Background. Due to the high prevalence of hepatitis B, Asian Americans have high rates of liver cancer. Screening for hepatitis B leads to monitoring and treatment and prevent further infection through vaccination of contacts. Methods. We reviewed the published literature up to 2006 on hepatitis B awareness, knowledge, and screening among Asian Americans. Results. Many Asian Americans lack knowledge about hepatitis B and have not been screened. Sociodemographics, knowledge, beliefs, and health care variables are associated with screening. Conclusions. Further research and health policy changes are needed to address the problem of hepatitis B and liver cancer among Asian Americans.
Backgyound. The extent to which academic general medicine providers screen Chinese -speaking patients for hepatitis B virus (HBV) is not known. Methods. Retrospective cohort study of Chinese -speaking patients' HBV screening status and survey of providers' HBV knowledge/screening. Results. Most patients (65%) received HBV screening. Being screened was independently associated with marital status and years in the clinic. Providers with Asian language abilities and greater knowledge of HBV risk factors/guidelines were more likely to screen. Conclusions. Chinese-speaking patients in this setting were underscreened for HBV. Providers underestimated the risks associated with Chinese ethnicity. Education is needed to improve risk assessment and guideline awareness.
Background. This study assessed cancer patients' knowledge and attitudes towards clinical trials (CTs). Methods. A survey was administered to 100/141 cancer outpatients. Results. 82% respondents had heard of CTs, but many could only provide limited definitions and perceived them as high risk. About half had previously been approached to participate in a trial, and 67% had agreed to participate. Factors influencing participation in trials, barriers to recruitment, and suggestions for increased recruitment in clinical trials were identified. Conclusions. The findings suggest general support of CTs. Education programs are needed to raise awareness, reduce fears, and dispel myths about CT participation.
Through the National Cancer Act and its amendments (National Cancer Act, 1971; National Cancer Act Amendments, 1974), the U.S. Congress mandated that the National Cancer Institute (NCI)-the nation's lead agency for cancer information and research-provides accurate, up-to-date information about cancer to all segments of the U.S. population. In 1975, the NCI established the Cancer Information Service (CIS), a premieer resource for providing cancer information and education to the nation. The CIS is designed to maximize reach to the public by responding to the cancer needs of clients through several communication technologies, including a telephone service, e-mail, and real-time instant messaging. By offering cancer information to the public through one-on-one interactions with CIS information specialists, the CIS is in a unique position to fill the gap that lies between the preferred, interpersonal source of the health care provider and the actual, impersonal Internet. Cancer Information Service can play an important role in providing health care practitioners, health departments, caregivers, and researchers with up-to-date and accurate information about cancer and clinical trials. Currently, 10% of CIS callers are health professionals. Referring patients to the CIS can augment health practitioners' ability to convey important health information to patients. The CIS program uses NCI resources to educate clients on cancer prevention, early detection, treatment, and rehabilitation and smoking cessation in simple terms that they can understand. Additionally, the CIS works with organizations to develop educational programs and interventions to reach underserved populations. A unique component of this information and education program is its ability to contribute to the field of health communications research by collaborating in research studies throughout the U.S. Finally, since its inception in 1975, the CIS has assisted international organizations with starting a cancer information service and as such is seen as a "stem cell" from which many international CIS programs have derived.
Background. We previously reported that doctor-patient communication in the cancer context may be suboptimal. We therefore developed measures to assess patient communication preferences and established feasibility of an Internet-based intervention to improve communication. Methods. Cancer patients completed an Internet-based survey about communication preferences, with a summary provided to the physician before the consultation. Patients completed a follow-up survey to assess consultation content and satisfaction. Results. Study procedures were feasible, measures exhibited strong internal consistency, and patients expressed satisfaction with the intervention, Conclusion. The Internet offers an opportunity to assess patient preferences and prompt physicians about individual patient informational needs prior to the clinical encounter.
Background. The objectives of this study were to (1) identify the number of published articles related to skin cancer in The New York Times newspaper from 1980-2004; (2) assess the content of the articles related to skin cancer, and (3) examine the trends in media coverage of skin cancer over time. Methods. We performed a content analysis on articles related to skin cancer appearing in The New York Times during January 1, 1980, through December 31, 2004, using the ProQuest (R) online content repository database and key words skin cancer. We conducted an advanced focus search of all "skin cancer" articles using key words "melanoma," "squamous cell carcinoma," "basal cell carcinoma " "sunscreen," "tanning," "sunbathing," and "tanning salon". Results. We identified 874 published articles relating to skin cancer. Melanoma was the primary subject of the 874 articles, with 29% of the articles focusing on some aspect of melanoma. Coverage of other major subjects included sunscreen (11%), tanning (9%), basal cell carcinoma (7%), squamous cell carcinoma (3%), sunbathing (2%), and tanning salon (2%). The remaining 37% of articles contained some mention of skin cancer, but skin cancer was not the main topic nor were any of the focus terms. Over the 25-year period we examined, there was a slight upward trend in the number of skin-cancer-related articles, although we observed year-to-year variation. Conclusions. Understanding how the print media portrays skin cancer issues provides valuable feedback for federal agencies and cancer organizations and may ultimately help promote skin cancer prevention and education.
Background. Although African American women have a lower incidence of breast cancer, they suffer a 30% higher age-adjusted mortality. Lower health literacy levels diminish women's ability to engage in cancer prevention and detection activities. Methods. We conducted a focus group with lay health workers, following their completion of structured literacy assessments. Results. The women's performance established the feasibility and acceptability of incorporating literacy assessments. However, the findings identified perceived limits in existing measures and identified attributes that should be included in cancer-focused literacy assessments. Conclusions. A cancer-specific literacy assessment could assist community health workers in measuring women's functional cancer literacy.
Background. Training on breast health is required to increase awareness of early detection of breast cancer, especially in countries with limited resources. Methods. Of the 784 invited women, 462 participated in the study (58.9%). The training included both theoretical and breast self-examination (BSE) training between preeducation and posteducation tests. Following the theoretical presentation, breast examination training was performed using a breast simulator. The competency of the participants on breast examination was assessed by an evaluation guide. Results. All breast cancer symptoms were stated at significantly higher rates compared to those before education (P <.05). The most commonly stated risk factor in both preeducation and posteducation tests was "no breast-feeding," with ratios of 15.2% and 56.3%, respectively. Early detection modalities for breast cancer were also stated more often in the posteducation test compared to the preeducation (P <.05). In the preeducation test, only 4.3% to 18.7% of the participant women could state most of the BSE steps. After BSE training, 85% to 92% of the participants were competent in BSE steps. Conclusions. Theoretical education on breast cancer and BSE training in low-educated women, even illiterate, is highly effective.
Background. Husbands of women with breast cancer may experience adjustment difficulties. We examined psychosocial predictors of husbands' adjustment to their wives' breast cancer 3 months following diagnosis, Methods. Women (N = 45) with Stage I or II breast cancer who were 3 months postdiagnosis and their husbands completed measures of adjustment, coping, marital adjustment, and quality of life. Results. Multiple regression analyses showed husbands' avoidant coping and wives' adjustment accounted for approximately 54% of the variance in husbands' adjustment. Conclusions. Further research on predictors of husbands' adjustment following wives' diagnoses of breast cancer is needed to inform intervention efforts.
Background. Pediatric palliative care has made substantial strides in the past decade; less attention has focused on providing emotional support to the pediatric oncologist. Methods. I interviewed a total of 30 pediatric oncologists throughout the United States using a semistructured interview guide; anxiety and depression scales were administered. Major themes were identified. Results. Most (57%) had experienced serious illnesses during their own childhood or adolescence; 77% had experienced significant medical events in their parents or siblings prior to adulthood. Conclusions. Pediatric oncologists need help mastering their own healing so they can be helpful to patients and families.
Background. Communication skills have not traditionally been included in nursing curriculum. The best educational method to improve health care providers' practice in communication skills is first, introduction of content, followed by continuous skills assessment and mentored feedback. Methods. A communication skills workshop using standardized patients (SPs) was planned for oncology nurse practitioner students. A 6-step development plan was used to design, implement, and evaluate the curriculum. Three patient cases using SPs were developed to represent a specific communication skill. SP teaching methodology is relatively new to nursing curriculum. Results. Four methods of evaluation revealed a high level of satisfaction with the course, a high level of communications skills demonstrated during the course, and student need to have more communication content throughout their curriculum. Confidence in communication skills increased following the workshop. Conclusions. This methodology has widespread application to other areas of cancer nursing including nurses with less oncology experience and practicing nurses on the oncology units. In addition, there is application throughout nursing curriculum for undergraduate and graduate programs. The content should be presented earlier in the curriculum and then reinforced throughout the remaining courses with clinical follow-up. J Cancer Educ. 2007; 22:149-153.
Background. Accepted practices of informed consent often result in suboptimal patient understanding of research studies. Methods. This pilot study aimed to assess trial-specific tailored materials, compared to a widely used generic booklet about clinical trials, randomly assigned to 118 candidates for cancer clinical trials. Study outcomes were: satisfaction with decision-making; satisfaction with materials; and subjective understanding of the clinical trial. Results. There were no major differences between groups. Participants rated tailored materials higher as a useful reference. Conclusions. Trial-specific materials hold utility for reference during clinical trials. Studies of informed consent are feasible, although important factors limit research.
Background. Field workers and lay community health educators are often children's first opportunity for correctly recognizing and responding to early signs and symptoms of pediatric cancers. Inadequate familiarity with the warning signs and symptoms of childhood cancer results in delayed referral to a physician for diagnosis and treatment. Methods. This pilot study assessed community health workers' baseline level of knowledge about childhood cancers. Community health workers from Brazil completed a pediatric cancer knowledge questionnaire. Results. Although all respondents knew to refer a child suspected to have cancer to a physician, their knowledge of the early warning signs and symptoms of pediatric cancer was very low. Conclusions. The findings demonstrate a link between training and knowledge and confirm the need for targeted education in the warning signs and symptoms of pediatric cancer for community health workers in developing countries. J Cancer Educ. 2007; 22:181-185.
The National Cancer Institute (NCI) supported four innovative demonstration research projects, "The Digital Divide Pilot Projects," to test new strategies for disseminating health information via computer to vulnerable consumers. These projects involved active research collaborations between the NCI's Cancer Information Service (CIS) and regional cancer control researchers to field test new approaches for enhancing cancer communication in vulnerable communities. The projects were able to use computers to successfully disseminate relevant cancer information to vulnerable populations. These demonstration research projects suggested effective new strategies for using communication technologies to educate underserved populations about cancer prevention, control, and care.
Background. There is a gap in the literature regarding the knowledge of college students about breast, cervical, and testicular cancers. Methods. I surveyed 3362 college students were surveyed about their knowledge of risk factors and screening recommendations for these 3 cancers during the 2002-2003 school year at a large public university in the Northeast. Results. Students knew approximately 50% of the information about risk factors and screening recommendations for these 3 cancers. Conclusions. Based on these results, college students appear to have limited knowledge about breast, cervical, and testicular cancers and need education about them.
Background. Systematic provision of compassionate end-of-life (EOL) care requires strategic training of health professionals. Disseminating EOL Education to Cancer Centers (DELEtCC) targeted education of interdisciplinary institutional teams. Methods. Competitively-selected two-person teams participated in a national three-day EOL conference. Nationally recognized faculty created and presented the curriculum. Project faculty supported teams over 18 months as they implemented EOL goals. Conference evaluations were very positive. Results. Independent participant and administrative evaluations reported successful implementation of goals aimed an improving EOL care. Conclusions. DELEtCC disseminated education representing best EOL practices, and participants used this knowledge to create and implement goals aimed at improving EOL care. J Cancer Educ. 2007; 22:140-148.
Late detection of breast cancer is still a leading cause of morbidity among patients. We aimed to evaluate the efficacy of preplanned breast self-examination (BSE) training on nursing and midwifery students. A total of 74 first-year nursing and midwifery students were trained on BSE. Data were collected before and after BSE education by a modified questionnaire. The BSE accuracy of the students was increased after education. Furthermore, positive attitude and behavior of the students toward BSE were improved. The students started to practice BSE with the right techniques and positions at the right time. The main reasons not to perform BSE were the lack of knowledge and motivation prior the education. BSE training is effective in nursing and midwifery students but should be repeated periodically for better efficacy.