TY - JOUR AU - Bhavnani, S.K. PY - 2003 TI - The distribution of online healthcare information: a case study on melanoma SP - 81-5 JF - AMIA Annu Symp Proc N1 - 14728138 N1 - Journal Article KW - Delivery of Health Care Health Education/methods/*standards Humans Information Dissemination/*methods Information Services/*standards Internet/standards Melanoma/*prevention & control Risk Factors Skin Neoplasms/*prevention & control N2 - To understand the difficulties users face when retrieving comprehensive healthcare information, this paper analyzes how facts related to a widely available healthcare topic are distributed across high-quality webpages. An inter-rater experiment with two skin-cancer physicians helped identify 14 facts necessary for a comprehensive understanding of melanoma risk and prevention. A second inter-rater experiment analyzed how those facts were distributed across 189 relevant webpages from high-quality sites. The analysis revealed that the distribution of facts is highly skewed, where few pages have many facts, many pages have a few facts, and no single page or site provides all the facts. A more detailed analysis suggests that the distribution is being caused by a trade-off between depth and breadth, leading to the existence of general, specialized, and sparse pages. Furthermore, the analyses reveal patterns and complexities in the relationships between facts, pages, and websites. These distribution results pinpoint the difficulties faced by searchers, and provide insights for the design of future systems that guide users in retrieving comprehensive healthcare information. AD - School of Information, University of Michigan, Ann Arbor, MI 48109-1092, USA. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=14728138 ID - 28 ER - TY - JOUR AU - Black, B.L. AU - Cowens-Alvarado, R. AU - Gershman, S. AU - Weir, H.K. PY - 2005 TI - Using data to motivate action: the need for high quality, an effective presentation, and an action context for decision-making SP - 15-25 JF - Cancer Causes Control VL - 16 Suppl 1 Y2 - Oct N1 - 16208571 N1 - 0957-5243 (Print) Journal Article Review KW - Data Collection *Decision Making, Organizational Health Planning/*organization & administration Humans Information Dissemination Neoplasms/*prevention & control Public Health Informatics *Quality Control *Speech Time Factors N2 - Three common barriers to the effective use of data to inform decisions and motivate action for the planning of cancer control are (1) failure to recognize the availability of high-quality data, (2) not presenting the data in a compelling format, and (3) failing to place the data in a historical and action context. Overcoming these barriers will go a long way toward demonstrating that high-quality data can be used to accomplish the desired outcomes in a Comprehensive Cancer Control (CCC) program. The article identifies existing sources of high-quality data, provides examples of effective presentation, and discusses successes in using data for program planning and implementation. The paper is not meant to provide a comprehensive discussion of using data for decision making, instead providing options to help key CCC stakeholders improve the effectiveness of their decisions as CCC plans are developed and implemented. AD - American Cancer Society, 1599 Clifton Rd., NE, Atlanta, GA 30329-4251, USA. bblack@cancer.org UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16208571 ID - 6 ER - TY - JOUR AU - Bryant, H. PY - 1996 TI - Breast cancer screening in Canada: climbing the diffusion curve SP - S60-2 JF - Can J Public Health VL - 87 Suppl 2 Y2 - Nov-Dec N1 - 9002347 N1 - 0008-4263 (Print) Journal Article KW - Aged Alberta Breast Neoplasms/*prevention & control Canada Diffusion of Innovation Female Health Services Accessibility Humans Mammography *Mass Screening Middle Aged Research/methods Rural Population N2 - Results of breast cancer screening studies, which point to the efficacy of screening mammography in the 50 to 69 year age group, have been available for several years. A number of initiatives are underway in Canada in an attempt to assure that the diffusion for this technology occurs consistently and rapidly. This paper outlines the initiative of the Canadian Workshop Group of Breast Cancer Screening, which convened in 1988, as well as other national initiatives in this area. In addition, it describes the experience of one screening program in assessing and acting upon shortcomings in screening diffusion in its own province. Specifically, the use of letters of invitation, community mobilization, and mobile service delivery are briefly outlined. This illustrates the use of outcome-based research and programmatic service delivery in assisting the diffusion effort. AD - Division of Epidemiology, Prevention and Screening, Alberta Cancer Board, Calgary. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9002347 ID - 38 ER - TY - JOUR AU - Buller, D.B. AU - Buller, M.K. AU - Kane, I. PY - 2005 TI - Web-based strategies to disseminate a sun safety curriculum to public elementary schools and state-licensed child-care facilities SP - 470-6 JF - Health Psychol VL - 24 IS - 5 Y2 - Sep N1 - 16162041 N1 - 0278-6133 (Print) Journal Article Multicenter Study Randomized Controlled Trial KW - Adolescent Adult Aged Aged, 80 and over Child *Child Day Care Centers Child, Preschool Curriculum *Diffusion of Innovation Female Health Education/*methods Health Knowledge, Attitudes, Practice Health Promotion/methods Humans Information Dissemination *Internet Male Middle Aged Pamphlets Research Support, N.I.H., Extramural Research Support, U.S. Gov't, P.H.S. *Safety School Health Services/organization & administration *Schools Skin Neoplasms/etiology/*prevention & control Sunlight/*adverse effects United States N2 - The Sunny Days, Healthy Ways curriculum, which has been effective in previous trials, was disseminated to public elementary schools (n=2,030) and state-licensed child-care facilities (n=3,755) in 4 states. Two Web sites were created, varying in the amount and type of information. Mailings referred principals and directors to the sites. Overall 117 unique users made 172 visits to the sites. More repeat visits were made to the enhanced than to the basic site (p=.04). In a survey, 20.0% of principals and directors recalled receiving the mailings and 80.9% of these read them. Web-based strategies were weak, but the low response rate may be typical for such marketing. They will require supplementation by more personal approaches. AD - The Cooper Institute, Golden, CO 80401, USA. dbuller@kleinbuendel.com UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16162041 ID - 11 ER - TY - JOUR AU - Chiasson, M.W. AU - Lovato, C.Y. PY - 2000 TI - The health planning context and its effect on a user's perceptions of software usefulness SP - 225-8 JF - Can J Public Health VL - 91 IS - 3 Y2 - May-Jun N1 - 10927854 N1 - 0008-4263 (Print) Journal Article KW - *Attitude to Computers Breast Neoplasms/prevention & control Consumer Satisfaction Expert Systems Female Health Planning/*methods Health Promotion/methods Hospitals, Urban Humans Mammography Organizational Case Studies Organizational Innovation Program Development Program Evaluation Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. Software/*standards *Technology Transfer User-Computer Interface N2 - This article reports a health planner's experience in using program planning software and the contextual factors that influenced her perceptions. The software examined (EMPOWER) is designed to support program planning for prevention of breast cancer through mammography screening. Use by a health professional in an urban hospital was examined through a case study approach. The user was interviewed at 3, 6, and 12 months following initial use. Transcripts were coded using Roger's characteristics of an innovation as a framework for categorizing the user's perceptions. Contextual factors identified as important in influencing her perceptions were open-coded and themes identified. The user referred to three contextual factors in describing characteristics of the innovation: implementation factors, user background, and work and community environment. The successful dissemination of software will depend not only on characteristics of the innovation, but also on situational circumstances that must be changed by, or accommodated in the technology. AD - Faculty of Management, University of Calgary. chiasson@ucalgary.ca UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10927854 ID - 34 ER - TY - JOUR AU - Cobau, C.D. PY - 1994 TI - Clinical trials in the community. The community clinical oncology program experience SP - 2694-700 JF - Cancer VL - 74 IS - 9 Suppl Y2 - Nov 1 N1 - 7954289 N1 - 0008-543X (Print) Journal Article Review KW - *Clinical Trials/economics *Community Health Services/economics/organization & administration Humans National Health Programs National Institutes of Health (U.S.) Neoplasms/prevention & control/*therapy Patient Selection Program Evaluation Technology Transfer United States N2 - In 1983, the National Cancer Institute initiated the community clinical oncology program (CCOP), the goal of which was to hasten the adoption of state-of-the-art cancer medicine in community-based institutions. The strategy adopted was to link community oncologists to major cancer centers and research bases for the conduct of clinical trials. Since the program was initiated, a significant amount of literature has been developed, providing insight into the operation and success of the program. These reports have been combined with experience of the author, a principal investigator of an established CCOP, in an effort to characterize the critical features of the program. Experience to date indicates that CCOPs have been successful in accruing patients to cancer-treatment clinical trials, contributing approximately one third of patients placed in investigational protocols. Since 1987, CCOPs have been required to participate in nontreatment-related research in cancer prevention, detection, and mitigation of cancer symptoms, or cancer control research. After a slow beginning, both the research bases and CCOPs have accumulated experience in the development of and accrual of patients in cancer control protocols. This review suggests that CCOPs, as they mature, will fulfill their goal as an important mechanism for the transfer of technology and the conduct of clinical research. AD - Department of Oncology, Flower Memorial Hospital, Sylvania, Ohio 43560. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7954289 ID - 41 ER - TY - JOUR AU - de Vet, H.C. AU - Kessels, A.G. AU - Leffers, P. AU - Knipschild, P.G. PY - 1993 TI - A randomized trial about the perceived informativeness of new empirical evidence. Does beta-carotene prevent (cervical) cancer? SP - 509-17 JF - J Clin Epidemiol VL - 46 IS - 6 Y2 - Jun N1 - 8501477 N1 - 0895-4356 (Print) Clinical Trial Journal Article Randomized Controlled Trial KW - Anticarcinogenic Agents/*pharmacology Carotenoids/*pharmacology Case-Control Studies *Diffusion of Innovation Female Humans Questionnaires Random Allocation Statistics Uterine Cervical Dysplasia/prevention & control Uterine Cervical Neoplasms/*prevention & control beta Carotene N2 - The perceived informativeness of a publication can be assessed by measuring the change in belief it induces among the scientific public, regarding a certain hypothesis. In a randomized trial, we studied the effect of empirical evidence from a clinical experiment and a case-control study on the hypothesis that beta-carotene protects against (cervical) cancer. The study population consisted of first authors of recently published patient-oriented research papers. They received an abstract of the clinical experiment, of the case-control study, or a "placebo" abstract. The latter was used to assess the specific effect of the empirical evidence in the two real studies. The change in belief in the hypotheses was expressed as a likelihood ratio (LR). All three abstracts led to a decrease in belief in the hypothesis. The median LRs of the abstracts of the experiment, case-control study and "placebo" were 0.33, 0.45, 0.75 respectively. This paper shows that the belief in a certain hypothesis is influenced by the quality of empirical evidence in a study. The magnitude of change induced by the experimental and case-control abstract had the anticipated order, but the change in belief induced by the "placebo" abstract was larger than we had expected. Reasons for this may be the concise information in the abstract and the variable methodological training of the study population. AD - Department of Epidemiology, University of Limburg, Maastricht, The Netherlands. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8501477 ID - 42 ER - TY - JOUR AU - Ellis, P. AU - Robinson, P. AU - Ciliska, D. AU - Armour, T. AU - Brouwers, M. AU - O'Brien, M.A. AU - Sussman, J. AU - Raina, P. PY - 2005 TI - A systematic review of studies evaluating diffusion and dissemination of selected cancer control interventions SP - 488-500 JF - Health Psychol VL - 24 IS - 5 Y2 - Sep N1 - 16162043 N1 - 0278-6133 (Print) Journal Article Review KW - *Diffusion of Innovation Evaluation Studies Health Knowledge, Attitudes, Practice Health Promotion/methods Health Services Research Humans Information Dissemination/*methods Life Style Neoplasms/etiology/*prevention & control Outcome and Process Assessment (Health Care) Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. N2 - With this review, the authors sought to determine what strategies have been evaluated (including the outcomes assessed) to disseminate cancer control interventions that promote the uptake of behavior change. Five topic areas along the cancer care continuum (smoking cessation, healthy diet, mammography, cervical cancer screening, and control of cancer pain) were selected to be representative. A systematic review was conducted of primary studies evaluating dissemination of a cancer control intervention. Thirty-one studies were identified that evaluated dissemination strategies in the 5 topic areas. No strong evidence currently exists to recommend any one dissemination strategy as effective in promoting the uptake of cancer control interventions. The authors conclude that there is a strong need for more research into dissemination of cancer control interventions. Future research should consider methodological issues such as the most appropriate study design and outcomes to be evaluated. AD - Hamilton Regional Cancer Centre, Hamilton, ON, Canada. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16162043 ID - 9 ER - TY - JOUR AU - Ellis, P. AU - Robinson, P. AU - Ciliska, D. AU - Armour, T. AU - Raina, P. AU - Brouwers, M. AU - O'Brien, M.A. AU - Gauld, M. AU - Baldassarre, F. PY - 2003 TI - Diffusion and dissemination of evidence-based cancer control interventions SP - 1-5 JF - Evid Rep Technol Assess (Summ) IS - 79 Y2 - May N1 - 12794961 N1 - 1530-440X (Print) Journal Article KW - Behavior Therapy *Evidence-Based Medicine Humans Information Dissemination Neoplasms/epidemiology/*prevention & control United States/epidemiology UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12794961 ID - 31 ER - TY - JOUR AU - Glanz, K. AU - Steffen, A. AU - Elliott, T. AU - O'Riordan, D. PY - 2005 TI - Diffusion of an effective skin cancer prevention program: design, theoretical foundations, and first-year implementation SP - 477-87 JF - Health Psychol VL - 24 IS - 5 Y2 - Sep N1 - 16162042 N1 - 0278-6133 (Print) Journal Article Multicenter Study Randomized Controlled Trial KW - Child Child, Preschool Cohort Studies *Diffusion of Innovation Follow-Up Studies Health Education/methods Health Knowledge, Attitudes, Practice *Health Plan Implementation Humans Outcome Assessment (Health Care) Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. *Safety Skin Neoplasms/etiology/*prevention & control Sunlight/*adverse effects Swimming Pools United States N2 - This article describes the design and theoretical foundations of the Pool Cool Diffusion Trial and reports 1st-year findings. Aims of the study are to evaluate the effects of 2 strategies for diffusion of the Pool Cool sun safety program on implementation, maintenance, and sustainability; improvements in environmental supports for sun safety in swimming pools; and sun protection habits and sunburn among participating children. There was a high rate of program participation (86.6%; n=375 swimming pools) in the 1st year and somewhat lower study participation (75.8%). Analysis of pool manager surveys revealed a time effect for overall sun safety programs and for sun safety policies, environmental strategies, and programs for pool users. There were few differences in implementation between treatment groups in year one. AD - Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA. kglanz@sph.emory.edu UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16162042 ID - 10 ER - TY - JOUR AU - Glaser, S.L. AU - Clarke, C.A. AU - Gomez, S.L. AU - O'Malley, C.D. AU - Purdie, D.M. AU - West, D.W. PY - 2005 TI - Cancer surveillance research: a vital subdiscipline of cancer epidemiology SP - 1009-19 JF - Cancer Causes Control VL - 16 IS - 9 Y2 - Nov N1 - 16184466 N1 - 0957-5243 (Print) Journal Article Review KW - Behavioral Risk Factor Surveillance System *Epidemiologic Research Design Humans Neoplasms/*epidemiology Population Surveillance/*methods Public Health Informatics Publishing SEER Program Software N2 - Public health surveillance systems relevant to cancer, centered around population-based cancer registration, have produced extensive, high-quality data for evaluating the cancer burden. However, these resources are underutilized by the epidemiology community due, we postulate, to under-appreciation of their scope and of the methods and software for using them. To remedy these misperceptions, this paper defines cancer surveillance research, reviews selected prior contributions, describes current resources, and presents challenges to and recommendations for advancing the field. Cancer surveillance research, in which systematically collected patient and population data are analyzed to examine and test hypotheses about cancer predictors, incidence, and outcomes in geographically defined populations over time, has produced not only cancer statistics and etiologic hypotheses but also information for public health education and for cancer prevention and control. Data on cancer patients are now available for all US states and, within SEER, since 1973, and have been enhanced by linkage to other population-based resources. Appropriate statistical methods and sophisticated interactive analytic software are readily available. Yet, publication of papers, funding opportunities, and professional training for cancer surveillance research remain inadequate. Improvement is necessary in these realms to permit cancer surveillance research to realize its potential in resolving the growing cancer burden. AD - Northern California Cancer Center, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538, USA. sglaser@nccc.org UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16184466 ID - 27 ER - TY - JOUR AU - Glasgow, R.E. AU - Marcus, A.C. AU - Bull, S.S. AU - Wilson, K.M. PY - 2004 TI - Disseminating effective cancer screening interventions SP - 1239-50 JF - Cancer VL - 101 IS - 5 Suppl Y2 - Sep 1 N1 - 15316911 N1 - 0008-543X (Print) Journal Article Review KW - Delivery of Health Care/standards Evidence-Based Medicine Health Services Research/*methods Humans *Information Dissemination Intervention Studies Mass Screening/*methods Neoplasms/*diagnosis/prevention & control Physician's Practice Patterns N2 - A large gap exists between the results of research concerning efficacious cancer screening programs and the programs delivered in practice. In this article, the authors discuss issues in, barriers to, and lessons learned regarding the dissemination of interventions. They summarize previous reviews, exemplary studies, and theories regarding the diffusion and dissemination of cancer screening interventions. Six lessons learned address the involvement of key stakeholders, factors influencing diffusion, the need for different types of efficacy and effectiveness studies with greater attention to external validity, replication, the use of theoretical and evaluation models, and the importance of policy infrastructure. In this article, the authors make recommendations for future research and practice, including improving the understanding of the intervention process and changing the types of grants funded and review criteria used. Also needed are an enhanced infrastructure, including policies to support dissemination, and the involvement of researchers, health care administrators, clinicians, and funding organizations in dissemination if the gap between research and practice in cancer screening is to be reduced. AD - Clinical Research Unit, Kaiser Permanente Colorado, Denver, Colorado 80237-8066, USA. russg@ris.net UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15316911 ID - 21 ER - TY - JOUR AU - Goodman, L.E. AU - Goodman, M.J. PY - 1986 TI - Prevention--how misuse of a concept undercuts its worth SP - 26-38 JF - Hastings Cent Rep VL - 16 IS - 2 Y2 - Apr N1 - 3700076 N1 - 0093-0334 (Print) Journal Article KW - Attitude Breast Neoplasms/prevention & control Child Abuse Coronary Disease/prevention & control Diabetes Mellitus, Type 2/prevention & control Diet Family Planning Services Female Fund Raising *Health Promotion Humans Hysterectomy Information Dissemination Magic Male Morals Neoplasms/prevention & control *Primary Prevention Questionnaires Risk *Risk Assessment Social Justice Vaccination been oversold. The National Cancer Institute and American Cancer Society's promotion of dietary changes to reduce cancer risk has spawned risky diets promoted by food faddists. Overuse of hysterectomy and estrogen replacement therapy and an overzealous swine flu immunization campaign have caused needless mortality and morbidity from complications. Promoting adolescent contraception as a means to reduce child abuse represents an overextension of the idea of preventive health measures into the nonmedical sphere, as do physicians' campaigns that amplify children's fears of nuclear disaster. Public confusion about the distinction between therapy and prevention has been fostered by groups soliciting funds for cancer research, while some health promotion campaigns have contributed to a blame-the-victim mentality and to the imputing of magical powers to certain prevention symbols. N2 - Some health leaders and researchers have launched mass prevention programs without sound biomedical groundwork. They have oversold the benefits of prevention and underestimated the secondary effects. Some have forced nonmedical concerns into the medical model. Others have blurred the distinctions between prevention and other measures such as screening or therapy. Some have transferred responsibility for disease to the victim. A few have imputed magical powers to certain symbols of prevention, in order to create an illusion of control. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3700076 ID - 46 ER - TY - JOUR AU - Grunfeld, E. AU - Zitzelsberger, L. AU - Hayter, C. AU - Berman, N. AU - Cameron, R. AU - Evans, W.K. AU - Stern, H. PY - 2004 TI - The role of knowledge translation for cancer control in Canada SP - 1-6 JF - Chronic Dis Can VL - 25 IS - 2 Y2 - Spring N1 - 15554605 N1 - 0228-8699 (Print) Journal Article Review KW - *Biomedical Research Canada Clinical Competence Humans Neoplasms/*therapy *Technology Transfer N2 - The definition and scope of cancer control has been evolving since its inception. The most recent model of cancer control in Canada has acknowledged the importance of knowledge translation to ensure that research results are implemented in practice and will be used to inform policy. However, without effort, the process of translation does not happen on a consistent basis. Knowledge translation focusses on improving the adoption of an innovation, e.g., research results. A number of health organizations in Canada have identified knowledge translation as an important activity and have begun to develop departments or initiatives dedicated to its achievement. As the emphasis in cancer control is on the application of knowledge, knowledge translation has a role to play in attaining the objectives of cancer control in Canada. It is an ideal time for the Canadian Strategy for Cancer Control and other Canadian cancer control initiatives to determine where they will locate knowledge translation in relation to their objectives. AD - Cancer Care Nova Scotia, Halifax, Nova Scotia, Canada. eva.grunfeld@ccns.nshealth.ca UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15554605 ID - 19 ER - TY - JOUR AU - Hallowell, N. AU - Murton, F. AU - Statham, H. AU - Green, J.M. AU - Richards, M.P. PY - 1997 TI - Women's need for information before attending genetic counselling for familial breast or ovarian cancer: a questionnaire, interview, and observational study SP - 281-3 JF - Bmj VL - 314 IS - 7076 Y2 - Jan 25 N1 - 9022494 N1 - 0959-8138 (Print) Journal Article KW - Adult Attitude to Health Breast Neoplasms/*genetics/prevention & control Communication *Comprehension England Female *Genetic Counseling Health Services Needs and Demand Humans *Medical Informatics Middle Aged Ovarian Neoplasms/*genetics/prevention & control *Patient Education Patient Satisfaction Prospective Studies Questionnaires Research Support, Non-U.S. Gov't N2 - OBJECTIVES: To describe women's information needs prior to genetic counselling for familial breast or ovarian cancer. DESIGN: Prospective study including semistructured telephone interviews before genetic counselling, observations of consultations, completion of postal questionnaires, and face-to face interviews within two months of counselling. SUBJECTS: 46 women attending genetic counselling for familial breast or ovarian cancer. MAIN OUTCOME MEASURES: Subjects' understanding of process and content of genetic counselling before attending and attitudes about their preparation for the counselling session. RESULTS: Although all women interviewed before the clinic expected to discuss their risk of developing cancer and risk management options, there was evidence of a lack of knowledge about the process and content of genetic counselling, 17 (37%) women said they did not know what else would happen. Most women interviewed after counselling viewed it positively, but 26 (65%) felt they had been inadequately prepared and 11 (28%) felt that their lack of preparation meant that they could not be given an accurate estimation of their risk of cancer. CONCLUSIONS: Some women felt that they did not obtain optimum benefit from genetic counselling because they were inadequately prepared for it. We suggest that cancer family history clinics should provide women with written information about the process and content of genetic counselling before their clinic attendance. AD - Centre for Family Research, Faculty of Social and Political Sciences, University of Cambridge. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9022494 ID - 37 ER - TY - JOUR AU - Hemminki, E. PY - 1988 TI - The use of combined estrogen-progestin replacement therapy SP - 511-9 JF - Int J Technol Assess Health Care VL - 4 IS - 4 N1 - 10291097 N1 - 0266-4623 (Print) Journal Article KW - *Communication *Diffusion of Innovation Drug Therapy, Combination Estrogens/adverse effects/*therapeutic use Female Humans Menopause/drug effects Progestins/adverse effects/*therapeutic use Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. *Technology Assessment, Biomedical United States Uterine Neoplasms/chemically induced N2 - The evaluation of innovations which use old technology poses different problems than does the evaluation of new technologies. The main necessity is the targeting of its use rather than the technology itself. The need to evaluate the extent of use and its problems is illustrated by the example of progestin use among menopausal and postmenopausal women in the United States. There progestins are not officially approved for use in menopause, even though they have been on the market for a long time with other indications. Estrogen-replacement therapy was widely used from the early 1960s until 1975, when the claim that estrogens cause endometrial cancer notably decreased their use. The use of estrogens increased again in the early 1980s, and one reason for this revival was the claim that progestins offered protection against endometrial cancer. When recommendations for combined estrogen-progestin therapy have been made, other health effects have been ignored. Two consensus conferences as well as the drug control authority have recommended against combined estrogen-progestin therapy until further research is completed. Absence of good research, specialization in medicine, and advantages for prescribers and the drug industry may have contributed to the wide use of this unassessed treatment. Possible solutions for prevention of the diffusion of these kinds of innovations are discussed. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10291097 ID - 45 ER - TY - JOUR AU - Hornbrook, M.C. AU - Hart, G. AU - Ellis, J.L. AU - Bachman, D.J. AU - Ansell, G. AU - Greene, S.M. AU - Wagner, E.H. AU - Pardee, R. AU - Schmidt, M.M. AU - Geiger, A. AU - Butani, A.L. AU - Field, T. AU - Fouayzi, H. AU - Miroshnik, I. AU - Liu, L. AU - Diseker, R. AU - Wells, K. AU - Krajenta, R. AU - Lamerato, L. AU - Neslund Dudas, C. PY - 2005 TI - Building a virtual cancer research organization SP - 12-25 JF - J Natl Cancer Inst Monogr IS - 35 N1 - 16287881 N1 - 1052-6773 (Print) Journal Article Multicenter Study KW - *Biomedical Research Computer Communication Networks/*organization & administration Health Services Research/*organization & administration Humans Medical Informatics/*organization & administration *Medical Oncology National Institutes of Health (U.S.) *Neoplasms Registries Research Support, N.I.H., Extramural United States N2 - BACKGROUND: The Cancer Research Network (CRN) comprises the National Cancer Institute and 11 nonprofit research centers affiliated with integrated health care delivery systems. The CRN, a public/private partnership, fosters multisite collaborative research on cancer prevention, screening, treatment, survival, and palliation in diverse populations. METHODS: The CRN's success hinges on producing innovative cancer research that likely would not have been developed by scientists working individually, and then translating those findings into clinical practice within multiple population laboratories. The CRN is a collaborative virtual research organization characterized by user-defined sharing among scientists and health care providers of data files as well as direct access to researchers, computers, software, data, research participants, and other resources. The CRN's research management Web site fosters a high-functioning virtual scientific community by publishing standardized data definitions, file specifications, and computer programs to support merging and analyzing data from multiple health care systems. RESULTS: Seven major types of standardized data files developed to date include demographics, health plan eligibility, tumor registry, inpatient and ambulatory utilization, medication dispensing, laboratory tests, and imaging procedures; more will follow. Data standardization avoids rework, increases multisite data integrity, increases data security, generates shorter times from initial proposal concept to submission, and stimulates more frequent collaborations among scientists across multiple institutions. CONCLUSIONS: The CRN research management Web site and associated standardized data files and procedures represent a quasi-public resource, and the CRN stands ready to collaborate with researchers from outside institutions in developing and conducting innovative public domain research. AD - Center for Health Research, Northwest/Hawaii, Kaiser Permanente Northwest, Portland, OR 97227, USA. mark.c.hornbrook@kpch.org UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16287881 ID - 2 ER - TY - JOUR AU - Houghton, J. AU - Fox, J.G. AU - Wang, T.C. PY - 2002 TI - Gastric cancer: laboratory bench to clinic SP - 495-502 JF - J Gastroenterol Hepatol VL - 17 IS - 4 Y2 - Apr N1 - 11982733 N1 - 0815-9319 (Print) Journal Article Review KW - Animals Cytokines/physiology Diet/adverse effects Diffusion of Innovation Gastric Acid/secretion Gastrins/physiology Growth Substances/metabolism Helicobacter Infections/complications Helicobacter pylori Humans *Mucins *Muscle Proteins *Neuropeptides Peptides/metabolism Sodium Chloride/administration & dosage/adverse effects Stomach Neoplasms/etiology/microbiology/pathology/*therapy N2 - Gastric cancer is the second most common cause of cancer-related mortality worldwide and the 14th overall cause of death. Detection of disease usually occurs at an advanced stage and overall survival rates for gastric cancer are poor. Our current model for gastric cancer progression clearly maintains Helicobacter infection as the primary inducer of gastric metaplastic and neoplastic disease. Helicobacter pylori is a ubiquitous organism, infecting more than half the world's population. It has been suggested that this infection directly contributes to the formation of gastric cancer in up to 80% of cases; however, gastric malignancy develops in only a subset (< 1%) of infected patients. Therefore, predisposition to Helicobacter-associated gastric cancer is most likely multifactorial, including the interaction of bacterial, host and environmental components. Our understanding of how the organism interacts with the gastric mucosa and synergizes with dietary and other environmental factors to induce malignant mucosal changes is evolving. Indeed, H. pylori has direct effects on the gastric mucosa, but the major factor in disease progression appears to be a robust host Th1 immune response in the setting of a permissive environment. In combination, these factors predispose to the formation of atrophy, metaplasia and gastric cancer. Understanding the interaction of the bacterium with the host and the environment can potentially identify patients most at risk. Identifying potentially removable factors (in addition to H. pylori infection) in the acquisition and progression of neoplastic disease may provide targets for early intervention and prevention strategies. AD - Department of Medicine, Division of Gastroenterology, University of Massachusetts Medical Center, NRB Second Floor, 364 Plantation Street, Worcester, MA 01605-2324, USA. jeanmarie.houghton@umassmed.edu UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11982733 ID - 32 ER - TY - JOUR AU - Jefford, M. AU - Kirke, B. AU - Grogan, S. AU - Yeoman, G. AU - Boyes, A. PY - 2005 TI - Australia's Cancer Helpline--an audit of utility and caller profile SP - 393-4 JF - Aust Fam Physician VL - 34 IS - 5 Y2 - May N1 - 15887947 N1 - 0300-8495 (Print) Journal Article KW - Age Distribution Australia Female Health Care Surveys Hotlines/*utilization Humans Information Dissemination/methods Male Middle Aged Neoplasms/diagnosis/*prevention & control/*psychology Sex Distribution N2 - BACKGROUND: The Cancer Helpline is a telephone information and support service operated throughout Australia. METHODS: Data from all calls received during the months of July, August and September from 2001 to 2003 were collected and analysed. RESULTS: Over 76,000 contacts were made, mostly from women (79%). Almost half of all calls were from people with general inquiries (rather than cancer patients, their families, or health professionals). The most common cancer type discussed was breast cancer, (26% of all calls, 42% of calls from people with cancer). Diagnosed cancer patients most frequently called about treatment/management and practical issues. People with general inquiries called to obtain information about the prevention and early detection of cancer. DISCUSSION: The helpline can complement the role of other information and support providers for people living with or concerned about cancer. AD - Cancer Information and Support Service, The Cancer Council Victoria. michael.jefford@cancervic.org.au UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15887947 ID - 16 ER - TY - JOUR AU - Kerner, J.F. AU - Guirguis-Blake, J. AU - Hennessy, K.D. AU - Brounstein, P.J. AU - Vinson, C. AU - Schwartz, R.H. AU - Myers, B.A. AU - Briss, P. PY - 2005 TI - Translating research into improved outcomes in comprehensive cancer control SP - 27-40 JF - Cancer Causes Control VL - 16 Suppl 1 Y2 - Oct N1 - 16208572 N1 - 0957-5243 (Print) Journal Article Review KW - *Biomedical Research Clinical Medicine Evidence-Based Medicine Humans Information Dissemination Neoplasms/*prevention & control Preventive Medicine World Health N2 - A key question in moving comprehensive cancer control (CCC) plans into action is, to what extent should the knowledge gained from investments in cancer prevention and control research influence the actions taken by states, tribes, and territories during implementation? Underlying this 'should' is the assumption that evidence-based approaches (i.e., a public health or clinical intervention or policy that has resulted in improved outcomes when scientifically tested), when implemented in a real-world setting, will increase the likelihood of improved outcomes. This article elucidates the barriers and opportunities for integrating science with practice across the cancer control continuum. However, given the scope of CCC and the substantial investment in generating new knowledge through science, it is difficult for any one agency, on its own, to make a sufficient investment to ensure new knowledge is translated and implemented at a national, state, or local level. Thus, if greater demand for evidence-based interventions and increased resources for adopting them are going to support the dissemination initiatives described herein, new interagency partnerships must be developed to ensure that sufficient means are dedicated to integrating science with service. Furthermore, for these collaborations to increase both in size and in frequency, agency leaders must clearly articulate their support for these collaborative initiatives and explicitly recognize those collaborative efforts that are successful. In this way, the whole (in this context, comprehensive cancer control) can become greater than the sum of its parts. AD - Division of Cancer Control and Population Sciences, National Cancer Institute, 6130 Executive Blvd. EPN 6144, Bethesda, MD 20892, USA. kernerj@mail.nih.gov UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16208572 ID - 5 ER - TY - JOUR AU - Lacey, L.M. AU - Hynes, D.M. AU - Kaluzny, A.D. PY - 1992 TI - Performance in quasi-firms: an example from the Community Clinical Oncology Program SP - 307-26 JF - J Health Hum Resour Adm VL - 14 IS - 3 Y2 - Winter N1 - 10118501 N1 - 0160-4198 (Print) Journal Article KW - *Clinical Trials Community Health Services/*organization & administration Diffusion of Innovation Humans Models, Theoretical National Health Programs/*organization & administration National Institutes of Health (U.S.) Neoplasms/*prevention & control Oncology Service, Hospital/*organization & administration/statistics & numerical data Organizational Affiliation Program Evaluation/methods/statistics & numerical data Regression Analysis United States N2 - In this analysis, the authors examined the effects of different sets of process, structure, and environmental variables on the performance of the CCOP as a quasi-firm. Specifically, they distinguished between internal organizational processes, structural, and size characteristics of the CCOP and the organizational environment created by prior NCI program experience and the relationship within the quasi-firm. The analysis revealed that these sets of organizational and environmental characteristics have differential effects on treatment accrual. The strongest predictors are those associated with the quasi-firm relationship between the CCOP and its chosen research bases. Any definitive policy implications for the design of organizational network relationships--especially the CCOPs--will require further analysis. Particular attention needs to be given to the longitudinal nature of the relationships and the ability of these organizational and environmental factors to affect other aspects of performance. Several points have been made within this initial assessment. First, the structural character of the CCOP and its relationship to its organizational environment are important factors affecting accrual performance. The subtleties of this multivariate model are not as important as simply demonstrating that the various internal and external characteristics of these organizations as quasi-firms simultaneously affect their ability to accrue patients to clinical trials. Secondly, the importance of research base relations, and particularly the significant role of nurses, needs to be emphasized. While CCOPs were originally designed as a network of physicians and hospitals, it appears that an infrastructure of professionally active nurses working within a larger organizational environment is critical to success--at least as defined by accrual to treatment protocols. Finally, the failure of prior experience with other NCI community programs to affect CCOP accrual performance suggests that such experience does not assure "organizational learning" that may enhance performance. This suggests that CCOPs can be designated de novo to maximize performance without necessarily having to undergo a developmental or experiential phase involving community cancer programs to be effective. However, the authors suspect that another method of characterizing experience may produce different results. Further analyses of these data will test these results against other measures of CCOP performance. Specifically, attention will be given to whether this same set of characteristics is predictive of accrual to cancer control research protocols. Similarly, these same organizational characteristics may or may not be associated with other dimensions of CCOP performance such as changes in physician practice patterns and/or levels of institutionalization of the CCOP within its local community.(ABSTRACT TRUNCATED AT 400 WORDS) AD - University of North Carolina, Chapel Hill. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10118501 ID - 43 ER - TY - JOUR AU - Lewis, E. AU - Mayer, J.A. AU - Slymen, D. AU - Belch, G. AU - Engelberg, M. AU - Walker, K. AU - Kwon, H. AU - Elder, J. PY - 2005 TI - Disseminating a sun safety program to zoological parks: the effects of tailoring SP - 456-62 JF - Health Psychol VL - 24 IS - 5 Y2 - Sep N1 - 16162039 N1 - 0278-6133 (Print) Journal Article Multicenter Study Randomized Controlled Trial KW - Adult Animals *Animals, Zoo Child Follow-Up Studies Health Education/*methods Health Knowledge, Attitudes, Practice Humans Information Dissemination/*methods Occupational Diseases/*prevention & control *Pamphlets *Recreation Risk *Safety Skin Neoplasms/etiology/*prevention & control Sunlight/*adverse effects Telephone United States N2 - Previous research found that a sun safety program for visitors at 1 zoo increased sun safety behaviors. This randomized study compared the effects of tailored dissemination materials plus 2 brief follow-up phone calls (tailored group) versus generic materials (basic group) on implementation by other zoos of the previously evaluated sun safety program. Education directors of 126 zoos completed surveys several months following initial dissemination and 1 year later. During Summer 1, 40% of tailored group zoos and 24% of basic group zoos offered visitors at least 1 sun safety activity (odds ratio=2.2, 95% confidence interval=1.0-4.8). During Summer 2, these rates were 34% and 44%, respectively (ns). The pattern of findings suggests that tailoring had no incremental long-term impact and that the generic materials produced a good level of dissemination. AD - Graduate School of Public HealthSan Diego State University, San Diego, CA 92182-4162, USA. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16162039 ID - 13 ER - TY - JOUR AU - Lin, J.S. AU - Finlay, A. AU - Tu, A. AU - Gany, F.M. PY - 2005 TI - Understanding immigrant Chinese Americans' participation in cancer screening and clinical trials SP - 451-66 JF - J Community Health VL - 30 IS - 6 Y2 - Dec N1 - 16370055 N1 - 0094-5145 (Print) Journal Article KW - Adult Attitude of Health Personnel/ethnology China/ethnology *Clinical Trials Cross-Sectional Studies Female Focus Groups *Health Knowledge, Attitudes, Practice Humans Information Dissemination/methods Male *Mass Screening Middle Aged Neoplasms/*diagnosis/*prevention & control New York City/epidemiology Patient Selection Physicians Research Support, N.I.H., Extramural N2 - The purpose of this study was to identify potential barriers and facilitators to Chinese immigrant participation in cancer screening and clinical trials. A series of focus groups, in English, Cantonese, and Mandarin, were conducted with physicians, community leaders, and first generation members of the Manhattan Chinatown community. Participants were asked to discuss their beliefs about cancer, cancer screening, clinical trials, and cancer health education materials. Focus group data were stratified by respondent group and analyzed for thematic content. Eleven physicians, 15 community leaders, and 38 community members participated. Some community members were not familiar with cancer screening as a preventive measure and had not received common screens such as PAP smears or mammograms. They described widespread misconceptions about cancer that act as screening deterrents, e.g. testing for cancer can cause cancer. Community members were unfamiliar with clinical trials and would not participate in a clinical trial unless "sick," and only on the recommendation of their physicians. Physicians did not see the relevance or value of clinical trials for their patients. Among first generation Chinese immigrants, there are many perceptual barriers to cancer screening and clinical trials recruitment. There is a need for effective culturally tailored health education on these health topics to address persistent misconceptions about cancer and to increase knowledge about cancer screening and clinical trials. Health education efforts and clinical trial recruitment in this community must involve community physicians. AD - New York University School of Medicine, Department of Medicine New York, NY 10016, USA. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16370055 ID - 1 ER - TY - JOUR AU - Love, R.R. PY - 1995 TI - Changing the health promotion behaviors of primary care physicians: lessons from two projects SP - 339-43 JF - Jt Comm J Qual Improv VL - 21 IS - 7 Y2 - Jul N1 - 7581737 N1 - 1070-3241 (Print) Journal Article KW - Breast Neoplasms/prevention & control Colorectal Neoplasms/prevention & control Diffusion of Innovation Education, Medical, Continuing Female Health Promotion/*methods Humans Male Mammography Mass Screening Middle Aged Neoplasms/etiology/*prevention & control Occult Blood Physician's Practice Patterns Practice Guidelines Primary Health Care/*standards *Quality Assurance, Health Care Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. United States AD - Department of Medicine, University of Wisconsin-Madison, USA. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7581737 ID - 40 ER - TY - JOUR AU - Mackereth, P.A. AU - Stringer, J. PY - 2005 TI - CAM and cancer care: champions for integration SP - 45-7 JF - Complement Ther Clin Pract VL - 11 IS - 1 Y2 - Feb N1 - 15984224 N1 - 1744-3881 (Print) Journal Article Review KW - Choice Behavior Complementary Therapies/*organization & administration Evidence-Based Medicine/organization & administration Health Services Needs and Demand Holistic Nursing/*organization & administration Humans Information Dissemination Information Services/organization & administration Medical Oncology/*organization & administration Neoplasms/psychology/therapy Oncologic Nursing/*organization & administration Patient Acceptance of Health Care/psychology Patient Education/organization & administration Primary Prevention Research/organization & administration Safety N2 - The paper reviews challenges and developments in the integration of complementary therapies in cancer care. These issues are examined by reflecting on papers published in CTNM in the last 10 years by champions of CAM in cancer care. Given the aim of the journal to encourage an inclusive readership, multidisciplinary and user perspectives are included. The paper argues for better information, improved service provision and CAM choices in public healthcare, leadership support, funded research and audit, and user and non-users views. AD - Clinical Leads, Complementary Therapy Service, Rehabilitation Unit, Christie Hospital, Manchester, UK. peter.a.mackereth@virgin.net UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15984224 ID - 15 ER - TY - JOUR AU - Maurizio, S.J. AU - Lukes, S.M. AU - DeMattei, R. PY - 2005 TI - An assessment of printed oral cancer materials from local health departments in Illinois SP - 10 JF - J Dent Hyg VL - 79 IS - 1 Y2 - Winter N1 - 16197759 N1 - 1553-0205 (Electronic) Evaluation Studies Journal Article Review KW - Dental Hygienists *Government Publications *Health Education, Dental Humans Illinois Information Dissemination *Local Government Mouth Neoplasms/diagnosis/*prevention & control Pilot Projects Professional Role *Public Health Administration Research Support, N.I.H., Extramural Risk Factors N2 - Local health departments can be resources for the public and health professionals to access educational materials on a variety of topics. Though the dental office is ideal, it should not be the only venue for obtaining oral cancer educational materials. As part of a cancer prevention and early detection project, this pilot study solicited printed educational materials concerning oral cancer from all local health departments (LHDs) in Illinois. Sixty of the 94 health departments responded, for a response rate of 63.8%. Only 32 had printed oral cancer educational materials for public and professional distribution, and most focused on tobacco. Forty-eight different samples were received. At least one risk factor was identified in all materials. The most common was tobacco usage, present in 100% of the materials. Twenty-nine (61%) identified tobacco use as the only risk factor. Alcohol consumption, the second most frequently identified risk factor, was mentioned in only 12 (26%) of the materials. Few materials comprehensively covered areas such as signs and symptoms, risk factors, and the importance of examinations for early detection. Only five materials (11%) acknowledged that early lesions are often asymptomatic. Local health departments are in an influential position to disseminate educational materials to the public and health professionals. Dental hygienists have the knowledge and expertise required to identify quality materials. They should be proactive in assisting LHDs with acquisition of appropriate printed materials and partner with them to advocate for prevention and early detection of oral cancer. In collaboration, the two can ensure that all LHDs have current and comprehensive printed materials about oral cancer to distribute to the public and other health professionals. AD - Southern Illinois University, Carbondale, Illinois, USA. maurizio@siu.edu UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16197759 ID - 8 ER - TY - JOUR AU - Micheli, A. AU - Capocaccia, R. AU - Martinez, C. AU - Mugno, E. AU - Coebergh, J.W. AU - Baili, P. AU - Verdecchia, A. AU - Berrino, F. AU - Coleman, M. PY - 2003 TI - Cancer control in Europe: a proposed set of European cancer health indicators SP - 116-8 JF - Eur J Public Health VL - 13 IS - 3 Suppl Y2 - Sep N1 - 14533761 N1 - 1101-1262 (Print) Journal Article KW - Comparative Study Databases, Factual Europe/epidemiology European Union *Health Status Indicators Humans International Cooperation Neoplasms/classification/*epidemiology/prevention & control Population Surveillance/*methods *Public Health Informatics Registries Research Support, Non-U.S. Gov't Risk Factors Survival Rate AD - Unit of Epidemiology, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy. micheli@istitutotumori.mi.it UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=14533761 ID - 30 ER - TY - JOUR AU - Norderhaug, I.N. AU - Sandberg, S. AU - Fossa, S.D. AU - Forland, F. AU - Malde, K. AU - Kvinnsland, S. AU - Traaholt, I. AU - Rossine, B.K. AU - Forde, O.H. PY - 2003 TI - Health technology assessment and implications for clinical practice: the case of prostate cancer screening SP - 331-8 JF - Scand J Clin Lab Invest VL - 63 IS - 5 N1 - 14599155 N1 - 0036-5513 (Print) Evaluation Studies Journal Article KW - Adult Aged Counseling Decision Making *Family Practice/standards Health Surveys Humans *Information Dissemination Internationality Male Mass Screening Meta-Analysis Middle Aged Norway Practice Guidelines Prostate-Specific Antigen/*blood Prostatic Neoplasms/*diagnosis/prevention & control/therapy *Technology Assessment, Biomedical *Urology/standards N2 - We describe an initiative to disseminate evidence from systematic reviews about the clinical effectiveness of prostate cancer screening to general practitioners and urologists in Norway. The Norwegian Centre for Health Technology Assessment invited The Norwegian Medical Association, The Norwegian Cancer Society, The Norwegian Board of Health, The Norwegian Urological Cancer Group and The Norwegian Patient Association to develop and disseminate clinical practice recommendations. The clinical effectiveness of prostate cancer screening has been assessed in nine independent systematic reviews, which are summarized in a joint INAHTA report. The conclusion was that there is no evidence from appropriately designed trials that early detection and treatment of prostate cancer can reduce mortality, morbidity or improve quality of life. The number of prostate-specific antigen (PSA) tests analysed in Norway increased by 47% [corrected] from 1996 to 1999; at the county level the increase ranged from 12 to 48%. On this background we disseminated leaflets with information about PSA and prostate cancer to 4100 general practitioners and specialists in urology. The main message was, i) PSA should not be taken in healthy men, ii) if the test is wanted, the physician is obliged to give information about the possible consequences. Despite efforts to anchor the information campaign within the mentioned organizations, this met with notable opposition from The Norwegian Urological Society. A survey among agencies within the INAHTA network showed that more than half of the countries within this collaboration have implemented guidelines or recommendations on prostate cancer screening. In conclusion, evidence obtained through an international collaboration such as the INAHTA collaboration may be used to develop and implement national guidelines or recommendations. AD - The Norwegian Centre for Health Technology Assessment, SINTEF Unimed, Oslo, Norway. Inger.N.Norderhaug@sintef.no UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=14599155 ID - 29 ER - TY - JOUR AU - O'Shea, K. AU - O'Connor, P. AU - Nucero, B.C. PY - 2004 TI - Research dissemination and utilization SP - 11 JF - N J Nurse VL - 34 IS - 5 Y2 - Jul-Aug N1 - 15508771 N1 - 0196-4895 (Print) Journal Article KW - Health Education/*organization & administration Humans Information Dissemination *Models, Nursing *Nurse's Role Nursing Research Skin Neoplasms/*prevention & control Sunscreening Agents/therapeutic use N2 - Why does sun protection and skin cancer awareness need to be addressed? Skin cancer is the most common form of cancer. There has been a steady increase in the incidence of melanoma every year. Evidence shows that ultraviolet radiation from sun exposure during early life is associated with an increased risk of skin cancer in later life. The majority of skin cancer can be prevented by limiting sun exposure. Children and adolescents spend more time exposed to the sun than adults. What are the obstacles to skin cancer prevention? Public perception of tanning needs to be changed. The public associates well being with a tan. The public is uneducated on skin cancer prevention. Skin cancer awareness does not take precedence in our society. School health providers are not active in stressing the importance of avoiding sun exposure. How can nurses promote sun protection? Become educated in the identification of atypical lesions. Reinforce the benefits of sun protection. Recommend sun protection techniques to clients at every office visit. Partner with parents in stressing to children the importance of skin protection. For more information contact. The American Academy of Dermatology (www.aad.org). The American Medical Association. The Centers for Disease Control and Prevention. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15508771 ID - 20 ER - TY - JOUR AU - Paolino, L. AU - Sebillo, M. AU - Cringoli, G. PY - 2005 TI - Geographical Information Systems and on-line GIServices for health data sharing and management SP - 171-5 JF - Parassitologia VL - 47 IS - 1 Y2 - Mar N1 - 16044687 N1 - 0048-2951 (Print) Journal Article Review KW - Cluster Analysis Data Display Databases, Factual *Epidemiology Female *Geographic Information Systems Health Services/statistics & numerical data Health Services Administration Humans Incidence Information Dissemination Internet Italy Male Management Information Systems Maps Neoplasms/epidemiology/mortality *Online Systems Software Terminology N2 - Integrating Geographical Information Systems (GIS) technology and public health experience may represent a solution for a better comprehension of spatial and temporal trends of phenomena. Useful applications can be built that support practitioners in their daily tasks, from risk assessment to prevention programmes. Also, making available data on the Internet through GIServices represents an important goal. Institutions and public health practitioners may benefit from the technological integration of GIS, the Web, handheld and mobile global positioning systems (GPS) devices. Expert users may be supported in deriving thematic maps which represent a spatial synthesis documentation starting from an analytic study expressed in terms of numbers and features. In this paper we show an example of an on-line data sharing and processing application, emphasizing ways GIS can provide added value to health research and management. AD - Dipartimento di Matematica e Informatica University of Salerno, Fisciano (SA), Italy. lpaolino@unisa.it UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16044687 ID - 14 ER - TY - JOUR AU - Passalacqua, R. AU - Caminiti, C. AU - Salvagni, S. AU - Barni, S. AU - Beretta, G.D. AU - Carlini, P. AU - Contu, A. AU - Di Costanzo, F. AU - Toscano, L. AU - Campione, F. PY - 2004 TI - Effects of media information on cancer patients' opinions, feelings, decision-making process and physician-patient communication SP - 1077-84 JF - Cancer VL - 100 IS - 5 Y2 - Mar 1 N1 - 14983505 N1 - 0008-543X (Print) Journal Article KW - Comparative Study Cross-Sectional Studies Decision Making Female Health Care Surveys Health Knowledge, Attitudes, Practice Humans Italy Male *Mass Media Medical Informatics Multivariate Analysis Neoplasms/prevention & control/psychology/*therapy Odds Ratio *Patient Participation Patient Satisfaction *Physician-Patient Relations Probability Questionnaires Research Support, Non-U.S. Gov't *Treatment Outcome N2 - BACKGROUND: The objective of the current study was to determine the influence of media information on the opinions and feelings of patients with cancer and to measure the factors that affected the decision-making process and physician-patient communication. METHODS: The study consisted of a sequence of 2 nationwide surveys across the same dynamic target population of 2600 unselected patients with cancer who attended 1 of 13 centers throughout Italy. The authors measured the changes in patients' opinions and attitudes at the peak of a media campaign promoting the Di Bella therapy, an unproven cancer treatment method, and after the publicized demonstration of its ineffectiveness. An identical 10-item questionnaire was used. RESULTS: Opinions and feelings changed in the two surveys according to the way the media described the efficacy of the treatment, but physician-patient communication and the decision-making process remained unchanged. Multivariate analysis confirmed the enormous influence of the media on patient opinions (odds ratio [OR], 4.67; P < 0.0001), feelings of hope (OR, 3.63; P < 0.0001), and confusion (OR, 0.51; P < 0.0001), but not on physician-patient communication or the decision-making process. Educational level influenced almost all of the studied factors, and communication and decision-making also were influenced by the patients' gender and place of residence. There was no significant correlation with patient age. CONCLUSIONS: The media play a powerful role in affecting patients' opinions and feelings; the physician-patient communication and the decision-making process are not subject to media influence but are related primarily to level of education. The power of the media should be directed toward improving the spread of scientific knowledge to encourage behavioral changes, particularly among individuals with lower levels of education. AD - Medical Oncology Division, Istituti Ospitalieri di Cremona, Cremona, Italy. rodolfopassalacqua@libero.it UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=14983505 ID - 26 ER - TY - JOUR AU - Powe, B. AU - Adderley-Kelly, B. PY - 2005 TI - Colorectal cancer in African-Americans: addressing the need for further research and research utilization SP - 48-54 JF - J Natl Black Nurses Assoc VL - 16 IS - 1 Y2 - Jul N1 - 16255314 N1 - 0885-6028 (Print) Journal Article Review KW - *African Americans/education/ethnology/genetics/statistics & numerical data Attitude to Health/ethnology Colorectal Neoplasms/*ethnology/prevention & control Diffusion of Innovation Health Knowledge, Attitudes, Practice Health Planning Guidelines *Health Services Needs and Demand Humans Information Services Internet Mass Screening Nursing Research/*organization & administration Research Design Risk Factors Risk Reduction Behavior Survival Rate United States/epidemiology N2 - Research on colorectal cancer and screening has lagged behind when compared to other cancers such as breast and prostate cancer. The purpose of this paper is to provide a brief overview of colorectal cancer including risks, development of the cancer, and screening and early detection recommendations. A critical analysis of nurse-initiated research on colorectal cancer in African-Americans, published in nursing research-intensive journals, was conducted to further the understanding of the factors that influence these disparities. The findings indicated that this body of research is very sparse. Given this fact, nurses need to consider the types of research that are being conducted and where this research is published. Given the current focus on health disparities, it is time that nurses step into the forefront to lead the way in research and research utilization. It is crucial that we start to see real and significant decreases in colorectal cancer disparities in African-Americans. AD - Special Populations Research, Behavioral Research Center, American Cancer Society, USA. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16255314 ID - 4 ER - TY - JOUR AU - Ramirez, A.G. AU - Villarreal, R. AU - McAlister, A. AU - Gallion, K.J. AU - Suarez, L. AU - Gomez, P. PY - 1999 TI - Advancing the role of participatory communication in the diffusion of cancer screening among Hispanics SP - 31-6 JF - J Health Commun VL - 4 IS - 1 Y2 - Jan-Mar N1 - 10977276 N1 - 1081-0730 (Print) Journal Article KW - Adult *Communication Comparative Study *Diffusion of Innovation Female Guideline Adherence *Hispanic Americans Humans Mass Screening/*utilization Neoplasms/*diagnosis Research Support, U.S. Gov't, P.H.S. Texas Vaginal Smears/*utilization N2 - Based on previously demonstrated methods, a cancer prevention program combining media and interpersonal communication was conducted in a Texas border city (Brownsville) in 1995-1996. To evaluate the program a quasi-experimental panel design study followed 107 women in a program site and 105 women in a comparison site from 1994 to 1996. Women in the program site reported an increase in levels of Pap screening adherence. AD - Department of Medicine, Center for Cancer Control Research, Baylor College of Medicine, Houston, TX 77030, USA. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10977276 ID - 33 ER - TY - JOUR AU - Randal, J. PY - 2004 TI - Study evaluates information on breast cancer Web sites SP - 430 JF - J Natl Cancer Inst VL - 96 IS - 6 Y2 - Mar 17 N1 - 15026464 N1 - 1460-2105 (Electronic) News KW - Breast Neoplasms/*prevention & control/radiography/therapy Female Humans *Information Dissemination *Internet Mammography *Mass Screening/adverse effects Risk UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15026464 ID - 25 ER - TY - JOUR AU - Rappaport, K.M. AU - Forrest, C.B. AU - Holtzman, N.A. PY - 2004 TI - Adoption of liquid-based cervical cancer screening tests by family physicians and gynecologists SP - 927-47 JF - Health Serv Res VL - 39 IS - 4 Pt 1 Y2 - Aug N1 - 15230935 N1 - 0017-9124 (Print) Journal Article KW - Clinical Competence Cross-Sectional Studies Diagnostic Tests, Routine/standards/*utilization *Diffusion of Innovation Family Practice/standards/*statistics & numerical data Female Gynecology/standards/*statistics & numerical data Humans Male Maryland Papillomavirus Infections/diagnosis *Physician's Practice Patterns Primary Health Care/*standards/statistics & numerical data Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. Sensitivity and Specificity Specimen Handling/methods Time Factors Uterine Cervical Neoplasms/*diagnosis/prevention & control Vaginal Smears/instrumentation/*utilization N2 - OBJECTIVE: To examine reasons for the adoption of liquid-based cervical cancer screening tests. DATA SOURCES/STUDY SETTING: A mailed survey of 250 family physicians and 250 gynecologists in Maryland in 2000. Additional data were obtained from the AMA Master File of Physicians. STUDY DESIGN: Key outcome variables in this cross-sectional survey were early adoption of a liquid-based test by the end of 1997 and overall adoption by the time of the survey. Adoption was viewed in terms of a supply and demand theoretical framework with marketing influencing physician and patient demand as well as supply by insurance companies and laboratories. DATA COLLECTION: Random samples of family physicians and gynecologists were selected from the AMA Master File of Physicians. The overall response rate was 61.9 percent. PRINCIPAL FINDINGS: By 2000, 96 percent of gynecologists and 75 percent of family physicians in Maryland were using liquid-based cervical cancer screening tests, most commonly the ThinPrep Pap Test. Gynecologists were more likely than family physicians to have been early adopters (34 percent versus 5 percent, p<.01). Part of this variation in adoption was due to aggressive marketing to gynecologists, who were more likely than family physicians to receive information in the mail from the test manufacturer (89 percent versus 56 percent, p<.01) and to have been informed by the manufacturer that a patient had inquired about physicians' use of the test (22 percent versus 8 percent, p<.01). CONCLUSIONS: The rapid diffusion of liquid-based cervical cancer screening tests occurred despite general agreement that the Pap smear has been one of the most successful cancer prevention interventions ever. Commercial marketing campaigns appear to contribute to the more rapid rate of diffusion of technology among specialists compared with generalists. AD - Department of Pediatrics, Johns Hopkins Medical Institutions, Genetics and Public Policy Studies, Baltimore, MD 21205, USA. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15230935 ID - 23 ER - TY - JOUR AU - Roila, F. PY - 2004 TI - Transferring scientific evidence to oncological practice: a trial on the impact of three different implementation strategies on antiemetic prescriptions SP - 446-53 JF - Support Care Cancer VL - 12 IS - 6 Y2 - Jun N1 - 15045572 N1 - 0941-4355 (Print) Evaluation Studies Journal Article Multicenter Study KW - Adult Aged Antiemetics/*therapeutic use Antineoplastic Agents/*adverse effects Breast Neoplasms/complications/*drug therapy Cancer Care Facilities/standards Chemotherapy, Adjuvant/adverse effects Comparative Study Diffusion of Innovation Female Guideline Adherence Humans Italy Male Middle Aged Outcome and Process Assessment (Health Care) Physician's Practice Patterns Prospective Studies Research Support, Non-U.S. Gov't Risk Factors Time Factors Vomiting/*chemically induced/*drug therapy/prevention & control N2 - GOALS: In 1996, a gap between the literature evidence for the prevention of chemotherapy-induced emesis and the prescription pattern in clinical practice was demonstrated in a drug utilization study. This study, carried out in 103 Italian oncological centers (77 new; 26 old that participated in the previous study) evaluates three different intervention strategies to implement these guidelines. PATIENTS AND METHODS: In cancer patients submitted to chemotherapy, prescriptions of antiemetics were prospectively monitored for 2 consecutive weeks in 1999. Simple diffusion of guidelines was evaluated in an observational study in the 77 new centers, while the double combination of simple diffusion and "audit and feedback" strategy was randomly compared in the old centers with the triple combination of the same two strategies plus an "educational outreach visit." MAIN RESULTS: Simple diffusion of guidelines improved the prescription but only for acute and delayed emesis induced by high-moderate emetogenic chemotherapy. No significant difference was detected in the prescriptions against cisplatin-induced emesis. The inappropriate use of 5-HT(3) antagonists for prophylaxis of low emetogenic chemotherapy was found most frequently. Similar poor results were achieved by the audit and feedback strategy, while the educational outreach visit significantly increased the prescription of the optimal prophylaxis for cisplatin-induced acute and delayed emesis. CONCLUSIONS: A combination of interventions, including an educational outreach visit, seems to be a good strategy for transferring the results of antiemetic research to oncological practice. AD - Medical Oncology Division, Policlinico Hospital, 06122 Perugia, Italy. roila.fausto@libero.it UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15045572 ID - 24 ER - TY - JOUR AU - Rutledge, D.N. AU - Kuebler, K.K. PY - 2005 TI - Applying evidence to palliative care SP - 36-43 JF - Semin Oncol Nurs VL - 21 IS - 1 Y2 - Feb N1 - 15807055 N1 - 0749-2081 (Print) Case Reports Journal Article Review KW - Benchmarking Carcinoma, Non-Small-Cell Lung/complications/therapy Clinical Trials Diffusion of Innovation Dyspnea/etiology/prevention & control Evidence-Based Medicine/*organization & administration Humans Information Services/organization & administration *Information Storage and Retrieval/methods Lung Neoplasms/complications/therapy Male Middle Aged Nurse Practitioners/organization & administration Nurse's Role Oncologic Nursing/*organization & administration Organizational Innovation Pain/etiology/prevention & control Palliative Care/*organization & administration Patient Care Planning Practice Guidelines Treatment Outcome N2 - OBJECTIVES: To discuss the evidence-based practice process for palliative care, from defining a clinical problem to implementation and evaluation of an evidence-based practice change. DATA SOURCES: Professional experience, literature, practice guidelines, and web sites related to evidence-based practice and palliative care. CONCLUSION: Nurses caring for patients needing palliative care need evidence from multiple sources. Using a systematic process to find and appraise evidence followed by strategically planning for implementation and evaluation of evidence-based practice changes optimizes the likelihood of enhanced patient care. IMPLICATIONS FOR NURSING PRACTICE: The integration of evidence-based practices into palliative care nursing will empower nurses to promote optimal patient outcomes and decrease practice variability. AD - California State University, Fullerton, CA, USA. drutledge1@cox.net UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15807055 ID - 17 ER - TY - JOUR AU - Schulte, P.A. PY - 1991 TI - New opportunities for interdisciplinary cancer communication SP - 3-4 JF - Cancer Epidemiol Biomarkers Prev VL - 1 IS - 1 Y2 - Nov-Dec N1 - 1845166 N1 - 1055-9965 (Print) Editorial KW - *Communication *Diffusion of Innovation Humans Neoplasms/epidemiology/*prevention & control *Patient Care Team UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1845166 ID - 44 ER - TY - JOUR AU - Schulte, P.A. AU - Ringen, K. PY - 1984 TI - Notification of workers at high risk: an emerging public health problem SP - 485-91 JF - Am J Public Health VL - 74 IS - 5 Y2 - May N1 - 6711724 N1 - 0090-0036 (Print) Journal Article KW - *Ethics, Medical Federal Government Government Regulation *Health Policy Humans Information Dissemination Informed Consent/*legislation & jurisprudence Legislation Male Neoplasms/etiology Occupational Diseases/*etiology Public Health Research Subjects Research Support, U.S. Gov't, P.H.S. Risk United States be notified if they are at high risk for occupational diseases. This commentary describes demonstration projects for notification and intervention in three cohorts at high risk for specific cancers. On the basis of these projects the authors formulate criteria for the development of a successful notification program. They also consider the broader issues of financial responsibility and support, psychological and socioeconomic impact on the worker at risk, and the fundamental question of entitlement to disclosure. N2 - During the last two decades, an increasing number of epidemiologic studies have found cohorts of workers to be at high risk of work-related chronic diseases, especially cancers. These studies frequently have led to the broad recognition of occupational hazards and eventually to the prevention of exposures to such hazards. Generally, however, the individual cohort members found to be at high risk have not been notified of study results, and programs of medical intervention or of palliative services directed at these individual workers have not been developed. Recently, the issue of whether or not workers have a right to be notified more directly about known health hazards to which they may have been exposed has emerged as a major, unresolved question in public health policy. Issues of concern include the criteria that should guide notifications; whom, when, and how to notify; and who should pay for notification and follow-up services. This commentary discusses the scientific, ethical, economic, and institutional aspects of worker notification, and describes three new demonstration projects that have provided notification and intervention for workers at high risk of bladder, colon, and lung cancer. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6711724 ID - 47 ER - TY - JOUR AU - Schwarz, R. PY - 1997 TI - Cancer education--the opportunities for the future SP - 28-31 JF - J Cancer Educ VL - 12 IS - 1 Y2 - Spring N1 - 9095437 N1 - 0885-8195 (Print) Journal Article KW - Clinical Competence Ethics, Medical Forecasting Health Care Reform/*organization & administration Health Education/*organization & administration Humans Medical Informatics/trends Neoplasms/*prevention & control Organizational Innovation Quality of Health Care World Health UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9095437 ID - 36 ER - TY - JOUR AU - Slater, J.S. AU - Finnegan, J.R., Jr. AU - Madigan, S.D. PY - 2005 TI - Incorporation of a successful community-based mammography intervention: dissemination beyond a community trial SP - 463-9 JF - Health Psychol VL - 24 IS - 5 Y2 - Sep N1 - 16162040 N1 - 0278-6133 (Print) Journal Article KW - Adult Advertising Aged Breast Neoplasms/*prevention & control *Community Health Services Cooperative Behavior Decision Making *Diffusion of Innovation Female Health Knowledge, Attitudes, Practice Humans Interprofessional Relations *Mammography *Mass Screening Middle Aged Minnesota Motivation Pamphlets Poverty Public Housing Research Support, N.I.H., Extramural Research Support, U.S. Gov't, P.H.S. *Urban Population N2 - Although a variety of interventions to increase breast cancer screening have been found to be effective in community-based trials, their ultimate contribution depends on the extent to which they are incorporated (i.e., adopted and adapted) by community organizations. From 1990 to 1995, the authors conducted a National Cancer Institute-funded community-based trial that increased screening mammography among women ages 40 and older living in Minneapolis public housing. This study describes the processes by which this intervention, called Friend to Friend, was successfully adopted by the American Cancer Society, Midwest Division, and adapted for use by women throughout the state. The authors offer insights from experience with this translational effort and make recommendations to facilitate collaboration between research and community organizations. AD - Cancer Control SectionMinnesota Department of Health, Minneapolis, MN 55440-9441, USA. jonathan.slater@health.state.mn.us UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16162040 ID - 12 ER - TY - JOUR AU - Steimle, S. PY - 2005 TI - Global player in cancer research: IARC celebrates its 40th anniversary SP - 1400-1 JF - J Natl Cancer Inst VL - 97 IS - 19 Y2 - Oct 5 N1 - 16204686 N1 - 1460-2105 (Electronic) News KW - *Biomedical Research/economics/education/organization & administration Fellowships and Scholarships Humans Incidence Information Dissemination *International Cooperation *Neoplasms/epidemiology/etiology/prevention & control Prevalence Registries Research Support World Health Organization UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16204686 ID - 7 ER - TY - JOUR AU - Tomlinson, A. AU - Kyrgiou, M. AU - Paraskevaidis, E. AU - Kitchener, H. AU - Martin-Hirsch, P. PY - 2004 TI - Does improving communication and information for women increase attendance at colposcopy in an inner city clinic? A randomised controlled trial SP - 445-8 JF - Eur J Gynaecol Oncol VL - 25 IS - 4 N1 - 15285300 N1 - 0392-2936 (Print) Clinical Trial Journal Article Randomized Controlled Trial KW - Adult Age Factors Ambulatory Care Facilities Attitude to Health Colposcopy/methods/*statistics & numerical data Communication Confidence Intervals Educational Status Female Great Britain Health Education/*methods Humans *Information Dissemination Mass Screening/methods Middle Aged Patient Compliance/*statistics & numerical data *Poverty Probability Reference Values Urban Population Uterine Cervical Neoplasms/*prevention & control N2 - PURPOSE: To establish whether information leaflets and appointment reminders improve attendance for diagnostic colposcopy. DESIGN & SETTING: Randomised controlled trial in an inner city colposcopy clinic. Participants: 500 women newly referred to the colposcopy clinic with abnormal cervical screening smear results were randomly assigned to an intervention or control group using computer-generated numbers. INTERVENTION: 233 women referred for colpoposcopy were sent a comprehensive information leaflet with their appointment details and additionally were sent reminder letters regarding their appointment 7-10 days prior to their appointment date. CONTROL: 267 women were sent the standard basic information prior to their appointment. MAIN OUTCOME MEASURE: Attendance and default rates for diagnostic colposcopy. RESULTS: Default in the intervention arm was 42 out of 233 (18%) compared with 93 out of 267 (35%) in the control arm. CONCLUSION: Improved communication and information in the form of a detailed leaflet and a reminder letter for women with a recently abnormal smear result increased attendance for initial colposcopy assessment. AD - Department Gynaecology-Obstetrics, St Mary's Hospital, Manchester, UK. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15285300 ID - 22 ER - TY - JOUR AU - Unruh, H.K. AU - Bowen, D.J. AU - Meischke, H. AU - Bush, N. AU - Wooldridge, J.A. PY - 2004 TI - Women's approaches to the use of new technology for cancer risk information SP - 59-78 JF - Women Health VL - 40 IS - 1 N1 - 15778132 N1 - 0363-0242 (Print) Journal Article KW - Adult Aged *Attitude to Health Breast Neoplasms/epidemiology/*prevention & control Communication Barriers Consumer Participation/*statistics & numerical data Consumer Satisfaction/statistics & numerical data Female Focus Groups Humans Information Dissemination/methods Internet/*standards Middle Aged Narration Patient Acceptance of Health Care/*statistics & numerical data Patient Education/*methods Questionnaires Research Support, U.S. Gov't, P.H.S. Time Factors Washington/epidemiology Women's Health Services/standards N2 - BACKGROUND: Women are currently offered multiple sources of breast cancer risk information, and the Internet is the most rapidly growing health information source. The objectives of this study were to identify women's preferences for receiving online breast cancer risk information, to identify barriers to accessing this information, and to identify differences in these factors between Internet users and non-users. METHODS: Eight focus groups were conducted with women aged 18 to 74 (n = 65) living in King County, Washington. RESULTS: Participants were interested in accessing online health information with the support of a real person to assist with information searches and in accessing personalized information online. Participants emphasized the importance of trust, both in the content provider and in the organization collecting their personal data. CONCLUSIONS: Web sites should provide personalized information and personal searching assistance. They should also include disclosures of content sources and a privacy policy that details how personal data is handled. AD - Fred Hutchinson Cancer Research Center, P.O. Box 19024, M3-B232, Seattle, WA 98109-1024, USA. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15778132 ID - 18 ER - TY - JOUR AU - Wolf, A.M. AU - Nasser, J.F. AU - Wolf, A.M. AU - Schorling, J.B. PY - 1996 TI - The impact of informed consent on patient interest in prostate-specific antigen screening SP - 1333-6 JF - Arch Intern Med VL - 156 IS - 12 Y2 - Jun 24 N1 - 8651843 N1 - 0003-9926 (Print) Clinical Trial Journal Article Randomized Controlled Trial KW - Aged Control Groups Decision Making *Disclosure Humans *Information Dissemination *Informed Consent Male *Mass Screening/methods Middle Aged *Patient Education *Patient Participation Prostate-Specific Antigen/*blood Prostatic Neoplasms/*diagnosis/immunology/prevention & control Research Support, Non-U.S. Gov't Risk Assessment Uncertainty Vulnerable Populations N2 - BACKGROUND: Because of the many uncertainties surrounding screening for prostate cancer, authorities recommend that patients be involved in the screening decision. OBJECTIVE: To determine the impact of informed consent on patient interest in undergoing prostate-specific antigen (PSA) screening. METHODS: Men 50 years or older with no prior PSA testing and no history of prostate cancer presenting to 1 of 4 university-affiliated primary care practices were eligible for enrollment. Patients were randomized to receive either a scripted informational intervention simulating an informed consent presentation (intervention group, n = 103) or a single sentence about the PSA (control group, n = 102). The main outcome measure was patient interest in undergoing PSA screening measured on a 5-point Likert scale. RESULTS: Patients who received the informational intervention were significantly less interested in undergoing PSA screening than controls (mean difference in interest, 0.8 on 5-point scale, P < .001). Informed patients were much less likely to indicate high interest in screening (odds ratio, 0.34; 95% confidence interval, 0.19-0.60; P < .001). In a multivariate model, family history of prostate cancer was associated with increased interest and advancing age with decreased interest in PSA screening, but the informational intervention remained the strongest predictor of interest. CONCLUSIONS: Among primary care patients of predominantly lower socioeconomic status, those who received informed consent were significantly less interested in PSA screening than those who did not. For physicians who offer the PSA as a screening test, this finding highlights the importance of apprising patients of the associated benefits, burdens, and uncertainties and allowing them to participate in the screening decision. AD - Department of Medicine, University of Virginia Health Sciences Center, Charlottesville, USA. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8651843 ID - 39 ER - TY - JOUR AU - Worden, J.K. AU - Solomon, L.J. AU - Flynn, B.S. AU - McVety, D.J. AU - Dorwaldt, A.L. AU - Geller, B.M. PY - 1999 TI - Community-based promotion of breast screening using small group education SP - 54-62 JF - J Public Health Manag Pract VL - 5 IS - 3 Y2 - May N1 - 10537607 N1 - 1078-4659 (Print) Journal Article KW - Adult Breast Neoplasms/*prevention & control Breast Self-Examination Diffusion of Innovation Female Florida Group Processes Health Education/*organization & administration/statistics & numerical data Humans Mammography/*utilization Mass Screening/*utilization Middle Aged Program Evaluation Research Support, U.S. Gov't, P.H.S. Voluntary Workers N2 - Small Group Education (SGE) to promote breast cancer screening was implemented in a community-wide program. Based on diffusion of innovations theory, SGE initially was directed toward women at higher occupation and education levels and then progressively shifted toward more vulnerable populations of women at risk of not getting screening. During the four-year intervention, 116 volunteers led SGE presentations, with 8,184 women participating in 740 groups at work sites, organizations, residences, and churches. High participation in SGE and positive participant responses suggest that delivery of SGE using a social diffusion model was an effective method for reaching women throughout the community. AD - Office of Health Promotion Research, University of Vermont, Burlington, USA. UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10537607 ID - 35 ER -