Decision aids and health information technology: One size does not fit all.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 74-74
Author(s):  
Katia Noyes ◽  
Christina Crabtree-Ide ◽  
David Holub ◽  
Michelle Shayne ◽  
Jennifer Rodriguez ◽  
...  
Keyword(s):  
Decision Making ◽  
Information Technology ◽  
Focus Group ◽  
Cancer Survivors ◽  
Care Coordination ◽  
Rural Areas ◽  
Psychosocial Support ◽  
Research Approach ◽  
Survivorship Care ◽  
Care Managers

74 Background: Nearly 3 million cancer survivors in the US reside in rural areas. Existing survivorship care models were developed mainly at large academic centers, and thus require adaption to meet the challenging needs of the rural community. Rural cancer survivors (RCS) face issues with coordination of care, decision-making, access to specialty services, supportive care resources, and time and resources required for travel. RCS are at greater risk for social isolation and inadequate emotional support. To address these challenges, many studies propose information technology (IT), mobile, and video solutions. We assessed the potential of online and mobile video technology applications to reduce barriers to survivorship care for RCS, families, and caregivers. Methods: We conducted 2 in-person focus groups with rural care managers, providers, and public health professionals, and one virtual cross-disciplinary focus group of patients, caregivers, and provider stakeholders to evaluate acceptability of video modules. Using a Community-Based Participatory Research approach, we worked with community partners to design and develop materials that adequately addressed their needs. Results: Focus group results indicate that video modules added little value for RCS due to sporadic internet access, limited patient IT literacy, vision and memory problems, and patient difficulty interpreting information. Therefore, we designed and piloted a paper RCS Checklist to be taken to appointments, available in waiting areas or through care managers, and to serve as a guide for shared patient-provider decision-making. The resulting checklist includes evidence-based information about survivorship care goals and approaches, care coordination strategies, information about local cancer supportive services, health insurance reimbursement, state disability policies, psychosocial support, and stress-reduction tips. Conclusions: In some special patient populations like RCS, use of health IT for patient empowerment and care coordination may be a poor choice. Engaging relevant stakeholders in the development of location-specific communication and decision aid materials is paramount to successful engagement of patients and caregivers.

A centralized, primary care medical home survivorship model at the GW Cancer Center.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 45-45
Author(s):  
Elizabeth Hatcher ◽  
Farzana L. Walcott ◽  
Cam Ha ◽  
April Barbour
Keyword(s):  
Primary Care ◽  
Physical Therapy ◽  
Cancer Survivors ◽  
Weight Management ◽  
Care Coordination ◽  
Medical Home ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
The Impact ◽  
Primary Care Medical Home

45 Background: Models for survivorship care are often oncology-based. George Washington (GW) Adult Cancer Survivorship Clinic (ACS) has developed a unique, centralized model for survivorship care delivery staffed by internal medicine providers. The objective is to provide care to survivors that encompass the broad array of chronic issues they face, in addition to guidance on cancer surveillance and prevention. Methods: We implemented a centralized, primary care, consultative model of survivorship care, emphasizing care coordination. A personalized, evidence based survivorship care plan (SCP) is provided to each patient. Patients with complex needs may be seen for follow-up. A copy of the SCP is sent to the patient’s primary care provider (PCP). Referrals are made to our network of specialists within the GW system including: cardiology, neurology, weight management, genetic counseling, dermatology, physical therapy, integrative medicine, psycho-oncology, sexual health, and oncofertility. Referrals are tracked to specialty services using the electronic medical record (EMR). Results: Based on preliminary data, from January 2016 to October 2017, 261 cancer survivors were seen in the survivorship clinic. The majority were breast cancer survivors (166). Referral records were available for 225 patients. Most common were dermatology for baseline skin cancer screening (28%), physical therapy (16%), social work and psycho-oncology (15%), and weight management (15%). Conclusions: Our clinic is based on a primary care medical home model for each survivor, which includes care coordination and referral to specialty services. Limitations include inconsistent referral tracking methods with our EMR and incomplete data for all survivorship patients. Future research plans include assessing the impact of referrals on patient-reported outcomes and morbidity.

scholarly journals Survivorship Care Focus Group Discussions for Breast Cancer Survivors and Primary Care Clinicians

2021 ◽  
pp. 1-4
Author(s):  
Hillary Klonoff-Cohen ◽  
Hillary Klonoff-Cohen ◽  
Mounika Polavarapu
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Focus Group ◽  
Cancer Survivors ◽  
Nurse Practitioners ◽  
Late Effects ◽  
Primary Care Physicians ◽  
Breast Cancer Survivors ◽  
Survivorship Care ◽  
Psychological Consequences

Purpose: This is the first pilot study to examine survivors’ experiences and primary care physicians and nurse practitioners’ knowledge and behaviour practices with respect to late effects (e.g., fatigue, chemobrain, lymphodema, cardiac problems, reproductive, infertility and sexual health issues, bone problems, and pain). Methods: Two separate focus groups consisting of 5 breast cancer survivors and 5 primary care physicians and nurse practitioners recruited from a local hospital in Central Illinois answered predetermined questions about cancer survivorship care. We intentionally limited the sample in order to conduct a detailed discussion (90 minutes) to gain every participant’s perspective. Results: Breast cancer survivors expressed a void in discussion and lack of knowledge among their primary care physicians regarding late effects as well as psychological consequences, referrals to support groups, and availability of resources (e.g., finances), thereby negatively affecting survivors’ quality of life. A primary care clinician (PCC) focus group revealed a service gap for mental health services for all patients, knowledge deficit about late effects, and lack of awareness of patient resources. Both cancer survivors and PCCs were extremely supportive about a shared care survivorship model between oncology and primary care. All focus group participants were unequivocally receptive about enhancing survivorship care throughout a cancer survivor’s lifetime. Conclusion: Complementing cancer survivorship care with primary care clinicians in the areas of late effects, in addition to psychological consequences, screening, and lifestyle habits will enhance a cancer survivor’s health-related quality of life.

scholarly journals Identification of Students' Needs for Multimedia Development in Craft and Entrepreneurial Topic: Information Technology-Assisted Learning

2020 ◽  
Vol 5 (4) ◽  
Author(s):  
Mochamad Kamil Budiarto
Keyword(s):  
Decision Making ◽  
Information Technology ◽  
Data Collection ◽  
Multimedia Learning ◽  
Needs Analysis ◽  
Research Approach ◽  
Study Report ◽  
Multimedia Development ◽  
Quantitative Descriptive

This study aimed to identify the need for multimedia development for craft and entrepreneurship learning. Quantitative descriptive is the research approach used. Data collection techniques using a needs analysis questionnaire and analyzed quantitatively using statistics to find out the means and percentage of responses from the sample. The subjects of this study consisted of 55 students of Class XI IPA of SMA N 1 Susukan, Cirebon. The results of the study report that the need for multimedia development for learning craft and entrepreneurship topic received positive responses from students and was supported by students who have the ability to operate computers, besides that schools had been supported by facilities such as computer laboratories. Given all this time, the module still dominates as a learning medium. This research can be used as a basis for decision making for the stages of developing multimedia learning products.

scholarly journals FACTORS INFLUENCING TI-IE DECISION -MAKING OF USING XL CELLULAR SERVICES (A STUDY AT XL CELLULAR USERS IN RURAL AREAS OF CENTRAL LOMBOK REGENCY)

2016 ◽  
Vol 5 (3) ◽  
Author(s):  
Silvia Herlina
Keyword(s):  
Decision Making ◽  
Rural Areas ◽  
Linear Regression Analysis ◽  
Sampling Technique ◽  
Multiple Linear Regression Analysis ◽  
Mobile Services ◽  
Dominant Factor ◽  
Research Approach ◽  
Service Center ◽  
Environmental Aspects

The use of mobile services as a medium of communication showed increasing trend over time in the community. it also affects the changes in their behavior patterns. especially people who want the ease of communicating and getting information.  The problem formulated in this study is: what factors are influencing the decision-making of buyers of mobile services XL (study of mobile users XL in rural areas of Central Lombok district). seen from the aspects of individual consumers. environmental aspects and marketing stimuli aspects. and which of these factor dominantly influence the decision on the purchase of XL's mobile products.  This research is the associative / relationship study described through quantitative research approach to determine the effect of variable on the number of XL product user services in rural areas of central Lombok regency. Methods of sampling used is non probabiliy sampling. While the sampling technique is accidental sampling. The total number of sample is 100 people. There are 13 research variables. Thc variable is measured with Likert scale. Hypothesis testing used is multiple linear regression analysis through F test and T test with confidence level at 95% (a=0,05). The Results of partial testing of the nine factors that have significant influence show that simultanously consumers need (X1). consumers income (X2). the influence of family / neighbors (X4). consumers social interaction (X5). recomendation of consumers' friends (X6). price of XL credits (X8), quality of XL cellular service (X9). the availability of the service center of XL cellular (X I 0) and the availability of stores or vendors that sell cellular services XL (X 12) affect the decision of XL cellular services in Central Lombok Regency. meanwhile, the availability of the service center of XL is the most dominant factor.  From the results of this study. it is suggested that the marketers pay attention on marketing stimuli factors, in particular the availability of the service center as a consideration in formulating marketing strategic. and also for fellow researchers to conduct research on consumer behavior related to the their needs and desires. Keyword : changing patterns of behavior, individual aspects of consumer, environmental aspects, aspects of marketing stimuli, decisions on purchasing XL mobile services, availibility of service centers, needs and desires.

Gaps in survivorship care plan delivery and potential benefits to survivorship care.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9594-9594 ◽  
Author(s):  
Laura Pence Forsythe ◽  
Carla Parry ◽  
Catherine M. Alfano ◽  
Erin E. Kent ◽  
Corinne Leach ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Survivors ◽  
Care Coordination ◽  
Primary Care Physicians ◽  
Physician Attitudes ◽  
Physician Communication ◽  
Survivorship Care ◽  
Treatment Summaries ◽  
Treatment Summary

9594 Background: Survivorship care plans (SCPs), consisting of a treatment summary and follow-up plan, are intended to promote coordination of post-treatment cancer care. Yet, little is known about the provision of these documents by oncologists to primary care physicians (PCPs). This study compared self-reported oncologist provision and PCP receipt of treatment summaries and follow-up plans, characterized oncologists who reported consistent provision of these documents to PCPs, and examined associations between PCP receipt of these documents and survivorship care. Methods: A nationally representative sample of medical oncologists (N=1130) and primary care physicians (PCPs; N=1020) were surveyed regarding follow-up care for breast and colon cancer survivors using the cross-sectional Survey of Physician Attitudes Regarding the Care of Cancer Survivors (SPARCCS) in 2009. Results: Nearly half of oncologists reported always/almost always providing treatment summaries, while 20.2% reported always/almost always providing SCPs (treatment summary + follow-up plan). Approximately one-third of PCPs indicated always/almost always receiving treatment summaries, while 13.4% reported always/almost always receiving SCPs. Oncologists who reported training in late and long-term effects of cancer and use of electronic medical records were more likely to report SCP provision (p<0.05). PCP receipt of SCPs was associated with better PCP-reported care coordination, physician-physician communication, and confidence in survivorship care knowledge compared to receipt of neither treatment summaries nor SCPs (p<0.05). Conclusions: Providing SCPs to PCPs may enhance survivorship care coordination, physician-physician communication, and PCP confidence in caring for survivors. However, a minority of oncologists report routinely delivering SCPs to PCPs. Considerable progress will be necessary to achieve sharing of SCPs among oncologists and PCPs.

Implementation of a novel primary care-centered clinic for survivorship care.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 41-41
Author(s):  
Archana Radhakrishnan ◽  
Youngjee Choi ◽  
Zackary Berger ◽  
Craig Evan Pollack ◽  
Sydney Morss Dy ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Cancer Care ◽  
Psychosocial Support ◽  
Primary Care Providers ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Survivorship Care ◽  
Care Providers

41 Background: Patients often face challenges in transitioning to the survivorship stage of cancer care and coordinating with primary care. Prior research has highlighted the uncertainty in who provides survivorship care, leaving patients “lost in transition”. Integrating primary care providers (PCP) into cancer care offers one potential solution. Expanding traditional PCP roles to participating throughout the cancer continuum and familiarizing PCPs with cancer patients’ needs can address this gap. We describe an innovative model of incorporating PCPs to delivering primary care to cancer survivors at a large academic institution. Methods: As one part of a plan to address an identified need for improving survivorship care for cancer patients at Johns Hopkins, PCPs and cancer survivorship care experts developed the Primary Care for Cancer Survivors clinic (PCCS) in 11/2015. The clinic receives referrals from the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center and patients are seen for either a one-time consultation or can transition their primary care to the clinic. We also are creating a database of internal and external referrals to meet the specific needs identified by patients. We descriptively analyzed the utilization of PCCS from 11/2015 through 9/2016. Results: A total of 35 patients have been seen at PCCS. The average age of patients was 56.8 (SD 12.4) and 32 were female and 3 were male. 24 patients identified as white, 8 black, 1 Asian, and 2 others. Most patients transitioned their PC to the clinic (n = 30). The majority of patients had breast (n = 19) and colorectal cancer (n = 5); 10 patients had metastatic disease (3 have deceased). Commonly, referrals were made to physical therapy, including pelvic rehabilitation and lymphedema management, and nutrition counseling. Conclusions: Patients with a wide variety of cancers and at all stages of disease were seen for survivorship care in the PCCS clinic. Integrating nutrition care, psychosocial support, exercise programs, and palliative care were key early factors in meeting patients’ needs. Continuing to assess and meet survivors’ individual needs and build referral networks are important next steps in the development of the clinic.

Gender inequity as a barrier to women’s access to skilled pregnancy care in rural Nigeria: a qualitative study

2019 ◽  
Vol 11 (6) ◽  
pp. 551-560 ◽  
Author(s):  
Sanni Yaya ◽  
Friday Okonofua ◽  
Lorretta Ntoimo ◽  
Ogochukwu Udenige ◽  
Ghose Bishwajit
Keyword(s):  
Decision Making ◽  
Focus Group ◽  
Qualitative Study ◽  
Maternal Mortality ◽  
Rural Areas ◽  
Quality Care ◽  
Healthcare Services ◽  
Maternal Healthcare ◽  
Edo State

Abstract Background Maternal mortality has been an issue of global importance, with continued efforts by the international development community towards its reduction. The provision of high quality maternal healthcare has been identified as a key strategy in preventing maternal mortality. Gendered intrahousehold power structures, gendered dynamics of resource allocation and women’s limited ability in decision-making can have a huge impact on maternal health-seeking behaviour and overall health status. Using a gender lens, this study explores the root causes of women’s limited access to and utilisation of maternal healthcare services in rural areas of Edo State, Nigeria. Methods This qualitative study involved the analysis of data collected from gender- and age-desegregated focus group discussions (FDGs) in 20 communities in Etsako East and Esan South East local government areas of Edo State, Nigeria. Focus group participants comprised women between the ages of 15–45 y who have been pregnant within the last 5 y and their male spouses and partners of varying ages. A total of 20 FGDs were conducted. Coded transcripts were reviewed and analysed using the gender framework as an analytical guide. Results Most responses indicated that women did not entirely have the power to make decisions regarding when to seek care during pregnancy. Women’s experiences of access to quality care showed intersecting areas of gender and social economic status (SES) and how they impact on access to health. Many of the responses suggested high levels of economic marginalisation among women with women being financially dependent on their spouses and partners for pregnancy healthcare-related costs. Furthermore, a man’s financial status determined the type of care his spouse or partner sought. Women identified a high workload as an issue during pregnancy and a barrier to accessing maternal healthcare services. The role of men within households was generally perceived as that of financial providers, therefore a husband’s support was commonly constructed to solely mean financial support. Conclusion This paper brings attention to the role of gender and SES in producing and sustaining limitations to women’s access to quality care. Interventions geared towards supporting women’s financial independence is an important step towards improving their access to skilled healthcare, more so are interventions that improve women’s decision-making capacities.

scholarly journals Perceptions and Barriers of Survivorship Care in Asia: Perceptions From Asian Breast Cancer Survivors

2017 ◽  
Vol 3 (2) ◽  
pp. 98-104 ◽  
Author(s):  
Alexandre Chan ◽  
Zheng Kang Lum ◽  
Terence Ng ◽  
Tewodros Eyob ◽  
Xiao Jun Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Focus Group ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Physical Symptoms ◽  
Post Treatment ◽  
Cancer Center ◽  
Survivorship Care ◽  
Focus Group Discussions ◽  
Group Discussions

Purpose With the long-term goal to optimize post-treatment cancer care in Asia, we conducted a qualitative study to gather in-depth descriptions from multiethnic Asian breast cancer survivors on their perceptions and experiences of cancer survivorship and their perceived barriers to post-treatment follow-up. Methods Twenty-four breast cancer survivors in Singapore participated in six structured focus group discussions. The focus group discussions were voice recorded, transcribed verbatim, and analyzed by thematic analysis. Results Breast cancer survivors were unfamiliar with and disliked the term “survivorship,” because it implies that survivors had undergone hardship during their treatment. Cognitive impairment and peripheral neuropathy were physical symptoms that bothered survivors the most, and many indicated that they experienced emotional distress during survivorship, for which they turned to religion and peers as coping strategies. Survivors indicated lack of consultation time and fear of unplanned hospitalization as main barriers to optimal survivorship care. Furthermore, survivors indicated that they preferred receipt of survivorship care at the specialty cancer center. Conclusion Budding survivorship programs in Asia must take survivor perspectives into consideration to ensure that survivorship care is fully optimized within the community.

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