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  1. Article ; Online: Care Delivery in Community Health Centers Before, During, and After the COVID-19 Pandemic (2019-2022).

    Cook, Nicole / McGrath, Brenda M / Navale, Suparna M / Koroukian, Siran M / Templeton, Anna R / Crocker, Laura C / Zyzanski, Stephen J / Bensken, Wyatt P / Stange, Kurt C

    Journal of the American Board of Family Medicine : JABFM

    2024  Volume 36, Issue 6, Page(s) 916–926

    Abstract: Introduction: Health centers provide primary and behavioral health care to the nation's safety net population. Many health centers served on the frontlines of the COVID-19 pandemic, which brought major changes to health center care delivery.: ... ...

    Abstract Introduction: Health centers provide primary and behavioral health care to the nation's safety net population. Many health centers served on the frontlines of the COVID-19 pandemic, which brought major changes to health center care delivery.
    Objective: To elucidate primary care and behavioral health service delivery patterns in health centers before and during the COVID-19 public health emergency (PHE).
    Methods: We compared annual and monthly patients from 2019 to 2022 for new and established patients by visit type (primary care, behavioral health) and encounter visits by modality (in-person, telehealth) across 218 health centers in 13 states.
    Results: There were 1581,744 unique patients in the sample, most from health disparate populations. Review of primary care data over 4 years show that health centers served fewer pediatric patients over time, while retaining the capacity to provide to patients 65+. Monthly data on encounters highlights that the initial shift in March/April 2020 to telehealth was not sustained and that in-person visits rose steadily after November/December 2020 to return as the predominant care delivery mode. With regards to behavioral health, health centers continued to provide care to established patients throughout the PHE, while serving fewer new patients over time. In contrast to primary care, after initial uptake of telehealth in March/April 2020, telehealth encounters remained the predominant care delivery mode through 2022.
    Conclusion: Four years of data demonstrate how COVID-19 impacted delivery of primary care and behavioral health care for patients, highlighting gaps in pediatric care delivery and trends in telehealth over time.
    MeSH term(s) Humans ; Child ; COVID-19/epidemiology ; Pandemics ; Delivery of Health Care ; Telemedicine ; Community Health Centers
    Language English
    Publishing date 2024-01-05
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2239939-2
    ISSN 1558-7118 ; 1557-2625
    ISSN (online) 1558-7118
    ISSN 1557-2625
    DOI 10.3122/jabfm.2023.230081R1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2626: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: How do couples and spouses/partners consider fertility preservation decisions during cancer treatment planning? A qualitative analysis of dyadic decision making.

    Mathur, Aakrati / Hoffman, Aubri S / Weston, June / Crocker, Laura C / Holman, Deborah A / Bradford, Andrea / Woodard, Terri L

    Journal of psychosocial oncology

    2020  Volume 39, Issue 2, Page(s) 268–284

    Abstract: Objective: This study assessed the needs and perspective of (1) couples and (2) spouses/partners when considering fertility preservation after a cancer diagnosis.: Research approach: Semi-structured interviews explored (1) couples' shared decision- ... ...

    Abstract Objective: This study assessed the needs and perspective of (1) couples and (2) spouses/partners when considering fertility preservation after a cancer diagnosis.
    Research approach: Semi-structured interviews explored (1) couples' shared decision-making and (2) spouses'/partners' individual perspectives.
    Participants: Twelve female cancer survivors and their partners (spouses or domestic/romantic partners) (
    Methodological approach: Dyadic and individual interviews were conducted using a Decisional Needs Assessment interview guide. Thematic analysis identified key themes.
    Findings: Couples reported making fertility preservation decisions like other major decisions, including prioritizing mutual satisfaction. Partners also reported concerns about patients' health, variable decision-making needs, and letting patients lead. Couples unanimously recommended fertility preservation consultations, and designing resources that provide information and assess needs for both patients and partners.
    Interpretations: Patients and partners have shared and unique needs when facing fertility preservation decisions.
    Implications for psychosocial providers or policy: Whenever feasible, psychosocial providers should assess and address couples' and partners' fertility preservation decision-making needs.
    MeSH term(s) Adolescent ; Adult ; Cancer Survivors/psychology ; Cancer Survivors/statistics & numerical data ; Decision Making ; Female ; Fertility Preservation/psychology ; Humans ; Interpersonal Relations ; Male ; Middle Aged ; Neoplasms/therapy ; Qualitative Research ; Spouses/psychology ; Spouses/statistics & numerical data ; Young Adult
    Language English
    Publishing date 2020-12-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 605892-9
    ISSN 1540-7586 ; 0734-7332
    ISSN (online) 1540-7586
    ISSN 0734-7332
    DOI 10.1080/07347332.2020.1836546
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2006: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Shared Decision-Making for Lung Cancer Screening: How Well Are We "Sharing"?

    Nishi, Shawn P E / Lowenstein, Lisa M / Mendoza, Tito R / Lopez Olivo, Maria A / Crocker, Laura C / Sepucha, Karen / Niu, Jiangong / Volk, Robert J

    Chest

    2021  Volume 160, Issue 1, Page(s) 330–340

    Abstract: Background: Lung cancer screening (LCS) reduces lung cancer mortality, but it also carries a range of risks. Shared decision-making (SDM) is a process of engaging patients in their health care decisions and is a vital component of LCS.: Research ... ...

    Abstract Background: Lung cancer screening (LCS) reduces lung cancer mortality, but it also carries a range of risks. Shared decision-making (SDM) is a process of engaging patients in their health care decisions and is a vital component of LCS.
    Research question: What is the quality of SDM among patients recently assessed for LCS?
    Study design and methods: Cross-sectional study of screened patients recruited from two academic tertiary care centers in the South Central Region of the United States. Self-reported surveys assessed patient demographics, values related to outcomes of LCS, knowledge, SDM components including receipt of educational materials, and decisional conflict.
    Results: Recently screened patients (n = 266) possessed varied LCS knowledge, answering an average of 41.4% of questions correctly. Patients valued finding cancer early over concerns about harms. Patients indicated that LCS benefits were presented to them by a health care provider far more often than harms (68.3% vs 20.8%, respectively), and 30.7% reported they received educational materials about LCS during the screening process. One-third of patients had some decisional conflict (33.6%) related to their screening decisions, whereas most patients (86.6%) noted that they were involved in the screening decision as much as they wanted. In multivariate models, non-White race and having less education were related to lower knowledge scores. Non-White patients and former smokers were more likely to be conflicted about the screening decision. Most patients (n = 227 [85.3%]) indicated that a health care provider had discussed smoking cessation or abstinence with them.
    Interpretation: Among recently screened patients, the quality of decision-making about LCS is highly variable. The low use of educational materials including decision aids and imbalance of conveying benefit vs risk information to patients is concerning. A structured approach using decision aids may assist with providing a balanced presentation of information and may improve the quality of SDM.
    MeSH term(s) Cross-Sectional Studies ; Decision Making, Shared ; Decision Support Techniques ; Early Detection of Cancer/methods ; Female ; Humans ; Lung/diagnostic imaging ; Lung Neoplasms/diagnosis ; Lung Neoplasms/epidemiology ; Male ; Mass Screening/methods ; Middle Aged ; Morbidity/trends ; Qualitative Research ; United States
    Language English
    Publishing date 2021-02-06
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2021.01.041
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Ui III Zs.45: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 349: Show issues

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  4. Article ; Online: Impact of the shared decision-making process on lung cancer screening decisions.

    Tan, Naomi Q P / Nishi, Shawn P E / Lowenstein, Lisa M / Mendoza, Tito R / Lopez-Olivo, Maria A / Crocker, Laura C / Sepucha, Karen R / Volk, Robert J

    Cancer medicine

    2021  Volume 11, Issue 3, Page(s) 790–797

    Abstract: Background: Professional organizations recommend the use of shared decision-making (SDM) in supporting patients' decisions about lung cancer screening (LCS). The objective of this study was to assess the impact of the SDM process on patient knowledge ... ...

    Abstract Background: Professional organizations recommend the use of shared decision-making (SDM) in supporting patients' decisions about lung cancer screening (LCS). The objective of this study was to assess the impact of the SDM process on patient knowledge about LCS, decisional conflict, intentions to adhere to screening recommendations, and its role in how the patient made the final decision.
    Methods: This study surveyed patients screened for lung cancer within 12 months of the survey, recruited from two academic tertiary care centers in the South Central Region of the U.S. (May to July 2018).
    Results: Two hundred and sixty-four patients completed the survey (87.9% White, 52% male, and mean age of 64.81). Higher SDM process scores (which indicates a better SDM process reported by patients) were significantly associated with greater knowledge of LCS (b = 0.17 p < 0.01). Higher SDM process scores were associated with less decisional conflict about their screening choice (b = 0.45, p < 0.001), greater intentions to make the same decision again (OR = 1.42, 95% CI = [1.06-1.89]), and greater intentions to undergo LCS again (OR = 1.32, 95% CI = [1.08-1.62]). The SDM process score was not associated with patients' report of whether or not they shared the final decision with the healthcare provider (OR = 1.07, 95% CI = [0.85-1.35]).
    Conclusion(s): This study found that a better SDM process was associated with better affective-cognitive outcomes among patients screened for lung cancer.
    MeSH term(s) Decision Making ; Decision Making, Shared ; Early Detection of Cancer ; Female ; Humans ; Lung Neoplasms/diagnosis ; Male ; Mass Screening ; Middle Aged ; Surveys and Questionnaires
    Language English
    Publishing date 2021-12-28
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2659751-2
    ISSN 2045-7634 ; 2045-7634
    ISSN (online) 2045-7634
    ISSN 2045-7634
    DOI 10.1002/cam4.4445
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Pathways

    Woodard, Terri Lynn / Hoffman, Aubri S / Crocker, Laura C / Holman, Deborah A / Hoffman, Derek B / Ma, Jusheng / Bassett, Roland L / Leal, Viola B / Volk, Robert J

    BMJ open

    2018  Volume 8, Issue 2, Page(s) e019994

    Abstract: Introduction: National guidelines recommend that all reproductive-age women with cancer be informed of their fertility risks and offered referral to fertility specialists to discuss fertility preservation options. However, reports indicate that only 5% ... ...

    Abstract Introduction: National guidelines recommend that all reproductive-age women with cancer be informed of their fertility risks and offered referral to fertility specialists to discuss fertility preservation options. However, reports indicate that only 5% of patients have consultations, and rates of long-term infertility-related distress remain high. Previous studies report several barriers to fertility preservation; however, initial success has been reported using provider education, patient decision aids and navigation support. This protocol will test effects of a multicomponent intervention compared with usual care on women's fertility preservation knowledge and decision-making outcomes.
    Methods and analysis: This cluster-randomised trial will compare the multicomponent intervention (provider education, patient decision aid and navigation support) with usual care (consultation and referral, if requested). One hundred newly diagnosed English-speaking women of reproductive age who are at risk of cancer-related infertility will be recruited from four regional oncology clinics.The
    Ethics and dissemination: The University of Texas MD Anderson Cancer Center provided approval and ongoing review of this protocol. Results will be presented at relevant scientific meetings and submitted for publication in a peer-reviewed journal.
    Trial registration number: NCT03141437; Pre-results.
    MeSH term(s) Adolescent ; Adult ; Cancer Survivors ; Counseling ; Decision Support Techniques ; Female ; Fertility Preservation ; Health Education/methods ; Health Knowledge, Attitudes, Practice ; Humans ; Infertility, Female/therapy ; Internet ; Linear Models ; Middle Aged ; Neoplasms/therapy ; Referral and Consultation/statistics & numerical data ; Research Design ; Surveys and Questionnaires ; Texas ; Young Adult
    Language English
    Publishing date 2018-02-21
    Publishing country England
    Document type Comparative Study ; Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2747269-3
    ISSN 2044-6055 ; 2044-6055 ; 2053-3624
    ISSN (online) 2044-6055
    ISSN 2044-6055 ; 2053-3624
    DOI 10.1136/bmjopen-2017-019994
    Database MEDical Literature Analysis and Retrieval System OnLINE

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