Juliette Christie

Patient education in allogeneic hematopoietic cell transplant: What patients wish they had known about quality of life

Quality of life (QOL) is increasingly recognized as an important clinical outcome of hematopoietic cell transplantation (HCT), but patient education is often overlooked. The aim of the current qualitative study was to examine education regarding post-HCT QOL from the patient’s perspective. Allogeneic HCT recipients participated in one of four focus groups. Participants were asked to recall what they had been told about post-HCT QOL as they were preparing for transplant, how their QOL differed from what they expected and how to educate future patients about post-HCT QOL. Verbatim transcripts were coded for both a priori and emergent themes using content analysis. A total of 24 patients participated (54% female, mean age 51, range 23–73 years). Participants frequently expressed the desire for additional education regarding post-HCT QOL, particularly late complications. They noted that late complications were often unexpected, had a profound impact on their QOL and threatened their ongoing sense of recovery. They emphasized that the timing, content and format of education regarding QOL should be flexible to meet their diverse needs. Findings from the current study draw attention to the importance of patient education regarding post-HCT QOL as well as additional QOL research designed with patient education in mind.

Provider factors associated with disparities in human papillomavirus vaccination among low-income 9- to 17-year-old girls†

Many women who develop cervical cancer are eligible for or are participants of Medicaid. Providing human papillomavirus (HPV) vaccination to girls enrolled in Medicaid may reduce cervical cancer disparities in low‐income and minority women. This study evaluated provider characteristics associated with HPV vaccination among 9‐ to 17‐year‐old female Medicaid enrollees.

A pilot study to examine patient awareness and provider discussion of the impact of cancer treatment on fertility in a registry-based sample of African American women with breast cancer

PurposeFertility is a concern for many cancer patients diagnosed during their reproductive years. Although African American women are more likely to be diagnosed with early breast cancer (i.e., ≤age 40), little is known about patient awareness of or provider discussion related to fertility in this group. We examined African American womens awareness of the possible impact of cancer treatment on fertility.MethodsIn a cross-sectional survey of African American women with early-onset breast cancer, demographic and clinical variables were compared with patient awareness and physician discussion of potential fertility loss.ResultsFor women in our sample (N = 48), 45.8% reported being aware of the potential impact of cancer treatment on fertility, and 56.3% reported that their providers discussed fertility with them. Bivariate analyses demonstrated that awareness was significantly higher in women diagnosed at age ≤45 (p < 0.05), who were nulliparous (p < 0.01), or who did not have tubal ligation (p < 0.001). Provider discussion was more often reported by patients who were diagnosed in stages 2/3 (p < 0.05) and had no children (p < 0.01).ConclusionStudy results suggest potential health disparities in reproductive health among early-onset breast cancer patients and demonstrate missed clinical opportunities to provide information about fertility that may impact long-term quality of life in early-onset African American breast cancer patients.

Nurse Perspectives on Referrals for Oncology Patients to Reproductive Endocrinologists: Results of a Learning Activity.

BACKGROUND Although concern about future fertility for adolescents and young adults (AYAs) with cancer is high, referrals to reproductive endocrinologists (REI) are low. Oncology nurses are well positioned to facilitate these referrals but may lack the knowledge and training. This report describes a learning activity in the Educating Nurses about Reproductive Issues in Cancer Healthcare (ENRICH) program whereby oncology nurses interviewed REIs. METHOD Participants were instructed to conduct an interview with an REI using a semistructured guide and provided a written report of the discussion. We examined responses to each question using qualitative content analysis. RESULTS Seventy-seven participants across 15 states provided a summary. Learner summaries highlighted four themes related to FP, including Cost, Time, Lack of Information or Referrals, and Learning About Available Options. CONCLUSION Oncology nurses have an opportunity for a partnership to ensure that concerns about fertility among AYA patients are addressed. J Contin Educ Nurs. 2016;47(8):376-384.

Provider Factors Associated with Disparities in HPV Vaccination among Low-Income 9–17-Year-Old Girls

Many women who develop cervical cancer are eligible for or are participants of Medicaid. Providing human papillomavirus (HPV) vaccination to girls enrolled in Medicaid may reduce cervical cancer disparities in low‐income and minority women. This study evaluated provider characteristics associated with HPV vaccination among 9‐ to 17‐year‐old female Medicaid enrollees.

Provider factors associated with disparities in human papillomavirus vaccination among low-income 9- to 17-year-old girls: Disparities in HPV Vaccination

Many women who develop cervical cancer are eligible for or are participants of Medicaid. Providing human papillomavirus (HPV) vaccination to girls enrolled in Medicaid may reduce cervical cancer disparities in low‐income and minority women. This study evaluated provider characteristics associated with HPV vaccination among 9‐ to 17‐year‐old female Medicaid enrollees.

Abstract B106: Provider factors associated with HPV vaccination among low-income 9- to 17-year-old girls

Background: Low-income and minority women bear a disproportionate burden of cervical cancer. Many women who develop cervical cancer are eligible for or are participants of Medicaid. Providing human papillomavirus (HPV) vaccination to girls in Medicaid may help reduce subsequent cervical disparities observed in low-income and minority women. Provider recommendation is a critical factor associated with HPV vaccination. Purpose: The primary aim of this study was to evaluate provider characteristics associated with HPV vaccination among 9–17 year old female Medicaid enrollees. Methods: A sample of 800 providers was randomly selected from the Florida Medicaid Master Provider File. The sampling frame was restricted to providers who had: a physical address in Florida, billed claims or an assigned panel that included 25 or more 9–17 year old girls in the past year, and a specialty of Pediatrics, Obstetrics and Gynecology, or Family Medicine that included internal medicine, general practice, or preventive medicine. Physicians were mailed a survey in October 2009 that evaluated key factors related to HPV vaccination, including: 1) demographic and practice characteristics, 2) HPV information and knowledge, 3) barriers to HPV vaccination, 4) vaccine practices, and 5) vaccine recommendation practices. To measure HPV vaccination, Medicaid claims data were used to calculate the proportion of eligible patients who received at least one dose of the vaccine from sampled providers within the study period. Provider factors (e.g., provider specialty) associated with HPV vaccination at the bivariate level were evaluated simultaneously in a multiple linear regression model with HPV vaccination as the outcome variable. Results: The response rate was 68.3% (n = 485). After excluding respondents who identified themselves as unlikely to be involved in vaccination (e.g., hospice, emergency care providers; n = 23) or reported a specialty other than what was requested or no specialty (n = 23), the current analysis included 439 providers. The prevalence of HPV vaccination ranged from 0% to 61.9% (mean = 19.9, SD = 14.4). About 33% of the variance in HPV vaccine administration was attributable to the independent variables, F(14, 382) = 13.2, p Conclusions: HPV vaccination has the potential to reduce cervical cancer disparities among low-income and minority women. Despite the financial coverage of the HPV vaccine for Medicaid-eligible girls, the average vaccination rates are low. Results of the current study can be used to target health services interventions to those providers least likely to administer HPV vaccine to female Medicaid enrollees. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B106.