Thomas V. Joshua

Access to hematopoietic stem cell transplantation: effect of race and sex.

The purpose of the current study was to determine whether the use of hematopoietic stem cell transplantation (HCT) to treat leukemia, lymphoma, or multiple myeloma (MM) differs by race and sex.

Design of a cluster-randomized controlled trial of a diabetes prevention program within African–American churches: The Fit Body and Soul study

Evidence from varied community settings has shown that the Group Lifestyle Balance (GLB) Program and other adaptations of the Diabetes Prevention Program (DPP) intervention are effective in lowering diabetes risk. Most DPP data originated from studies of pre-diabetic whites, with only sparse evidence of the effect of DPP in African Americans (AAs) in community settings. This paper describes the design, methods, baseline characteristics and cost effective measures, of a single-blinded, cluster-randomized trial of a faith-based adaptation of the GLB program, Fit Body and Soul (FBAS). The major aims are to test efficacy and cost utility of FBAS in twenty AA churches. Randomization occurred at the church level and 604 AA overweight/obese (BMI≥25kg/m(2)) adults with fasting plasma glucose range from normal to pre-diabetic received either FBAS or a health-education comparison program. FBAS is a group-based, multi-level intervention delivered by trained church health advisors (health professionals from within the church), with the goal of ≥7% weight loss, achieved through increasing physical activity, healthy eating and behavior modification. The primary outcome is weight change at 12weeks post intervention. Secondary outcomes include hemoglobin A1C, fasting plasma glucose, waist circumference, blood pressure, physical activity level, quality of life measures, and cost-effectiveness. FBAS is the largest known cohort of AAs enrolled in a faith-based DPP translation. Reliance on health professionals from within the church for program implementation and the cost analysis are unique aspects of this trial. The design provides a model for faith-based DPPs and holds promise for program sustainability and widespread dissemination.

Retraction notice to: Comparison of Central Line-Associated Bloodstream Infection Rates when Changing to a Zero Fluid Displacement Intravenous Needleless Connector in Acute Care Settings. Am J Infect Control. 2014;42:200–202.

This was a multicenter, quasiexperimental, 140-month, acute care study comparing central line-associated bloodstream infection rates associated with positive or negative intravenous connectors to a zero fluid displacement connector. A decrease in central line-associated bloodstream infections was found after changing from either negative or positive intravenous connectors to the zero fluid displacement connector (P = .004) with total cost savings of over

Online Tobacco Cessation Education to Optimize Standards of Practice for Psychiatric Mental Health Nurses

3 million.

The Impact of the Georgia Health Sciences University Nursing Faculty Practice on Tobacco Cessation Rates

This article presents an overview of an online education offering to improve standards of practice for nurses intervening with tobacco-dependent mentally ill populations. Designed as a pilot study and guided by the theory of reasoned action framework, the pretest-posttest educational program was conducted to examine attitudes and beliefs, knowledge, and intentions to integrate tobacco cessation interventions into practice. Although positive attitudes and beliefs were demonstrated, knowledge gaps continued to exist after the online program. Strengths and challenges of the online education offering are presented with recommendations for future research.

Percent weight reduction required to achieve minimal clinically important improvements in health-related quality of life among African Americans: A secondary analysis of the fit body and soul study

Nursing faculty practice groups can play a vital role in tobacco cessation in academic medical centers. Outcomes from the Georgia Health Sciences University Nursing Faculty Practice Group Tobacco Cessation Program revealed 64% abstinence outcomes at the end of treatment (N = 160) over a 2-year period from the campus-wide tobacco-free policy initiation. A nurse-led, evidence-based, interdisciplinary approach can be an effective strategy to make a difference in the lives of tobacco-dependent individuals, while at the same time integrating practice with education and research.

P001: Comparison of central line-associated bloodstream infection rates when changing to a zero fluid displacement intravenous needleless connector in acute care

Objective To calculate the percent weight reduction required to achieve minimal clinically important improvement (MCII) in health-related quality of life (HRQOL) Design Secondary data analysis from the longitudinal cohort of a single-blinded, cluster-randomized community trial to test the efficacy of the faith-based adaptation of the Diabetes Prevention Program Setting African-American churches Participants This study included 472 congregants with a body mass index of ≥ 25 and fasting plasma glucose<126 mg/dl. Main Outcome Measure Percent weight reduction required to achieve the MCII in HRQOL measured by two instruments, SF-12 and EQ-5D, one year following baseline Analysis The percent weight reduction required to achieve established MCII in SF-12 Physical Component Summary (PCS), SF-12 Mental Component Summary (MCS), and EQ-5D Health Status (HS) at one-year follow-up were calculated using fitted linear regression models. In addition to models for the total sample, we generated models, stratified by baseline BMI, PCS, and HS, to calculate the percent weight reduction required to achieve MCII in HRQOL for those most in need of weight reduction and those in need of improved HRQOL. Results The percent weight reduction was a significant predictor of improvement in the SF-12PCS and the EQ-5DHS but not SF-12MCS. To achieve a MCII in SF-12PCS and EQ-5DHS, 18% and 30% weight reductions were required, respectively. A smaller percent weight reduction was required when the baseline BMI was ≥ 40. Conclusions and Implications Improvements in HRQOL among African-American congregants seeking weight reduction required more than the 3–5% weight reduction associated with improvements in physical health.

Increasing Stroke Recognition and Behavioral Intent to Call Emergency Management Services in a Vietnamese American Population

The ability to decrease CLA-BSI has seen some improvement but more is necessary to prevent negative patient outcomes. One area that has not been researched is the actual technology or connector product and its effect on bloodstream infections.

Cost-effectiveness of a faith-based lifestyle intervention for diabetes prevention among African Americans: A within-trial analysis

Objective: Serious complications of stroke, one of the leading causes of morbidity and mortality in the United States can be mitigated if treated in a timely manner. Stroke outcome disparity in Vietnamese Americans (VAs) is attributable to pre-hospital delay. To increase acute stroke recognition and behavior intent to call Emergency Management Services (EMS) among VAs and their families, an evidence-based, culturally and linguisticallyappropriate educational intervention was pilot-tested. Methods: A convenience sample of 38 Vietnamese-speaking adults recruited from a free community clinic participated in a one-hour educational session. Pre and post intervention surveys were administered to assess knowledge and intent. Results: Differences in pre-test and post-test means were large for stroke knowledge (Cohens D=2.39), associated emergency action (Cohens D=2.57) and behavioral intent to call EMS (Cohens D=0.94). Conclusion: A linguistically and culturally appropriate community-based education intervention may be effective in increasing stroke recognition and behavior intent to call EMS among VAs.

Community Trial of a Faith-Based Lifestyle Intervention to Prevent Diabetes Among African-Americans

AIMS We assessed costs and cost-effectiveness of implementing Fit Body and Soul (FBAS), a church-based 18-session lifestyle education intervention for African Americans. METHODS We calculated incremental cost-effectiveness ratios (ICER) using data from a cluster randomized controlled trial comparing FBAS with health education (HE) among 604 overweight participants in 20 churches. The ICER was the adjusted difference in costs to deliver FBAS versus HE over the difference in weight change (kilograms [kg]) at one-year follow-up. Costs included those incurred for participant identification and program implementation. We fitted linear mixed-effects regression models, accounting for clustering of participants within churches and for age, sex, and educational attainment. We repeated these analyses for secondary outcomes (waist circumference [cm], physical activity [MET], glucose, blood pressure, and quality of life). RESULTS Per-person intervention cost of FBAS was