Choosing Wisely: Opportunities for improving value of cancer care in the Deep South.

13 Background: Under the Choosing Wisely (CW) Campaign, the American Society of Clinical Oncology (ASCO) and the American Society of Therapeutic Radiology and Oncology (ASTRO) recommend against non-evidence-based costly medications, tests, and procedures. CW recommendation adherence in the Deep South is largely unknown, and opportunities to reduce overuse and costs may exist. Methods: Analysis of administrative claims and tumor registry data from 12 cancer centers of the University of Alabama Health System Cancer Community Network, for Medicare beneficiaries ≥65 years old with cancer. Main outcome: percent of beneficiaries adhering to 9 CW recommendations. Results: 2012-2015 (Q1) adherence varied across CW recommendations and cancer centers, and increased over time for CW 2 and 7, decreased for 3, 5, and 6, and did not change for others. Conclusions: Opportunities to improve quality and value of cancer care exist in the Deep South. Research should understand how to minimize use of non-evidence based medications, tests, and procedures. [Table: see text]

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Disparities Research at the Deep South Alzheimer’s Disease Center of the University of Alabama at Birmingham

Innovation in Aging ◽

10.1093/geroni/igab046.379 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 100-100

Author(s):

Maria Pisu ◽

David Geldmacher

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

South Carolina ◽

African American ◽

African Americans ◽

Deep South ◽

Medicare Beneficiaries ◽

University Of Alabama ◽

The Us ◽

The University

Abstract Residents of the US Deep South (Alabama, Georgia, Louisiana, Mississippi, and South Carolina) have a 20–30% higher risk of developing Alzheimer’s disease or related dementia (ADRD). Moreover, >20% of African Americans, who are at higher ADRD risk than whites, live in this region. Therefore, one important goals of the Deep South Alzheimer’s Disease Center (DS-ADC) of the University of Alabama at Birmingham is to spearhead research to address these disparities. This panel presents current DS-ADC research, with two presentations focusing on the local patient population and the last two on the Deep South population compared to the rest of the nation. Addressing the challenge of recruiting representative samples in clinical research, the first paper is part of a research program to understand difference that may exist between African American and white research participants. The second paper examines patients with multiple conditions, in particular dementia and cancer, showing a marked disadvantage in cognition outcomes for African Americans. The next two papers take a broader perspective to better understand the population of older adults with ADRD in the Deep South and in the rest of the US. The third paper examines socioeconomic and medical contexts of African American and white older Medicare beneficiaries with ADRD, and the fourth paper examines differences in utilization of specialists, ADRD drugs, and hospitalizations in the two regions taking these contexts into account. The discussant will close the session by placing these studies in the larger context of the disparities research at the DS-ADC.

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INTEREST GROUP SESSION—PATIENT/PERSON ENGAGEMENT IN RESEARCH INTEREST GROUP (PPER-IG): STRENGTH IN AGE: ENGAGING OLDER ADULTS AS HEALTH RESEARCHERS THROUGH COMMUNITY-BASED PARTNERSHIPS

Innovation in Aging ◽

10.1093/geroni/igz038.1500 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S404-S404

Author(s):

Silvia Sörensen ◽

Rebecca S Allen ◽

Reza Yousefi Nooraie

Keyword(s):

Older Adults ◽

Interest Group ◽

Health Research ◽

Deep South ◽

University Of Alabama ◽

Community Members ◽

Patient Centered ◽

Community Stakeholders ◽

Research Findings ◽

The University

Abstract The lack of clear translation of health research to improving older under-served patients’ lives presents a serious problem. Studies of aging rarely include the older adults themselves in the process of conceptualizing questions, implementing the research, and applying and evaluating the results. Lack of input particularly from marginalized and minority older adults may compromise the relevance and accuracy of health research findings. In this symposium, we present the design and evaluation of two projects funded by the Patient-Centered Outcomes Research Institute (PCORI), in which older adults are trained to understand research language, culture, and methods, and are subsequently incorporated into research projects in a variety of roles. Silvia Sörensen will describe the “Engaging Older Adult Learners as Health Researchers” (ENGOAL) in Rochester, NY. This program provides six months of weekly classes and 4-6 months of research apprenticeships for older adults. Dorine Otieno and Kate Kondolf will describe evaluation results from both quantitative and qualitative analyses. Rebecca Allen will describe the design and implementation of “Sharing Opinions and Advice about Research (SOAR) in the Deep South,” a partnership of The University of Alabama with community stakeholders from Sumter and Holt County to recruit and train community members to assist in the formulation of research questions based on the needs of their communities. Allen and Dragan will present the evaluation results from this project with regard to implementation and graduate education. Reza Yousefi-Nooraie will synthesize the insights from these projects and add the perspective of a social network analyst.

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Partnering Between Cancer Centers: The American College of Surgeons, National Cancer Institute, American Cancer Society, Centers of Disease Control, American Society of Clinical Oncology, Society of Surgical Oncology, American Society of Therapeutic Radiation and Oncology, and Association of Community Cancer Centers Are Needed to Stimulate Improved Clinical Cancer Care

Journal of Clinical Oncology ◽

10.1200/jco.2003.99.013 ◽

2003 ◽

Vol 21 (9) ◽

pp. 1895-1895

Author(s):

Robert W. Frelick

Keyword(s):

Disease Control ◽

Clinical Oncology ◽

National Cancer Institute ◽

Cancer Care ◽

Surgical Oncology ◽

Cancer Society ◽

Cancer Centers ◽

American College Of Surgeons ◽

American Society ◽

Therapeutic Radiation

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Opioid Overdose Crises During the COVID-19 Pandemic: Implication of Health Disparities

10.21203/rs.3.rs-572796/v1 ◽

2021 ◽

Author(s):

Ishika Patel ◽

Lauren Walter ◽

Li Li

Keyword(s):

Health Disparities ◽

Medical Records ◽

Opioid Overdose ◽

Deep South ◽

University Of Alabama ◽

Overdose Prevention ◽

Ed Visits ◽

The Mean ◽

The University ◽

Overdose Deaths

Abstract Background. Recent data suggests a disproportionate impact of opioid overdoses on Black Americans. The study aims to describe emergency department (ED) visits at a Southern, urban ED pertaining to opioid overdose and associated health disparities. Methods. Patients presenting to the ED at the University of Alabama at Birmingham Hospital with opioid overdoses from January 1 to October 31, 2019, and from January 1 to October 31, 2020, were identified from electronic medical records. Results. The total number of opioid overdose visits increased 9.7% (556 to 611) between January through October 2020 compared with 2019. Among patients who presented with opioid overdose, the mean ages were 50.3 years and 48.3 years, in 2019 and 2020, respectively. In both 2019 and 2020, more Blacks than whites were treated for opioid overdose in the ED (284 vs. 258 in 2019, and 306 vs. 271 in 2020) although 28 patients did not record their race in 2020. Consistently, more overdose deaths were observed in Blacks than in Whites in 2020. More individuals seeking opioid overdose treatment were single in both years. Conclusions. The study reported a greater number of visits for opioid overdoses from January to October of 2020 in an ED of a deep south region, as well as higher overdose deaths in Blacks. Our findings highlight the importance of substance use treatment, harm reduction, and overdose prevention efforts that should be immediately present to reduce opioid overdose especially for vulnerable populations in the South, i.e., Black community, and individuals experiencing singlehood.

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The Emergence of a Sustainable Tobacco Treatment Program across the Cancer Care Continuum: A Systems Approach for Implementation at the University of California Davis Comprehensive Cancer Center

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17093241 ◽

2020 ◽

Vol 17 (9) ◽

pp. 3241 ◽

Cited By ~ 1

Author(s):

Elisa K. Tong ◽

Terri Wolf ◽

David T. Cooke ◽

Nathan Fairman ◽

Moon S. Chen

Keyword(s):

Treatment Program ◽

Cancer Care ◽

University Of California ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Cancer Centers ◽

Care Continuum ◽

Tobacco Treatment ◽

Cancer Care Continuum ◽

The University

Tobacco treatment is increasingly recognized as important to cancer care, but few cancer centers have implemented sustainable tobacco treatment programs. The University of California Davis Comprehensive Cancer Center (UCD CCC) was funded to integrate tobacco treatment into cancer care. Lessons learned from the UCD CCC are illustrated across a systems framework with the Cancer Care Continuum and by applying constructs from the Consolidated Framework for Implementation Research. Findings demonstrate different motivational drivers for the cancer center and the broader health system. Implementation readiness across the domains of the Cancer Care Continuum with clinical entities was more mature in the Prevention domain, but Screening, Diagnosis, Treatment, and Survivorship domains demonstrated less implementation readiness despite leadership engagement. Over a two-year implementation process, the UCD CCC focused on enhancing information and knowledge sharing within the treatment domain with the support of the cancer committee infrastructure, while identifying available resources and adapting workflows for various cancer care service lines. The UCD CCC findings, while it may not be generalizable to all cancer centers, demonstrate the application of conceptual frameworks to accelerate implementation for a sustainable tobacco treatment program. Key common elements that may be shared across oncology settings include a state quitline for an adaptable intervention, cancer committees for outer/inner setting infrastructure, tobacco quality metrics for data reporting, and non-physician staff for integrated services.

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