Medicine and Health Sciences Commons^™

Implementing Routine Communication About Costs Of Cancer Treatment: Perspectives Of Providers, Patients, And Caregivers, Marie Haverfield, A. E. Singer, C. Gray, A. Shelley, A. Nash, K. A. Lorenz

Faculty Publications

Objectives Rising costs in oncology care often impact patients and families directly, making communication about costs and financial impacts of treatment crucial. Cost expenditures could offer opportunities for estimation and prediction, affording personalized conversations about financial impact. We sought to explore providers’, patients’, and caregivers’ preferences towards implementing communication about cost, including when, how, and by whom such information might be provided.

Methods We conducted semi-structured phone interviews with a diverse population including 12 oncology providers, 12 patients, and 8 patient caregivers (N = 32). The constant comparative method was used to identify mutually agreed upon themes.

Results Participant groups …

What Is Clinician Presence? A Qualitative Interview Study Comparing Physician And Non-Physician Insights About Practices Of Human Connection, Cati Brown-Johnson, Rachel Schwartz, Amrapali Maitra, Marie Haverfield, Aaron Tierney, Jonathan Shaw, Dani Zionts, Nadia Safaeinili, Sonoo Thadaney Israni, Abraham Verghese, Donna Zulman

Faculty Publications

Objective We sought to investigate the concept and practices of ‘clinician presence’, exploring how physicians and professionals create connection, engage in interpersonal interaction, and build trust with individuals across different circumstances and contexts.Design In 2017–2018, we conducted qualitative semistructured interviews with 10 physicians and 30 non-medical professionals from the fields of protective services, business, management, education, art/design/entertainment, social services, and legal/personal services.Setting Physicians were recruited from primary care clinics in an academic medical centre, a Veterans Affairs clinic, and a federally qualified health centre.Participants Participants were 55% men and 45% women; 40% were non-white.Results Qualitative analyses yielded a definition of …

Social Support Networks And Symptom Severity Among Patients With Co-Occurring Mental Health And Substance Use Disorders, Marie Haverfield, Mark Ilgen, Eric Schmidt, Alexandra Shelley, Christine Timko

Faculty Publications

Patients entering an inpatient psychiatry program (N = 406) with co-occurring mental health and substance use disorders reported on their social support networks (source, type) at treatment intake, and completed symptom measures at baseline and 3-, 9-, and 15-month follow-ups (77%). Longitudinal growth models found aspects of participants’ support networks were associated with specific symptoms over time. Less family support (i.e., more conflict) was the most consistent predictor of mental health and substance use outcomes and was associated with greater psychiatric, depression, Post Traumatic Stress Disorder (PTSD), and drug use severity. More peer support (via mutual-help involvement) was associated with …

Chinese College Students' Health Information Seeking Behavior: Implications For Academic Libraries, Yanxia Shi, Lili Luo

Faculty Publications

In 2016, Zexi Wei, a 21-year old Chinese college student died after receiving experimental treatment for synovial sarcoma at the Second Hospital of the Beijing Armed Police Corps. He learned about this treatment from a promoted result on the Chinese search engine Baidu (the equivalent of Google in China), and ultimately discovered that the hospital had misled patients by providing fraudulent information about the treatment's success rate. Wei's death prompted Chinese regulators to investigate Baidu's advertising practices, and drew widespread attention from the public about the ill-regulated practices of online dissemination of health information. As academic librarians, this tragic incident …

Who Put The Super In Superhero? Transformation And Heroism As A Function Of Evolution, Susan Ross

Faculty Publications

Transformation and heroism are reciprocally related. Transformation produces an individual that others may call hero; one who inspires, guides, and protects something precious—an ordinary extraordinary person, master of the self. Heroes exhibit the further reaches of human development by transforming into entirely new, resplendent individuals that demonstrate valuable capacities whiles still being mortal. Because transformation is the means through which heroes are made, a more thorough understanding of the forces affecting transformation may advance collective understanding of the demands upon the individual. Founded on the scholarship of seminal authors of depth psychology, East Indian spirituality, anthropology, physics, mythology, Hermetic science, …

Experiences Of Commercially Sexually Exploited Youth In The United States: A Qualitative Systematic Review, Michelle Hampton, Michelle Lieggi

Faculty Publications

Background: Youth at highest risk for commercial sexual exploitation in the United States (US) are runaway, homeless, and transgender youth. Despite the availability of research evidence pertaining to this phenomenon, there is a lack of research synthesis to enable easy access and use by health professionals and others who serve this population. This review’s purpose was to aggregate the qualitative evidence regarding commercially sexually exploited youth (CSEY) in the US to inform the development of appropriate interventions and response systems. Methods: The search included published and unpublished qualitative studies with current or former CSEY who resided in the US. Results: …

Patient-Centered Pain Management Communication From The Patient Perspective, Marie Haverfield, Karleen Giannitrapani, Christine Timko, Karl Lorenz

Faculty Publications

BackgroundPain management discussions between patient and provider can be stressful to navigate and greatly impact the care received. Because of the complexity, emotional color, and sensitivity of pain management, such discussions require a high degree of skill.ObjectiveTo identify patients’ perspectives of patient-centered care communication within the context of pain management discussions.DesignWe conducted semi-structured interviews (25–65 min) with patients regarding their experiences with pain assessment and management.Participants: 36 patients (29 males, 7 females), from 3 Veteran Affairs healthcare locations. Participant age ranged from 28 to 94 with pain intensity ranging from 0 to 10, based on the “pain now” numeric rating …

The Use Of Anecdotal Information In A Hypothetical Lung Cancer Treatment Decision, Preston Brown, Victor Kwan, Michael Vallerga, Hardeep Obhi, Erin Woodhead

Faculty Publications

This mixed-methods study examined variables associated with use of experience-based (i.e., anecdotal) decisional strategies among 85 undergraduate students presented with 2 hypothetical lung cancer scenarios. Participants were asked to think aloud while they made their treatment choice. Eleven decisional strategies were identified and grouped into either data or experience-based strategies. Approximately, 25% of participants used experience-based strategies. Use of experience-based strategies was more likely if the participant reported involvement in the life of someone going through cancer treatment, and if they rated print-based media sources as less important. Use of experience-based strategies was associated with choosing surgery instead of radiation …

Alcoholic And Nonalcoholic Parents’ Orientations Toward Conformity And Conversation As Predictors Of Attachment And Psychological Well-Being For Adult Children Of Alcoholics, Marie Haverfield, Jennifer Theiss

Faculty Publications

Alcoholism is a family illness that has implications for the physical, emotional, and psychological well-being of the spouse and children of individuals with alcoholism (Johnson & Stone, 2009). One in four families in the United States is affected by alcoholism (Grant, 2000), with approximately 26.8 million children growing up with a parent with alcoholism (Alcohol and Drug Programs [ADP], 2007). Children of parents with alcoholism tend to experience more frequent depression and struggle to develop healthy intimate relationships when compared to children of parents without alcoholism (Drejer, Theikjaard, Teasedale, Schulsinger, & Goodwin, 1985). Adult children of alcoholics (ACoA) who had …

Social Support Strategies In Online Forums Among Adult Offspring Of Parents With Harmful Alcohol Use, Marie Haverfield, John Leustek, Christine Timko

Faculty Publications

The authors categorized communication strategies employed to exchange social support (type and person centeredness) in three online forums about parents with harmful drinking. Data included discussion postreplies over 2 months; N = 1,644 units of analysis. Support type categories were identification, emotional, informational, network, and esteem. For person centeredness, most messages were moderate (expressed sympathy, provided distraction), followed by high (helped with feelings), and then low (minimized feelings). Adult offspring of parents with harmful drinking predominantly communicate self-interested forms of support in online forums. Based on principles of supportive communication, esteem support and high person centeredness may enhance social support …

Relationship Of Religiosity And Spirituality To Hazardous Drinking, Drug Use, And Depression Among Sexual Minority Women, Laurie Drabble, Cindy Veldhuis, Barth Riley, Sharon Rostosky, Tonda Hughes

Faculty Publications

Using data from Wave 3 of the Chicago Health and Life Experiences of Women (CHLEW) study (N = 699), we explored whether religiosity and spirituality were associated with risk of hazardous drinking, drug use, and depression among sexual minority women (SMW; i.e., lesbian, bisexual) and possible differences by race/ethnicity. Participants were more likely to endorse spirituality than religiosity, and endorsement of each was highest among African American SMW. We found no protective effect of religiosity or spirituality for hazardous drinking or drug use. An association initially found between identifying as very spiritual and past-year depression disappeared when controlling for help-seeking. …

Situation Awareness, Sociotechnical Systems, And Automation In Emergency Medical Services: Theory And Measurement, David Schuster, Dan Nathan-Roberts

Faculty Publications

No abstract provided.

Conducting Qualitative Interviews By Telephone: Lessons Learned From A Study Of Alcohol Use Among Sexual Minority And Heterosexual Women, Laurie Drabble, Karen Trocki, Brenda Salcedo, Patricia Walker, Rachael Korcha

Faculty Publications

This study explored effective interviewer strategies and lessons learned based on collection of narrative data by telephone with a subsample of women from a population-based survey, which included sexual minority women. Qualitative follow-up, in-depth life history interviews were conducted over the telephone with 48 women who had participated in the 2009–2010 National Alcohol Survey. Questions explored the lives and experiences of women, including use of alcohol and drugs, social relationships, identity, and past traumatic experiences. Strategies for success in interviews emerged in three overarching areas: (1) cultivating rapport and maintaining connection; (2) demonstrating responsiveness to interviewee content, concerns; and (3) …

Prevention Strategies And Mental Health In Vietnam, Edward Cohen

Faculty Publications

This paper addresses the current state of mental health services in Vietnam and provides recommendations for improving the care of people with mental illness. Vietnam’s mental health problems are as prevalent as anywhere else in the world. The country has recently begun an initiative to reform mental health care by improving community-based services for people with serious mental illness. However, mental illness has not been a part of public discourse in Vietnam. There is little recognition of prevalent common mental illnesses (such as depression, anxiety and alcohol abuse) and the care of people with serious mental illnesses relies on either …

Mobile Health-Care Information For All: A Global Challenge, Geoff Royston, Christine Hagar, Lesley-Anne Long, Dennis Mcmahon, Neil Pakenham-Walsh, Nand Wadhwani

Faculty Publications

Access to health-care information for citizens is a key determinant to reach both the Millennium Development Goals (MDGs) and the emerging post-2015 Sustainable Development Goals, but this challenge has repeatedly been relegated to the sidelines.1 What might kickstart progress? An obvious candidate is the mobile phone, which is becoming ubiquitous in low-income and middle-income countries.

A Qualitative Examination About Providers’ Perceptions And Recommendations Regarding The Role Of Public Librarians In Addressing Communities’ Health Literacy., Van Ta Park, Lili Luo, Denise Rosidi

Faculty Publications

We assessed health care providers’ perspectives on libraries as a source of health information and elicited input on how to adequately prepare public librarians to provide health information services. Sample text-based reference transactions were shown to determine whether they think the health inquiries were adequately answered. Results showed that participants had favorable perspectives about public libraries, and thought that the public librarians’ role includes addressing the health literacy community needs. Participants provided recommendations for public librarians to improve health literacy. To enhance the ability of public librarians to meet the health literacy needs of their communities, diverse perspectives such as …

State Responses To Alcohol Use And Pregnancy: Findings From The Alcohol Policy Information System, Laurie Drabble, Sue Thomas, Lisa O'Connor, Sarah Roberts

Faculty Publications

This article describes U.S. state policies related to alcohol use during pregnancy, using data from the National Institute on Alcohol Abuse and Alcoholism Alcohol Policy Information System. Specifically, this study examines trends in policies enacted by states over time and types of policies enacted across states in the United States, with a focus on whether laws were supportive or punitive toward women. Findings revealed substantial variability in characteristics of policies (19 primarily supportive, 12 primarily punitive, 12 with a mixed approach, and 8 with no policies). Findings underscore the need to examine possible consequences of policies, especially of punitive policies …

Strategies Employed By Inner-City Activists To Reduce Alcohol-Related Problems And Advance Social Justice, Laurie Drabble, Denise Herd

Faculty Publications

This study explored strategies employed by activists engaged in efforts to change policies and laws related to selling and promoting alcoholic beverages based on in-depth interviews with 184 social activists in seven U.S. major cities. Nine strategies aimed at improving local conditions and influencing policy were described by activists across regional contexts. Grassroots mobilization was central to all other strategies, which included the creation or enforcement of laws, meeting with elected officials, media advocacy, working with police/law enforcement, education and training, direct action, changing community norms, and negotiating with store owners.

Text 4 Health: Addressing Consumer Health Information Needs Via Text Reference Service, Van M. Ta Park

Faculty Publications

This study seeks to provide empirical evidence about how health-related questions are answered in text reference service in order to further the understanding of how to best use texting as a reference service venue to fulfill people’s health information needs. Two hundred health reference transactions from My Info Quest, the first nation-wide collaborative text reference service, were analyzed identify the types of questions, length of transactions, question-answering behavior, and information sources used in the transactions. Findings indicate that texting-based health reference transactions are usually brief, and cover a wide variety of topics. The most popular questions are those seeking general …

Preparing Public Librarians For Consumer Health Information Service: A Nation-Wide Study, L. Luo, Van M. Ta Park

Faculty Publications

A nationwide survey study was conducted to gain understanding as to how to prepare public librarians for consumer health information service. Findings indicate that the popular health information needs encountered by public librarians cover a wide variety of topics, including the human body, a medical/health condition, a disease, a medical concept, and fitness/diet/nutrition. The top two challenges faced by public librarians when providing consumer health information service are difficulty in interpreting patrons' questions and lack of knowledge about available and trusted/appropriate medical/health information sources. Public librarians wish to receive training on a number of topics that could help address the …

Alcohol In The Life Narratives Of Women: Commonalities And Differences By Sexual Orientation, Laurie A. Drabble, K. Trocki

Faculty Publications

Aim: The aim of this study was to explore social representations of alcohol use among women, with a focus on possible differences between sexual minority and heterosexual women. Methods: This qualitative study was part of a larger study examining mediators of heavier drinking among sexual minority women (lesbian identified, bisexual identified, and heterosexual identified with same sex partners) compared to heterosexual women based on the National Alcohol Survey. Qualitative in-depth life history interviews were conducted over the telephone with 48 women who had participated in the 2009–2010 National Alcohol Survey, including respondents representing different sexual orientation groups. Questions explored the …

Advancing Trauma-Informed Systems Change In A Family Drug Treatment Court Context, Laurie Drabble, Shelby Jones, Vivian Brown

Faculty Publications

A growing body of literature documents the importance of trauma-informed and trauma-specific services and systems change in both addiction treatment and child welfare fields. The overall aim of this qualitative study was to explore barriers, benefits, and facilitating factors associated with a trauma-informed systems assessment and improvement initiative conducted in the context of a family drug treatment court (FDTC). Semistructured in-depth interviews with 12 key informants and historical analyses of project documents over a 4-year time span were conducted. Results underscore the relevance of trauma-informed systems change in collaborative contexts designed to address the complex needs of children and families.

Dual Diagnosis, Mutual-Help Use, And Outcomes: A Naturalistic Follow-Up, Erin Woodhead, Alexandra Hindash, Christine Timko

Faculty Publications

Objective: Individuals with dual diagnoses benefit from participation in mutual-help groups, though it is unclear how much such participation contributes to outcomes when accounting for utilization of treatment. Methods: We used mixed-model regressions to examine associations between participation in mutual-help groups reported at 6-month, 1-year, and 2-year follow-ups with substance use and psychiatric outcomes among outpatients with dual diagnoses (N = 304), while controlling for amounts of substance use disorder and mental health outpatient treatment. Results: Follow-up rates were 81%, 82%, and 84% at 6 months, 1 year, and 2 years, respectively. Mean involvement in mutual-help groups (scale of …

Facilitating War-Affected Young Mothers’ Reintegration: Lessons From A Participatory Action Research Study In Liberia, Sierra Leone, And Uganda., Miranda E. Worthen, G. Onyango, A. Veale, M. Wessells, S. Mckay

Faculty Publications

Young women and girls formerly associated with armed forces and armed groups face multiple challenges. Many become pregnant or have children while they are associated and face stigma and marginalization upon reintegration into civilian communities. This article describes a multi-year participatory action research study that took place in twenty communities in Liberia, Sierra Leone, and northern Uganda from 2006 – 2009 and included more than 650 young mother participants. We find that this community-based approach to reintegration improved the wellbeing of young mother participants and their children. We discuss the challenges and limitations of conducting participatory action research with war-affected …

Lines In The Sand: Social Representations Of Substance Use Boundaries In Life Narratives, K. F. Trocki, L. O. Michalak, Laurie A. Drabble

Faculty Publications

This study identifies social representations in interviews about alcohol and substance use in the discourse of 129 young adults, who were interviewed for 2.5 to 3.5 hr each for their life histories and use or nonuse of alcoholic beverages and drugs. Respondents spontaneously delineated their substance use boundaries, creating a continuum of behaviors with boundary points separating acceptable from unacceptable behaviors. They used signaling expressions to indicate go and stop signs and movement along the substance use continuum and reported negotiating substance use boundaries both internally and with peers. A ubiquitous narrative element was the cautionary tale, in which a …

Exploring The Impact Of Race On Mental Health Service Utilization Among African Americans And Whites With Severe Mental Illness, Michelle Hampton, Linda Chafetz, Mary White

Faculty Publications

BACKGROUND: Disparities among African Americans and Whites with severe mental illness have been identified in numerous studies. Yet it remains unknown if disparities are associated with race or other vulnerabilities common to this population. OBJECTIVES: This study used the Behavioral Model for Vulnerable Populations to examine mental health service utilization among 155 African Americans and Whites with severe mental illness for 12 months after discharge from a residential crisis program. DESIGN: This cross-sectional study was a secondary analysis of data from a randomized trial. RESULTS: Race did not emerge as a significant predictor of mental health service utilization. Factors associated …

Eligibility, Recruitment, And Retention Of African Americans With Severe Mental Illness In Community Research, Michelle Hampton, Mary White, Linda Chafetz

Faculty Publications

Data that addresses severely mentally ill (SMI) African Americans (AAs) likelihood to participate in clinical research is limited. This study’s purpose was to determine if differences exist between races regarding eligibility, recruitment, and retention in a community-based clinical trial. The sample included 293 participants. Data sources included clinical records and interviews. Logistic regression was used for analysis. AAs were as likely to participate and to complete followup interviews as Whites. In contrast to studies about non-mentally ill AAs, AAs with SMI appeared to be as willing to consent to and to remain in clinical research studies as Whites.

Progress And Opportunities In Lesbian, Gay, Bisexual And Transgender Health Communications, Laurie A. Drabble, J. Keatley, G. Marcelle

Faculty Publications

This article describes elements of effective health communication and highlights strategies that may best be adopted or adapted in relation to lesbian, gay, bisexual, and transgender (LGBT) populations. Studies have documented the utility of multidimensional approaches to health communication from the macro level of interventions targeting entire populations to the micro level of communication between health care provider and consumer. Although evidence of health disparities in LGBT communities underscores the importance of population-specific interventions, health promotion campaigns rarely target these populations and health communication activities seldom account for the diversity of LGBT communities. Advances in health communication suggest promising direction …

Alcohol, Tobacco, And Pharmaceutical Industry Funding: Considerations For Organizations Serving Lesbian, Gay, Bisexual And Transgender Communities, Laurie A. Drabble

Faculty Publications

Emerging research suggests that alcohol, tobacco and drug-related problems may be higher in lesbian and gay communities than in the population as a whole. At the same time, alcohol, tobacco and pharmaceutical industries have increased marketing strategies that are targeted specifically to lesbian and gay communities. Lesbian, Gay, Bisexual and Transgender (LGBT) and HTV/AIDS organizations, often marginalized and under-funded, have frequently faced significant challenges in funding programs and special events. These organizations are often the very same groups needed to promote and support effective substance abuse countermeasures in LGBT communities. Agency leaders, community members, and substance abuse prevention advocates all …