A5058650776- Mobile Health and mHealth Applications
- Cancer survivorship and care
- Global Cancer Incidence and Screening
- HIV/AIDS Research and Interventions
- Family Support in Illness
- BRCA gene mutations in cancer
- Digital Mental Health Interventions
- Digital Radiography and Breast Imaging
- Smoking Behavior and Cessation
- Health Literacy and Information Accessibility
- Palliative Care and End-of-Life Issues
- Health Policy Implementation Science
- Childhood Cancer Survivors' Quality of Life
- COVID-19 and healthcare impacts
- Nutrition, Genetics, and Disease
- Technology Use by Older Adults
- Food Security and Health in Diverse Populations
- ICT in Developing Communities
- Health Systems, Economic Evaluations, Quality of Life
- Patient-Provider Communication in Healthcare
- Ethics in Clinical Research
- Nutritional Studies and Diet
- Genetic factors in colorectal cancer
- Health disparities and outcomes
- Primary Care and Health Outcomes
University of Virginia
2016-2025
University of Virginia Cancer Center
2022-2025
University of Virginia Health System
2001-2022
Although cognitive behavior therapy for insomnia (CBT-I) has been established as the first-line recommendation millions of adults with chronic insomnia, there is a paucity trained clinicians to deliver this much needed treatment. Internet-delivered CBT-I shown promise method overcome obstacle; however, long-term effectiveness not proven in representative sample insomnia.To evaluate web-based, automated intervention improve short term (9 weeks) and long (1 year).A randomized clinical trial...
Mobile health interventions may help People Living with HIV (PLWH) improve engagement in care. We designed and piloted PositiveLinks, a clinic-affiliated mobile intervention for PLWH, assessed longitudinal impact on retention care viral suppression. The program was based at an academic Ryan White Clinic serving nonurban population Central Virginia. PL included smartphone app that connected participants to clinic staff provided educational resources, daily queries of stress, mood medication...
A detailed family health history is currently the most potentially useful tool for diagnosis and risk assessment in clinical genetics. We developed evaluated usability analytic validity of a patient-driven web-based collection analysis tool. Health Heritage(©) guides users through their by relative, generates pedigree, completes assessment, stratification, recommendations 89 conditions. compared performance Heritage to that Usual Care using nonrandomized cohort trial 109 volunteers....
The examination of health disparities among people within Appalachian counties compared to living in other is needed find ways strategically target improvements community the United States America (USA).
Accurate breast cancer risk assessment for women attending routine screening is needed to guide and preventive interventions. We evaluated the accuracy of predictions from both visual volumetric mammographic density combined with Tyrer-Cuzick model. A case-control study (474 patient participants 2243 healthy control participants) aged 40-79 years was performed using self-reported classical factors. Breast measured by automated software Imaging Reporting Data System (BI-RADS) categories. Odds...
Linkage to and retention in HIV care are challenging, especially the Southeastern United States. The rise mobile phone app use potential for an deliver just time messaging provides a new opportunity improve linkage among people living with (PLWH).This study aimed develop engage, link, retain care. We evaluated acceptability, feasibility, impact of users.App development was informed by principles chronic disease self-management formative interviews PLWH. Once developed, distributed...
public and private schools affected at least 55.1 million students through the end of 2019-20 school year.† During summer 2020, approximately 82% 8,947 U.S. overnight camps did not operate.§ In Maine, only 20% 100 opened.¶ An camp in Georgia recently reported SARS-CoV-2, virus that causes COVID-19, transmission among campers staff members when nonpharmaceutical interventions (NPIs) were strictly followed (1); however, NPIs have been successfully used to mitigate SARS-CoV-2 military basic...
In 2005, the American Medical Informatics Association undertook a set of activities relating to clinical decision support (CDS), with from office national coordinator and Agency for Healthcare Research Quality. They culminated in release roadmap action on CDS 2006. This article assesses progress toward short-term goals within roadmap, recommends continue improve adoption throughout United States. The report finds that considerable has been made past four years, although significant work...
Informal caregivers express strong interest in technology innovations to help them their caregiving role; however, divides across sociodemographic characteristics internet and access may preclude the most vulnerable from accessing such resources.This study aims examine caregivers' use, both generally for seeking health-related information, whether usage differs as a function of characteristics.Data were analyzed Health Information National Trends Survey 5 Cycle 1. Participants included...
Stigma has negative consequences for quality of life and HIV care outcomes. PositiveLinks is a mobile health intervention that includes secure anonymous community message board (CMB). We investigated discussion stigma changes in scores. Of 77 participants our pilot, 63% were male, 49% Black, 72% had incomes below the federal poverty level. Twenty-one percent CMB posts (394/1834) contained stigma-related content including (experiencing stigma) positive (overcoming addressing intrapersonal...
Background PositiveLinks (PL) is a smartphone-based platform designed in partnership with people living HIV (PLWH) to improve engagement care. PL provides daily medication reminders, check-ins about mood and stress, educational resources, community message board, an ability providers. The objective of this study was evaluate the impact up 24 months use on viral suppression care examine whether greater associated improved outcomes. Setting This occurred between September 2013 March 2017 at...
The COVID-19 pandemic involved business closures (e.g., gyms), social distancing policies, and prolonged stressful situations that may have impacted engagement in health behaviors. Our study assessed changes cancer-related behaviors during the pandemic, specifically physical activity, fruit/vegetable intake, smoking/tobacco use, alcohol consumption. Eight cancer centers administered mailed/web-based/telephone surveys between June 2020 March 2021. Surveys demographics, perceptions on...
Purpose: Sleep quality and sexual functioning are interrelated, with problems in these domains frequent among breast cancer survivors. As there is limited evidence on how constructs influence one another over time, this secondary analysis examines the prospective association between survivors’ sleep satisfaction.Methods: 313 distressed survivors (age M=52, 84% non-Hispanic White) were randomized to either a mobile app distress intervention (IntelliCare) or psychoeducational control app....
<sec> <title>BACKGROUND</title> Evaluating implementation of digital health interventions (DHIs) in practice settings is complex, involving diverse users and multistep processes. Proactive planning can ensure determinants outcomes are captured for hybrid studies, but operational guidance DHI studies limited. </sec> <title>OBJECTIVE</title> We aimed to proactively define, prioritize operationalize measurement a effectiveness-implementation trial. describe unique advantages limitations the...
Little is known about the factors influencing patients' decisions whether to utilize cancer genetic counseling services. The purpose of this study identify potential barriers broad utilization such Of a total 136 decliners services at our institution, 117 were deemed eligible participate. these, 73 randomly selected for study. A 37/73 (51%) agreed participate in semistructured telephone survey designed assess that impacted their decline counseling. An interview script, composed both closed-...
Abstract Background Adult smoking rates in the USA are highest economically depressed rural Appalachia. Pharmacist-delivered tobacco cessation support that incorporates medication therapy management (such as QuitAid intervention) is a promising approach to address this need. Methods Twenty-four adult smokers recruited between September and November 2021 through an independent pharmacy Appalachia were randomized non-blinded 2 × factorial design (1) pharmacist delivered intervention (yes vs....
A major promise of genomic research is information that can transform health care and public through earlier diagnosis, more effective prevention treatment disease, avoidance drug side effects. Although there interest in the early adoption emerging applications cancer treatment, are substantial evidence gaps further compounded by difficulties designing adequately powered studies to generate this evidence, thus limiting uptake these tools into clinical practice. Comparative effectiveness...
The purpose of this study was to identify risk factors for poor health-related quality life (HRQL) in multi-morbid adult cancer survivors and explore whether perceived treatment self-management burden mediate any these relationships.Ninety-one (median age: 65 years) completed surveys at baseline 6 months. Demographic, psychosocial, health care-related were assessed as general HRQL (physical mental health). Data on medical diagnoses extracted from the record. Bivariate correlations screened...
Nearly half of the patients with breast cancer experience clinically significant mental distress within first year receiving their diagnosis. There is an urgent need to identify scalable and cost-efficient ways delivering empirically supported health interventions cancer.The aim this study was evaluate feasibility in-clinic recruitment for a mobile phone app usability preliminary impact suite apps (IntelliCare) coaching on psychosocial symptoms in recently diagnosed cancer.This pilot adopted...
Although there is growing interest in mobile applications and online support groups to enhance chronic disease self-management, little known about their potential impact for people living with HIV (PLWH).We developed an innovative group delivered through a community message board (CMB) within clinic-affiliated smartphone application Positive Links (PL). We analyzed characteristics of posters nonposters the CMB evaluated content posted CMB.For this study, 38 HIV-infected patients received...
Women cancer survivors, especially those in rural areas, with high levels of depression may be acutely susceptible to pain due the ways they think, feel, and behave. The current study seeks elucidate relationship between symptoms severity women by examining putative mediators involved this relationship, specifically their self-efficacy for managing health, how overwhelmed were from life's responsibilities, relational burden.
Abstract Background: Mammographic density (MD) is associated with increased breast cancer risk, yet limited data exist on an association between MD and molecular subtypes. Methods: Women ages 18 years older available mammograms 2003 2012 were enrolled in a larger study MD. was classified by the Breast Imaging Reporting Data System (BI-RADS) classification volumetric percent (Volpara Solutions). Subtype assigned hormone receptor status, tumor grade, mitotic score (MS). Subtypes included:...