A5023425137- Colorectal Cancer Screening and Detection
- Gastric Cancer Management and Outcomes
- Global Cancer Incidence and Screening
- Health Policy Implementation Science
- Primary Care and Health Outcomes
- Genetic factors in colorectal cancer
- Diverticular Disease and Complications
- Health Systems, Economic Evaluations, Quality of Life
- Economic and Financial Impacts of Cancer
- Chronic Disease Management Strategies
- Music Therapy and Health
- Cancer survivorship and care
- Ethics in Clinical Research
- Obstructive Sleep Apnea Research
- Health and Medical Research Impacts
- Endometriosis Research and Treatment
- Machine Learning in Healthcare
- Community Health and Development
- Frailty in Older Adults
- Cervical Cancer and HPV Research
- Cardiovascular Health and Risk Factors
- Testicular diseases and treatments
- Dietetics, Nutrition, and Education
- Delphi Technique in Research
- Traditional Chinese Medicine Studies
University of North Carolina at Chapel Hill
2018-2024
UNC Lineberger Comprehensive Cancer Center
2024
McMaster University
2019-2022
Durham VA Health Care System
2017-2021
Durham VA Medical Center
2017-2021
Segeberger Kliniken
2021
South Health Campus
2021
Memorial University of Newfoundland
2015-2016
Queen's University
2016
Robert Wood Johnson University Hospital
2009
In several recent articles, authors have called for aligning the fields of implementation and improvement science. this paper, we call science to also align with practice. Multiple scholars highlighted importance designing strategies fit existing culture, infrastructure, practice a healthcare system. Worldwide, systems are adopting models as their primary approach improving delivery outcomes. The prevalence raises question how scientists might best efforts systems' infrastructure practice.We...
Abstract Background Economic evaluations of the implementation health-related evidence-based interventions (EBIs) are conducted infrequently and, when performed, often use a limited set quantitative methods to estimate cost and effectiveness EBIs. These studies underestimate resources required implement sustain EBIs in diverse populations settings, part due inadequate scoping EBI boundaries underutilization designed understand local context. We call for increased methods, especially...
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...
Abstract Purpose We assessed fecal immunochemical test (FIT) uptake following a mailed FIT intervention among 45–49-year-olds newly eligible for colorectal cancer (CRC) screening based on 2021 United States Preventive Services Task Force recommendations. also tested the effect of an enhanced versus plain mailing envelope uptake. Methods In February 2022 we FITs to at one Federally Qualified Health Center (FQHC) clinic. determined proportion who completed within 60 days. conducted nested...
Colorectal cancer (CRC) can be effectively prevented or detected with guideline concordant screening, yet Medicaid enrollees experience disparities. We used microsimulation to project CRC screening patterns, cases averted, and life-years gained in the population of 68,077 Oregon 50-64 over a five year period starting January 2019. The simulation estimated cost-effectiveness intervention scenarios - academic detailing plus provider audit feedback (Detailing+), patient reminders (Reminders),...
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,...
Recruitment into clinical trials remains a key determinant to study completion and success. While various strategies have been proposed, it is unclear how they apply across different populations, diseases, and/or goals. The ability effectively overcome challenges may require approaches that more broadly focus on addressing obstacles among sites cannot be by individual studies.The Department of Veterans Affairs (VA) Cooperative Studies Program (CSP) established the Network Dedicated...
Background. The purpose of this study is to determine if colonoscopy quality associated with the annual case volume endoscopists. Methods. A retrospective cohort was performed on 3235 patients who underwent in city St. John's, NL, between January and June 2012. Data collected included completion (CCR) adenoma detection rates (ADR). Endoscopists were divided into quintiles based volume. To account for potential confounding variables, univariate analyses followed by multivariable logistic...
Background Mailed reminders to promote colorectal cancer (CRC) screening by fecal immunochemical testing (FIT) have been shown be effective in the Medicaid population, which is underused. However, little known regarding cost‐effectiveness of these interventions, with or without an included FIT kit. METHODS The authors conducted a analysis randomized controlled trial that compared effectiveness reminder + intervention versus reminder‐only increasing screening. costs per person screened for...
Although screening is effective in reducing incidence, mortality, and costs of treating colorectal cancer (CRC), it remains underutilized, part due to limited insurance access. We used microsimulation estimate the health financial effects expansion reduction scenarios North Carolina (NC). simulated full lifetime a population 3,298,265 residents age-eligible for CRC (ages 50-75) during 5-year period starting January 1, 2018, including polyp incidence progression screening, diagnosis,...
In 2012 the Canadian Association of Gastroenterology published 19 indicators safety compromise. We studied incidence these by reviewing all colonoscopies performed in St. John's, NL, between January 1, 2012, and June 30, 2012. Results. A total 3235 were included. Adverse events are as follows. Medication-related includes use reversal agents 0.1%, hypoxia 9.9%, hypotension 15.4%, hypertension 0.9%. No patients required CPR or experienced allergic reactions laryngospasm/bronchospasm. The...
<h3>• Objective.</h3> —A pilot study to determine if the synthetic prostaglandin E<sub>1</sub>misoprostol is effective in treating severe tinnitus, test hypothesis that tinnitus production related metabolism. <h3>Design.</h3> —Blinded, placebo controlled, hemicrossover. <h3>Setting.</h3> —House Ear Clinic, Los Angeles, Calif. <h3>Patients.</h3> volunteer and convenience sample of 24 subjects complaining was recruited from mailings, telephone calls, clinic population. The patients were not...
Abstract Purpose We aimed to understand how an interactive, web-based simulation tool can be optimized support decision-making about the implementation of evidence-based interventions (EBIs) for improving colorectal cancer (CRC) screening. Methods Interviews were conducted with decision-makers, including health administrators, advocates, and researchers, a strong foundation in CRC prevention. Following demonstration microsimulation modeling tool, participants reflected on tool’s potential...
The goal of this study was to assess acceptability using process flow diagrams (or maps) depicting a previously implemented evidence-based intervention (EBI) inform the implementation similar interventions in new settings.We developed three different versions maps, each visualizing same multicomponent colorectal cancer (CRC) screening EBI community health centers but including varying levels detail about how it implemented. Interviews with professionals and practitioners at other sites not...
Despite its widely acknowledged influence on implementation, limited research has been done how the external environment (i.e., outer setting) determines when organizations adopt and implement new interventions. Determinant frameworks identify several setting-level factors such as funding streams, inter-organizational relationships, peer pressure. However, these do not explain or why outer-setting implementation. To advance in this area, we argue for importance of deriving theory-based...
Hepatitis B virus (HBV) reactivation may occur with high risk immunosuppression, such as anti-cluster of differentiation (CD)20 antibodies (Abs). Appropriate HBV prophylaxis during anti-CD20 Ab therapy averts hepatitis, chemotherapy disruption, and death. Serologic evidence prior exposure is present in one nine veterans the Veterans Health Administration (VHA). In 2014, most (61%-73%) patients VHA who were receiving treatment underwent testing, yet <20% eligible received antiviral...