Medicine and Health Sciences Commons^™

The Landscape Of Connected Cancer Symptom Management In Rural America: A Narrative Review Of Opportunities For Launching Connected Health Interventions, Ming-Yuan Chih, Anna Mccowan, Sadie Whittaker, Melinda Krakow, David K. Ahern, Eliah Aronoff-Spencer, Bradford W. Hesse, Timothy W. Mullett, Robin C. Vanderpool

Journal of Appalachian Health

Background: The 2016 President’s Cancer Panel called for projects focusing on improving cancer symptom management using connected health technologies (broadband and telecommunications). However, rural communities, like those in Appalachia, may experience a “double burden” of high cancer rates and lower rates of broadband access and adoption necessary for connected health solutions.

Purpose: To better understand the current landscape of connected health in the management of cancer symptoms in rural America.

Methods: A literature search was conducted using four academic databases (PubMed, CINAHL, MEDLINE, and PsycINFO) to locate articles published from 2010 to 2019 relevant to connected cancer symptom management in …

Advancing Cancer Prevention Practice Facilitation Work In Rural Primary Care During Covid-19, Dannell Boatman, Susan Eason, Mary E. Conn, Summer Miller, Stephenie Kennedy-Rea

Journal of Appalachian Health

COVID-19 and the response to slow the virus spread in West Virginia (WV), including a statewide stay-at-home order, presented challenges to rural primary care clinics on the frontlines. These challenges affected critical quality improvement work, including cancer screening services. In this commentary, the authors present the results of a survey of WV primary care practices that highlight potential long-term implications and identifies opportunities for practice facilitators to partner with rural primary care clinics to address them.

Integrated Multiparametric Radiomics And Informatics System For Characterizing Breast Tumor Characteristics With The Oncotypedx Gene Assay, Michael A. Jacobs, Christopher B. Umbricht, Vishwa S. Parekh, Riham H. El Khouli, Leslie Cope, Katarzyna J. Macura, Susan Harvey, Antonio C. Wolff

Radiology Faculty Publications

Optimal use of multiparametric magnetic resonance imaging (mpMRI) can identify key MRI parameters and provide unique tissue signatures defining phenotypes of breast cancer. We have developed and implemented a new machine-learning informatic system, termed Informatics Radiomics Integration System (IRIS) that integrates clinical variables, derived from imaging and electronic medical health records (EHR) with multiparametric radiomics (mpRad) for identifying potential risk of local or systemic recurrence in breast cancer patients. We tested the model in patients (n = 80) who had Estrogen Receptor positive disease and underwent OncotypeDX gene testing, radiomic analysis, and breast mpMRI. The IRIS method was trained …

Experiencing Cancer In Appalachian Kentucky, Melanie Mccomsey, David Ahern, Robin C. Vanderpool, Timothy W. Mullett, Ming-Yuan Chih, Meghan Johnson, Michele Ellison, Karen Onyeije, Bradford W. Hesse, Eliah Aronoff-Spencer

Journal of Appalachian Health

Nothing tells the story of people working together better than a community quilt. A diversity of talents, colors, and materials brought together through skill and shared purpose. Perhaps never before have we as Americans needed a stronger reminder that many hands make short work of big problems. The work presented here by the L.A.U.N.C.H. Collaborative offers a new framework for health care that could be compared to a digital quilt, powered by community-based participatory design, with lived expertise and the newest advances in broadband-enabled connected health solutions. This work demonstrates the value and need to engage local communities and what …

Preface: Experiencing Cancer In Appalachian Kentucky, Michele Ellison, Robin C. Vanderpool

Journal of Appalachian Health

Connected cancer care is of increasing importance in light of the COVID-19 pandemic. The Linking & Amplifying User-Centered Networks through Connected Health (L.A.U.N.C.H.) Collaborative in Appalachian Kentucky has pioneered a new roadmap for equipping communities with the transformative power of broadband to innovate around the future of cancer care and to better scale their ideas. The roadmap involves reaching across disciplines, including public health, anthropology, telecommunications, and user-centered design. The goal is to leverage connectivity and cancer communication research and practice to make a real difference for patients and families.

A Web-Based, Positive Emotion Skills Intervention For Enhancing Posttreatment Psychological Well-Being In Young Adult Cancer Survivors (Empower): Protocol For A Single-Arm Feasibility Trial, John M. Salsman, Laurie E. Mclouth, Michael Cohn, Janet A. Tooze, Mia Sorkin, Judith T. Moskowitz

Behavioral Science Faculty Publications

BACKGROUND: Adolescent and young adult cancer survivors (AYAs) experience clinically significant distress and have limited access to supportive care services. Interventions to enhance psychological well-being have improved positive affect and reduced depression in clinical and healthy populations but have not been routinely tested in AYAs.

OBJECTIVE: The aim of this protocol is to (1) test the feasibility and acceptability of a Web-based positive emotion skills intervention for posttreatment AYAs called Enhancing Management of Psychological Outcomes With Emotion Regulation (EMPOWER) and (2) examine proof of concept for reducing psychological distress and enhancing psychological well-being.

METHODS: The intervention development and testing are …

Using Case-Level Context To Classify Cancer Pathology Reports, Shang Gao, Mohammed Alawad, Noah Schaefferkoetter, Lynne Penberthy, Xiao-Cheng Wu, Eric B. Durbin, Linda Coyle, Arvind Ramanathan, Georgia Tourassi

Kentucky Cancer Registry Faculty Publications

Individual electronic health records (EHRs) and clinical reports are often part of a larger sequence-for example, a single patient may generate multiple reports over the trajectory of a disease. In applications such as cancer pathology reports, it is necessary not only to extract information from individual reports, but also to capture aggregate information regarding the entire cancer case based off case-level context from all reports in the sequence. In this paper, we introduce a simple modular add-on for capturing case-level context that is designed to be compatible with most existing deep learning architectures for text classification on individual reports. We …

A Brief Educational Intervention Enhances Basic Cancer Literacy Among Kentucky Middle And High School Students, Lauren Hudson, Kerrigan M. Samons, Haley E. Dicken, Chris Prichard, L. Todd Weiss, Jean Edward, Robin C. Vanderpool, Nathan L. Vanderford

Markey Cancer Center Faculty Publications

Kentucky experiences the highest overall cancer incidence and mortality rates in the USA with the greatest burden in the eastern, Appalachian region of the state. Cancer disparities in Kentucky are driven in part by poor health behaviors, poverty, lack of health care access, low education levels, and low health literacy. Individuals with inadequate health literacy are less likely to participate in preventive measures such as obtaining screenings and making healthy lifestyle choices, thus increasing their chances of developing and dying from cancer. By increasing cancer literacy among youth and adults, it may be possible to decrease cancer disparities across Kentucky. …

Barn-Raising On The Digital Frontier: The L.A.U.N.C.H. Collaborative, Bradford W. Hesse, David Ahern, Michele Ellison, Eliah Aronoff-Spencer, Robin C. Vanderpool, Karen Onyeije, Michael C. Gibbons, Timothy W. Mullett, Ming-Yuan Chih, Victoria Attencio, Grant Patterson, Jessica Boten, Christopher Hartshorn, Ben Bartolome, Katie Gorscak, Melanie Mccomsey, Alexandra Hubenko, Bin Huang, Corey Baker, Don Norman

Journal of Appalachian Health

A meta-analysis of oncology papers from around the world revealed that cancer patients who lived more than 50 miles away from hospital centers routinely presented with more advanced stages of disease at diagnosis, exhibited lower adherence to prescribed treatments, presented with poorer diagnoses, and reported a lower quality of life than patients who lived nearer to care facilities. Connected health approaches—or the use of broadband and telecommunications technologies to evaluate, diagnose, and monitor patients beyond the clinic—are becoming an indispensable tool in medicine to overcome the obstacle of distance.

Introducing The L.A.U.N.C.H. Collaborative, F. Douglas Scutchfield Md, Kevin Patrick

Journal of Appalachian Health

The L.A.U.N.C.H. Collaborative: Linking & Amplifying User-Centered Networks through Connected Health: A Demonstration of Broadband-Enabled Connected Health and Community-Based Co-Design brings together a group of organizations that are eager to use Appalachian Kentucky as a site for the development of a project aimed at creating an environment that addresses two of the nation’s major concerns about cancer. First, individuals who live in rural and remote areas are more likely to die of cancer than those who live in urban or suburban settings. And second, geographic obstacles hinder their ability to access evidence-based strategies that can prevent cancer or treat it …

Evaluating Colorectal Cancer Screening Rates In An Urban Primary Care Practice, Kristen Makowski

DNP Projects

Colorectal cancer accounts for 8% of all cancer deaths and can be prevented through timely removal of colon polyps. Despite recommendations for routine screening, approximately 31.2% of patients go unscreened for this disease (Centers for Disease Control and Prevention, 2018). The purpose of this project was to determine screening rates and documentation mechanisms for colorectal cancer in an urban primary care practice, to determine how many patients completed the screening, and to present findings to the practice providers along with exploring ways to increase screenings. An additional purpose of this project was to determine and identify patient demographics which can …