A5027685656- Colorectal Cancer Screening and Detection
- Health Systems, Economic Evaluations, Quality of Life
- Global Cancer Incidence and Screening
- Infant Development and Preterm Care
- Gastric Cancer Management and Outcomes
- Gestational Diabetes Research and Management
- Primary Care and Health Outcomes
- Pharmaceutical Practices and Patient Outcomes
- Obesity, Physical Activity, Diet
- Healthcare Policy and Management
- Economic and Financial Impacts of Cancer
- Child and Adolescent Health
- Medication Adherence and Compliance
- Family and Patient Care in Intensive Care Units
- Maternal and Perinatal Health Interventions
- Maternal and Neonatal Healthcare
- Neonatal Respiratory Health Research
- Health Policy Implementation Science
- Telemedicine and Telehealth Implementation
- Global Maternal and Child Health
- Patient Satisfaction in Healthcare
- Cervical Cancer and HPV Research
- Genetic factors in colorectal cancer
- Microscopic Colitis
- Bariatric Surgery and Outcomes
University of North Carolina at Chapel Hill
2013-2025
UNC Lineberger Comprehensive Cancer Center
2019-2024
Queen's University Belfast
2009
Purpose Cervical cancer disproportionately impacts women in low- and middle-income countries (LMICs). The World Health Organization’s (WHO) 90/70/90 strategy aims to eliminate cervical by 2030 increasing HPV vaccination coverage 90%, screening 70% of eligible women, effectively treating 90% those with abnormal results 2030, potentially preventing 62 million deaths LMICs. LMICs, however, struggle limited access precancer treatment, part due a lack trained professionals weak health systems....
We evaluated community pharmacists' perspectives on addressing social determinants of health for their patients in the United States. From 9/2022-1/2023, we conducted a national, online survey 578 pharmacists to evaluate barriers affecting patients, pharmacy staff's ability address these barriers, and resources available or needed barriers. Healthcare access quality was perceived as most addressable barrier (59 %), while education (24 %) neighborhood/built environment were least (14 %)....
Groups making recommendations need evidence about whether preventive services improve health outcomes (HOs). When such is not available, groups may choose to evaluate effects on intermediate (IOs) and the link between IOs HOs. This paper aims describe considerations for assessing linking changes in HOs.Working definitions of IOs, HOs, other were developed. All current U.S. Preventive Services Task Force (USPSTF) through April 2016 examined identify how IO-HO was gathered criteria that...
Completion rates for follow-up colonoscopies after an abnormal fecal immunochemical test (FIT) are suboptimal in federally qualified health center (FQHC) settings. We implemented a screening intervention that included mailed FIT outreach to North Carolina FQHC patients from June 2020 September 2021 and centralized patient navigation support with FITs completing colonoscopy. evaluated the reach effectiveness of using electronic medical record data navigator call logs detailing interactions...
Women in low- and middle-income countries (LMICs) bear a disproportionate burden of cervical cancer, despite being preventable disease. Prevention efforts LMICs are hindered part by lack access to precancer treatment, due weak health infrastructure adequate human resources deliver current provider-administered treatments. Innovative strategies urgently needed close the treatment gap LMICs, including use self-administered topical therapies such as 5-fluorouracil imiquimod, for which efficacy...
Abstract Background Implementation science emerged from the recognized need to speed translation of effective interventions into practice. In US, has evolved place an ever-increasing focus on implementation strategies. The long list strategies, terminology used name and time required tailor strategies all may contribute delays in translating evidence-based (EBIs) To EBI translation, we propose a streamlined approach classifying tailoring Main text A multidisciplinary team eight scholars...
Abstract Purpose To assess preferences for design of a pharmacy-based colorectal cancer (CRC) screening program (PharmFIT™) among screening-eligible adults in the United States (US) and explore impact rurality on pharmacy use patterns (e.g., type, prescription pick-up preference, service quality rating). Methods We conducted national online survey non-institutionalized US through panels managed by Qualtrics, research company. A total 1,045 (response rate 62%) completed between March April...
Although patient navigation has shown promise for increasing participation in colorectal cancer screening and follow-up, little evidence is available to guide implementation of clinical practice. We characterize 8 programs being implemented as part multi-component interventions the National Cancer Institute's Moonshot Accelerating Colorectal Screening Follow-Up Through Implementation Science (ACCSIS) initiative.We developed a data collection template organized by ACCSIS framework domains....
Background Telehealth (telemedicine and telepharmacy) services increase access to patient ensure continuity of care. However, few studies have assessed factors that influence patients’ willingness use telehealth services, we sought investigate this. Objective This study aims examine respondents’ (aged between 45 75 years) (telepharmacy telemedicine) the correlates services. Methods We administered a cross-sectional national survey 1045 noninstitutionalized US adults aged years in March April...
The experience of parenting in a highly medicalized, unnatural environment can result impaired mother-infant bonding, but increased maternal presence at the infant's bedside has been associated with improved infant and outcomes. primary objective this study was to explore barriers facilitators during NICU Experience regard an NICU.
Importance Colorectal cancer (CRC) screening is effective but remains underused in federally qualified health centers (FQHCs). Objective To assess the effectiveness of a centralized CRC outreach intervention involving mailed fecal immunochemical testing (FIT) and patient navigation to colonoscopy after abnormal results FIT. Design, Setting, Participants A pragmatic randomized clinical trial was conducted, using intention-to-treat analysis. were enrolled from July 6, 2020, September 17, 2021,...
To explore the association between healthcare provider advice about weight loss and physical activity in postpartum period retention levels women assessed at 3 months postpartum.Using data from a prospective cohort study, we explored of with 688 postpartum. Data home visits included anthropometric measurements information collected sociodemographic, health behavior, psychosocial questionnaires. Weight was calculated as minus prepregnancy weight; were based on maternal self-report. Linear...
Background. Concerns have been raised about both over- and underutilization of colorectal cancer (CRC) screening in older patients the need to align behavior with likelihood net benefit. Objective. The purpose this study was test a novel use patient decision aid (PtDA) promote appropriate CRC adults. Methods. A total 424 ages 70 84 y who were not up date participated double-blinded randomized controlled trial PtDA targeted adults making decisions whether undergo from March 2012 February...
Abstract Background Although colorectal cancer (CRC) screening is effective in reducing CRC mortality, rates vulnerable populations served by community health centers (CHCs) remain below national targets. CHCs North Carolina are challenged to reach targets as they tend be under-resourced, have limited capacity implement and sustain population interventions, typically operate independently from one another regional colonoscopy providers. The Scaling Colorectal Cancer Screening Through...
Distributing CRC screening through pharmacies, a highly accessible health service, may create opportunities for more equitable access to screening. However, providing in new context introduces substantial implementation challenge.
Purpose: American Indian adults have not experienced decreases in colorectal cancer (CRC) incidence and mortality observed other races or ethnic groups their screening rates are low. Decision aids that explain available CRC options one potential strategy to promote screening. The goal of this study was test the effect a culturally adapted decision aid on CRC-related outcomes among adults, including screening-related knowledge, attitudes, self-efficacy, intentions, modality preferences....
Background: Mothers with babies in the neonatal intensive care unit (NICU) face a host of challenges following childbirth. Limited information is available on these mothers' postpartum health needs and access to services. Objective: To identify NICU mothers, services, potential service improvements. Design: A mixed-methods study including retrospective cohort study, in-depth interviews, focus groups. Setting: Large, Level IV, regional referral, university-affiliated hospital United States....
Abstract Colorectal cancer (CRC) is a common and preventable cancer. CRC screening underutilized, particularly within medically underserved communities. Most interventions aimed at increasing are delivered through primary care clinics. Pharmacies more accessible than traditional settings may be ideally suited for delivering access. Fecal immunochemical test an at-home, stool-based that could distributed pharmacies. The purpose of our study was to assess patient perspectives on receiving...
Abstract Objective To examine the impact of a Medicaid‐serving pediatric accountable care organization ( ACO ) on health service use by children who qualify for Medicaid virtue disability under “aged, blind, and disabled” ABD eligibility criteria. Data Sources/Study Setting We evaluated 2013 Ohio policy change that effectively moved into an model using administrative claims data years 2011‐2016. Study Design used difference‐in‐difference design to changes in patterns ‐enrolled before after...
Women with infants in a neonatal intensive care unit (NICU) encounter multiple challenges following childbirth, including greater burden of chronic disease and increased risk for depression, compared women well infants. At the same time, they are confronted trauma hospitalized infant while also managing their postpartum recovery. Limited research exists describing health needs these women, despite many numbers living this experience daily. This study aimed to better understand NICU 90 days...
The United States Preventive Services Task Force (USPSTF) lists 32 grade A or B recommended preventive services for non-pregnant (US) adults, including colorectal cancer screening (CRC). Little guidance is given on how to implement these with consistency and fidelity in primary care. Given limited patient visit time competing demands, care providers (PCPs) tend prioritize a small subset of recommendations. Completion rates some services, CRC screening, are suboptimal. Expanding delivery...
Abstract Purpose Cervical cancer disproportionately impacts women in low- and middle-income countries (LMICs). The World Health Organization’s (WHO) 90/70/90 strategy aims to eliminate cervical by 2030 increasing HPV vaccination coverage 90%, screening 70% of eligible women, effectively treating 90% those with abnormal results 2030, potentially preventing 62 million deaths LMICs. LMICs, however, struggle limited access precancer treatment, part due a lack trained professionals weak health...