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1.
Healthcare (Basel) ; 12(7)2024 Apr 03.
Artículo en Inglés | MEDLINE | ID: mdl-38610203

RESUMEN

The human papillomavirus (HPV) vaccine can prevent HPV-related oropharyngeal cancers. Dental practitioners are uniquely positioned to promote HPV vaccines during routine dental care but experience barriers to doing so. Qualitative interviews were conducted with dental practitioners to understand barriers and inform intervention strategies to promote HPV vaccines. Dental practitioners were invited to participate in phone interviews about knowledge, self-efficacy, and the fear of negative consequences related to HPV vaccine promotion as well as feedback on potential interventions to address these barriers. Interviews were audio recorded, transcribed, and analyzed using rapid qualitative analysis with a sort-and-sift matrix approach. Interviews were completed with 11 practitioners from six dental clinics (avg. 31 min). Though most thought HPV vaccination was important, they lacked detailed knowledge about when and to whom the vaccine should be recommended. This led to a hypothesized need for discussions of sexual history, feelings of limited self-efficacy to make the recommendation, and fear of patient concerns. Still, practitioners were supportive of additional training opportunities and provided input into specific interventions. The nuance of how these barriers were described by practitioners, as well as the possible solutions they identified, will help shape future interventions supporting HPV vaccine promotion in dental care.

2.
J Cancer Educ ; 39(1): 78-85, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37919624

RESUMEN

Health systems are interested in increasing colorectal cancer (CRC) screening rates as CRC is a leading cause of preventable cancer death. Learning health systems are ones that use data to continually improve care. Data can and should include qualitative local perspectives to improve patient and provider education and care. This study sought to understand local perspectives on CRC screening to inform future strategies to increase screening rates across our integrated health system. Health insurance plan members who were eligible for CRC screening were invited to participate in semi-structured phone interviews. Qualitative content analysis was conducted using an inductive approach. Forty member interviews were completed and analyzed. Identified barriers included ambivalence about screening options (e.g., "If it had the same performance, I'd rather do home fecal sample test. But I'm just too skeptical [so I do the colonoscopy]."), negative prior CRC screening experiences, and competing priorities. Identified facilitators included a positive general attitude towards health (e.g., "I'm a rule follower. There are certain things I'll bend rules. But certain medical things, you just got to do."), social support, a perceived risk of developing CRC, and positive prior CRC screening experiences. Study findings were used by the health system leaders to inform the selection of CRC screening outreach and education strategies to be tested in a future simulation model. For example, the identified barrier related to ambivalence about screening options led to a proposed revision of outreach materials that describe screening types more clearly.


Asunto(s)
Neoplasias Colorrectales , Aprendizaje del Sistema de Salud , Humanos , Detección Precoz del Cáncer , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/prevención & control , Colonoscopía , Sangre Oculta , Tamizaje Masivo
3.
Prog Cardiovasc Dis ; 76: 69-75, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36563922

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic necessitated the implementation and prioritizing of strict public health strategies to mitigate COVID-19 transmission and infection over all else. As we enter a 'recovery' phase in which the impact of the virus recedes (but does not relent), we ask, "How do we develop a game plan that considers prevention over management of public health threats of a more chronic nature, including cardiovascular disease?" We frame this choice point as a "Humpty-Dumpty" moment for public health with enduring and potentially irreversible consequences. Citing clear examples of other public health successes and failures, we outline in detail how sustaining cardiovascular population health under complex post-pandemic conditions will necessitate decision-making to be informed with a systems science approach, in which interventions, goals, outcomes and features of complex systems are carefully aligned.


Asunto(s)
COVID-19 , Enfermedades Cardiovasculares , Humanos , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Salud Pública
4.
Am J Clin Nutr ; 116(6): 1877-1900, 2022 12 19.
Artículo en Inglés | MEDLINE | ID: mdl-36055772

RESUMEN

Precision nutrition is an emerging concept that aims to develop nutrition recommendations tailored to different people's circumstances and biological characteristics. Responses to dietary change and the resulting health outcomes from consuming different diets may vary significantly between people based on interactions between their genetic backgrounds, physiology, microbiome, underlying health status, behaviors, social influences, and environmental exposures. On 11-12 January 2021, the National Institutes of Health convened a workshop entitled "Precision Nutrition: Research Gaps and Opportunities" to bring together experts to discuss the issues involved in better understanding and addressing precision nutrition. The workshop proceeded in 3 parts: part I covered many aspects of genetics and physiology that mediate the links between nutrient intake and health conditions such as cardiovascular disease, Alzheimer disease, and cancer; part II reviewed potential contributors to interindividual variability in dietary exposures and responses such as baseline nutritional status, circadian rhythm/sleep, environmental exposures, sensory properties of food, stress, inflammation, and the social determinants of health; part III presented the need for systems approaches, with new methods and technologies that can facilitate the study and implementation of precision nutrition, and workforce development needed to create a new generation of researchers. The workshop concluded that much research will be needed before more precise nutrition recommendations can be achieved. This includes better understanding and accounting for variables such as age, sex, ethnicity, medical history, genetics, and social and environmental factors. The advent of new methods and technologies and the availability of considerably more data bring tremendous opportunity. However, the field must proceed with appropriate levels of caution and make sure the factors listed above are all considered, and systems approaches and methods are incorporated. It will be important to develop and train an expanded workforce with the goal of reducing health disparities and improving precision nutritional advice for all Americans.


Asunto(s)
Lagunas en las Evidencias , Estado Nutricional , Humanos , Estados Unidos , Medicina de Precisión/métodos , Dieta , National Institutes of Health (U.S.) , Nutrigenómica
6.
J Pers Med ; 11(9)2021 Aug 25.
Artículo en Inglés | MEDLINE | ID: mdl-34575609

RESUMEN

INTRODUCTION: Precision medicine is focused on serving the unique needs of individuals. Oral and oropharyngeal cancer risk assessment identifies individual risk factors while providing support to reduce risk. The objective is to examine potential current and future strategies to broadly implement evidence-based oral and oropharyngeal cancer risk assessment and screening in dental practices throughout the United States. METHODS: Feasible and effective oral cancer risk assessment and risk reduction strategies, ripe for implementation in dental practice, were identified in the published literature. RESULTS: The Screening, Brief Intervention, Referral for Treatment (SBIRT) model is a feasible approach to assessing individual oral cancer risk and providing risk reducing interventions in the dental setting. HPV is a more recently identified risk factor that dentistry is well positioned to address. Evidence supporting the utilization of specific risk assessment tools and risk reduction strategies is summarized and future opportunities discussed. DISCUSSION: Current knowledge of risk factors for oral and oropharyngeal cancers support the recommendation for dental providers to routinely assess all patients for risk factors, educate them about their personal level of cancer risk, and recommend actions to reduce relevant risk factors. Individuals ages 9-26 should be asked about their HPV vaccination status, educated about HPV and oropharyngeal cancer and receive a recommendation to get the HPV vaccination.

7.
Proc Natl Acad Sci U S A ; 117(39): 24154-24164, 2020 09 29.
Artículo en Inglés | MEDLINE | ID: mdl-32929006

RESUMEN

Science is undergoing rapid change with the movement to improve science focused largely on reproducibility/replicability and open science practices. This moment of change-in which science turns inward to examine its methods and practices-provides an opportunity to address its historic lack of diversity and noninclusive culture. Through network modeling and semantic analysis, we provide an initial exploration of the structure, cultural frames, and women's participation in the open science and reproducibility literatures (n = 2,926 articles and conference proceedings). Network analyses suggest that the open science and reproducibility literatures are emerging relatively independently of each other, sharing few common papers or authors. We next examine whether the literatures differentially incorporate collaborative, prosocial ideals that are known to engage members of underrepresented groups more than independent, winner-takes-all approaches. We find that open science has a more connected, collaborative structure than does reproducibility. Semantic analyses of paper abstracts reveal that these literatures have adopted different cultural frames: open science includes more explicitly communal and prosocial language than does reproducibility. Finally, consistent with literature suggesting the diversity benefits of communal and prosocial purposes, we find that women publish more frequently in high-status author positions (first or last) within open science (vs. reproducibility). Furthermore, this finding is further patterned by team size and time. Women are more represented in larger teams within reproducibility, and women's participation is increasing in open science over time and decreasing in reproducibility. We conclude with actionable suggestions for cultivating a more prosocial and diverse culture of science.


Asunto(s)
Reproducibilidad de los Resultados , Ciencia/tendencias , Mujeres , Autoria , Humanos , Difusión de la Información , Publicación de Acceso Abierto
9.
Health Educ Behav ; 47(2): 185-190, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32090654

RESUMEN

Systems science can help public health professionals to better understand the complex dynamics between factors affecting health behaviors and outcomes and to identify intervention opportunities. Despite their demonstrated utility in addressing health topics such influenza, tobacco control, and obesity, the associated methods continue to be underutilized by researchers and practitioners addressing health behaviors. This article discusses the growth of systems science methods (e.g., system dynamics, social network analysis, and agent-based modeling) in health research, provides a frame for the articles included in this themed issue, and closes with recommendations for enhancing the future of systems science and health behavior research. We argue that integrating systems sciences methods into health behavior research and practice is essential for improved population health and look forward to supporting the evolution of the field.


Asunto(s)
Salud Poblacional , Salud Pública , Conductas Relacionadas con la Salud , Humanos
10.
Front Big Data ; 3: 556282, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33693415

RESUMEN

Big bibliographic datasets hold promise for revolutionizing the scientific enterprise when combined with state-of-the-science computational capabilities. Yet, hosting proprietary and open big bibliographic datasets poses significant difficulties for libraries, both large and small. Libraries face significant barriers to hosting such assets, including cost and expertise, which has limited their ability to provide stewardship for big datasets, and thus has hampered researchers' access to them. What is needed is a solution to address the libraries' and researchers' joint needs. This article outlines the theoretical framework that underpins the Collaborative Archive and Data Research Environment project. We recommend a shared cloud-based infrastructure to address this need built on five pillars: 1) Community-a community of libraries and industry partners who support and maintain the platform and a community of researchers who use it; 2) Access-the sharing platform should be accessible and affordable to both proprietary data customers and the general public; 3) Data-Centric-the platform is optimized for efficient and high-quality bibliographic data services, satisfying diverse data needs; 4) Reproducibility-the platform should be designed to foster and encourage reproducible research; 5) Empowerment-the platform should empower researchers to perform big data analytics on the hosted datasets. In this article, we describe the many facets of the problem faced by American academic libraries and researchers wanting to work with big datasets. We propose a practical solution based on the five pillars: The Collaborative Archive and Data Research Environment. Finally, we address potential barriers to implementing this solution and strategies for overcoming them.

11.
Am J Prev Med ; 55(6): 915-925, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30458950

RESUMEN

INTRODUCTION: This paper provides the first detailed analysis of the NIH prevention research portfolio for primary and secondary prevention research in humans and related methods research. METHODS: The Office of Disease Prevention developed a taxonomy of 128 topics and applied it to 11,082 projects representing 91.7% of all new projects and 84.1% of all dollars used for new projects awarded using grant and cooperative agreement activity codes that supported research in fiscal years 2012-2017. Projects were coded in 2016-2018 and analyzed in 2018. RESULTS: Only 16.7% of projects and 22.6% of dollars were used for primary and secondary prevention research in humans or related methods research. Most of the leading risk factors for death and disability in the U.S. were selected as an outcome in <5% of the projects. Many more projects included an observational study, or an analysis of existing data, than a randomized intervention. These patterns were consistent over time. CONCLUSIONS: The appropriate level of support for primary and secondary prevention research in humans from NIH will differ by field and stage of research. The estimates reported here may be overestimates, as credit was given for a project even if only a portion of that project addressed prevention research. Given that 74% of the variability in county-level life expectancy across the U.S. is explained by established risk factors, it seems appropriate to devote additional resources to developing and testing interventions to address those risk factors.


Asunto(s)
Financiación Gubernamental , Investigación sobre Servicios de Salud/economía , National Institutes of Health (U.S.) , Prevención Primaria , Prevención Secundaria , Humanos , Estados Unidos
12.
Int J Behav Med ; 22(3): 283-91, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24852184

RESUMEN

BACKGROUND: Dissemination and implementation (D&I) research seeks to understand and overcome barriers to adoption of behavioral interventions that address complex problems, specifically interventions that arise from multiple interacting influences crossing socio-ecological levels. It is often difficult for research to accurately represent and address the complexities of the real world, and traditional methodological approaches are generally inadequate for this task. Systems science methods, expressly designed to study complex systems, can be effectively employed for an improved understanding about dissemination and implementation of evidence-based interventions. PURPOSE: The aims of this study were to understand the complex factors influencing successful D&I of programs in community settings and to identify D&I challenges imposed by system complexity. METHOD: Case examples of three systems science methods-system dynamics modeling, agent-based modeling, and network analysis-are used to illustrate how each method can be used to address D&I challenges. RESULTS: The case studies feature relevant behavioral topical areas: chronic disease prevention, community violence prevention, and educational intervention. To emphasize consistency with D&I priorities, the discussion of the value of each method is framed around the elements of the established Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework. CONCLUSION: Systems science methods can help researchers, public health decision makers, and program implementers to understand the complex factors influencing successful D&I of programs in community settings and to identify D&I challenges imposed by system complexity.


Asunto(s)
Difusión de la Información , Salud Pública , Investigación/tendencias , Humanos
14.
Am J Public Health ; 104(7): 1181-6, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24832426

RESUMEN

Dynamic modeling and simulation are systems science tools that examine behaviors and outcomes resulting from interactions among multiple system components over time. Although there are excellent examples of their application, they have not been adopted as mainstream tools in population health planning and policymaking. Impediments to their use include the legacy and ease of use of statistical approaches that produce estimates with confidence intervals, the difficulty of multidisciplinary collaboration for modeling and simulation, systems scientists' inability to communicate effectively the added value of the tools, and low funding for population health systems science. Proposed remedies include aggregation of diverse data sets, systems science training for public health and other health professionals, changing research incentives toward collaboration, and increased funding for population health systems science projects.


Asunto(s)
Simulación por Computador , Modelos Teóricos , Salud Pública , Proyectos de Investigación , Teoría de Sistemas , Comunicación , Conducta Cooperativa , Conductas Relacionadas con la Salud , Planificación en Salud , Humanos , Obesidad/prevención & control , Formulación de Políticas
17.
Nicotine Tob Res ; 16 Suppl 2: S73-5, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24711629

RESUMEN

Advances in technology and the associated cultural norms, especially the advent of the smartphone, offer an unprecedented opportunity to collect data on relevant health behaviors and experiences unobtrusively at a greater frequency and in greater volumes than ever before. This special issue will acquaint the readership of Nicotine and Tobacco Research with the potential for intensive longitudinal data and will illustrate some innovative analytic techniques for addressing research questions associated with this type of complex data. This introductory article will provide a brief history of the analytic techniques for intensive longitudinal data and will point to some resources that support and enable the use of these techniques.


Asunto(s)
Investigación Conductal/métodos , Recolección de Datos/métodos , Humanos , Estudios Longitudinales , Psicofarmacología/métodos
18.
Health Educ Behav ; 40(1 Suppl): 123S-31S, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24084395

RESUMEN

Although systems science has emerged as a set of innovative approaches to study complex phenomena, many topically focused researchers including clinicians and scientists working in public health are somewhat befuddled by this methodology that at times appears to be radically different from analytic methods, such as statistical modeling, to which the researchers are accustomed. There also appears to be conflicts between complex systems approaches and traditional statistical methodologies, both in terms of their underlying strategies and the languages they use. We argue that the conflicts are resolvable, and the sooner the better for the field. In this article, we show how statistical and systems science approaches can be reconciled, and how together they can advance solutions to complex problems. We do this by comparing the methods within a theoretical framework based on the work of population biologist Richard Levins. We present different types of models as representing different tradeoffs among the four desiderata of generality, realism, fit, and precision.


Asunto(s)
Modelos Estadísticos , Obesidad/prevención & control , Salud Pública/métodos , Niño , Interpretación Estadística de Datos , Humanos , Obesidad/epidemiología , Obesidad/terapia , Relaciones Padres-Hijo , Grupo Paritario , Salud Pública/estadística & datos numéricos , Apoyo Social , Teoría de Sistemas
20.
Health Educ Behav ; 40(1 Suppl): 9S-12S, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24084406

RESUMEN

This supplement of Health Education & Behavior showcases the current state of the field of systems science applications in health promotion and public health. Behind this work lies a steady stream of public dollars at the federal level. This perspective details nearly a decade of investment by the National Institutes of Health's Office of Behavioral and Social Sciences Research. These investments have included funding opportunity announcements, training programs, developing resources for researchers, cross-disciplinary fertilization, and publication. While much progress has been made, continuing investment is needed in the future to ensure the viability and sustainability of this young but increasingly important field.


Asunto(s)
Investigación Conductal/métodos , Promoción de la Salud/métodos , Investigación sobre Servicios de Salud/métodos , Salud Pública/métodos , Investigación Conductal/economía , Financiación Gubernamental , Promoción de la Salud/economía , Investigación sobre Servicios de Salud/economía , Humanos , National Institutes of Health (U.S.) , Salud Pública/economía , Apoyo a la Investigación como Asunto , Estados Unidos
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