Hmong Cross-Cultural Adaptation of Stroke Educational Material.

BACKGROUND: The presence of significant cultural and language barriers can affect timely, effective dissemination of stroke education for Hmong patients. Our aim was to design stroke educational material suitable for the Hmong community, using culturally sensitive strategies and patient education best practices. METHODS: We collaborated with the American Heart Association/American Stroke Association to adapt existing English educational material for use among Hmong patients. A team of experts in stroke care, patient education, and interpreter services-along with Hmong community members and health care providers-modified the original documents for health literacy and cultural relevance. The revised materials were translated into Hmong. Final edits were made using feedback from the Hmong community. RESULTS: Eight patient education documents on stroke-related topics were disseminated throughout our health care system and shared with various regional community partners for Hmong patients. DISCUSSION: Incorporating cultural humility principles is key to providing effective patient education tools for reducing disparities and engaging at-risk populations in disease prevention.

Responses to a Social Media Campaign Promoting Safe Fish Consumption Among Women.

We used a framework to systematically evaluate which Facebook advertisements promoting safe fish consumption increased traffic to our website. Keeping images and headlines constant, we tested 11 message types in 5 categories between 2 audiences over a 24-hour weekday period. We identified clear preferences in 9 of 10 comparisons and evidence to suggest that more women prefer presentation of question format compared with narratives, marketing compared with patient education copy, and uncertain compared with certain copy. Our test of messages on a social media platform is a quick and inexpensive way to select the most engaging public health messages for broad dissemination.

Oncology Clinicians and the Minnesota Medical Cannabis Program: A Survey on Medical Cannabis Practice Patterns, Barriers to Enrollment, and Educational Needs.

Background: Medical cannabis has been available in the State of Minnesota since July 2015 through the Minnesota Medical Cannabis Program (MMCP). Objectives: Our study aimed to delineate oncology providers' views on medical cannabis, identify barriers to patient enrollment, and assess clinicians' interest in a clinical trial of medical cannabis in patients with stage IV cancer. Methods: From June to August 2017, we distributed a 14-question survey to Minnesota oncology physicians, advanced practice nurses, and physician assistants who care for adults and children with cancer. Descriptive analyses for each question were provided for all survey respondents. Results: Of the 529 eligible survey participants, 153 (29%) responded to our survey; 68 respondents were registered with the MMCP. Most identified themselves as a medical oncologist or medical oncology nurse practitioner/physician assistant (n=125, 82%), and most practiced in a community setting (n=102, 67%). Overall, 65% of respondents supported the use of medical cannabis. Perceived cost and inadequate research were the highest barriers to MMCP patient enrollment. The lowest barriers included lack of health group support for allowing certification of patients and risk of social stigma. Of all respondents, 36% lacked confidence in discussing the risks and benefits of medical cannabis, and 85% wanted more education. Conclusions: Although support for cannabis use in the cancer setting is growing, significant barriers remain. This study illustrates a clear need to give clinicians both data and education to guide their discussions about the benefits, risks, and cost considerations of using medical cannabis for cancer-related symptoms.

Establishment of Personalized Pain Goals in Oncology Patients to Improve Care and Decrease Costs.

PURPOSE: Cancer-related pain is common, negatively affects quality of life and survival, and often requires treatment with opioid analgesics. Patient-reported data that describe the incidence and severity of pain, medication use, and patient satisfaction with care are lacking. METHODS: We analyzed 18 months of outpatient oncology clinic encounters from the electronic medical record to obtain data on pain levels and opioid and nonopioid treatments. In June 2014, we instituted a pain intervention by creating a pain management information handout for patients, educating clinicians on opioid cost-effectiveness, and implementing a nursing protocol to document personalized pain goals (PPGs). RESULTS: Moderate to severe pain was reported in nearly 15% of patient encounters. We observed an increase in the percentage of encounters with a documented PPG of 16% to 71% ( P < .001). On average, PPG was achieved in 84% of patients. Rates of high-cost long-acting opioid prescriptions (oxycodone controlled release and fentanyl patches), as a total of all long-acting opioids, declined from 45% preintervention to 33% postintervention ( P = .005). CONCLUSION: Our intervention improved rates of PPG documentation and decreased the number of prescriptions for high-cost long-acting opioids. Oncology clinics can implement simple quality improvement methods, such as asking patients about their PPG and educating clinicians about opioid costs, to improve outcomes and lower treatment costs.