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1.
West J Emerg Med ; 25(1): 101-110, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38205991

RESUMO

Introduction: People without reliable access to healthcare are more likely to be diagnosed with late-stage cancer that could have been treated more effectively if diagnosed earlier. Emergency departments (ED) may be a novel place for cancer screening education for underserved patients. In this study we sought to determine patient characteristics and barriers to cancer screening for those patients who presented to a large, academic safety-net ED and were overdue for breast, cervical, and colorectal cancer screening since the coronavirus 2019 (COVID-19) pandemic. Methods: Adult ED patients eligible for at least one cancer screening based on US Preventive Serivces Task Force guidelines completed a web-based survey. We examined the association of demographic characteristics and having a personal physician with being overdue on screening using chi-square or the Fisher exact test for categorical variables and t-tests for continuous variables. Results: Of 221 participants, 144 were eligible for colorectal, 96 for cervical, and 55 for breast cancer screening. Of eligible patients, 46% (25/55) were overdue for breast cancer screening, 43% (62/144) for colorectal, and 40% (38/96) for cervical cancer screening. There were no significant characteristics associated with breast cancer screening. Being overdue for cervical cancer screening was significantly more likely for patients who were of Asian race (P = 0.02), had less than a high school diploma (P = 0.01), and were without a routine checkup within the prior five years (P = 0.01). Overdue for colorectal cancer screening was associated with patients not having insurance (P = 0.04), being in their 40s (P = 0.03), being Hispanic (P = 0.01), and not having a primary care physician (P=0.01). Of 97 patients overdue for at least one screening, the most common barriers were cost (37%), lack of time (37%), and lack of knowledge of screening recommendations (34%). Only 8.3% reported that the COVID-19 pandemic delayed their screening. Conclusion: The ED may be a novel setting to target patients for cancer screening education. Future work that refers patients to free screening programs and primary care physicians may help improve disparities in cancer screening and cancer mortality rates for underserved populations.


Assuntos
Neoplasias da Mama , Neoplasias Colorretais , Infecções por Coronavirus , Coronavirus , Neoplasias do Colo do Útero , Adulto , Feminino , Humanos , Detecção Precoce de Câncer , Pandemias , Neoplasias do Colo do Útero/diagnóstico , Serviço Hospitalar de Emergência , Neoplasias da Mama/diagnóstico , Neoplasias Colorretais/diagnóstico
2.
J Clin Transl Sci ; 7(1): e253, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38380393

RESUMO

Community health needs assessments (CHNAs) are important tools to determine community health needs, however, populations that face inequities may not be represented in existing data. The use of mixed methods becomes essential to ensure the needs of underrepresented populations are included in the assessment. We created an in-school public health course where students acted as citizen scientists to determine health needs in New Brunswick, New Jersey adults. By engaging members of their own community, students reached more representative respondents and health needs of the local community than a CHNA completed by the academic hospital located in the same community as the school which relies on many key health statistics provided at a county level. New Brunswick adults reported significantly more discrimination, fewer healthy behaviors, more food insecurity, and more barriers to accessing healthcare than county-level participants. New Brunswick participants had significantly lower rates of health conditions but also had significantly lower rates of health screenings and higher rates of barriers to care. Hospitals should consider partnering with local schools to engage students to reach populations that face inequities, such as individuals who do not speak English, to obtain more representative CHNA data.

3.
Am J Addict ; 31(6): 486-493, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35962766

RESUMO

BACKGROUND AND OBJECTIVES: While the relationship between recreational cannabis and nicotine use is well established, little is known about nicotine use among users of cannabis for therapeutic purposes (CTP). METHODS: Patients attending a medical marijuana dispensary (N = 697; 75.3% White; 60.0% male) completed a survey examining nicotine use, motivation to quit cigarette smoking, routes of administration of nicotine and cannabis, and CTP qualifying conditions. RESULTS: More than one-third (39.3%) of participants reported current nicotine use. Compared to exclusive cigarette smokers, e-cigarette users and non-users of nicotine were approximately four times more likely to vape, rather than to smoke, cannabis. Furthermore, 46.8% of cigarette smokers reported plans to quit smoking in the next 6 months (but not in the next month) and an additional 31.6% planned to quit in the next month. Having a psychiatric condition was associated with nicotine use and higher motivation to quit smoking. DISCUSSION AND CONCLUSIONS: Users of CTP are more likely to use nicotine products than the general population and the route of administration of nicotine products is related to the route of administration of CTP. If aerosolized CTP is a less harmful route of administration than smoked CTP, dispensary staff should be aware of this relationship and take this into account when recommending a noncombustible route. SCIENTIFIC SIGNIFICANCE: This study further characterizes nicotine use behaviors and motivation to quit smoking among users of CTP and may be among the first to examine nicotine use among patients of a medical marijuana dispensary.


Assuntos
Cannabis , Sistemas Eletrônicos de Liberação de Nicotina , Alucinógenos , Maconha Medicinal , Abandono do Hábito de Fumar , Produtos do Tabaco , Feminino , Humanos , Masculino , Maconha Medicinal/uso terapêutico , Nicotina , Abandono do Hábito de Fumar/psicologia , Nicotiana
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