Browsing by Author "Head, Katharine J."
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Item Are Health Care Professionals Prepared to Implement Human Papillomavirus Testing? A Review of Psychosocial Determinants of Human Papillomavirus Test Acceptability in Primary Cervical Cancer Screening(Liebert, 2020-03) Tatar, Ovidiu; Wade, Kristina; McBride, Emily; Thompson, Erika; Head, Katharine J.; Perez, Samara; Shapiro, Gilla K.; Waller, Jo; Zimet, Gregory; Rosberger, Zeev; Communication Studies, School of Liberal ArtsBackground: Guidelines for cervical cancer screening have been updated to include human papillomavirus (HPV) testing, which is more sensitive compared to cytology in detecting cervical intraepithelial neoplasia. Because of its increased sensitivity, a negative HPV test is more reassuring for a woman that she is at low risk for precancerous cervical lesions than a negative Pap test. Prompted by the inadequate translation of HPV test-based screening guidelines into practice, we aimed to synthesize the literature regarding health care providers (HCPs) knowledge, attitudes, and practices related to HPV testing and the influence of psychosocial factors on HCPs acceptability of HPV testing in primary cervical cancer screening. Materials and Methods: We searched MEDLINE, Embase, PsycINFO, CINAHL, Global Health, and Web of Science for journal articles from January 1, 1980 to July 25, 2018. A narrative synthesis of HCPs knowledge, attitudes, and practices related to HPV testing is provided. Informed by the Patient Pathway framework, we used deductive thematic analysis to synthesize the influence of psychosocial factors on HCPs acceptability of HPV testing. Results: The most important HCP knowledge gaps are related to the superior sensitivity of the HPV test and age-specific guideline recommendations for HPV testing. Thirty to fifty percent of HCPs are not compliant with guideline recommendations for HPV testing, for example, screening at shorter intervals than recommended. Barriers, facilitators, and contradictory evidence of HCPs' acceptability of the HPV test are grouped by category: (1) factors related to the HCP; (2) patient intrinsic factors; (3) factors corresponding to HCP's practice environment; and (4) health care system factors. Conclusions: HCP's adherence to guidelines for HPV testing in cervical cancer screening is suboptimal and could be improved by specialty organizations ensuring consistency across guidelines. Targeted educational interventions to address barriers of HPV test acceptability identified in this review may facilitate the translation of HPV testing recommendations into practice.Item Asian American women's perspectives on donating healthy breast tissue: implications for recruitment methods and messaging(2016-12) Ridley-Merriweather, Katherine E.; Parrish-Sprowl, John; Bute, Jennifer J.; Head, Katharine J.Asian women have a lower risk than Caucasians, African Americans, and Latinas of developing breast cancer (BC). Yet, once Asians move to the U.S. their risk rates measurably increase. The Susan G. Komen® Tissue Bank at the IU Simon Cancer Center (KTB), the only biobank of its kind in the world, collects healthy breast tissue from women of all racial groups to use as controls in BC research. The KTB represents a critical tool in efforts to treat and prevent BC; however, Asian American (AA) women display marked reticence towards donating tissue to the KTB. The purpose of this study is to use the basic components of Grounded Practical Theory to explore potential messaging that may result in AAs’ more positive outlook on breast tissue donation. This study recruited seventeen (N=17) AA women to share their perspectives on donating breast tissue for research purposes. Participants took part in an interactive focus group exploring potential messaging for successfully recruiting AA women to the KTB study. Findings revealed that: a) participants retained a culturally-embedded discomfort with donating, and a general distrust that their donation would be handled ethically and appropriately; b) the women possessed an extraordinary need for knowledge about all facets of the donation process; c) participants perceived that they lack a personal connection to BC, making it difficult for them to generate any truly altruistic tendencies to perform the desired behavior, or to understand a need to do so; and d) they possess a strong desire to learn why it seems important to the KTB to collect their tissue, and especially about the increased BC rates and risk for Asians who move to or are born in the U.S. The findings from this study have important implications for others who work in applied clinical settings and are interested in addressing racial disparities in medical research through more effective and targeted recruitment messaging.Item Associations between HPV vaccination among women and their 11–14-year-old children(Taylor & Francis, 2019-01-07) Kornides, Melanie; Head, Katharine J.; Feemster, Kristen; Zimet, Gregory D.; Panozzo, Catherine A.; Pediatrics, School of MedicineThe human papillomavirus (HPV) vaccine has been available in the United States for over a decade. We sought to examine the associations between self-reported receipt of HPV vaccination among women and their 11–14-year-old children in 27 low-coverage states. Among the 3,261 mothers we surveyed, 18% reported receiving ≥1 dose of HPV vaccine. A significantly higher proportion of vaccinated women reported vaccination of their children compared to unvaccinated women (83% vs. 56%, p < .001). In multivariable logistic regression, vaccinated women (vs. unvaccinated) had 3.58 (95% CI: 2.81–4.56) times the adjusted-odds of vaccinating their children (≥1 dose HPV vaccine). Among unvaccinated children, vaccinated mothers (vs. unvaccinated) had 3.32 (95% CI: 2.09–5.26) times the adjusted odds of high intention to vaccinate their children in the next 12 months. We did not observe associations between mothers’ vaccination confidence and their vaccination status. We conclude that mothers who received ≥1 dose of HPV vaccine may be more likely to initiate or highly intend to initiate the HPV vaccine series for their children. This may have important implications for meeting population goals for HPV vaccination coverage as an increasing proportion of mothers are likely to be vaccinated over time.Item The Development and Psychometric Testing of an Inventory to Measure Health-Focused Perceived Family Support and Communication Behaviors with Chronic Disease Patients: A Three-Phase Study(2019-06) Harsin, Amanda M.; Brann, Maria; Head, Katharine J.; Bute, Jennifer J.; Rawl, Susan M.Hospitals and policymakers acknowledge the importance of the family in improved healthcare outcomes. Although there has been an increase in policies and research to bring families into planning, delivery, and evaluation of healthcare, there has not been a means to assess health-focused perceived support and communication behaviors. Without a means of assessing these factors, healthcare professionals cannot succinctly evaluate support and communication in a family system or provide recommendations for engaging family members in providing beneficial health-focused support and communication. This study involved the creation of the Inventory for Family Health-Focused Perceived Support and Communication Behaviors (Family HF-PSCB). Informed by family systems theory, social support literature, and health communication behaviors research, this three-phase study consisted of (a) generating items for the Family HF-PSCB, (b) establishing test-retest reliability, and (c) establishing a factor structure and convergent validity. Because of the increase of chronic disease in the United States, the Family HF-PSCB was created and tested with samples of individuals having chronic disease(s). Using a mixed methods approach, in-depth interviews with 12 participants generated 91 items for psychometric analysis. These items were tested through expert content review, and in pilot testing (n = 23), the remaining 84 items demonstrated test- retest and internal reliability. Through factor analysis (n = 209), two factors emerged to explain 72.1% of the variance. The final Family HF-PSCB contains 13 items, which indicates an individual’s perception of family health-focused support and communication behaviors. The factor explaining 63.2% of the variance has 8 items demonstrating healthfocused communication behaviors, and the second factor has 5 items demonstrating health-focused instrumental support. The developed scale suggests that family healthfocused communication behaviors may be a more explanatory variable in the family system for someone with chronic disease(s). The 13-item Family HF-PSCB demonstrates convergent validity through significant correlations with the Perceived Social Support Family Scale and the General Functioning Scale of the McMaster Family Assessment Device. Future studies should explore the correlation of the Family HF-PSCB with health outcomes attributed to symptom management in populations of chronic disease patients.Item The effects of message framing and healthcare provider recommendation on adult hepatitis B vaccination: A randomized controlled trial(Elsevier, 2019-08-09) Kasting, Monica L.; Head, Katharine J.; Cox, Dena; Cox, Anthony D.; Zimet, Gregory D.; Pediatrics, School of MedicineMany adults in the U.S. do not receive recommended vaccines, and the research literature remains inconclusive on the best communication strategies for increasing this behavior. This study examined the association of message framing (gained-framed vs. loss-framed vs. control), and healthcare provider (HCP) recommendation (offered vs. recommended) on uptake of adult hepatitis B virus (HBV) vaccination in a high risk population using a 3×2 block design randomized controlled trial. Fear of shots, fear of vaccines, and perceived message framing were examined in secondary analyses. Of the 1,747 participants, 47.7% (n=833) received 0 doses of HBV vaccine, 27.8% (n=485) received 1 dose, 10.4% received 2 doses, and 14.1% received all 3 recommended doses. There was not a significant interaction between message framing and HCP recommendation (p =.59). Mean number of doses received by the gain-framed group (m=.96) was not significantly different from the loss-framed group (m=.97, RR=.99, 95% CI=.88–1.12). However, those receiving any framing message received significantly more doses (m= .96) than those in the control condition (m=.81, RR=1.17, 95%CI=1.06–1.31). Participants who received a HCP recommendation received significantly more vaccine doses (m=.95) than those in the vaccine-offered condition (mean=.82, RR=1.16, 95%CI=1.05–1.28). These results suggest there is no difference in vaccine uptake between gain-frame and loss-frame messages, but both are better than a control message. These results also support advising HCP to provide a strong recommendation for vaccinations beyond merely offering it to patients. This study has implications for vaccine uptake beyond HBV, and can inform future research on effective vaccine communication research.Item Efficacy of tailored messages to improve behavioral intent to accept HPV vaccination among mothers may be moderated by sociodemographics(Elsevier, 2021-05-29) Feemster, Kristen A.; Head, Katharine J.; Panozzo, Catherine A.; O'Dell, Sean M.; Zimet, Gregory D.; Kornides, Melanie L.; Pediatrics, School of MedicineWe assessed differences in response to a tailored recommendation intervention for HPV vaccine by participants’ sociodemographic characteristics in this exploratory sub-analysis of a larger web-based, randomized-controlled trial on tailored messaging among mothers with low intent to vaccinate their 11–14-year-old child against HPV. The intervention consisted of pre-recorded video messages tailored to 1–5 common concerns about HPV vaccine. In these exploratory analyses, we used generalized linear models to assess differences in post-intervention intent across intervention arms, stratified by sociodemographic characteristics among 496 trial participants. We found significantly higher post-intervention intent in the intervention participants versus the control group among mothers: 1) with younger children; 2) with white vs. black children; 3) with Non-Hispanic children; 4) who were younger; 5) with some college or vocational training; with household incomes of ≥$100,000; and 7) with 1–2 children. Our findings of effect modification by certain sociodemographic factors such as age, race/ethnicity, and household income should be considered when designing similar tailored messaging interventions.Item Examining the benefits and harms of Alzheimer's disease screening for family members of older adults: study protocol for a randomized controlled trial(BMC, 2020-02-19) Fowler, Nicole R.; Head, Katharine J.; Perkins, Anthony J.; Gao, Sujuan; Callahan, Christopher M.; Bakas, Tamilyn; Suarez, Shelley D.; Boustani, Malaz A.; Medicine, School of MedicineBACKGROUND: Multiple national expert panels have identified early detection of Alzheimer's disease and related dementias (ADRD) as a national priority. However, the United States Preventive Services Task Force (USPSTF) does not currently support screening for ADRD in primary care given that the risks and benefits are unknown. The USPSTF stresses the need for research examining the impact of ADRD screening on family caregiver outcomes. METHODS: The Caregiver Outcomes of Alzheimer's Disease Screening (COADS) is a randomized controlled trial that will examine the potential benefits or harms of ADRD screening on family caregivers. It will also compare the effectiveness of two strategies for diagnostic evaluation and management after ADRD screening. COADS will enroll 1800 dyads who will be randomized into three groups (n = 600/group): the 'Screening Only' group will receive ADRD screening at baseline and disclosure of the screening results, with positive-screen participants receiving a list of local resources for diagnostic follow-up; the 'Screening Plus' group will receive ADRD screening at baseline coupled with disclosure of the screening results, with positive-screen participants referred to a dementia collaborative care program for diagnostic evaluation and potential care; and the control group will receive no screening. The COADS trial will measure the quality of life of the family member (the primary outcome) and family member mood, anxiety, preparedness and self-efficacy (the secondary outcomes) at baseline and at 6, 12, 18 and 24 months. Additionally, the trial will examine the congruence of depressive and anxiety symptoms between older adults and family members at 6, 12, 18 and 24 months and compare the effectiveness of two strategies for diagnostic evaluation and management after ADRD screening between the two groups randomized to screening (Screening Only versus Screening Plus). DISCUSSION: We hypothesize that caregivers in the screening arms will express higher levels of health-related quality of life, lower depressive and anxiety symptoms, and better preparation for caregiving with higher self-efficacy at 24 months. Results from this study will directly inform the National Plan to Address Alzheimer's Disease, the USPSTF and other organizations regarding ADRD screening and early detection policies.Item Exploring Male And Female Healthcare Provider Communication With Alzheimer’s Patients: A Qualitative Study(2021-05) Lyu, Ying; Goering, Elizabeth; Head, Katharine J.; Bute, JenniferToday, Alzheimer’s is a devastating disease that affects more than 46.8 million people worldwide. Caring for people with AD is stressful and emotionally draining for both family members and healthcare providers and would be exacerbated by the breakdown in communication. While communication challenges can take many forms, one understudied area in AD patient-provider communication is how gender role might affect the outcomes and perceived feelings during interaction. Without knowledge and attentiveness of how gender may affect patient-provider communication, healthcare providers may become more frustrated in their attempts to apply unadjusted skills, which can cause further breakdown and stress. This study is to explore how gender might be a role affecting caregiving communication within the context of Alzheimer’s. Eleven participants were recruited to have a semi-structured interview through online flyers. The findings from this study yield broad suggestions for future work within the field of Alzheimer’s communication research and specific suggestions for designing the communication training.Item From “A Spoonful of Sugar” to Operation Warp Speed: COVID-19 Vaccines and Their Metaphors(Harvard Law School, 2020-12-15) Silverman, Ross D.; Head, Katharine J.; Beckman, Emily; Health Policy and Management, School of Public HealthWe must remain cognizant of the many ways metaphors may distort, divide, or misrepresent important details.Item Implications for Training on Smartphone Medication Reminder App Use by Adults With Chronic Conditions: Pilot Study Applying the Technology Acceptance Model(JMIR, 2017) Park, Daniel Y.; Goering, Elizabeth M.; Head, Katharine J.; Bartlett Ellis, Rebecca J.; School of NursingBackground: The majority of middle-aged to older patients with chronic conditions report forgetting to take medications as prescribed. The promotion of patients’ smartphone medication reminder app (SMRA) use shows promise as a feasible and cost-effective way to support their medication adherence. Providing training on SMRA use, guided by the technology acceptance model (TAM), could be a promising intervention to promote patients’ app use. Objective: The aim of this pilot study was to (1) assess the feasibility of an SMRA training session designed to increase patients’ intention to use the app through targeting perceived usefulness of app, perceived ease of app use, and positive subjective norm regarding app use and (2) understand the ways to improve the design and implementation of the training session in a hospital setting. Methods: A two-group design was employed. A total of 11 patients older than 40 years (median=58, SD=9.55) and taking 3 or more prescribed medications took part in the study on one of two different dates as participants in either the training group (n=5) or nontraining group (n=6). The training group received an approximately 2-hour intervention training session designed to target TAM variables regarding one popular SMRA, the Medisafe app. The nontraining group received an approximately 2-hour control training session where the participants individually explored Medisafe app features. Each training session was concluded with a one-time survey and a one-time focus group. Results: Mann-Whitney U tests revealed that the level of perceived ease of use (P=.13) and the level of intention to use an SMRA (P=.33) were higher in the training group (median=7.00, median=6.67, respectively) than in the nontraining group (median=6.25, median=5.83). However, the level of perceived usefulness (U=4.50, Z=−1.99, P=.05) and the level of positive subjective norm (P=.25) were lower in the training group (median=6.50, median=4.29) than in the nontraining group (median=6.92, median=4.50). Focus groups revealed the following participants’ perceptions of SMRA use in the real-world setting that the intervention training session would need to emphasize in targeting perceived usefulness and positive subjective norm: (1) the participants would find an SMRA to be useful if they thought the app could help address specific struggles in medication adherence in their lives and (2) the participants think that their family members (or health care providers) might view positively the participants’ SMRA use in primary care settings (or during routine medical checkups). Conclusions: Intervention training session, guided by TAM, appeared feasible in targeting patients’ perceived ease of use and, thereby, increasing intention to use an SMRA. Emphasizing the real-world utility of SMRA, the training session could better target patients’ perceived usefulness and positive subjective norm that are also important in increasing their intention to use the app. [JMIR Formativ Res 2017;1(1):e5]