Variations in the Design and Use of Attention Control Groups in Type 2 Diabetes Randomized Controlled Trials: a Systematic Review.

PURPOSE OF REVIEW: In type 2 diabetes (T2D) research, the phrase "attention control group" (ACGs) has been used with varying descriptions. We aimed to systematically review the variations in the design and use of ACGs for T2D studies. RECENT FINDINGS: Twenty studies utilizing ACGs were included in the final evaluation. Control group activities had the potential to influence the primary outcome of the study in 13 of the 20 articles. Prevention of contamination across groups was not mentioned in 45% of the articles. Eighty-five percent of articles met or somewhat met the criteria for having comparable activities between the ACG and intervention arms. Wide variations in descriptions and the lack of standardization have led to an inaccurate use of the phrase "ACGs" when describing the control arm of trials, indicating a need for future research with focus on the adoption of uniform guidelines for use of ACGs in T2D RCTs.

Society of Behavioral Medicine Update: retain support for the National Colorectal Cancer Roundtable's call to action to reach 80% colorectal cancer screening.

Colorectal cancer (CRC) remains the third most commonly diagnosed cancer and the third leading cause of cancer-related death in the USA. CRC can be prevented through regular screening and removal of precancerous polyps. However, roughly one third of eligible adults in the USA are not up to date with recommended CRC screening. To increase timely CRC screening uptake in the USA, in 2014, the National Colorectal Cancer Roundtable (NCCRT) launched 80% by 2018. This multilevel effort involved more than 1,500 pledged organizations targeting patients, providers, health care systems, and policymakers to increase U.S. CRC screening rates to 80% by 2018. Concurrent with this campaign, between 2012 and 2018, CRC screening rates increased nationwide by 3.6% from 65.2% to 68.8%, meaning that about 9.3 million more U.S. adults are being screened. NCCRT attributes these successes to widespread implementation of center- and system-wide evidence-based interventions to increase screening uptake, including direct patient communication, provider reminders via electronic health records, and patient navigation, among others. Moving beyond 2018, NCCRT has rebranded the initiative as the 80% Pledge and has since identified several targeted campaigns, including increased outreach to Hispanics, Latinos, and Asians, whose CRC screening uptake remains less than 50%; encouragement of Medicaid outreach activities around CRC screening in all 50 states; and advocacy for screening right at 50 years of age. Society of Behavioral Medicine continues to support NCCRT and encourages policymakers to do the same by taking legislative action to assure funding for Medicaid outreach, research innovations, and clinical quality improvement that supports the 80% Pledge.

Leveraging an Implementation Science Framework to Adapt and Scale a Patient Navigator Intervention to Improve Mammography Screening Outreach in a New Community.

Helping Her Live (HHL) is a community health worker-led outreach model that navigates women from vulnerable communities to mammography screening and diagnostic follow-up. The objective of this study was to evaluate HHL implementation on the southwest side of Chicago. HHL has been implemented on the west side of Chicago since 2008, where it has increased mammogram completion and diagnostic follow-up rates among Black and Hispanic women from resource poor communities. In 2014, HHL was translated to the southwest side of Chicago; implementation success was evaluated by comparing outreach, navigation request, and mammogram completion metrics with the west side. During January 2014-December 2015, outreach was less extensive in the southwest setting (SW) compared to the benchmark west setting (W); however, the proportion of women who completed mammograms in SW was 50%, which compared favorably to the proportion observed in the benchmark setting W (42%). The distribution of insurance status and the racial and ethnic makeup of individuals met on outreach in the W and SW were significantly different (p < 0.0005). This successful expansion of HHL in terms of both geographic and demographic reach justifies further studies leveraging these results and tailoring HHL to additional underserved communities.

Building Cross-Institutional Collaborative Infrastructure and Processes: Early Lessons From the Chicago Cancer Health Equity Collaborative.

BACKGROUND: Addressing cancer health disparities requires a multitiered, comprehensive approach. The Chicago Cancer Health Equity Collaborative (ChicagoCHEC) was established as a tri-institutional partnership to advance cancer health equity through scientific discovery, education, and community engagement. OBJECTIVES: Large-scale partnerships rarely document the challenges encountered when establishing processes and operations in the formative years of engagement. We outline selected lessons learned from the first three years of ChicagoCHEC in hopes that future collaborations may be better poised to hit the ground running and create the needed infrastructure for a strong, effective, and sustainable partnership. LESSONS LEARNED: Unifying a diverse group of stakeholders under a shared mission is imperative. A shared governance structure, in which all individuals understand the aims of partnership and can facilitate progress, is crucial for success. Ongoing monitoring of collaborative processes should occur and attention should be given to the optimization of communications. CONCLUSIONS: Large-scale collaborative research and education projects across institutions can be challenging, particularly when establishing a working infrastructure and aligning priorities. However, the benefit of establishing key processes in the early years of the collaborative process can lead to high-quality research output, impact, and a sustainable partnership.

Community-Academic Partnerships to Reduce Cancer Inequities: The ChicagoCHEC Community Engagement Core.

BACKGROUND: In 2015, Chicago Cancer Health Equity Collaborative (ChicagoCHEC) was formed to address cancer inequities. The Community Engagement Core (CEC) is one of the key components aimed at establishing meaningful partnerships between the academic institutions and the community. Herein, we describe ChicagoCHEC CEC processes, challenges, opportunities, successes, and preliminary evaluation results. METHODS: CEC stresses participatory and empowerment approaches in all aspects of ChicagoCHEC work. Evaluation processes were conducted to assess, report back, and respond to community needs and to evaluate the strength of the partnership. RESULTS: CEC has facilitated meaningful community integration and involvement in all ChicagoCHEC work. The partnership resulted in annual cancer symposium; more than 50 outreach and education activities, including cancer screening and referrals; the development of health resources; and providing expertise in culturally and health literacy appropriate research targeting minorities. Preliminary partnership evaluation results show that ChicagoCHEC researchers and community partners have developed trust and cohesiveness and value the community benefits resulting from the partnership. CONCLUSIONS: CEC is essential in achieving research objectives following community participatory action research (CPAR) approaches. Some key lessons learned include 1) the need for clear, honest, and open channels of communication not only among the three participating academic institutions, but also among the community partners, 2) transparent operational processes, and 3) mutual trust and understanding regarding the different cultures, structure, foci and processes, expectations at each institution and partnering organization.

Evaluation of Mammogram Parties as an Effective Community Navigation Method.

Women of color do not have the same level of access to mammography services as their White counterparts, and this inequity may be one of the contributing factors to the documented racial disparity in breast cancer mortality in the US. The present study sought to assess the effectiveness of the mammogram party, a promising, but under-studied approach to increasing mammography uptake, particularly among under-served populations. The program targeted mammogram-eligible women in community settings on the west and southwest sides of Chicago, gathering basic demographic information, mammography history, and interest in assistance obtaining a mammogram. Women were navigated either through traditional one-on-one navigation or to a mammogram party. Seven outcome metrics were calculated for each type of navigation. We compared navigation outcomes for those who attended to those who did not attend a mammogram party using two-tailed t tests and chi-square tests. We found that the mammography completion rate for mammogram parties was comparable to that for standard one-on-one navigation (65.8 vs. 63.7%), which is more labor-intensive as evidenced by the number of contacts needed to successfully navigate a woman to mammography (10.9 vs. 15.0). Mammogram parties offer a unique opportunity for fellowship and support for clients who are particularly fearful of mammograms or identifying breast cancer. Programmatically, mammogram parties are an efficient way to complete several mammograms in 1 day. Having the option to both navigate women to mammogram parties or one-on-one navigation allows for more flexibility for scheduling and may ensure a completed a mammogram.

Keys to the Successful Implementation of Community-Based Outreach and Navigation: Lessons from a Breast Health Navigation Program.

The well-documented racial disparities in breast cancer mortality have prompted an aggressive response from the public health community, including the development and implementation of breast health education and breast cancer navigation programs. Many programs are successfully reaching women and providing education and motivation to get screened, and separately, many programs are successfully navigating women who have received abnormal results from a screening mammogram and need follow-up. However, a crucial gap in services remains, where women in the community are not receiving systematic navigation to their initial screening mammogram. This paper describes a community-based, community health worker-led breast health education and screening navigation program, details the metrics used to measure navigation outcomes, and discusses unique features of this project which could be adapted within other settings to initiate similar programming.