Quentin W. Smith

Tailored messages for breast and cervical cancer screening of low-income and minority women using medical records data

Barriers to screening and early detection often result in cancers in low-income and minority women diagnosed at stages too advanced for optimal treatment. This randomized controlled trial examined whether a personalized form (PF) letter containing generic cancer information and a personalized tailored (PT) letter containing minimally tailored individualized risk factor information based on medical records data affected breast and cervical cancer screening among 1574 urban low-income and minority women. The personalized form-letter group was significantly more likely to schedule a screening appointment and to have undergone a Pap test and mammography within 1 year after the intervention than were the tailored letter and control groups (P<0.001 for all comparisons). Personalized tailored letters that contain individualized cancer risk factor information may decrease the likelihood of receiving cancer screening among medically underserved low-income and minority women, but personalized form letters that contain generic cancer information may improve these rates in this disadvantaged population.

Baylor's program to attract minority students and others to science and medicine

To attract minority students and others to careers in medical practice and biomedical research and to prepare them for such careers, Baylor College of Medicine conducts a variety of summer enrichment programs and other programs to improve how science is presented to students in their preprofessional years from elementary grades through college. These efforts aim to increase the number of competitive candidates for medical school, particularly those from minority groups underrepresented in medicine. They entail close collaboration between the Baylor administration and faculty from Texas public schools and two-year and four-year colleges and universities. The authors discuss the rationale for these programs and comment about the need for institutional commitments of faculty and financial support. They note that these programs are an investment in the future and that longitudinal assessment is needed to determine their ultimate success.

Differing Levels of Clinical Evidence: Exploring Communication Challenges in Shared Decision Making

The near ubiquitous access to information is transforming the roles and relationships among clinical professionals, patients, and their care givers in nearly all aspects of healthcare. Informed patients engage their physicians in conversations about their conditions, options and the tradeoffs among diagnostic and therapeutic benefits and harms. The processes of care today increasingly and explicitly integrate exploration of patient values and preferences as patients and clinicians jointly engage in reaching decisions about care. The informed patient of today who can understand and use scientific information can participate as an equal partner with her clinician. Others with beliefs or educational, cultural, or literacy backgrounds that pose challenges to comprehending and applying evidence may face disenfranchisement. These barriers are significant enough, even in the face of certainty of evidence, that clinicians and investigators have given much thought to how best to engage all patients in decision making. However, barriers remain, as most decision making must occur in settings where uncertainty, if not considerable uncertainty, accompanies any statement of what we know. In September 2011, health care and health communication experts came together in Rockville, Maryland under the auspices of the Agency for Healthcare Research and Quality (AHRQ) John M. Eisenberg Center for Clinical Decisions and Communications Science Annual Meeting to explore the challenges of differing levels of evidence in promoting shared decisions and to propose strategies for going forward in addressing these challenges. Eight scholarly papers emerged, and with this introductory article, comprise this special issue of Medical Care Research and Review.

The Prospects for Web 2.0 Technologies for Engagement, Communication, and Dissemination in the Era of Patient-Centered Outcomes Research: Selected Articles Developed From the Eisenberg Conference Series 2010 Meeting

The Eisenberg Conference Series 2010 Meeting on The Prospects for Web 2.0 Technologies for Engagement, Communication and Dissemination in the Era of Patient-Centered Outcome Research was conducted by the John M. Eisenberg Center for Clinical Decisions and Communications Science at Baylor College of Medicine, Houston, Texas under contract to the Agency for Healthcare Research and Quality Contract No. HHSA290200810015C, Rockville, MD. The authors of this article are responsible for its content. No statement may be construed as the official position of the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services. Address correspondence to Michael Fordis, Baylor College of Medicine, One Baylor Plaza, MS BCM 155, Houston, TX 77030, USA. E-mail: fordis@bcm.edu Journal of Health Communication, 16:3–9, 2011 Copyright # Taylor & Francis Group, LLC ISSN: 1081-0730 print=1087-0415 online DOI: 10.1080/10810730.2011.598398

Training school counselors in substance abuse risk reduction techniques for use with children and adolescents.

A training project prepared school counselors for expanded roles in the prevention, early detection, and appropriate referral of students at high risk of substance abuse. The project trained middle and high school counselors to work as facilitators of support groups for students at greatest risk for substance abuse; the results were: 1) greater perceived self-efficacy, comfort, confidence, and competence by counselors as a result of Initial, Experiential, and Concurrent training, and 2) improved ability to use group counseling techniques as a result of training.

Perceived barriers to careers involving math and science: The perspective of medical school admissions officials

The medical community has become increasingly sensitive to the need to expand minority representation in the health professions, given that members of minority populations have poorer health status and use fewer health‐care resources relative to their needs. It has been argued that increased minority representation in the health professions may result in improved access to health care or increased willingness to seek needed care. Recent views suggest that such efforts must begin early in the students’ academic lives. This study solicited perceptions of medical school admissions officials regarding the preparation of students across four ethnic groups. Results suggest two distinct patterns of perceptions distinguishing different combinations of ethnic groups. The predominant discriminant function reflected a generalized perception that Blacks and Hispanics are receiving differentially poorer advisement, assessment, academic preparation, and access to educational resources relative to nonminority students. ...

Supporting informed decision making when clinical evidence and conventional wisdom collide: papers developed from the Eisenberg Center Conference Series 2012

AHRQ involvement in exploring issues that impact clinical decision making The AHRQ Effective Health Care (EHC) Program was created in 2003 under the legislative provisions of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA). The EHC Program supports individual researchers, research centers, and academic organizations working together with AHRQ to produce effectiveness and comparative effectiveness research for various audiences (http://www.effectivehealthcare.ahrq.gov). The EHC Program does this through: 1) reviewing and synthesizing published and unpublished scientific evidence; 2) generating new scientific evidence and analytic tools; and 3) compiling research findings that are synthesized and/or generated and translating these materials into useful formats for clinicians, consumers, and policymakers. Much of the work focusing on translation and dissemination of research findings is done through the John M. Eisenberg Center for Clinical Decisions and Communications Science (the Eisenberg Center), a specialized Center within the EHC Program charged with working in concert with other EHC Program components to organize research results into summaries and other tools that are useful to clinicians, healthcare policy makers, and patients. An important function of the Eisenberg Center involves planning and implementing the Eisenberg Conference Series. This series brings together experts in health communication, health literacy, shared decisionmaking, and related fields to produce white papers (and stakeholder commentaries) that explore developments and advances in the fields of clinical decisionmaking and health communication. The papers from the 2012 Conference Series are assembled here as a supplement in BMC Medical Informatics and Decision Making.