Evaluating the Feasibility of Using a Mobile App to Track Oncology Patient Navigation Activities and Outcomes.

Background: The Centers for Disease Control and Prevention supports the implementation of evidence-based interventions to prevent and control cancer, including patient navigation (PN); however, PN lacks standardized tools to measure effectiveness and aggregate data across programs. Using a mobile application (app) could provide a systematic infrastructure for cataloging PN activities and measuring patient outcomes. Objective: Our goal was to evaluate the feasibility of using a mobile app to assist with PN services within cancer control programs. Methods: Seven navigators in 6 geographically diverse PN programs evaluated the mobile app over a period of 5 to 9 months by using the app to track their daily activities. We evaluated the app's capability for collecting and reporting core data elements, such as time spent on outreach, patient care, and administrative tasks, as well as standardized metrics for program evaluation and monitoring. We obtained qualitative data during calls with the navigators through weekly journals and in-depth interviews. Results: The app was effective in tracking caseload, profiling patients' health challenges and barriers to screening and treatment, and capturing PN activities performed during patient encounters. App limitations included an unreliable reporting function, a requirement for internet connectivity, patient privacy concerns, and evolving technology. Discussion: Lessons learned from this evaluation will be useful in developing an app with more robust capabilities while retaining user-friendly features. Conclusion: Mobile technology may reduce individual and health system barriers to accessing cancer care and treatment and support posttreatment cancer survivors while also assisting navigators in conducting their work efficiently and effectively.

Comprehensive cancer control: promoting survivor health and wellness.

PURPOSE: As of 2016, an estimated 15.5 million cancer survivors were living in the United States and the number of cancer survivors is expected to increase to 20.3 million by 2026. Numerous clinical studies have shown that comorbidities, such as obesity and diabetes, and unhealthy lifestyle choices, such as physical inactivity and heavy smoking, negatively influence overall quality of life and long-term survival of cancer survivors. Accordingly, survivorship programs seek to focus on overall wellness, including symptom management, monitoring for late effects of treatment, monitoring for recurrence, helping patients adapt healthy behaviors, and quality of life. This paper provides a broad overview of public health efforts to address the needs of cancer survivors. METHODS: To describe a range of examples of survivorship initiatives in comprehensive cancer control, we analyzed documents from comprehensive cancer control programs and coalitions and solicited detailed examples from several national partners. RESULTS: Comprehensive cancer control programs, coalitions, and partners are undertaking myriad initiatives to address cancer survivorship and building upon evidence-based interventions to promote healthy behaviors for cancer survivors across the country. CONCLUSION: A coordinated public health approach to caring for the growing population of cancer survivors can help address the long-term physical, psychosocial, and economic effects of cancer treatment on cancer survivors and their families.

Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC.

Group B streptococcus (GBS) remains a leading cause of serious neonatal infection despite great progress in perinatal GBS disease prevention in the 1990s. In 1996, CDC, in collaboration with other agencies, published guidelines for the prevention of perinatal group B streptococcal disease (CDC. Prevention of perinatal group B streptococcal disease: a public health perspective. MMWR 1996;45[RR-7]:1-24). Data collected after the issuance of the 1996 guidelines prompted reevaluation of prevention strategies at a meeting of clinical and public health representatives in November 2001. This report replaces CDC's 1996 guidelines. The recommendations are based on available evidence and expert opinion where sufficient evidence was lacking. Although many of the recommendations in the 2002 guidelines are the same as those in 1996, they include some key changes: * Recommendation of universal prenatal screening for vaginal and rectal GBS colonization of all pregnant women at 35-37 weeks' gestation, based on recent documentation in a large retrospective cohort study of a strong protective effect of this culture-based screening strategy relative to the risk-based strategy * Updated prophylaxis regimens for women with penicillin allergy * Detailed instruction on prenatal specimen collection and expanded methods of GBS culture processing, including instructions on antimicrobial susceptibility testing * Recommendation against routine intrapartum antibiotic prophylaxis for GBS-colonized women undergoing planned cesarean deliveries who have not begun labor or had rupture of membranes * A suggested algorithm for management of patients with threatened preterm delivery * An updated algorithm for management of newborns exposed to intrapartum antibiotic prophylaxis Although universal screening for GBS colonization is anticipated to result in further reductions in the burden of GBS disease, the need to monitor for potential adverse consequences of intrapartum antibiotic use, such as emergence of bacterial antimicrobial resistance or increased incidence or severity of non-GBS neonatal pathogens, continues, and intrapartum antibiotics are still viewed as an interim strategy until GBS vaccines achieve licensure.