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The purpose of this paper is to provide a case study of a multifaceted institutional approach to minimizing cancer health disparities, presenting a novel organizational framework entitled, “A.C.C.E.S.S.” to guide those efforts.

This paper presents a case study of an organization that operates under the theory that cancer health disparities are a result of the cumulative incongruence of differences that exist between people in various contexts and interactions over time. Consequently, the A.C.C.E.S.S. framework is used to demonstrate the range of opportunities within an organization to intervene and mitigate gaps that result in inequality.

Addressing A.C.C.E.S.S. in various interactions and contexts over a sustained period of time results in a continuous improvement cycle that attenuates cancer health disparity.

The antecedents and impacts of cancer health disparities are well documented. However, there is a dearth of directionality for institutions and organizations in achieving equality in cancer treatment and care. This paper provides a framework to consider in organizing such endeavors.

The purpose of this paper is to apply Paulo Freire’s writings from Pedagogy of the Oppressed to critique current efforts to reduce cancer health disparities (CHDs) among Latinos in the USA.

Freire’s writings on oppression, critical consciousness, praxis and dialogical education are applied to recent efforts to reduce CHDs among Latinos in the USA through the use of promotores.

Freireian teachings can provide insight on ways to engage Latino communities in culturally sensitive conversations that respect deeply rooted beliefs, and address the political and socioeconomic inequities many continue to face. Programs must revisit Freire’s political and transformative roots to ensure efforts to reduce CHDs also promote health equity and community empowerment.

Public health initiatives should incorporate Freireian principles of dialogical education and critical consciousness in the development of cancer prevention and screening programs tailored to Latinos in the USA to ensure program longevity and success.

Approaching conversations and interactions dialogically can foster critical engagement and empower collective action among Latino communities in efforts to improve their environments and reduce health disparities.

This is a multi-layered analysis of different social and structural factors influencing CHDs among Latinos in the USA, and is coupled with a historical overview of colonialism and oppression in Latin America. It culminates in suggestions on ways to improve future public health efforts that embrace Freireian approaches and promote health equity.

HR leaders and corporate benefits managers must balance organizational costs with decisions about which new tools and treatments will be covered by their employee health insurance plans. Getting it right can mean the difference between life and death for cancer patients. Most HR leaders, however, are not experts in cancer treatment and do not know how to make sure their plan benefits do not create roadblocks to treatment.

A total of 295 people who were diagnosed with cancer from 2019 to 2022 participated in the 2023 CancerCare Biomarker Survey, which was conducted in January 2023.

CancerCare’s 2023 survey of cancer patients found that biomarker testing helped doctors tailor therapy for nearly all the patients (93%) whose cancers were tested over the past three years. Two in 10 cancer patients (20%) avoided unnecessary chemotherapy and/or radiation and one in 10 (10%) became eligible for a clinical trial because of biomarker testing.

Biomarker testing is a necessary tool in the advancing world of precision cancer treatment. Despite the significant and demonstrable benefits to surveyed patients, three out of 10 respondents (29%) who received biomarker testing did not have the test covered by their insurance. Some survey respondents reported that biomarker test coverage was originally denied and they had to fight to get it covered. Others had to find ways to pay out-of-pocket or seek financial assistance to cover the cost of the testing.

Unfortunately, health insurance plans often limit cancer patients’ access to recommended biomarker testing, impose burdensome prior authorization (PA) protocols or require unaffordable cost-sharing, which can prevent or delay cancer patients’ access to optimal treatments. PA, a significant source of roadblocks to timely testing and treatment, was required by a quarter (25%) of the cancer patients surveyed.

Biomarker testing is increasingly a health care equity issue and there are significant gaps in the rate of biomarker testing between black and white lung and colorectal cancer patients, which can lead to disparities in clinical trial participation and hinder access to the most effective treatments. A key way to address these barriers is to broaden insurance coverage of biomarker testing, as recommended by medical experts.

The purpose of this paper is to gain an in-depth understanding of beliefs, attitudes, and reasons for decision making about colorectal cancer (CRC) screening among South Asian (SA) immigrants.

Six focus groups conducted in English, Punjabi, and Urdu were held with 42 SA immigrants, 50-74 years old and at average risk for CRC, from November 2012 to May 2013. All focus group discussions were audio-taped and transcribed verbatim. Data analysis used an inductive and systematic approach employing constant comparison techniques.

Three dominant themes emerged. Beliefs and attitudes towards cancer and screening represented SA immigrant’s perceptions that early detection was beneficial; screening was not necessary in the absence of symptoms; cancer was scary; and the loss of previously established bowel practices upon immigration as potential risks for CRC. Knowledge and awareness focused on unscreened participants’ cancer stories; screened participants’ knowledge of CRC, risk factors, and screening; experiential learning from focus groups; and screened participants’ strategies to promote screening. Support and accessibility concentrated on physician support and responsibility to provide information, explanation, and recommend screening to facilitate access.

Findings provide novel insights on socio-cultural context, beliefs, and barriers to CRC screening among SA immigrants. Culturally appropriate community-based strategies included story-telling, the use of social networks, and greater physician engagement. Enhancing collaborative partnerships with physicians and public health may minimize structural barriers and reduce health disparities. Future research could explore effectiveness of outreach strategies including these collaborations.

Purpose: For deaf people who use American Sign Language (ASL), including cancer survivors, there are documented reports of difficulties in accessing and understanding health information. More than five years ago, a local breast cancer knowledge study with deaf signers found that only 23% of this sample cited the Internet as a source of health information. More research is needed to understand the current trends of a nationwide adult sample of deaf people’s experience with seeking and understanding health information across technology-mediated platforms.

Methodology/Approach: The Health Information National Trends Survey in American Sign Language survey included sections on health status, Internet use, and social media. We used several approaches to recruit deaf people across the USA, including Hawaii, Alaska, and Puerto Rico. The survey was administered online, in person, or through videophone. Following data cleaning, we conducted multiple logistic regression analyses, controlling for demographic factors associated with eHealth-seeking behaviors. The outcome variables of interest were Internet use and sharing health information on social media.

Findings: A total of 713 deaf people in USA (M = 49 years old; SD = 19) provided informed consent and took the survey. Half of the participants had a college degree. Twenty percent of the sample included those who self-identified as lesbian, gay, or bisexual and 38% who were people of color. White, educated, or younger deaf adults were more likely to cite the Internet as the first source of health information. Although all sub-groups were comparable in using social media, younger or ASL/English bilingual deaf adults were more likely to actively share health information through social media. While perceived trust in health information on the Internet did not differ across subgroups within the deaf sample, frustration in finding and understanding information was strongly linked to increasing age as well as those who prefer using ASL only. Users of YouTube for health-related information were likely to be younger or female.

Conclusions: Deaf users of eHealth information are diverse in terms of language usage, which affects their perception of accessing and using health information across technology-mediated platforms. While using YouTube for health appears to be accessible to deaf people, further improvements are needed to make health information sharing through social media inclusive of people who prefer ASL only. The addition of multimodal delivery features (text, audio, and video) in social networking sites has the strong potential to improve health information access and inclusion for all groups, including deaf ASL users. To make online health information inclusive of all groups, materials need to be accessible and easy to understand by all groups.

As health care delivery becomes increasingly focused on patient-centered models, interventions such as patient navigation that have the potential to improve care coordination garner interest from health care managers and clinicians. The ability to understand how and to what extent patient navigation is successful in addressing coordination issues, however, is hampered by multiple definitions, vague boundaries, and different contextual implementations of patient navigation. Using a systematic review strategy and classification method, we review both the conceptual and empirical literature regarding navigation in multiple clinical contexts. We then describe and conceptualize variation in how patient navigation has been defined, implemented, and theorized to affect outcomes. This review suggests that patient navigation varies along multiple dimensions and that the variation is related to differing resources, constraints, and goals. We propose a conceptual model to frame further research and suggest that research in this area must carefully account for this variation in order to accurately assess the benefits of patient navigation and provide actionable knowledge for managers.

The aim of this paper is to call for an increased focus on the ethics of direct-to-consumer (DTC) prescription drug advertising. This is important, not only to improve DTC prescription drug advertising, but also to inform DTC advertising of future medical advances.

This conceptual paper discusses two examples of medical advances – personal genetic testing services and surgically implanted medical devices – to explain how investigating the research of DTC prescription drug advertising can set the stage for more ethical advertising of future medical advances.

Specific issues related to health literacy, at-risk populations impacted by health disparities, and medicalization of issues common to aging relate to the DTC advertising of prescription drugs and other medical advances. Creative approaches to investigating these issues in the context of prescription drug advertising can enrich the debate about drug advertising, but also prepare researchers, policymakers, and consumers for future advertising of new medical developments.

The value of this paper is its call for increased focus on the ethics of DTC prescription drug advertising, to improve the current marketing environment but also lay the foundation for other healthcare marketing in the future.

Proponents of community engagement to promote social change advocate bringing together researchers, practitioners, politicians, business leaders, advocates and other relevant stakeholders to identify and solve community problems and issues. This chapter will describe the need for academic and community partnerships, how academic institutions can develop priorities, governance and financial structures that facilitate stronger, more effective community relationships and make contributions to the resolution of social ills. The current literature on community engagement, community-based participatory research, community action research, community-engaged scholarship and service-learning are reviewed. The principles and tenets of engaged scholarship are reviewed, barriers to implementation are discussed and examples provided. Academic institutions can play an important role in social change if they are willing to embrace community engagement. A key to success is building trust, sharing power, fostering co-learning, enhancing strengths and resources, building capacity, and addressing community-identified needs. Academic participation requires institutional and faculty commitment to engagement principles, flexible and inclusive governance structures and strategies to educate community members. The development of the relationships and structures required for successful community engagement can be inhibited by imbalances in power and knowledge that often exist among practitioners, researchers, and community members. This review may assist academic institutions to examine implementation of tenure and promotion policies, oversight strategies and structures that assure community development and benefit, as well as opportunities for faculty, staff and student training on principles and best practices of community-engaged research.