (online)	1097-6744
ISSN	0002-8703
DOI	10.1016/j.ahj.2006.06.036
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Article: Minimally invasive total hip arthroplasty. Development, early results, and a critical analysis. Presented at the Annual Meeting of the American Orthopaedic Association, Charleston, South Carolina, USA, June 14, 2003.

Berry, Daniel J / Berger, Richard A / Callaghan, John J / Dorr, Lawrence D / Duwelius, Paul J / Hartzband, Mark A / Lieberman, Jay R / Mears, Dana C

The Journal of bone and joint surgery. American volume

2003 Volume 85, Issue 11, Page(s) 2235–2246

MeSH term(s)	Arthroplasty, Replacement, Hip/methods ; Humans ; Minimally Invasive Surgical Procedures
Language	English
Publishing date	2003-11
Publishing country	United States
Document type	Congress ; Research Support, Non-U.S. Gov't
ZDB-ID	220625-0
ISSN	1535-1386 ; 0021-9355
ISSN (online)	1535-1386
ISSN	0021-9355
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Article ; Online: Impact of high-risk disease on the efficacy of chimeric antigen receptor T-cell therapy for multiple myeloma: a meta-analysis of 723 patients.

Gagelmann, Nico / Ayuk, Francis A / Klyuchnikov, Evgeny / Wolschke, Christine / Berger, Susanna Carolina / Kröger, Nicolaus

Haematologica

2023 Volume 108, Issue 10, Page(s) 2799–2802

MeSH term(s)	Humans ; Receptors, Chimeric Antigen/genetics ; Multiple Myeloma/therapy ; Immunotherapy, Adoptive/adverse effects ; T-Lymphocytes ; Cell- and Tissue-Based Therapy ; B-Cell Maturation Antigen ; Receptors, Antigen, T-Cell/genetics
Chemical Substances	Receptors, Chimeric Antigen ; B-Cell Maturation Antigen ; Receptors, Antigen, T-Cell
Language	English
Publishing date	2023-10-01
Publishing country	Italy
Document type	Meta-Analysis ; Journal Article
ZDB-ID	2333-4
ISSN	1592-8721 ; 0017-6567 ; 0390-6078
ISSN (online)	1592-8721
ISSN	0017-6567 ; 0390-6078
DOI	10.3324/haematol.2022.282510
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