Adapting a Narrative Curriculum to a Remote Format in the Context of Socially Distanced Middle School Education Resulting from COVID-19

This paper describes the development of two versions of an NGSS-aligned principles of engineering design unit for use in middle schools. By employing a narrative framework that can help students to connect more deeply with the human contexts and consequences of the engineering design process, our goal was to enhance students' cognitive and emotional engagement in the learning of engineering design concepts. We first detail the design of an initial version of the unit, titled The Survivorama, which used narrative to enrich a primarily traditional, in-person teaching approach. We then describe the adapted version of the unit, titled the Molasses Disaster, and the modifications we made to the stories and transmedia story elements that facilitated the creation of a fully remote version of the unit. To investigate questions related to the effectiveness of the remote curriculum in sustaining student engagement in the remote context, we carried out a mixed-methods study that looked at (1) teachers' characterizations of the effect of the curriculum on student engagement and (2) student learning outcomes as measured by performance assessment tasks. Qualitative analysis of teacher interviews supported the notion that teachers found both versions of the curriculum to be highly engaging for their students, though with some important caveats regarding younger students and students who were less literate. Quantitative analysis comparing 2019 and 2020 student response data for students in the 2019 nontreatment, 2019 treatment, and 2020 treatment groups found statistically significant differences in the pattern of responses for both problem-solving and conceptual drawing performance assessment tasks. The pattern of responses supported the inference that student engagement was similar for students in both the 2019 in-person context and the 2020 remote context, and that both differed significantly from the 2019 nontreatment group. © 2022, Purdue University Press. All rights reserved.

Implementing a patient navigation program to improve adherence with cancer treatment for community health center patients newly diagnosed with cancer

Background: Community health centers' (CHCs) patients newly diagnosed with cancer often experience barriers to accessing timely treatment. Patient navigation decreases barriers to cancer screening and diagnostic care, but the exact impact on cancer treatment is unclear. We implemented patient navigation to provide underserved patients with support to access and adhere to cancer treatment. The goal of our study is to determine the effect of patient navigation on missed appointment rates, treatment adherence, and health outcomes among an underserved patient population. Here, we present preliminary data about program implementation. Methods: Utilizing a population health registry, TopCare, and referrals from CHCs physician champions, newly diagnosed cancer patients from Massachusetts General Hospital CHCs were referred to the Cancer Center, identified and verbally consented to participate in the study's intervention. Patients are randomized either to receive in-person patient navigation or enhanced usual care, which consists of two reminder phone calls prior to each oncology appointment. Adherence to treatment, healthcare utilization, patient satisfaction with cancer care and patient navigation, patient engagement, financial burden, symptom burden, health-related quality of life, and psychosocial care are longitudinally assessed. Our primary outcome is missed appointment rate to oncology appointments. Results: The trial started in November 2017 and as of April 2021, we have identified 349 eligible patients and enrolled 261 (82% consent rate for reached patients). Of 261 enrolled patients, 50% were women, 38% identified as non-White, 25% identified as Hispanic or Latino, and 28% did not speak English. The most frequent cancer types enrolled include genitourinary (n=67), thoracic (n=47), gastrointestinal (n=47), and breast (n=46). Patients had 6257 visits and 195 were missed (3.1%). Navigators performed 4553 interventions. There were 152 emergency department visits and 127 unplanned hospital admissions. Of 120 referrals to supportive care, 54 were to social work, 38 to palliative care and 28 to Psychiatric Oncology or behavioral health. Conclusions: Patient navigation is feasible for underserved CHC patients newly diagnosed with cancer. Our current missed appointment rate is 3.1%, including the time period of the COVID-19 pandemic. After trial completion in July 2021, we will compare the outcomes in patients who received in-person patient navigation to patients who were randomized to enhanced usual care.

A systematic review and meta-analysis of effects of psychosocial interventions on spiritual well-being in adults with cancer.

Objective: Spiritual well-being (SpWb) is an important dimension of health-related quality of life for many cancer patients. Accordingly, an increasing number of psychosocial intervention studies have included SpWb as a study endpoint, and may improve SpWb even if not designed explicitly to do so. This meta-analysis of randomized controlled trials (RCTs) evaluated effects of psychosocial interventions on SpWb in adults with cancer and tested potential moderators of intervention effects. Methods: Six literature databases were systematically searched to identify RCTs of psychosocial interventions in which SpWb was an outcome. Doctoral-level rater pairs extracted data using Covidence following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Standard meta-analytic techniques were applied, including meta-regression with robust variance estimation and risk-of-bias sensitivity analysis. Results: Forty-one RCTs were identified, encompassing 88 treatment effects among 3883 survivors. Interventions were associated with significant improvements in SpWb (g = 0.22, 95% CI [0.14, 0.29], p < 0.0001). Studies assessing the FACIT-Sp demonstrated larger effect sizes than did those using other measures of SpWb (g = 0.25, 95% CI [0.17, 0.34], vs. g = 0.10, 95% CI [-0.02, 0.23], p = 0.03]. No other intervention, clinical, or demographic characteristics significantly moderated effect size. Conclusions: Psychosocial interventions are associated with small-to-medium-sized effects on SpWb among cancer survivors. Future research should focus on conceptually coherent interventions explicitly targeting SpWb and evaluate interventions in samples that are diverse with respect to race and ethnicity, sex and cancer type.

Culture Matters in Communicating the Global Response to COVID-19.

Current communication messages in the COVID-19 pandemic tend to focus more on individual risks than community risks resulting from existing inequities. Culture is central to an effective community-engaged public health communication to reduce collective risks. In this commentary, we discuss the importance of culture in unpacking messages that may be the same globally (physical/social distancing) yet different across cultures and communities (individualist versus collectivist). Structural inequity continues to fuel the disproportionate impact of COVID-19 on black and brown communities nationally and globally. PEN-3 offers a cultural framework for a community-engaged global communication response to COVID-19.