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Article: Community Health workers United to Reduce Colorectal cancer and cardiovascular disease among people at Higher risk (CHURCH): study protocol for a randomized controlled trial.

Williams, Olajide / Ting, Tina / Matthews, Lisa / Block, Gladys / Block, Torin / Teresi, Jeanne / Eimicke, Joseph / Kong, Jian / Silver, Stephanie / Ravenell, Joseph / Mallaiah, Janhavi / Jammalamadaka, Soujanya / Nelson, Laura Maudene / Karmally, Wahida / Hankerson, Sidney

Research square

2024

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2024-04-09
Publishing country	United States
Document type	Preprint
DOI	10.21203/rs.3.rs-3797889/v1
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Article ; Online: Using economic evaluations in implementation science to increase transparency in costs and outcomes for organizational decision-makers.

Saldana, Lisa / Ritzwoller, Debra P / Campbell, Mark / Block, Eryn Piper

Implementation science communications

2022 Volume 3, Issue 1, Page(s) 40

Abstract: Background: Economic evaluations frequently are utilized to compare the value of different interventions in medicine and health in concrete terms. Implementation science also would benefit from the incorporation of economic evaluations, but such studies ...

Abstract	Background: Economic evaluations frequently are utilized to compare the value of different interventions in medicine and health in concrete terms. Implementation science also would benefit from the incorporation of economic evaluations, but such studies are rare in the literature. The National Cancer Institute has supported a special collection of articles focusing on economic evaluations in implementation science. Even when interventions are supported by substantial evidence, they are implemented infrequently in the field. Implementation costs are important determinants for whether organizational decision-makers choose to adopt an intervention and whether the implementation process is successful. Economic evaluations, such as cost-effectiveness analyses, can help organizational decision-makers choose between implementation approaches for evidence-based interventions by accounting for costs and succinctly presenting cost/benefit tradeoffs. Main text: This manuscript presents a discussion of important considerations for incorporating economic evaluations into implementation science. First, the distinction between intervention and implementation costs is presented, along with an explanation of why the comprehensive representation of implementation costs is elusive. Then, the manuscript describes how economic evaluations in implementation science may differ from those in medicine and health intervention studies, especially in terms of determining the perspectives and outcomes of interest. Finally, referencing a scale-up trial of an evidence-based behavioral health intervention, concrete case examples of how cost data can be collected and used in economic evaluations targeting implementation, rather than clinical outcomes, are described. Conclusions: By gaining a greater understanding of the costs and economic impact associated with different implementation approaches, organizational decision-makers will have better transparency for future replication and scale-up. The use of economic evaluations can help to advance this understanding and provide researchers, purveyors or third-party intermediaries, and organizational decision-makers with essential information to facilitate implementation.
Language	English
Publishing date	2022-04-11
Publishing country	England
Document type	Journal Article
ISSN	2662-2211
ISSN (online)	2662-2211
DOI	10.1186/s43058-022-00295-1
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Article ; Online: Community Health workers United to Reduce Colorectal cancer and cardiovascular disease among people at Higher risk (CHURCH): study protocol for a randomized controlled trial.

Trials

2024 Volume 25, Issue 1, Page(s) 283

Abstract: Background: Colorectal cancer (CRC) is the second most lethal cancer in the United States (U.S.) with the highest incidence and mortality rates among African Americans (AAs) compared to other racial groups. Despite these disparities, AAs are the least ... ...

Abstract	Background: Colorectal cancer (CRC) is the second most lethal cancer in the United States (U.S.) with the highest incidence and mortality rates among African Americans (AAs) compared to other racial groups. Despite these disparities, AAs are the least likely to undergo CRC screening, have precancerous colorectal polyps removed, and have CRC detected at stages early enough for curative excision. In addition, compelling evidence links inflammatory dietary patterns to increased CRC and cardiovascular disease risk. Studies show that AA churches can successfully engage in health promotion activities including those related to cancer control. The current study seeks to leverage church-placed Community Health Workers (CHWs) to increase CRC screening and reduce CRC risk. Design and methods: We aim to (1) increase guideline concordant CRC screening uptake using church-placed CHWs trained in screening with a validated instrument, Brief Intervention using Motivational Interviewing, and Referral to Treatment (SBIRT); and (2) reduce dietary risk factors (inflammatory dietary patterns) linked to CRC. The latter will be addressed by culturally adapting an existing, web-based lifestyle program called Alive!. Using a Hybrid Type 1 Implementation-Effectiveness cluster randomized design, we will randomize 22 AA churches into either the dual intervention arm (CHW-led SBIRT intervention plus Alive!) or a usual care arm comprised of CRC prevention educational pamphlets and a list of CRC screening sites. We will recruit 440 subjects and evaluate the effects of both arms on screening uptake (colonoscopy, fecal DNA) (primary outcome) and dietary inflammation score (secondary outcome) at 6-month follow-up, and Life Simple7 (LS7)-a cardiovascular disease (CVD) risk score-at 6 months and 1 year (secondary outcome). Finally, guided by a racism-conscious adaptation of the Consolidated Framework for Implementation Research (CFIR), we will conduct a mixed-methods process evaluation with key stakeholders to understand multi-level influences on CRC screening and CVD risk behaviors. Discussion: Church-placed CHWs are trusted influential connectors between communities and health systems. Studies have shown that these CHWs can successfully implement health prevention protocols in churches, including those related to cancer control, making them potentially important community mediators of CRC screening uptake and CRC/CVD risk reduction. Trial registration: NCT05174286; clinicaltrials.gov; August 31
MeSH term(s)	Humans ; Colorectal Neoplasms/prevention & control ; Colorectal Neoplasms/diagnosis ; Community Health Workers ; Cardiovascular Diseases/prevention & control ; Cardiovascular Diseases/ethnology ; Early Detection of Cancer ; Black or African American ; Randomized Controlled Trials as Topic ; Risk Factors ; Motivational Interviewing ; Risk Reduction Behavior ; Risk Assessment ; Health Knowledge, Attitudes, Practice ; Time Factors ; Diet, Healthy ; Referral and Consultation ; Health Promotion/methods ; Predictive Value of Tests
Language	English
Publishing date	2024-04-26
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article
ZDB-ID	2040523-6
ISSN	1745-6215 ; 1468-6694 ; 1745-6215
ISSN (online)	1745-6215
ISSN	1468-6694 ; 1745-6215
DOI	10.1186/s13063-024-08110-z
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Article ; Online: Giant prolactinomas, a detailed analysis of 196 adult cases.

Lisa, Billion / Arno, Verleye / Christophe, De Block / Heyning Paul, Van de / Carlien, De Herdt

Pituitary

2023 Volume 26, Issue 5, Page(s) 529–537

Abstract: Purpose: Giant prolactinomas are a rare entity, representing approximately 5% of all prolactinomas. A systematic review of 196 adult cases was performed. A comparison of the clinical, biochemical and radiological characteristics, management and ... ...

Abstract	Purpose: Giant prolactinomas are a rare entity, representing approximately 5% of all prolactinomas. A systematic review of 196 adult cases was performed. A comparison of the clinical, biochemical and radiological characteristics, management and therapeutic outcomes in men versus women is made. Methods: A structured search was conducted using the term 'giant prolactinoma'. Following inclusion criteria were used: diameter ≥ 40 mm, prolactin levels > 1000 ng/ml and no concomitant GH/ ACTH secretion. Results: 196 cases were included [age: 38 (28-50) years, F/M ratio: 1/3.6]. Median tumor diameter was 53 (43-69) mm. Pituitary deficiency was present in 91% of cases, with hypogonadotropic hypogonadism being the most frequent. Most common presenting symptoms were visual impairment (73%) and headache (50%) in men and amenorrhea (58%) in women. 82% of cases were treated with a dopamine agonist (DA) as first-line treatment which led to normoprolactinemia, tumor shrinkage and visual improvement in 51%, 88% and 85% of cases, respectively. Surgery was performed in 29% of cases and all showed tumor remnant and persistent hyperprolactinemia. Women had a lower prolactin level and a smaller tumor diameter at diagnosis but pituitary deficiencies were more frequent and outcome was worse. Conclusion: Giant prolactinomas are rare and have a male predominance. Visual impairment is the most frequent presenting symptom in men and amenorrhea in women. The gender-related difference in tumor size and level of prolactin was confirmed in this analysis where men had a larger diameter and a higher baseline prolactin level. DAs are the treatment of choice, irrespective of tumor size and presence of visual impairment. As only half of the cases achieved normoprolactinemia we do not, in contrast to previous literature, state giant prolactinomas to be exquisitely sensitive to DAs. Patient characteristics associated with persistent hyperprolactinemia after treatment with a DA were female gender, higher baseline prolactin and larger tumor size . This analysis did show TSH- and ACTH-deficiency to be more frequent after surgery which was not seen for LH/FSH deficiency.
MeSH term(s)	Female ; Adult ; Male ; Humans ; Prolactinoma/pathology ; Pituitary Neoplasms/pathology ; Hyperprolactinemia/drug therapy ; Prolactin ; Amenorrhea ; Dopamine Agonists/therapeutic use ; Hypopituitarism/drug therapy ; Vision Disorders ; Adrenocorticotropic Hormone
Chemical Substances	Prolactin (9002-62-4) ; Dopamine Agonists ; Adrenocorticotropic Hormone (9002-60-2)
Language	English
Publishing date	2023-08-07
Publishing country	United States
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	1385151-2
ISSN	1573-7403 ; 1386-341X
ISSN (online)	1573-7403
ISSN	1386-341X
DOI	10.1007/s11102-023-01337-0
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Article ; Online: Public health implications of multiple disaster exposures.

Leppold, Claire / Gibbs, Lisa / Block, Karen / Reifels, Lennart / Quinn, Phoebe

The Lancet. Public health

2022 Volume 7, Issue 3, Page(s) e274–e286

Abstract: Disasters are an important public health issue; however, there is scarce evidence to date on what happens when communities and populations experience more than one disaster. This scoping review identifies literature on the effects of multiple disasters ... ...

Abstract	Disasters are an important public health issue; however, there is scarce evidence to date on what happens when communities and populations experience more than one disaster. This scoping review identifies literature on the effects of multiple disasters published until Aug 2, 2021, 1425 articles were identified, of which 150 articles were included. We analysed direct and indirect public health implications of multiple disasters. Our analysis suggests that exposure to multiple disasters can affect mental health, physical health, and wellbeing, with some evidence that the potential risks of multiple disaster exposure exceed those of single disaster exposure. We also identified indirect public health implications of multiple disaster exposure, related to changes in health-care facilities, changes in public risk perception, and governmental responses to multiple disasters. We present findings on community recovery and methodological challenges to the study of multiple disasters, and directions for future research.
MeSH term(s)	Disasters ; Humans ; Mental Health ; Public Health
Language	English
Publishing date	2022-01-20
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ISSN	2468-2667
ISSN (online)	2468-2667
DOI	10.1016/S2468-2667(21)00255-3
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Article ; Online: Gender-based violence, religion and forced displacement

Sandra Pertek / Karen Block / Lisa Goodson / Pakinam Hassan / Jeanine Hourani / Jenny Phillimore

Frontiers in Human Dynamics, Vol

Protective and risk factors

2023 Volume 5

Abstract: IntroductionThis paper examines the relationship between gender-based violence (GBV) and religion in a range of forced displacement contexts. While it has been acknowledged that religion frequently shapes experiences of GBV survivors, little is known ... ...

Abstract	IntroductionThis paper examines the relationship between gender-based violence (GBV) and religion in a range of forced displacement contexts. While it has been acknowledged that religion frequently shapes experiences of GBV survivors, little is known about the influences of religion on GBV experiences in forced displacement and its potential role in strengthening interventions.MethodsUtilizing empirical evidence from 58 interviews from the SEREDA project with forced migrants in Sweden, UK, Turkey and Australia, we outline the interactions between religious resources and GBV in migrants' forced displacement experiences. We conceptualise religious resources as comprising religious ideas, religious practices, religious experience and religious organization.ResultsSurvivors talked about religion spontaneously when responding to questions relating to resilience, coping mechanisms, and risk factors. Religion acted as both a “protective” and “risk” factor for GBV experiences. Religious beliefs were assets in coping with GBV experiences, but also contributed to creating an environment in which violence was normalized, exposing women to further harm. Religious practices supported survivors emotionally to cope with GBV but also some practices posed risks. Religious organizations in many cases served as a lifeline for many displaced women, offering practical and emotional support, however religious leaders at times encouraged survivors to stay in abusive relationships. Religious experiences “empowered” and “disempowered” survivors across the processes of forced migration.DiscussionWe demonstrate the relevance and importance of acknowledging the role of religion in the experiences of GBV in forced displacement. Our analysis advances the understanding of religious resources as both protective and risk factors that affect forced migrants' experiences of GBV over time and place. We suggest a way forward for practitioners and researchers to account for the roles of religion in experiences of GBV and forced displacement, as ...
Keywords	gender-based violence ; religion ; migrant ; refugee ; displacement ; Social Sciences ; H
Subject code	290 ; 200
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Using economic evaluations in implementation science to increase transparency in costs and outcomes for organizational decision-makers

Lisa Saldana / Debra P. Ritzwoller / Mark Campbell / Eryn Piper Block

Implementation Science Communications, Vol 3, Iss 1, Pp 1-

2022 Volume 11

Abstract: Abstract Background Economic evaluations frequently are utilized to compare the value of different interventions in medicine and health in concrete terms. Implementation science also would benefit from the incorporation of economic evaluations, but such ... ...

Abstract	Abstract Background Economic evaluations frequently are utilized to compare the value of different interventions in medicine and health in concrete terms. Implementation science also would benefit from the incorporation of economic evaluations, but such studies are rare in the literature. The National Cancer Institute has supported a special collection of articles focusing on economic evaluations in implementation science. Even when interventions are supported by substantial evidence, they are implemented infrequently in the field. Implementation costs are important determinants for whether organizational decision-makers choose to adopt an intervention and whether the implementation process is successful. Economic evaluations, such as cost-effectiveness analyses, can help organizational decision-makers choose between implementation approaches for evidence-based interventions by accounting for costs and succinctly presenting cost/benefit tradeoffs. Main text This manuscript presents a discussion of important considerations for incorporating economic evaluations into implementation science. First, the distinction between intervention and implementation costs is presented, along with an explanation of why the comprehensive representation of implementation costs is elusive. Then, the manuscript describes how economic evaluations in implementation science may differ from those in medicine and health intervention studies, especially in terms of determining the perspectives and outcomes of interest. Finally, referencing a scale-up trial of an evidence-based behavioral health intervention, concrete case examples of how cost data can be collected and used in economic evaluations targeting implementation, rather than clinical outcomes, are described. Conclusions By gaining a greater understanding of the costs and economic impact associated with different implementation approaches, organizational decision-makers will have better transparency for future replication and scale-up. The use of economic evaluations can help to ...
Keywords	Implementation cost ; Resources ; Decision-makers ; Economic evaluation ; COINS ; Cost-effectiveness ; Medicine (General) ; R5-920
Subject code	306
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Evaluating the representation of disaster hazards in SNOMED CT: gaps and opportunities.

Lokmic-Tomkins, Zerina / Block, Lorraine J / Davies, Shauna / Reid, Lisa / Ronquillo, Charlene Esteban / von Gerich, Hanna / Peltonen, Laura-Maria

Journal of the American Medical Informatics Association : JAMIA

2023 Volume 30, Issue 11, Page(s) 1762–1772

Abstract: Objective: Climate change, an underlying risk driver of natural disasters, threatens the environmental sustainability, planetary health, and sustainable development goals. Incorporating disaster-related health impacts into electronic health records ... ...

Abstract	Objective: Climate change, an underlying risk driver of natural disasters, threatens the environmental sustainability, planetary health, and sustainable development goals. Incorporating disaster-related health impacts into electronic health records helps to comprehend their impact on populations, clinicians, and healthcare systems. This study aims to: (1) map the United Nations Office for Disaster Risk Reduction and International Science Council (UNDRR-ISC) Hazard Information Profiles to SNOMED CT International, a clinical terminology used by clinicians, to manage patients and provide healthcare services; and (2) to determine the extent of clinical terminologies available to capture disaster-related events. Materials and methods: Concepts related to disasters were extracted from the UNDRR-ISC's Hazard Information Profiles and mapped to a health terminology using a procedural framework for standardized clinical terminology mapping. The mapping process involved evaluating candidate matches and creating a final list of matches to determine concept coverage. Results: A total of 226 disaster hazard concepts were identified to adversely impact human health. Chemical and biological disaster hazard concepts had better representation than meteorological, hydrological, extraterrestrial, geohazards, environmental, technical, and societal hazard concepts in SNOMED CT. Heatwave, drought, and geographically unique disaster hazards were not found in SNOMED CT. Conclusion: To enhance clinical reporting of disaster hazards and climate-sensitive health outcomes, the poorly represented and missing concepts in SNOMED CT must be included. Documenting the impacts of climate change on public health using standardized clinical terminology provides the necessary real time data to capture climate-sensitive outcomes. These data are crucial for building climate-resilient healthcare systems, enhanced public health disaster responses and workflows, tracking individual health outcomes, supporting disaster risk reduction modeling, and aiding in disaster preparedness, response, and recovery efforts.
MeSH term(s)	Humans ; Systematized Nomenclature of Medicine ; Vocabulary, Controlled ; Electronic Health Records ; Disasters
Language	English
Publishing date	2023-08-09
Publishing country	England
Document type	Journal Article
ZDB-ID	1205156-1
ISSN	1527-974X ; 1067-5027
ISSN (online)	1527-974X
ISSN	1067-5027
DOI	10.1093/jamia/ocad153
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Article ; Online: Identification and Characterization of Immune Checkpoint Inhibitor-Induced Toxicities From Electronic Health Records Using Natural Language Processing.

Barman, Hannah / Venkateswaran, Sriram / Santo, Antonio Del / Yoo, Unice / Silvert, Eli / Rao, Krishna / Raghunathan, Bharathwaj / Kottschade, Lisa A / Block, Matthew S / Chandler, G Scott / Zalis, Joshua / Wagner, Tyler E / Mohindra, Rajat

JCO clinical cancer informatics

2024 Volume 8, Page(s) e2300151

Abstract: Purpose: Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, yet their use is associated with immune-related adverse events (irAEs). Estimating the prevalence and patient impact of these irAEs in the real-world data setting is ... ...

Abstract	Purpose: Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, yet their use is associated with immune-related adverse events (irAEs). Estimating the prevalence and patient impact of these irAEs in the real-world data setting is critical for characterizing the benefit/risk profile of ICI therapies beyond the clinical trial population. Diagnosis codes, such as International Classification of Diseases codes, do not comprehensively illustrate a patient's care journey and offer no insight into drug-irAE causality. This study aims to capture the relationship between ICIs and irAEs more accurately by using augmented curation (AC), a natural language processing-based innovation, on unstructured data in electronic health records. Methods: In a cohort of 9,290 patients treated with ICIs at Mayo Clinic from 2005 to 2021, we compared the prevalence of irAEs using diagnosis codes and AC models, which classify drug-irAE pairs in clinical notes with implied textual causality. Four illustrative irAEs with high patient impact-myocarditis, encephalitis, pneumonitis, and severe cutaneous adverse reactions, abbreviated as MEPS-were analyzed using corticosteroid administration and ICI discontinuation as proxies of severity. Results: For MEPS, only 70% (n = 118) of patients found by AC were also identified by diagnosis codes. Using AC models, patients with MEPS received corticosteroids for their respective irAE 82% of the time and permanently discontinued the ICI because of the irAE 35.9% (n = 115) of the time. Conclusion: Overall, AC models enabled more accurate identification and assessment of patient impact of ICI-induced irAEs not found using diagnosis codes, demonstrating a novel and more efficient strategy to assess real-world clinical outcomes in patients treated with ICIs.
MeSH term(s)	Humans ; Natural Language Processing ; Electronic Health Records ; Immune Checkpoint Inhibitors/adverse effects ; Female ; Male ; Drug-Related Side Effects and Adverse Reactions/epidemiology ; Drug-Related Side Effects and Adverse Reactions/diagnosis ; Drug-Related Side Effects and Adverse Reactions/etiology ; Neoplasms/drug therapy ; Middle Aged ; Aged
Chemical Substances	Immune Checkpoint Inhibitors
Language	English
Publishing date	2024-04-30
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ISSN	2473-4276
ISSN (online)	2473-4276
DOI	10.1200/CCI.23.00151
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Article ; Online: The Crooked Nose: A Practical Guide to Successful Management.

Block, Lisa / Pfaff, Miles J / Harris, Alexandria / Goldstein, Jesse A / Losee, Joseph E

Plastic and reconstructive surgery

2022 Volume 149, Issue 4, Page(s) 779e–788e

Abstract: Learning objectives: After studying this article, the participant should be able to: (1) Preoperatively evaluate the patient with a crooked nose. (2) Develop a comprehensive preoperative plan specific to the patient. (3) Effectively "deconstruct" and ... ...

Abstract	Learning objectives: After studying this article, the participant should be able to: (1) Preoperatively evaluate the patient with a crooked nose. (2) Develop a comprehensive preoperative plan specific to the patient. (3) Effectively "deconstruct" and rebuild the crooked nose to address both aesthetic and functional concerns. (4) Use postoperative techniques to maximize outcomes. Summary: Correction of the crooked nose requires a detailed understanding of the relevant surgical anatomy, identification of the deforming forces-both intrinsic and extrinsic-contributing to the deformity, and knowledge of techniques needed to effect the desired change. This continuing medical education article takes the reader through the evaluation and formulation processes to develop a patient-specific plan and provides surgical pearls necessary to get the best results possible. Most importantly, this article emphasizes the need to treat the crooked nose as a reconstructive rather than routine aesthetic operation.
MeSH term(s)	Esthetics ; Humans ; Nasal Septum/surgery ; Nose/surgery ; Nose Deformities, Acquired/surgery ; Reconstructive Surgical Procedures/methods ; Rhinoplasty/methods ; Treatment Outcome
Language	English
Publishing date	2022-04-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	208012-6
ISSN	1529-4242 ; 0032-1052 ; 0096-8501
ISSN (online)	1529-4242
ISSN	0032-1052 ; 0096-8501
DOI	10.1097/PRS.0000000000008918
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