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Objectives: To identify the unmet, actionable social needs of gynecologic oncology patients using a self-administered social needs assessment tool and quantify the interventions subsequently provided to our patients. Method(s): This is a study of data collected in an ongoing performance improvement initiative in a gynecologic oncology clinic at a safety net hospital and was determined to be exempt from review by the institutional IRB. Eligible patients completed the social needs screening tool from October 2021 to March 2022. The following social needs domains were assessed: food insecurity, utility insecurity, housing insecurity, transportation insecurity, need for childcare, exposure to violence, lack of companionship, difficulty reading, or difficulty accessing medical care due to fear of losing job. Patients were asked if they desired to speak with a social worker and if any needs were urgent. Data from the screening tool was collected and supplemented by data from the EMR. Univariate descriptive statistics were used to report the patient demographic information, prevalence of social needs, and referral rates for social needs identified. Result(s): There were 475 patients seen in the gynecologic oncology clinic since October 2021. 286 (60%) patients completed the screening tool. 139 (49%) screened positive for at least 1 social need;of those 98 (70%) were Hispanic with a median age of 56 years. 27 (6%) patients were receiving treatment for a gynecologic malignancy, of whom 19 (70%) had at least 1 social need. 25 (92%) patients were insured through Medi-Cal. 12 (44%) patients were being treated for endometrial cancer, followed by ovarian (7, 26%) and cervical (4, 15%). The social needs identified in all patients and in patients actively receiving cancer treatment are summarized in Fig. 1. Patients reporting lack of companionship were referred to mental health or cancer support groups through the American Cancer Society or the Los Angeles County Department of Public Health. Those needing transportation or utility services were linked with services available through their insurance or LA County, ride share vouchers, low-income energy assistance programs, COVID rent/mortgage relief programs. Patients with food and housing insecurity were assisted in applying for public housing or food stamps;local food banks were provided. Patients were assisted with applying for disability insurance as needed. To date, all actively treated patients reporting lack of companionship, need for transportation, avoiding medical care for fear of losing their job, and utility insecurity were provided resources;80% received resources for food insecurity. Conclusion(s): Universal screening for social needs in gynecologic cancer patients identifies a high rate of unmet needs within a safety net hospital. Cancer care navigators can successfully provide these patients community-based resources tailored to their individual social needs. Our next steps will be to determine if and how these resources impact our patients' experiences and treatment outcomes.[Formula presented]Copyright © 2022 Elsevier Inc.
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There is limited research on effective leadership approaches in 501(c)(3) non-profit organizations. Non-profit organizations help to build community sustainability. The problem to be addressed by the study is the difficulty of identifying the appropriate leadership approach to use in 501(c)(3) non-profit organizations that enhance community sustainability. This qualitative multiple case study aimed to explore the leadership approaches 501(c)(3) non-profit organization decision makers in North Carolina use and why they perceive these approaches to be effective in enhancing the community sustainability of the communities they serve. The aspect of community sustainability focused on was social well-being. Participants were decision makers in a 501(c)(3) non-profit organization in North Carolina;were two executive directors, a president, and a program director, from different 501(c)(3) non-profit organizations;and had experience planning programs and events for the community. The sample size for this study was four. Semi-structured interviews, participant observations, and a leadership checklist were used to collect data. The data were analyzed using thematic analysis. Five themes answered the research question: (a) focused approach, (b) additional approaches, (c) decision making, (d) employee growth, and (e) impact. The findings from this study may help 501(c)(3) non-profit organization leaders understand which leadership approaches may effectively enhance the social well-being of the communities they serve. A limitation of this study is the small sample size due to COVID-19. Another limitation is not being able to talk to all 501(c)(3) non-profit organization decision makers. Future researchers can improve this study by conducting sustained interviews and multiple participant observations in person with each participant. Future researchers should also interview other employees, volunteers, and constituents in the organization. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Background: Breast cancer disparities between Black and White women have persisted in the US, with breast cancer death rates 40% higher in Black women compared to White women (American Cancer Society Cancer Facts & Figures for African American/Black People 2022-2024). Education and interventions at the community level can potentially reduce racial gaps, particularly in curbing late-stage diagnoses that disproportionately affect Black women with breast cancer. Together, the American Cancer Society (ACS) and Pfizer Global Medical Grants (Pfizer) developed a collaborative model to support health systems in engaging communities to reduce breast cancer disparities between Black and White women. This collaboration aimed to identify novel interventions and provide foundational support for these communities to advance their work in bridging the gap in breast cancer disparities. Method(s): This collaborative grant program divided project responsibilities, in which Pfizer provided funding and ACS provided project oversight and technical support. An advisory committee provided input on the areas of most need, impact and project direction. Funding applicants were required to partner with local organizations to implement evidence-based initiatives for education and/or quality improvement within the respected community. The grant award selection committee comprised of experts in the field, including breast cancer survivors and individuals from racial/ethnic minority groups. In response to a Request for Proposals, over 100 applications were systematically reviewed based on the National Cancer Institute grant selection process. The committee selected 9 grantees with innovative proposals addressing breast cancer disparities for Black women along the cancer-care continuum. Bi-annual progress reports were used to measure progress, with a final report to mark projects' impact and reach. The COVID-19 pandemic presented numerous obstacles during the project period and the ability to convene with partners virtually through web-based sessions helped to foster opportunities for collaboration and knowledge sharing among leaders in cancer disparities research. Result(s): The projects occurred from January 2020 to June 2022, with no-cost extensions given to accommodate COVID-19 pandemic delays. During this period grantees successfully completed project goals in one of three areas: screening, identifying areas of need and education. Approximately 10,000 patients and 200 healthcare professions were impacted among three projects focused on increasing mammography efforts in Black women during the project period. Three projects incorporated surveys and focus groups to identify novel areas for intervention/need and interviewed over 350 patients and over 60 health care professionals. The remaining three grantee projects that focused on education successfully implemented advertisement campaigns and lecture series to target patients and healthcare professionals. The projects selected under this model independently completed their goals within the project period while also laying a foundation to continue work in reducing disparities along the cancer care continuum with their enhanced community partner relations. Additionally, the project period also provided opportunities for external collaborations and discussion among all grantees through 8 ACS-coordinated online sessions and 3 summits. Conclusion(s): Projects selected by the public-private grant initiative model can enhance community relationships and provide infrastructure to continue work along the cancer care continuum. We believe this collaborative competitive grant program can be used for future efforts to address breast cancer and other health disparities at the community level. Similar collaborative funding projects related to prostate and pan-tumor disparities have been launched and are currently ongoing.
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Background: Integrative therapies are shown to support cancer patients' treatment plans, help with side effect management, and improve patients' quality of life ([1-9]). In 2017, the American Society of Clinical Oncology endorsed the Association of Integrative Oncology's Clinical Practice Guidelines highlighting their importance in breast cancer care. Recent studies suggest that more evidence is needed to bring attention to the role of integrative therapies in advanced breast cancer care [4, 7, 8, 10]. This analysis explores participants' experiences with a wellness program implemented by Unite for HER (UFH), a non-profit organization that delivers integrative therapies and support services such as whole food nutrition services, medical acupuncture, oncology massage therapy, counseling, reiki, meditation, yoga, and fitness classes to patients with breast, metastatic breast, and ovarian cancer. As of April 2022, there were over 1,700 women diagnosed with metastatic breast cancer (MBC) participating in UFH locally and nationally. Method(s): UFH members completed a survey about the impact of the UFH Wellness Program on the overall quality of life, including measures on side-effect management, OTC/prescription drug utilization rate, stress reduction, changes to wellness habits, and the social and emotional challenges associated with living with MBC. In total, 119 unique UFH members with MBC answered online surveys distributed by email in 2020 and 2021. Survey questions were designed to evaluate the impact of the UFH Wellness Program. Descriptive analyses of survey questions and openended comments were conducted to assess program impact. Result(s): All respondents were MBC patients/survivors. No other demographic information was collected. While 2020 respondents received mostly in-person services for part of their program, all 2021 respondents received primarily virtual services due to the Covid-19 restrictions. Despite the inaccessibility of in-person services, the satisfaction levels with the wellness program did not drop significantly in 2021. More than two-thirds of respondents (80% in 2020, 67% in 2021) indicated that the therapies offered through UFH Wellness Program significantly improved the side effects of their treatment for MBC. Notably, more than a quarter of respondents (28% in 2020, 26% in 2021) specified that due to UFH integrative therapies they were able to reduce or eliminate one or more OTC/prescription drugs to manage side effects. At the same time, the majority reported experiencing reduced levels of stress after utilizing integrative therapies offered by UFH (93% in 2020, 81% in 2021), as well as improvements in their emotional wellbeing (95% in 2020, 83% in 2021), and quality of life during or after treatment for MBC (97% in 2020, 96% in 2021). Also, 86% of respondents in both years indicated that UFH services, such as nutrition counseling, cooking classes, and exercise classes, helped them adopt and maintain healthier habits in their life. Furthermore, a qualitative analysis of open-ended comments found that 1) respondents expressed deep gratitude and appreciation for UFH integrative therapies, 2) noted that they would otherwise not be able to access such therapies due to financial barriers, and 3) helped them feel better prepared to cope with the psychosocial aspects of their MBC experience. Discussion(s): These results suggest that integrative therapies such as those offered by UFH can play a significant role in improving patients' outcomes by reducing stress and drug utilization to manage side effects and improving patients' well-being and quality of life during metastatic breast cancer treatment. These findings highlight the importance of choosing integrative oncology programs to support MBC patients' needs in managing the psychosocial and physical side effects of the disease.
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Background: Poor prognosis of lung cancer is linked to its late diagnosis, typically in the advanced stage 4 in 50-70% of incidental cases. Lung Cancer Screening Programs provide low-dose lung CT screening to current and former smokers who are at high risk for developing this disease. Greece is an EU country, returning strong from a long period of economic recession, ranked 2nd place in overall age-standardized tobacco smoking prevalence in the EU. In December 2020, at the Metropolitan Hospital of Athens, we started the 1st Screening Program in the country. We present our initial results and pitfalls met. Method(s): A weekly outpatient clinic offers consultation to possible candidates. LDCT (<=3.0mGy), Siemens VIA, Artificial Intelligence multi-computer-aided diagnosis (multi-CAD) system and LungRADS (v.1.1) are used for the validation of any abnormal findings with semi-auto measurement of volume and volume doubling time. Patients get connected when necessary with the smoking cessation and Pulmonology clinic. USPSTF guidelines are used, (plus updated version). Abnormal CT findings are discussed by an MDT board with radiologists, pulmonologists/interventional pulmonologists, oncologists and thoracic surgeons. A collaboration with Fairlife Lung Cancer Care the first non-profit organization in Greece is done, in order to offer the program to population with low income too. An advertisement campaign was organized to inform family doctors and the people about screening programs, together with an anti-tobacco campaign. Result(s): 106 people were screened, 74 males & 32 females (mean age 62yo), 27/106 had an abnormal finding (25%). 2 were diagnosed with a resectable lung cancer tumor (primary adenocarcinoma) of early-stage (1.8%). 2 with extended SCLC (lung lesion & mediastinal adenopathy). 1 with multiple nodules (pancreatic cancer not known until then). 3 patients with mediastinal and hilar lymphadenopathy (2 diagnosed with lymphoma, 1 with sarcoidosis). 19 patients were diagnosed with pulmonary nodules (RADS 2-3, 17%) - CT follow up algorithm. Conclusion(s): We are presenting our initial results, from the first lung cancer screening program in Greece. Greece represents a country many smokers, who also started smoking at a young age, with a both public and private health sector, returning from a long period of economic recession. COVID-19 pandemia has cause practical difficulties along the way. LDCT with AI software, with an MDT board and availability of modern diagnostic and therapeutic alternatives should be considered as essential. A collaboration spirit with other hospitals around the country is being built, in order to share current experience and expertise. Copyright © 2022
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Background: There is considerable evidence suggesting that parenting programmes reduce violence against children (VAC). Based on this evidence, there have been calls for implementation of parenting programmes at scale. However, most of the existing evidence on implementation quality and scale-up comes from high-income countries and very little research ascertains the perspectives and experiences of programme implementers from low-income settings. Objective(s): To explore the views and experiences of implementers from six non-profit organisations who delivered Parenting for Lifelong Health for Teens (PLH-Teens) programme at scale in Tanzania in 2020 and 2021. Method(s): This paper employed a qualitative research design involving 44 in-depth interviews and 12 focus group discussions (FGDs) with facilitators, coaches, and local implementing partners (LIPs). Data were collected on implementers' experiences of delivering the programme at scale by exploring topics including programme delivery, training and support they received and details around programme logistics. All interviews and FGDs were audio-recorded with the permission of the participants. With the aid of NVIVO 12 qualitative analysis software, thematic analysis was used to synthesise the interview and FGD data. Result(s): Thematic analyses of the interviews and FGDs revealed three themes: 1) implementers' reflections on factors promoting scale-up;2) implementers motivation for implementation of the programme;and 3) barriers to scale up. Implementers described factors that promoted successful scale up as: planning and working closely with community organisations, which enhanced trust and buy-in;delivering the programme through role plays;and delivery by skilled implementers. Implementers were motivated to deliver the programme at scale for reasons such as prestige/respect, financial incentives, and acquiring skills for their own parenting. This study highlights barriers to programme scale-up as: conflicting demands on staff time;beneficiaries' initial doubt of the programme's value;COVID-19 related disruptions;and logistical challenges that affected how both implementers and parents/caregivers engaged with the programme. Despite these obstacles, implementers remained flexible in scheduling and adapting the programme to ensure successful completion. Conclusion(s): This paper highlights the perspectives of staff implementing a parenting programme aiming to reduce VAC at scale. The study suggests that several factors support staff in delivering the programme whereas other factors hindered successful implementation. It is important for all programme stakeholders to understand these factors and find ways of addressing them for desired programme impact. The study also reveals that the successful delivery of parenting programme should allow for flexibility in modes of delivery by allowing for necessary adaptations and adjustments.
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Background: The COVID-19 global pandemic has shed light on the importance of testing to stop the spread of disease. For a developing country with a large population of over 200 million inhabitants such as Pakistan, widespread testing can be difficult. To date, 957,371 cases have been confirmed and over 14 million tests have been performed in Pakistan, with only 1% of the population vaccinated. In a country already burdened by health disparities with little to no resources, the challenges became ever apparent as case numbers grew. According to the WHO, complacency among the population in cooperating with public protective measures is a rising challenge. Several violent incidents have occurred in hospital wards in Pakistan, prompting medical staff to fear for their lives and demand extra security not only from the virus, but from volatile patients and families. The incidents are thought to be rooted in a mix of anger at a lack of resources, and mistrust of the medical system. The objective of this study was to survey Pediatric emergency medicine (PEM) physicians in Pakistan on their ability to test for COVID-19 and their limitations experienced. Methods: An anonymous prospective survey was performed from February to March 2021 in association with the ChildLife Foundation, a nonprofit organization that operates and manages Pediatric EDs in 10 government teaching hospitals in the province of Sindh. 170 PEM providers were surveyed on their experiences with COVID-19 testing, reasoning for why testing was not performed when infection was suspected and reasoning for patient refusals. Results: 68% of respondents had COVID-19 on their differential for patients under their care in the week prior to survey. However, 49% of respondents did not order any COVID-19 testing. 37% of those providers had at least one patient in whom COVID-19 was on the differential. 81% of providers claimed to collect COVID-19 testing every time when suspected. When surveying reasoning for not acquiring COVID-19 testing, providers listed patient refusal as the top reason, followed by limited availability and cost, mild presentation of disease, patient leaving AMA, fear of violence against healthcare professionals, social stigma/fear from patients of being labelled as COVID-19 positive and denial of the diagnosis. Conclusion: According to this survey, PEM providers in Pakistan were not always able to send COVID-19 testing, when indicated, due to a variety of factors. Testing limitations despite suspicion for disease can be a major hurdle in identifying cases and limiting spread in unvaccinated populations.
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SETTING AND PARTICIPANTS: In response to the need for innovative community engagement and pre-medical education, the COVID-19 STEM Community Education and Empowerment Internship program (CCEEI) was developed as a collaboration between six New York City medical schools and Mentoring in Medicine, a non-profit organization. This virtual program was attended by 1045 underrepresented in medicine (UriM), first-generation, and disadvantaged college and gap year students who were interested in medical and health careers, over the first three cohorts. Participants learned about COVID-19 and disparities, vaccine science, the roles of medicine and public health, and strategies for community education and empowerment. 1045 U.S. based students participated over three cohorts as well as additional students from around the world. DESCRIPTION: 4-8 sessions, each 2-4 hours long, each of which consisted of lectures (e.g. virology and pandemics, COVID-19 biology and prevention, how vaccines work, etc.) followed by interactive discussions. Learner assessment included mid-point survey, end of program survey, and post-30 day survey, and capstone projects presented during the final session of the program;capstones were intended to raise awareness of COVID-19 safety measures and vaccines to a lay audience. Examples included Tik Tok videos, infographics, PowerPoint presentations, etc. Each student received a certificate of acknowledgment for their participation in the COVID-19 STEM Education and Empowerment Internship. EVALUATION: Recruiting efforts were successful in providing this premedical program available to students from URiM backgrounds, 55% identified as Black or Latino and 97% were interested in health professional careers. Program evaluation consisted of aggregate learner assessments and administration of a mixed-method survey seeking participant perspectives. Program participants applied knowledge they gained and self-reported outreach to at least 13,499 people in their communities on COVID-19 and COVID-19 vaccination. Most frequent modes of communication included: TikTok, YouTube, and Instagram. DISCUSSION / REFLECTION / LESSONS LEARNED: Program adjustments including curriculum changes were made based on mid-point, end-of-course, and post-surveys. There was an overwhelming response from students wanting to gain knowledge and be a part of outreach efforts to impact their communities. In the first session, many students shared in their e-poster personal impacts of COVID, ranging from loss of family and friends, and isolation experienced. There is much promise in reaching pre-medical students through a virtual education program as students reported gaining communication skills to address myths and vaccine hesitancy and felt empowered to use technology to share knowledge gained from the program with their networks.
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Purpose: Especially with the COVID19 pandemic, the necessity of technology-based interventions using computers and mobile devices has increased in cancer survivorship management including symptom management. However, little is known about the effectiveness of a technology-based intervention in improving symptom experience of racial/ethnic minorities including Asian American breast cancer survivors. The purpose of this study was to examine the efficacy of a technologybased intervention in improving symptom experience of Asian American breast cancer survivors. Methods: This study was conducted as a part of an ongoing randomized clinical trial among 199 Asian American breast cancer survivors. The technology-based intervention included three subethnic specific social media sites, interactive online educational sessions, and online resources. Both groups (intervention and control groups) used the American Cancer Society's website on breast cancer, and only the intervention group used the technology-based intervention. Only the data collected using the questionnaire on background characteristics and health/disease status and the Memorial Symptom Assessment Scale-Short Form (MSAS) were analyzed for this study. The data were analyzed using separate intent-to-treat growth curve models. Results: While both groups reported decreases in symptom scores from the pre-test to post 3- months (p<.01), the intervention group had larger decreases in symptom scores compared with the control group (p<.01). There existed significant group∗time interactive effects on the Global Distress Index (β = - 0.234), the Physical Symptom Distress scores (β = -0.266), the psychological symptom distress scores (β = - 0.212c), the total number of symptoms (β = -0.261), and the total symptom distress scores ( β = -0.261). Conclusions: The findings of this study clearly indicated symptom improvement among Asian American breast cancer survivors by a technology-based intervention using computers and mobile devices. Further studies with diverse racial/ethnic minorities are warranted to confirm the effectiveness of technology-based interventions in improving symptom experience of cancer survivors across different types of cancer.
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Methods: Reiki Medic-Care is a non-profit organization that provides remote Reiki to National Health Service healthcare professionals in the UK. Healthcare professionals (e.g., physicians, nurses) negatively impacted by the COVID-19 pandemic were eligible to sign up for the Reiki program and were invited to participate in the research study. Each participant was assigned eight Reiki practitioners who gave them remote Reiki for 20 minutes for four consecutive days. Participants' stress, anxiety, pain, sleep quality and overall wellbeing were evaluated with 7-point numerical rating scales based on the Measure Yourself Medical Outcome Profile-based questionnaire. Measures were completed online when signing up to receive Reiki (pre) and following the final Reiki session (post). Pre and post data were analyzed using Wilcoxon signed ranks tests. Results: Seventy-nine healthcare professionals agreed to be in the study and provided baseline survey data (pre), and N = 40 participants completed both pre and post. Participants were 97% female and mean age was 43.9 years old (21-64 years). Healthcare professional participants included nurses (n = 15;37%), physicians (n = 14;35%), and other clinical staff such as therapists or patient care assistants (n = 11;28%). Statistically significant improvements in stress (p < .001, d = .634), anxiety (p < .001, d = .698), pain (p < .001, d = .630), wellbeing (p < .001, d = .578), and sleep (p = .019, d = .371) were observed from pre to post. Background: To conduct a pragmatic effectiveness trial of a Reiki program for healthcare professionals who have been negatively impacted by the COVID-19 pandemic. Conclusion: The Reiki program for healthcare professionals demonstrates preliminary effectiveness for improving stress, anxiety, pain, wellbeing, and sleep in frontline healthcare workers in the UK impacted by the COVID-19 pandemic. Future research will include a larger sample size and longterm follow-up.
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Background: Compared with the general older adult population, Holocaust survivors (HS) are disproportionately affected by mental illness, including post-traumatic stress disorder, and geriatric syndromes such as osteoporosis. While access to primary care is partially available to homebound patients through the public healthcare system in Israel, specialized care is often expensive or unavailable. Many HS lost the majority of their family during the holocaust and subsequently have less social support, are socially isolated and lack access to specialty care. HS are an understudied population with unique needs, as they age, the opportunity to study and to provide care for this generation is nearing an end. “Lemaanam” is a non-profit organization in Israel, created by doctors in the midst of the COVID19 pandemic, with the goal of providing homebound HS free access to specialty care. A case series is presented to demonstrate the ability to recruit a cadre of volunteer physicians to provide access to specialty care for HS. Methods: This case series uses data from the 435 HS who contacted Lemaanam Between November 2020 and June 2021. Results: 435 HS approached Lemmanam requesting help accessing specialty care. Their average age was 87. Lemmanam provided 107 home visits, 83 clinic visits and 58 televisits in a variety of different medical and surgical specialties. Additionally 59 HS received assistance with making appointments within the public healthcare system or were helped by providing transportation or volunteers to accompany them. Activity has increased in recent months and more than 850 specialists now volunteer to provide free medical care. Most volunteers were recruited via social media physician groups. Funding for Lemmanam relies solely on donations. Conclusion: Lemmanam is successfully providing specialty care to homebound HS by creating a network of physicians and surgeons willing to provide free care to those who endured one of history's worst horrors and survived.
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Inadequate funding is a common and longstanding concern for local public park and recreation agencies. Traditionally, these services are funded predominantly through tax-based allocations, supplemented by other streams such as earned revenue, dedicated levies, and sponsorship agreements. Cost-cutting measures such as outsourcing, overall staffing reductions, and an increasing reliance on a parttime workforce have also become increasingly common in the context of local park and recreation service delivery. Partnership with nonprofit organizations represents another potential strategy to adequately fund local park and recreation services.Partnerships between local park and recreation agencies and nonprofit park and recreation foundations have a long history, and help support local park and recreation agencies in a variety of capacities. Their importance may also be growing as a function of the decline in tax-based support and earned revenue due to both the Great Recession and the global COVID-19 pandemic. Such partnerships are not unique to local parks and recreation however, and are common—and widely studied—at the national and transnational level. Despite their importance to local park and recreation service delivery, and the established body of knowledge examining these partnerships at the national and transnational level, the local agency-foundation relationship remains understudied. In this manuscript we begin to address this gap by providing a clearer picture of the agency-foundation relationship, and identifying strategies for how local park and recreation agencies can most effectively leverage these partnerships. To do so, we employ a qualitative research method, interviewing leaders from both local public park and recreation agencies and nonprofit park foundations. Results illustrate a variety of motivations for initiating an agency-foundation relationship (funding/capacity, deteriorating conditions, and equity), as well as a number of distinct benefits of such a partnership (increased operational capacity, advocacy and outreach, expertise, and non-governmental status). Respondents also identified various characteristics of a successful agency-foundation relationship (effective communication, clear roles and responsibilities, strong connections, and flexibility/responsiveness), and challenges to success (competition for scarce resources, and equity). Based on these results, we propose several strategies to help local park and recreation agencies maximize these partnerships (communicate frequently and with purpose, build relationships, formalize ties, and strive for equitable outcomes). Subscribe to JPRA
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Food insecurity has been a chronic and significant issue in our society, specifically in low-income areas. Hunger, poor nutrition and health, and early death are only a few of the terrible impacts. Hunger is caused more often than not by a lack of food;rather, it is a matter of figuring out how to make the food that is available, accessible to everybody. Non-profit organization work to alleviate the negative consequences of food insecurity by giving food and services to those who are hungry. This organization rely on the generosity of donors, food donations, to achieve their goals. This paper focuses on creating a mobile and web application called Foodernity with the goal of easing the burden of needy people who require food to survive. This is critical, especially in times of crisis like the COVID-19 pandemic, where most of the people in low-income areas don't have enough budget for their food every day. Furthermore, the application also wants to help in reducing the problem of food waste. The whole process of developing both mobile and web application, in particular, followed the Agile Model's formal and logical processes. This study recommends that the beneficiary to use this application to evaluate its functionality. Those who are hungry or needy people who relies mostly on food donation from the organization will benefit from this application by allowing the donors to give donation to the organization that helps needy people to have access to food.
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Background. Black women diagnosed with breast cancer are 40 percent more likely to die than their Caucasian peers. They are often diagnosed with higher staged cancers, when treatments are more toxic and costly (Centers for Disease Control, 2018). In addition, Black women have worse stage-specific survival than white women (American Cancer Society, Cancer Facts and Figures for African Americans 2019-2021). Lack of medical knowledge and social isolation are contributing factors to health care disparities. To address these factors, in fall 2019 a member of the board of directors of Living Beyond Breast Cancer approached LBBC to design an educational program for Black patients newly diagnosed with early-stage and metastatic breast cancer. The overarching program goal was to address health care disparities for Black people. The program aimed to increase knowledge about breast cancer and about the implicit and explicit bias Black patients encounter in health care settings, and to provide tools to address it. The program also prepared patients to be informed partners in their health care and connected them to existing resources and to other Black patients for peer support. Methods. LBBC convened an advisory board of ten Black community leaders with expertise in oncology, health care disparities, social and practical support, and advocacy. Most had a personal history of breast cancer. A consultant with expertise in program development and health disparities was hired to oversee the project. The advisory board met monthly to develop content, format, outreach, and speaker recommendations. Initial plans were to deliver the program as a one-day symposium attached to LBBC's fall conference. Because of the COVID-19 pandemic, the advisory board decided to offer the program virtually using a combination of live sessions supplemented with video content. Learnings were intended to prepare participants to more effectively communicate with health care professionals and empower them with practical steps to access appropriate care. An evaluation was designed, and participants received an emailprompting them to offer feedback after each session. Results. The program was delivered from September through October 2020. Speakers were Black oncologists, social workers, researchers, and advocates. The first session was an on-demand video offering guidance to recently diagnosed Black breast cancer patients. Three live sessions were delivered weekly on the topics of identifying barriers to accessing care, early-stage breast cancer treatment, and metastatic breast cancer treatment. The last two sessions focused on self-care and advocacy, with the final session delivered at LBBC's virtual fall conference. LBBC registered 436 people from 36 states and Washington, DC, Canada, and the United Kingdom. Participants ranged from age 27 to 83 and lived in urban, suburban, and rural areas. In all, 307 registrants identified as Black, and 40 reported a breast cancer diagnosis in the last six months. Of participants who completed program evaluations, 75 percent reported an increase in knowledge of breast cancer, 77 percent reported increased understanding of treatment, 82 percent reported increased confidence to have conversations with loved ones or health care providers, and 85 percent said they learned strategies to address implicit and explicit bias. An informal assessment of open-field responses demonstrated that attendees valued the programmatic focus on their unique needs as Black breast cancer patients. Conclusions. An educational program led and designed by Black health care professionals and patients can be successfully delivered in a combination live and virtual content format to improve knowledge, communication skills, and feelings of self-efficacy for Black people with breast cancer.
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The Society performed various activities to increase the awareness for the prevention of osteoporotic fractures and loss of independence The Turkish Osteoporosis Society is a national, neutral, nonprofit organization which aims to increase the standards in the field of “osteoporosis osteoarthritis and musculoskeletal problems” including education of health professionals, patient care and treatment The society was founded in 1998 by the medical school faculty members who had been working in the field of osteoporosis aiming to create or make contributions for the development of technical, scientific and social facilities and it also cooperates with international and national institutions organizations, foundations and societies for this purpose. The Turkish Osteoporosis Society is a member of International Osteoporosis Foundation (IOF). Education- In order to prevent osteoporotic fractures one of the priorities of the society is education for the physicians and the other health professionals. Since its foundation the society performed various activities regarding the osteoporosis prevention, early diagnosis and effective treatment approaches not only for the health professionals but for the public as well. Pharmacologic treatment and nonpharmacologic approaches, also the chronic consequences and rehabilitation are considered as the important themes in these training programmes Congresses, symposiums and courses are organized regularly. Also various conferences and panels are organized by the society in different cities of the country with the local tutors. Recently OSTEOACADEMYIstanbul was organized online on October 10-11, 2020 and OSTEO2021 “Osteoporosis, Osteoarthritis and Musculoskeletal Pain Congress” will be held on digital platform on October 8-10, 2021 Other important events that should be mentioned are, Turkish Osteoporosis Society organized several Clinical Densitometry Certificate Courses, which were endorsed by IOF Publications: The Turkish Journal of Osteoporosis is the society's scientific publication, which has been published regularly since 1998 and is included in the Emerging Science Citation Index-ESCI. By the Scientific Council of the Turkish Osteoporosis Society several books were published for the physicians. Also various booklets were distributed free of charge for the public. Recently 3 newspapers (osteogazette) were prepared, published and distributed in the digital platform. A consensus report entitled;“Updated approach for the management of osteoporosis in Turkey” was published in 2020. A panel of multidisciplinary experts developed a thorough review to assist clinicians in identifying osteoporosis and associated fracture risk patients, diagnosing the disease with the appropriate available diagnostic methods, classifying the disease, and initiating appropriate treatment. The panel expects to increase the awareness of this prevalent disease, decrease consequences of osteoporosis with corresponding cost savings and, ultimately, decrease the overall burden of osteoporosis and related fractures in Turkey. The Turkish Osteoporosis Society's epidemiologic, scientific publication on the prevalence of hip fracture in Turkey has led to the national data in country based FRAX and is used in our country for risk assessment Public Education Activities: Translations of IOF publications continue to be made and shared on the society's web page. Very recently a document entitled “Osteoporosis in the Covid 19 pandemic” was prepared by the board of Directors of the society Virtual Osteoporosis Congress for the Public: A two days Osteoporosis Congress was held free of charge for the public education in April 1-2 2021 also. Important aspects of osteoporosis prevention, early diagnosis lifestyle modification and awareness on risk factors were discussed in detail World Osteoporosis Day: Public conferences and BMD measurements for screening (calcaneal US) are performed free of charge every year on the World Osteoporosis Day in various cities of the country. Also press conferences and press release are prepared. In 2020 a declaration was made by the board of directors of Turkish Osteoporosis Society focusing on: “Osteoporosis is a disease that should not be overshadowed during the COVID-19 pandemic” Social Responsibility Projects: Turkish Osteoporosis Society planted 1000 pine saplings in 1998 as a social responsibility project. 20 years later the planted saplings became a magnificent pine grove. In order to attract interest and raise awareness, in 2020 “Break records, not bones ” campaign was organized. The Society took place in the Guinness Book of World Records for the highest number of BMD screening in 24 h The most important project aiming at prevention of the disease and solution of fractures is the latest one entitled;“Keep on living with healthy bones”. In this context all the members of the executive board of the society prepared videos about the risk factors, signs and symptoms, diagnosis prevention, treatment of osteoporosis. Also nutrition, physical activity and the impact on quality of life are presented in those videos in the web site of the society. The activities are announced and shared not only by the web site, but Facebook and Instagram pages as well FLS: Fracture liaison service is another solution for post fracture care. In coordination of the IOF, training of the Turkish FLS teamhas been started with the representatives of our society. This programme is considered as an important goal is to increase the number of FLS centers throughout Turkey Since 1998, a considerable number of people have been reached through various activities carried out by the Society on different platforms and have contributed to the protection of this public health issue by raising awareness of disease prevention and early diagnosis.
ABSTRACT
Background: Vaso-occlusive crises (VOC) are the most common acute complication of sickle cell disease (SCD). Crizanlizumab, an anti-P-selectin monoclonal antibody, is an FDA-approved disease-modifying therapy (DMT) for SCD patients (pts) aged ≥16 yrs to reduce the frequency of VOC. To better understand its use and impact, the National Alliance for Sickle Cell Centers (NASCC) conducted a retrospective study of pts prescribed crizanlizumab from 11/2019-6/30/2021. NASCC is a non-profit organization formed to support SCD centers in delivering quality comprehensive care by setting and adopting specific standards and advocating for improved health outcomes in SCD. This study describes the largest real-world cohort of pts treated with crizanlizumab. Methods: This is a two-part study. Part 1 was to evaluate NASCC center crizanlizumab practice and to summarize data on insurance approval and the frequency of drug discontinuation. Part 2 includes pt level data to evaluate reasons for discontinuation and acute care utilization pre and post therapy. Acute care use includes day hospital/infusion, emergency department visits, and hospitalizations for VOC (excluding COVID-19). The index date for each pt is defined as the 1st crizanlizumab infusion date. Chart review (electronic health records) was used to identify all acute care visits 12 months pre-index and ≤12 months post index. Acute care data will be analyzed in aggregate. Evaluation of center-specific use of crizanlizumab, time to initial site level formulary approval and drug discontinuation were analyzed. Pt level data collection is ongoing to include sufficient time post index date. VOC characteristics will be summarized using medians, median differences (pre/post treatment), and 95% confidence intervals. Additional evaluation of effectiveness of crizanlizumab will include analysis based on number of doses received, pre-treatment VOC burden, concomitant hydroxyurea (HU) use and genotype. Results: Data includes pts prescribed crizanlizumab at 11 NASCC centers. Site- formulary approvals to use crizanlizumab varied from 12/2019-12/2020. As a result, the 1st pt to receive treatment at each site varied from 1/15/2020-1/20/2021. Mean time from site-level approval to first infusion was 77 days (range: 0-394). Over 50% of sites received insurance denials mainly due to “insufficient medical necessity” or “medication not covered by the prescription plan.” Sites were able to successfully appeal denials for 71% of pts (Table 1). Treatment Delivery: Each site gives infusions over 30 minutes and the majority (64%) do not use pre-medication unless pts had reactions. Some sites use diphenhydramine/acetaminophen (3) or normal saline and ketorolac (1). All sites prescribe crizanlizumab to pts of all SCD genotypes. Pts Treated: 297 pts were prescribed crizanlizumab of whom 238 received ≥ 1 infusion. There was variation in number of pts/site (range 6-73, mean 21) due to time to site-level approval, insurance and pt population. Of these 238, 75 pts (32%) discontinued treatment (0-17 pts/site). Sites reported pts perceived lack of improvement or feeling their overall pain was increased, transportation issues and infusion related reactions (IRRs) characterized by pain as some of the reasons for discontinuation. Evaluation of real-world efficacy measured by changes in acute care utilization, including sub-analysis by genotype, pre-treatment VOC burden and concomitant HU use, are pending sample size dependent feasibility. Discussion: This is the first multi-center real-world analysis of crizanlizumab. Findings demonstrate some insurance barriers to therapy. The majority of pts who initiated crizanlizumab have remained on therapy;however, 1/3 of pts had lack of effect or barriers to care. Pt level data will include characteristics related to treatment failure or IRR. Improving the understanding of phenotype-specific response to novel therapies is essential in SCD. Conclusion: Post-approval therapies for rare diseases must undergo real-world evaluation to ensure study results transla e to the community. NASCC uses defined criteria for multidisciplinary care for Alliance inclusion and findings reflect the use of DMT in such centers. This is the first NASCC study of DMT in SCD. Part 2 of the study will give early insights into the effectiveness of crizanlizumab;long term follow-up is needed for a full understanding of its utility in SCD. [Formula presented] Disclosures: Kanter: Fulcrum Therapeutics, Inc.: Consultancy;Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees;Forma: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees;Agios: Honoraria, Membership on an entity's Board of Directors or advisory committees;Beam: Honoraria, Membership on an entity's Board of Directors or advisory committees;Sanofi: Honoraria, Membership on an entity's Board of Directors or advisory committees;Graphite Bio: Consultancy;GuidePoint Global: Honoraria;Fulcrum Tx: Consultancy. Manwani: Novartis: Consultancy. Idowu: Novartis: Membership on an entity's Board of Directors or advisory committees, Research Funding;Pfizer: Research Funding;Global Blood Therapeutics: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau;Forma Therapeutics, Inc.: Research Funding;Ironwood: Research Funding. Treadwell: National Alliance of Sickle Cell Centers: Other: Early Evaluation of the Use of Crizanlizumab in Sickle Cell Disease. Clay: GBT: Membership on an entity's Board of Directors or advisory committees;Novartis: Honoraria. Little: Hemex Health, Inc.: Patents & Royalties;Biochip Labs: Patents & Royalties. Desai: Global Blood Therapeutics: Honoraria, Research Funding;Novartis: Research Funding, Speakers Bureau;Pfizer: Other: Publication Fee, Research Funding;Forma: Consultancy;Foundation for Sickle Cell Research: Honoraria. Lanzkron: Shire: Research Funding;Pfizer: Current holder of individual stocks in a privately-held company;Bluebird Bio: Consultancy;Teva: Current holder of individual stocks in a privately-held company;Novo Nordisk: Consultancy;GBT: Research Funding;Imara: Research Funding;CSL Behring: Research Funding;Novartis: Research Funding.