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  1. Article: Using a Prerequisite Skills Assessment to Identify Optimal Modalities for Mand Training.

    Valentino, Amber L / LeBlanc, Linda A / Veazey, Sarah E / Weaver, Lauren A / Raetz, Paige B

    Behavior analysis in practice

    2018  Volume 12, Issue 1, Page(s) 22–32

    Abstract: This study examined the utility of a brief prerequisite assessment in predicting the subsequent effectiveness and rate of acquisition of mand training in each of three response modalities (sign, picture exchange, and vocalizations). Overall, the picture ... ...

    Abstract This study examined the utility of a brief prerequisite assessment in predicting the subsequent effectiveness and rate of acquisition of mand training in each of three response modalities (sign, picture exchange, and vocalizations). Overall, the picture exchange was the most effective and efficient modality for acquiring the targeted mand. The vocal modality was the least effective except when the prerequisite assessment indicated that two-syllable vocal imitation was intact. The implications for selection of response modality for early mand training are discussed.
    Language English
    Publishing date 2018-05-07
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2583900-7
    ISSN 2196-8934 ; 1998-1929
    ISSN (online) 2196-8934
    ISSN 1998-1929
    DOI 10.1007/s40617-018-0256-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Determinants of targeted cancer therapy use in community oncology practice: a qualitative study using the Theoretical Domains Framework and Rummler-Brache process mapping.

    Ellis, Shellie D / Brooks, Joanna Veazey / Birken, Sarah A / Morrow, Emily / Hilbig, Zachary S / Wulff-Burchfield, Elizabeth / Kinney, Anita Y / Ellerbeck, Edward F

    Implementation science communications

    2023  Volume 4, Issue 1, Page(s) 66

    Abstract: Background: Precision medicine holds enormous potential to improve outcomes for cancer patients, offering improved rates of cancer control and quality of life. Not all patients who could benefit from targeted cancer therapy receive it, and some who may ... ...

    Abstract Background: Precision medicine holds enormous potential to improve outcomes for cancer patients, offering improved rates of cancer control and quality of life. Not all patients who could benefit from targeted cancer therapy receive it, and some who may not benefit do receive targeted therapy. We sought to comprehensively identify determinants of targeted therapy use among community oncology programs, where most cancer patients receive their care.
    Methods: Guided by the Theoretical Domains Framework, we conducted semi-structured interviews with 24 community cancer care providers and mapped targeted therapy delivery across 11 cancer care delivery teams using a Rummler-Brache diagram. Transcripts were coded to the framework using template analysis, and inductive coding was used to identify key behaviors. Coding was revised until a consensus was reached.
    Results: Intention to deliver precision medicine was high across all participants interviewed, who also reported untenable knowledge demands. We identified distinctly different teams, processes, and determinants for (1) genomic test ordering and (2) delivery of targeted therapies. A key determinant of molecular testing was role alignment. The dominant expectation for oncologists to order and interpret genomic tests is at odds with their role as treatment decision-makers' and pathologists' typical role to stage tumors. Programs in which pathologists considered genomic test ordering as part of their staging responsibilities reported high and timely testing rates. Determinants of treatment delivery were contingent on resources and ability to offset delivery costs, which low- volume programs could not do. Rural programs faced additional treatment delivery challenges.
    Conclusions: We identified novel determinants of targeted therapy delivery that potentially could be addressed through role re-alignment. Standardized, pathology-initiated genomic testing may prove fruitful in ensuring patients eligible for targeted therapy are identified, even if the care they need cannot be delivered at small and rural sites which may have distinct challenges in treatment delivery. Incorporating behavior specification and Rummler-Brache process mapping with determinant analysis may extend its usefulness beyond the identification of the need for contextual adaptation.
    Language English
    Publishing date 2023-06-12
    Publishing country England
    Document type Journal Article
    ISSN 2662-2211
    ISSN (online) 2662-2211
    DOI 10.1186/s43058-023-00441-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Improving Clinician Decisions and Communication in Critical Care Using Novel Information Technology.

    Pamplin, Jeremy / Nemeth, Christopher P / Serio-Melvin, Maria L / Murray, Sarah J / Rule, Gregory T / Veinott, Elizabeth S / Veazey, Sena R / Hamilton, Anthony J / Fenrich, Craig A / Laufersweiler, Dawn E / Salinas, Jose

    Military medicine

    2019  Volume 185, Issue 1-2, Page(s) e254–e261

    Abstract: Introduction: The electronic medical record (EMR) is presumed to support clinician decisions by documenting and retrieving patient information. Research shows that the EMR variably affects patient care and clinical decision making. The way information ... ...

    Abstract Introduction: The electronic medical record (EMR) is presumed to support clinician decisions by documenting and retrieving patient information. Research shows that the EMR variably affects patient care and clinical decision making. The way information is presented likely has a significant impact on this variability. Well-designed representations of salient information can make a task easier by integrating information in useful patterns that clinicians use to make improved clinical judgments and decisions. Using Cognitive Systems Engineering methods, our research team developed a novel health information technology (NHIT) that interfaces with the EMR to display salient clinical information and enabled communication with a dedicated text-messaging feature. The software allows clinicians to customize displays according to their role and information needs. Here we present results of usability and validation assessments of the NHIT.
    Materials and methods: Our subjects were physicians, nurses, respiratory therapists, and physician trainees. Two arms of this study were conducted, a usability assessment and then a validation assessment. The usability assessment was a computer-based simulation using deceased patient data. After a brief five-minute orientation, the usability assessment measured individual clinician performance of typical tasks in two clinical scenarios using the NHIT. The clinical scenarios included patient admission to the unit and patient readiness for surgery. We evaluated clinician perspective about the NHIT after completing tasks using 7-point Likert scale surveys. In the usability assessment, the primary outcome was participant perceptions about the system's ease of use compared to the legacy system.A subsequent cross-over, validation assessment compared performance of two clinical teams during simulated care scenarios: one using only the legacy IT system and one using the NHIT in addition to the legacy IT system. We oriented both teams to the NHIT during a 1-hour session on the night before the first scenario. Scenarios were conducted using high-fidelity simulation in a real burn intensive care unit room. We used observations, task completion times, semi-structured interviews, and surveys to compare user decisions and perceptions about their performance. The primary outcome for the validation assessment was time to reach accurate (correct) decision points.
    Results: During the usability assessment, clinicians were able to complete all tasks requested. Clinicians reported the NHIT was easier to use and the novel information display allowed for easier data interpretation compared to subject recollection of the legacy EMR.In the validation assessment, a more junior team of clinicians using the NHIT arrived at accurate diagnoses and decision points at similar times as a more experienced team. Both teams noted improved communication between team members when using the NHIT and overall rated the NHIT as easier to use than the legacy EMR, especially with respect to finding information.
    Conclusions: The primary findings of these assessments are that clinicians found the NHIT easy to use despite minimal training and experience and that it did not degrade clinician efficiency or decision-making accuracy. These findings are in contrast to common user experiences when introduced to new EMRs in clinical practice.
    MeSH term(s) Communication ; Critical Care ; Electronic Health Records ; Humans ; Information Technology ; User-Computer Interface
    Language English
    Publishing date 2019-07-04
    Publishing country England
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 391061-1
    ISSN 1930-613X ; 0026-4075
    ISSN (online) 1930-613X
    ISSN 0026-4075
    DOI 10.1093/milmed/usz151
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Teaching Feminine Hygiene Skills to Young females with Autism Spectrum Disorder and Intellectual Disability.

    Veazey, Sarah E / Valentino, Amber L / Low, Adeline I / McElroy, Alyssa R / LeBlanc, Linda A

    Behavior analysis in practice

    2015  Volume 9, Issue 2, Page(s) 184–189

    Abstract: Little applied research focuses on teaching feminine hygiene skills to females with disabilities, yet this is a common clinical concern. The current study demonstrates the use of chaining to teach two young females with autism spectrum disorder feminine ... ...

    Abstract Little applied research focuses on teaching feminine hygiene skills to females with disabilities, yet this is a common clinical concern. The current study demonstrates the use of chaining to teach two young females with autism spectrum disorder feminine hygiene skills. A nonconcurrent multiple baseline across participants was utilized, and the results indicate that both participants acquired the skill. Generalization probes with one participant indicated the skill generalized to novel stimuli.
    Language English
    Publishing date 2015-10-16
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2583900-7
    ISSN 2196-8934 ; 1998-1929
    ISSN (online) 2196-8934
    ISSN 1998-1929
    DOI 10.1007/s40617-015-0065-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Geographic differences in community oncology provider and practice location characteristics in the central United States.

    Ellis, Shellie D / Thompson, Jeffrey A / Boyd, Samuel S / Roberts, Andrew W / Charlton, Mary / Brooks, Joanna Veazey / Birken, Sarah A / Wulff-Burchfield, Elizabeth / Amponsah, Jonah / Petersen, Shariska / Kinney, Anita Y / Ellerbeck, Edward

    The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association

    2022  Volume 38, Issue 4, Page(s) 865–875

    Abstract: Purpose: How care delivery influences urban-rural disparities in cancer outcomes is unclear. We sought to understand community oncologists' practice settings to inform cancer care delivery interventions.: Methods: We conducted secondary analysis of a ...

    Abstract Purpose: How care delivery influences urban-rural disparities in cancer outcomes is unclear. We sought to understand community oncologists' practice settings to inform cancer care delivery interventions.
    Methods: We conducted secondary analysis of a national dataset of providers billing Medicare from June 1, 2019 to May 31, 2020 in 13 states in the central United States. We used Kruskal-Wallis rank and Fisher's exact tests to compare physician characteristics and practice settings among rural and urban community oncologists.
    Findings: We identified 1,963 oncologists practicing in 1,492 community locations; 67.5% practiced in exclusively urban locations, 11.3% in exclusively rural locations, and 21.1% in both rural and urban locations. Rural-only, urban-only, and urban-rural spanning oncologists practice in an average of 1.6, 2.4, and 5.1 different locations, respectively. A higher proportion of rural community sites were solo practices (11.7% vs 4.0%, P<.001) or single specialty practices (16.4% vs 9.4%, P<.001); and had less diversity in training environments (86.5% vs 67.8% with <2 medical schools represented, P<.001) than urban community sites. Rural multispecialty group sites were less likely to include other cancer specialists.
    Conclusions: We identified 2 potentially distinct styles of care delivery in rural communities, which may require distinct interventions: (1) innovation-isolated rural oncologists, who are more likely to be solo providers, provide care at few locations, and practice with doctors with similar training experiences; and (2) urban-rural spanning oncologists who provide care at a high number of locations and have potential to spread innovation, but may face high complexity and limited opportunity for care standardization.
    MeSH term(s) Aged ; Humans ; Medicare ; Neoplasms/epidemiology ; Neoplasms/therapy ; Professional Practice Location ; Rural Population ; Specialization ; United States
    Language English
    Publishing date 2022-04-05
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 639160-6
    ISSN 1748-0361 ; 0890-765X
    ISSN (online) 1748-0361
    ISSN 0890-765X
    DOI 10.1111/jrh.12663
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