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Gierisch, Jennifer M.

Overview:

Jennifer Gierisch, PhD, MPH is behavioral scientist and an Associate Professor in the Department of Medicine at Duke University. She also is a faculty member with the Center for Health Services Research in Primary Care at the Durham Veteran Affairs Medical Center and an Adjunct Assistant Professor in Health Behavior at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. She is the Associate Director of the CTSA Community Engagement Core of the Duke Center for Community and Population Health Improvement and Associate Director of the Durham Veteran Affairs Medical Center Evidence-based Synthesis Program.


Dr. Gierisch’s research focuses on three overarching areas: 1) behavioral research that provides knowledge on the psychosocial factors that influence appropriate uptake and maintenance of complex health behaviors (eg., weight management, smoking cessation, cancer screening); 2) evidence synthesis on key health and healthcare topics to enhance uptake of evidence-based interventions to improve patient outcomes; and 3) stakeholder and community engagement in the research enterprise.

Positions:

Associate Professor in Medicine

Medicine, General Internal Medicine
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Member in the Duke Clinical Research Institute

Duke Clinical Research Institute
School of Medicine

Education:

M.P.H. 2000

M.P.H. — University of North Carolina at Chapel Hill

Ph.D. 2008

Ph.D. — University of North Carolina at Chapel Hill

News:

Grants:

Incentivizing behavior change skills to promote weight loss

Administered By
School of Nursing
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
August 01, 2015
End Date
April 30, 2018

Duke CTSA (UL1)

Administered By
Duke Clinical & Translational Science Institute
AwardedBy
National Institutes of Health
Role
Assistant Research Professor
Start Date
September 26, 2013
End Date
April 30, 2018

PCORI Conference Grant

Administered By
Duke Clinical Research Institute
AwardedBy
Patient-Centered Outcomes Research Institute
Role
Investigator
Start Date
December 01, 2015
End Date
November 30, 2017

Topic Refinement, Task order 8 PCSK9

Administered By
Duke Clinical Research Institute
AwardedBy
Patient-Centered Outcomes Research Institute
Role
Co Investigator
Start Date
August 29, 2016
End Date
November 14, 2016

Topic Refinement 2015

Administered By
Duke Clinical Research Institute
AwardedBy
Patient-Centered Outcomes Research Institute
Role
Co Investigator
Start Date
September 09, 2015
End Date
October 15, 2015

Topic Refinement 2015

Administered By
Duke Clinical Research Institute
AwardedBy
Patient-Centered Outcomes Research Institute
Role
Co Investigator
Start Date
May 27, 2015
End Date
July 10, 2015

PCORI_Triage and FR Prioritization - Amendment #3

Administered By
Duke Clinical Research Institute
AwardedBy
Patient-Centered Outcomes Research Institute
Role
Co Investigator
Start Date
February 15, 2013
End Date
December 31, 2014

EPC Project: Mental Health

Administered By
Duke Clinical Research Institute
AwardedBy
Agency for Healthcare Research and Quality
Role
Co Investigator
Start Date
June 22, 2011
End Date
September 24, 2012

EPC: Postpartum Depression

Administered By
Duke Clinical Research Institute
AwardedBy
Agency for Healthcare Research and Quality
Role
Co Investigator
Start Date
June 21, 2011
End Date
September 24, 2012
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Publications:

The Impact of Interventions that Integrate Accelerometers on Physical Activity and Weight Loss: A Systematic Review.

Regular physical activity is important for improving and maintaining health, but sedentary behavior is difficult to change. Providing objective, real-time feedback on physical activity with wearable motion-sensing technologies (activity monitors) may be a promising, scalable strategy to increase physical activity or decrease weight.We synthesized the literature on the use of wearable activity monitors for improving physical activity and weight-related outcomes and evaluated moderating factors that may have an impact on effectiveness.We searched five databases from January 2000 to January 2015 for peer-reviewed, English-language randomized controlled trials among adults. Random-effects models were used to produce standardized mean differences (SMDs) for physical activity outcomes and mean differences (MDs) for weight outcomes. Heterogeneity was measured with I 2.Fourteen trials (2972 total participants) met eligibility criteria; accelerometers were used in all trials. Twelve trials examined accelerometer interventions for increasing physical activity. A small significant effect was found for increasing physical activity (SMD 0.26; 95 % CI 0.04 to 0.49; I 2 = 64.7 %). Intervention duration was the only moderator found to significantly explain high heterogeneity for physical activity. Eleven trials examined the effects of accelerometer interventions on weight. Pooled estimates showed a small significant effect for weight loss (MD -1.65 kg; 95 % CI -3.03 to -0.28; I 2  = 81 %), and no moderators were significant.Accelerometers demonstrated small positive effects on physical activity and weight loss. The small sample sizes with moderate to high heterogeneity in the current studies limit the conclusions that may be drawn. Future studies should focus on how best to integrate accelerometers with other strategies to increase physical activity and weight loss.

Authors
Goode, AP; Hall, KS; Batch, BC; Huffman, KM; Hastings, SN; Allen, KD; Shaw, RJ; Kanach, FA; McDuffie, JR; Kosinski, AS; Williams, JW; Gierisch, JM
MLA Citation
Goode, AP, Hall, KS, Batch, BC, Huffman, KM, Hastings, SN, Allen, KD, Shaw, RJ, Kanach, FA, McDuffie, JR, Kosinski, AS, Williams, JW, and Gierisch, JM. "The Impact of Interventions that Integrate Accelerometers on Physical Activity and Weight Loss: A Systematic Review." Annals of behavioral medicine : a publication of the Society of Behavioral Medicine 51.1 (February 2017): 79-93.
PMID
27565168
Source
epmc
Published In
Annals of Behavioral Medicine
Volume
51
Issue
1
Publish Date
2017
Start Page
79
End Page
93
DOI
10.1007/s12160-016-9829-1

A Coaching by Telephone Intervention for Veterans and Care Team Engagement (ACTIVATE): A study protocol for a Hybrid Type I effectiveness-implementation randomized controlled trial.

A large proportion of deaths and many illnesses can be attributed to three modifiable risk factors: tobacco use, overweight/obesity, and physical inactivity. Health risk assessments (HRAs) are widely available online but have not been consistently used in healthcare systems to activate patients to participate in prevention programs aimed at improving lifestyle behaviors.The goal of this study is to test whether adding telephone-based coaching to use of a comprehensive HRA increases at-risk patients' activation and enrollment into a prevention program compared to HRA use alone.Participants were randomized to either complete an HRA alone or in conjunction with a telephone coaching intervention. To be eligible Veterans had to have at least one modifiable risk factor (current smoker, overweight/obese, or physically inactive). The primary outcome is enrollment and participation in a prevention program by 6months. Secondary outcomes include change in a Patient Activation Measure and Framingham Risk Score.This study is the first to test a web-based health risk assessment coupled with a health coaching intervention within a large healthcare system. Results from this study will help the Veterans Health Administration (VHA) implement its national plan to include comprehensive health risk assessments as a tool to engage Veterans in prevention. The results will also inform health systems outside VHA who seek to implement Medicare's advisement that health risk assessment become a mandatory component of care under the Affordable Care Act.

Authors
Oddone, EZ; Damschroder, LJ; Gierisch, J; Olsen, M; Fagerlin, A; Sanders, L; Sparks, J; Turner, M; May, C; McCant, F; Curry, D; White-Clark, C; Juntilla, K
MLA Citation
Oddone, EZ, Damschroder, LJ, Gierisch, J, Olsen, M, Fagerlin, A, Sanders, L, Sparks, J, Turner, M, May, C, McCant, F, Curry, D, White-Clark, C, and Juntilla, K. "A Coaching by Telephone Intervention for Veterans and Care Team Engagement (ACTIVATE): A study protocol for a Hybrid Type I effectiveness-implementation randomized controlled trial." Contemporary clinical trials 55 (January 23, 2017): 1-9.
PMID
28126455
Source
epmc
Published In
Contemporary Clinical Trials
Volume
55
Publish Date
2017
Start Page
1
End Page
9
DOI
10.1016/j.cct.2017.01.007

Reporting of Sex Effects by Systematic Reviews on Interventions for Depression, Diabetes, and Chronic Pain.

Systematic reviews (SRs) have the potential to contribute uniquely to the evaluation of sex and gender differences (termed "sex effects"). This article describes the reporting of sex effects by SRs on interventions for depression, type 2 diabetes mellitus, and chronic pain conditions (chronic low back pain, knee osteoarthritis, and fibromyalgia). It includes SRs published since 1 October 2009 that evaluate medications, behavioral interventions, exercise, quality improvement, and some condition-specific treatments. The reporting of sex effects by primary randomized, controlled trials is also examined. Of 313 eligible SRs (86 for depression, 159 for type 2 diabetes mellitus, and 68 for chronic pain), few (n = 29) reported sex effects. Most SRs reporting sex effects used metaregression, whereas 9 SRs used subgroup analysis or individual-patient data meta-analysis. The proportion of SRs reporting the sex distribution of primary studies varied from a low of 31% (n = 8) for low back pain to a high of 68% (n = 23) for fibromyalgia. Primary randomized, controlled trials also infrequently reported sex effects, and most lacked an adequate sample size to examine them. Therefore, all SRs should report the proportion of women enrolled in primary studies and evaluate sex effects using appropriate methods whenever power is adequate.

Authors
Duan-Porter, W; Goldstein, KM; McDuffie, JR; Hughes, JM; Clowse, MEB; Klap, RS; Masilamani, V; Allen LaPointe, NM; Nagi, A; Gierisch, JM; Williams, JW
MLA Citation
Duan-Porter, W, Goldstein, KM, McDuffie, JR, Hughes, JM, Clowse, MEB, Klap, RS, Masilamani, V, Allen LaPointe, NM, Nagi, A, Gierisch, JM, and Williams, JW. "Reporting of Sex Effects by Systematic Reviews on Interventions for Depression, Diabetes, and Chronic Pain." Annals of internal medicine 165.3 (August 2016): 184-193.
PMID
27111355
Source
epmc
Published In
Annals of internal medicine
Volume
165
Issue
3
Publish Date
2016
Start Page
184
End Page
193
DOI
10.7326/m15-2877

An overview and discussion of the Patient-Centered Outcomes Research Institute's decision aid portfolio.

Decision aids (DAs) help patients make informed healthcare decisions in a manner consistent with their values and preferences. Despite their promise, DAs developed with public research dollars are not being implemented and adopted in real-world patient care settings at a rate consistent with which they are being developed. To appraise the sum of the parts of the portfolio and create a strategic imperative surrounding future funding, the Patient-Centered Outcomes Research Institute (PCORI) tasked the Duke Evidence Synthesis Group with evaluating its DA portfolio. This paper describes PCORI's portfolio of DAs according to the Duke Evidence Synthesis Group's analysis in the context of PCORI's mission and the field of decision science. The results revealed a diversity within PCORI's portfolio of funded DA projects. Findings support the movement toward more rigorous DA development, assessment and maintenance. PCORI's funding priorities related to DAs are clarified and comparative questions of interest are posed.

Authors
Gayer, CC; Crowley, MJ; Lawrence, WF; Gierisch, JM; Gaglio, B; Williams, JW; Myers, ER; Kendrick, A; Slutsky, J; Sanders, GD
MLA Citation
Gayer, CC, Crowley, MJ, Lawrence, WF, Gierisch, JM, Gaglio, B, Williams, JW, Myers, ER, Kendrick, A, Slutsky, J, and Sanders, GD. "An overview and discussion of the Patient-Centered Outcomes Research Institute's decision aid portfolio." Journal of comparative effectiveness research 5.4 (July 2016): 407-415.
PMID
27298206
Source
epmc
Published In
Journal of Comparative Effectiveness Research
Volume
5
Issue
4
Publish Date
2016
Start Page
407
End Page
415
DOI
10.2217/cer-2016-0002

Benefits and Harms of Breast Cancer Screening: A Systematic Review (vol 314, pg 1615, 2015)

Authors
Myers, ER; Moorman, P; Gierisch, JM
MLA Citation
Myers, ER, Moorman, P, and Gierisch, JM. "Benefits and Harms of Breast Cancer Screening: A Systematic Review (vol 314, pg 1615, 2015)." JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION 315.13 (April 5, 2016): 1406-1406.
Source
wos-lite
Published In
JAMA : the journal of the American Medical Association
Volume
315
Issue
13
Publish Date
2016
Start Page
1406
End Page
1406

Effectiveness of an Evidence-Based Quality Improvement Approach to Cultural Competence Training: The Veterans Affairs' "Caring for Women Veterans" Program.

Although providing culturally sensitive health care is vitally important, there is little consensus regarding the most effective strategy for implementing cultural competence trainings in the health care setting. Evidence-based quality improvement (EBQI), which involves adapting evidence-based practices to meet local needs, may improve uptake and effectiveness of a variety of health care innovations. Yet, to our knowledge, EBQI has not yet been applied to cultural competence training. To evaluate whether EBQI could enhance the impact of an evidence-based training intended to improve veterans affairs health care staff gender sensitivity and knowledge (Caring for Women Veterans; CWV), we compared the reach and effectiveness of EBQI delivery versus standard web-based implementation strategies of CWV and assessed barriers and facilitators to EBQI implementation.Workgroups at four diverse veterans affairs health care sites were randomized to either an EBQI or standard web-based implementation condition (SI). All EBQI sites selected a group-based implementation strategy. Employees (N = 84) completed pretraining and posttraining assessments of gender sensitivity and knowledge, and focus groups/interviews were conducted with leadership and staff before and after implementation.Reach of CWV was greater in the EBQI condition versus the SI condition. Whereas both gender sensitivity and knowledge improved in the EBQI condition, only gender sensitivity improved in the SI condition. Qualitative analyses revealed that the EBQI approach was well received, although a number of barriers were identified.Findings suggest that EBQI can enhance the uptake and effectiveness of employee trainings. However, the decision to pursue EBQI must be informed by a consideration of available resources.

Authors
Fox, AB; Hamilton, AB; Frayne, SM; Wiltsey-Stirman, S; Bean-Mayberry, B; Carney, D; Di Leone, BAL; Gierisch, JM; Goldstein, KM; Romodan, Y; Sadler, AG; Yano, EM; Yee, EF; Vogt, D
MLA Citation
Fox, AB, Hamilton, AB, Frayne, SM, Wiltsey-Stirman, S, Bean-Mayberry, B, Carney, D, Di Leone, BAL, Gierisch, JM, Goldstein, KM, Romodan, Y, Sadler, AG, Yano, EM, Yee, EF, and Vogt, D. "Effectiveness of an Evidence-Based Quality Improvement Approach to Cultural Competence Training: The Veterans Affairs' "Caring for Women Veterans" Program." The Journal of continuing education in the health professions 36.2 (March 2016): 96-103.
PMID
27262152
Source
epmc
Published In
The Journal of Continuing Education in the Health Professions
Volume
36
Issue
2
Publish Date
2016
Start Page
96
End Page
103
DOI
10.1097/ceh.0000000000000073

Differences in Active and Passive Smoking Exposures and Lung Cancer Incidence Between Veterans and Non-Veterans in the Women's Health Initiative.

Women Veterans may have higher rates of both active and passive tobacco exposure than their civilian counterparts, thereby increasing their risk for lung cancer.To compare differences in active and passive smoking exposure and lung cancer incidence among women Veterans and non-Veterans using prospective data from the Women's Health Initiative (WHI).We used data from the WHI, which collected longitudinal demographic, clinical, and laboratory data on 161,808 postmenopausal women. We employed linear and multinomial regression and generalized linear models to compare active and passive smoking exposure between Veterans and non-Veterans and Cox proportional hazards models to estimate differences in lung cancer incidence rates.After adjustment, Veterans had 2.54 additional pack years of smoking compared with non-Veterans (95% confidence interval [CI] 1.68, 3.40). Veterans also had a 1% increase in risk of any passive smoking exposure (95% CI 1.00, 1.02) and a 9% increase in risk of any workplace exposure (95% CI 1.07, 1.11) compared with non-Veterans. After adjustment for age and smoking exposures, Veterans did not have a higher risk of lung cancer compared with non-Veterans (relative risk = 1.06 95% CI 0.86, 1.30).Women Veterans had higher rates of tobacco use and exposure to passive smoking, which were associated with a higher risk for lung cancer compared with non-Veterans. Clinicians who care for Veterans need to be aware that older women Veterans have more exposures to risk factors for lung cancer.

Authors
Bastian, LA; Gray, KE; DeRycke, E; Mirza, S; Gierisch, JM; Haskell, SG; Magruder, KM; Wakelee, HA; Wang, A; Ho, GYF; LaCroix, AZ
MLA Citation
Bastian, LA, Gray, KE, DeRycke, E, Mirza, S, Gierisch, JM, Haskell, SG, Magruder, KM, Wakelee, HA, Wang, A, Ho, GYF, and LaCroix, AZ. "Differences in Active and Passive Smoking Exposures and Lung Cancer Incidence Between Veterans and Non-Veterans in the Women's Health Initiative." The Gerontologist 56 Suppl 1 (February 2016): S102-S111.
PMID
26768384
Source
epmc
Published In
The Gerontologist
Volume
56 Suppl 1
Publish Date
2016
Start Page
S102
End Page
S111
DOI
10.1093/geront/gnv664

Future Research Prioritization: Implantable Cardioverter-Defibrillator Therapy in Older Patients.

Although the implantable cardioverter-defibrillator (ICD) is highly effective therapy for preventing sudden cardiac death, there is considerable uncertainty about its benefits and harms in older patients, especially in the presence of factors, other than old age, that increase the risk of death.To develop a prioritized research agenda for the Patient-Centered Outcomes Research Institute as informed by a diverse group of stakeholders on the use and outcomes of the ICD in older patients.The existing literature was reviewed to identify evidence gaps, which were then refined by engaged stakeholders. Using a forced-ranking prioritization method, the stakeholders ranked evidence gaps by importance. For the highest-ranked evidence gaps, relevant recent studies were identified using PubMed, and relevant ongoing trials were identified using ClinicalTrials.gov.Eighteen stakeholders, including clinical experts and researchers in the prevention of sudden cardiac death and ICD therapy, representatives from federal and non-governmental funding agencies, representatives from relevant professional societies, health care decision-makers and policymakers, and representatives from related consumer and patient advocacy groupsThe top 12 evidence gaps prioritized by stakeholders were related to the safety and effectiveness of ICDs in older patient subgroups not well represented in clinical trials, predictors of SCD, the impact of the ICD on quality of life, the use of shared decision-making, disparities in ICD use, risk stratification strategies, patient preferences, and distribution of modes of death in older patients.In this paper, we identify evidence gaps of high priority for current and future investigations of ICD therapy. Addressing these gaps will likely resolve many of the uncertainties surrounding the use and outcomes of the ICD in older patients seen in clinical practice.

Authors
Al-Khatib, SM; Gierisch, JM; Crowley, MJ; Coeytaux, RR; Myers, ER; Kendrick, A; Sanders, GD
MLA Citation
Al-Khatib, SM, Gierisch, JM, Crowley, MJ, Coeytaux, RR, Myers, ER, Kendrick, A, and Sanders, GD. "Future Research Prioritization: Implantable Cardioverter-Defibrillator Therapy in Older Patients." Journal of general internal medicine 30.12 (December 2015): 1812-1820.
PMID
26014894
Source
epmc
Published In
Journal of General Internal Medicine
Volume
30
Issue
12
Publish Date
2015
Start Page
1812
End Page
1820
DOI
10.1007/s11606-015-3411-6

Impact of Smoking Cessation on Subsequent Pain Intensity Among Chronically Ill Veterans Enrolled in a Smoking Cessation Trial.

Prior cross-sectional studies have reported greater pain intensity among persistent smokers compared with nonsmokers or former smokers; yet, few prospective studies have examined how smoking abstinence affects pain intensity.To determine the impact of smoking cessation on subsequent pain intensity in smokers with chronic illness enrolled in a smoking cessation trial.We recruited veteran smokers with chronic illness (heart disease, cancer, chronic obstructive pulmonary disease, diabetes, or hypertension) for a randomized controlled smoking cessation trial and prospectively examined pain intensity and smoking status. Participants (n = 380) were asked to rate their pain in the past week from 0 to 10 at baseline and the five-month follow-up. The primary outcome measure was self-reported pain intensity at the five-month follow-up survey. Self-reported smoking status was categorized as an abstainer if patients reported no cigarettes in the seven days before the follow-up survey.In unadjusted analyses, abstainers reported significantly lower pain levels at the five-month follow-up compared with patients who continued to smoke (parameter estimate = -1.07; 95% CI = -1.77, -0.36). In multivariable modeling, abstaining from cigarettes was not associated with subsequent pain intensity at five-month follow-up (parameter estimate = -0.27; 95% CI = -0.79, 0.25).Participants who were classified as abstainers did not report significantly different levels of pain intensity than patients who continued to smoke. Future studies should expand on our findings and monitor pain intensity in smoking cessation trials.ClinicalTrials.govNCT00448344.

Authors
Bastian, LA; Fish, LJ; Gierisch, JM; Stechuchak, KM; Grambow, SC; Keefe, FJ
MLA Citation
Bastian, LA, Fish, LJ, Gierisch, JM, Stechuchak, KM, Grambow, SC, and Keefe, FJ. "Impact of Smoking Cessation on Subsequent Pain Intensity Among Chronically Ill Veterans Enrolled in a Smoking Cessation Trial." Journal of pain and symptom management 50.6 (December 2015): 822-829.
PMID
26210348
Source
epmc
Published In
Journal of Pain and Symptom Management
Volume
50
Issue
6
Publish Date
2015
Start Page
822
End Page
829
DOI
10.1016/j.jpainsymman.2015.06.012

Benefits and Harms of Breast Cancer Screening: A Systematic Review.

Patients need to consider both benefits and harms of breast cancer screening.To systematically synthesize available evidence on the association of mammographic screening and clinical breast examination (CBE) at different ages and intervals with breast cancer mortality, overdiagnosis, false-positive biopsy findings, life expectancy, and quality-adjusted life expectancy.We searched PubMed (to March 6, 2014), CINAHL (to September 10, 2013), and PsycINFO (to September 10, 2013) for systematic reviews, randomized clinical trials (RCTs) (with no limit to publication date), and observational and modeling studies published after January 1, 2000, as well as systematic reviews of all study designs. Included studies (7 reviews, 10 RCTs, 72 observational, 1 modeling) provided evidence on the association between screening with mammography, CBE, or both and prespecified critical outcomes among women at average risk of breast cancer (no known genetic susceptibility, family history, previous breast neoplasia, or chest irradiation). We used summary estimates from existing reviews, supplemented by qualitative synthesis of studies not included in those reviews.Across all ages of women at average risk, pooled estimates of association between mammography screening and mortality reduction after 13 years of follow-up were similar for 3 meta-analyses of clinical trials (UK Independent Panel: relative risk [RR], 0.80 [95% CI, 0.73-0.89]; Canadian Task Force: RR, 0.82 [95% CI, 0.74-0.94]; Cochrane: RR, 0.81 [95% CI, 0.74-0.87]); were greater in a meta-analysis of cohort studies (RR, 0.75 [95% CI, 0.69 to 0.81]); and were comparable in a modeling study (CISNET; median RR equivalent among 7 models, 0.85 [range, 0.77-0.93]). Uncertainty remains about the magnitude of associated mortality reduction in the entire US population, among women 40 to 49 years, and with annual screening compared with biennial screening. There is uncertainty about the magnitude of overdiagnosis associated with different screening strategies, attributable in part to lack of consensus on methods of estimation and the importance of ductal carcinoma in situ in overdiagnosis. For women with a first mammography screening at age 40 years, estimated 10-year cumulative risk of a false-positive biopsy result was higher (7.0% [95% CI, 6.1%-7.8%]) for annual compared with biennial (4.8% [95% CI, 4.4%-5.2%]) screening. Although 10-year probabilities of false-positive biopsy results were similar for women beginning screening at age 50 years, indirect estimates of lifetime probability of false-positive results were lower. Evidence for the relationship between screening and life expectancy and quality-adjusted life expectancy was low in quality. There was no direct evidence for any additional mortality benefit associated with the addition of CBE to mammography, but observational evidence from the United States and Canada suggested an increase in false-positive findings compared with mammography alone, with both studies finding an estimated 55 additional false-positive findings per extra breast cancer detected with the addition of CBE.For women of all ages at average risk, screening was associated with a reduction in breast cancer mortality of approximately 20%, although there was uncertainty about quantitative estimates of outcomes for different breast cancer screening strategies in the United States. These findings and the related uncertainty should be considered when making recommendations based on judgments about the balance of benefits and harms of breast cancer screening.

Authors
Myers, ER; Moorman, P; Gierisch, JM; Havrilesky, LJ; Grimm, LJ; Ghate, S; Davidson, B; Mongtomery, RC; Crowley, MJ; McCrory, DC; Kendrick, A; Sanders, GD
MLA Citation
Myers, ER, Moorman, P, Gierisch, JM, Havrilesky, LJ, Grimm, LJ, Ghate, S, Davidson, B, Mongtomery, RC, Crowley, MJ, McCrory, DC, Kendrick, A, and Sanders, GD. "Benefits and Harms of Breast Cancer Screening: A Systematic Review." JAMA 314.15 (October 2015): 1615-1634.
PMID
26501537
Source
epmc
Published In
JAMA : the journal of the American Medical Association
Volume
314
Issue
15
Publish Date
2015
Start Page
1615
End Page
1634
DOI
10.1001/jama.2015.13183

Evaluating the implementation and sustainability of a program for enhancing veterans' intimate relationships.

The Warrior to Soul Mate (W2SM) program is a grassroots initiative on the part of Veterans Affairs chaplain services to provide relationship enhancement skills to veterans and significant others based on the Practical Application of Intimate Relationship Skills model. To examine the implementation and sustainability of the W2SM program, two online surveys were sent to each participating facility's W2SM leader. The first examined how individual W2SM events were conducted (100% response rate, 67 surveys) and the second assessed facility-level issues impacting program sustainability (100% response rate, 23 surveys). Four sites were selected for qualitative interviews based on levels of sustainability. In 2013, W2SM served 1,664 people including 847 veterans, incurring reasonable program costs when compared to other intensive Veterans Affairs services. However, there have been important systematic (e.g., contracting processes) and resource (e.g., time, concern over funding) challenges that are reflected in the wide range of predicted program sustainability.

Authors
Fortune-Britt, AG; Nieuwsma, JA; Gierisch, JM; Datta, SK; Stolldorf, DP; Cantrell, WC; Ethridge, AK; Angel, C; Millspaugh, D; Bauch, SL; Jackson, GL
MLA Citation
Fortune-Britt, AG, Nieuwsma, JA, Gierisch, JM, Datta, SK, Stolldorf, DP, Cantrell, WC, Ethridge, AK, Angel, C, Millspaugh, D, Bauch, SL, and Jackson, GL. "Evaluating the implementation and sustainability of a program for enhancing veterans' intimate relationships." Military medicine 180.6 (June 2015): 676-683.
PMID
26032383
Source
epmc
Published In
Military medicine
Volume
180
Issue
6
Publish Date
2015
Start Page
676
End Page
683
DOI
10.7205/milmed-d-14-00336

The association of smoking and acute pancreatitis: a systematic review and meta-analysis.

Cigarette smoking is an independent risk factor for chronic pancreatitis. We conducted a systematic review of the literature assessing whether cigarette smoking is a risk factor for acute pancreatitis (AP) and recurrent AP (RAP).MEDLINE, PubMed, Embase, and Cochrane Database of Systematic Reviews were searched for studies published from database inception through March 2013. Two investigators independently reviewed articles for eligibility; discordant decisions were resolved by a third investigator's review and consensus. When there were sufficient studies, random-effects meta-analyses were performed by estimating pooled hazards ratios (HRs) with 95% confidence intervals (CIs).Twelve studies met the eligibility criteria: 7 for AP, 5 for RAP. Compared with never smokers, the risk for AP was significantly increased in current smokers (6 studies; HR, 1.75; 95% CI, 1.26-2.44) and former smokers (5 studies; HR, 1.63; 95% CI, 1.18-2.27). Compared with never smokers, ever smokers were at higher risk for developing RAP (5 studies; HR, 1.59; 95% CI, 1.19-2.12).This meta-analysis provides supportive evidence for the association of smoking status and AP. This effect is most pronounced for current smokers, but the risk exists among the former smokers compared with never smokers. There was an increased risk for RAP among ever smokers compared with that among never smokers.

Authors
Majumder, S; Gierisch, JM; Bastian, LA
MLA Citation
Majumder, S, Gierisch, JM, and Bastian, LA. "The association of smoking and acute pancreatitis: a systematic review and meta-analysis." Pancreas 44.4 (May 2015): 540-546. (Review)
PMID
25872130
Source
epmc
Published In
Pancreas
Volume
44
Issue
4
Publish Date
2015
Start Page
540
End Page
546
DOI
10.1097/mpa.0000000000000301

Shared medical appointments for patients with diabetes mellitus: a systematic review.

Shared medical appointments (SMAs) are an increasingly used system-redesign strategy for improving access to and quality of chronic illness care. We conducted a systematic review of the existing literature on SMA interventions for patients with diabetes in order to understand their impact on outcomes.MEDLINE, EMBASE, CINAHL, PsycINFO, and Web of Science from January 1996 through April 2012. PubMed search updated June 2013.English-language peer-reviewed publications of randomized controlled trials (RCTs), nonrandomized cluster controlled trials, controlled before-and-after studies, or interrupted time-series designs conducted among adult patients with diabetes. Two independent reviewers used prespecified criteria to screen titles and abstracts for full text review.Two different reviewers abstracted data and rated study quality and strength of evidence. When possible, we used random-effects models to synthesize the effects quantitatively, reporting by a weighted difference of the means when the same scale was used across studies, and a standardized mean difference when the scales differed. We measured heterogeneity in study effects using Forest Plots, Cochran's Q, and I(2), and explored heterogeneity by using subgroup analyses for categorical variables and meta-regression analyses for continuous or discrete variables. Outcomes not suitable to meta-analysis were summarized qualitatively.Twenty-five articles representing 17 unique studies compared SMA interventions with usual care. Among patients with diabetes, SMAs improved hemoglobin A1c (∆ = -0.55 percentage points [95 % CI, -0.11 to -0.99]); improved systolic blood pressure (∆ = -5.2 mmHg [95 % CI, -3.0 to -7.4]); and did not improve LDL cholesterol (∆ = -6.6 mg/dl [95 % CI, 2.8 to -16.1]). Nonbiophysical outcomes, including economic outcomes, were reported too infrequently to meta-analyze, or to draw conclusions from. The A1c result had significant heterogeneity among studies, likely secondary to the heterogeneity among included SMA interventions.Heterogeneity among the components of diabetes SMAs leads to uncertainty about what makes a particular SMA successful.SMA interventions improve biophysical outcomes among patients with diabetes. There was inadequate literature to determine SMA effects on patient experience, utilization, and costs.

Authors
Edelman, D; Gierisch, JM; McDuffie, JR; Oddone, E; Williams, JW
MLA Citation
Edelman, D, Gierisch, JM, McDuffie, JR, Oddone, E, and Williams, JW. "Shared medical appointments for patients with diabetes mellitus: a systematic review." Journal of general internal medicine 30.1 (January 2015): 99-106. (Review)
PMID
25107290
Source
epmc
Published In
Journal of General Internal Medicine
Volume
30
Issue
1
Publish Date
2015
Start Page
99
End Page
106
DOI
10.1007/s11606-014-2978-7

Study design and protocol for a theory-based behavioral intervention focusing on maintenance of weight loss: the Maintenance After Initiation of Nutrition TrAINing (MAINTAIN) study.

Obesity is a significant public health problem. Although various lifestyle approaches are effective for inducing significant weight loss, few effective behavioral weight maintenance strategies have been identified. It has been proposed that behavior maintenance is a distinct state that involves different psychological processes and behavioral skills than initial behavior change. Previously, we created a conceptual model that distinguishes behavior initiation from maintenance. This model was used to generate Maintenance After Initiation of Nutrition TrAINing (MAINTAIN), an intervention to enhance weight loss maintenance following initiation. The effectiveness of MAINTAIN is being evaluated in an ongoing trial, the rationale and procedures of which are reported herein.Veterans aged ≤ 75 with body mass index ≥ 30 kg/m(2) participate in a 16-week, group-based weight loss program. Participants who lose ≥ 4 kg by the end of 16 weeks (target n = 230) are randomized 1:1 to receive (a) usual care for 56 weeks or (b) MAINTAIN, a theoretically-informed weight loss maintenance intervention for 40 weeks, followed by 16 weeks of no intervention contact. MAINTAIN involves 3 in-person group visits that transition to 8 individualized telephone calls with decreasing contact frequency. MAINTAIN focuses on satisfaction with outcomes, weight self-monitoring, relapse prevention, and social support. We hypothesize that, compared to usual care, MAINTAIN will result in at least 3.5 kg less regain and better relative levels of caloric intake and physical activity over 56 weeks, and that it will be cost-effective.If effective, MAINTAIN could serve as a model for redesigning existing weight loss programs.NCT01357551.

Authors
Voils, CI; Gierisch, JM; Olsen, MK; Maciejewski, ML; Grubber, J; McVay, MA; Strauss, JL; Bolton, J; Gaillard, L; Strawbridge, E; Yancy, WS
MLA Citation
Voils, CI, Gierisch, JM, Olsen, MK, Maciejewski, ML, Grubber, J, McVay, MA, Strauss, JL, Bolton, J, Gaillard, L, Strawbridge, E, and Yancy, WS. "Study design and protocol for a theory-based behavioral intervention focusing on maintenance of weight loss: the Maintenance After Initiation of Nutrition TrAINing (MAINTAIN) study." Contemporary clinical trials 39.1 (September 2014): 95-105.
PMID
25117805
Source
epmc
Published In
Contemporary Clinical Trials
Volume
39
Issue
1
Publish Date
2014
Start Page
95
End Page
105
DOI
10.1016/j.cct.2014.08.002

Differentiating Behavior Initiation and Maintenance: Theoretical Framework and Proof of Concept.

Although many interventions are effective for health behavior initiation, maintenance has proven elusive. Interventions targeting maintenance often extend the duration with which initiation content is delivered or the duration of follow-up without intervention. We posit that health behavior initiation and maintenance require separate psychological processes and skills. To determine the value of operationalizing maintenance as a process separate from initiation, we conducted a pilot study of a telephone-delivered intervention to assist people in transitioning from behavior initiation to maintenance. Participants were 20 veterans who had initiated lifestyle changes during a randomized controlled trial of a cholesterol reduction intervention. After completing the randomized controlled trial, these participants were enrolled in the pilot maintenance intervention, which involved three monthly telephone calls from a nurse interventionist focusing on behavioral maintenance skills. To evaluate the feasibility and acceptability of this intervention, we assessed recruitment and retention rates as well as 4-month pre-post changes in health behaviors and associated psychological processes. We also conducted individual interviews with participants after study completion. Although not powered to detect significant changes, there was evidence of improvement in dietary intake and of maintenance of physical activity and low-density lipoprotein cholesterol during the 4-month maintenance study. Participants found it helpful to plan for relapses, self-monitor, and obtain social support, but they had mixed reactions about reflecting on satisfaction with outcomes. Participants accepted the intervention and desired ongoing contact to maintain accountability. This pilot maintenance intervention warrants further evaluation in a randomized controlled trial.

Authors
Voils, CI; Gierisch, JM; Yancy, WS; Sandelowski, M; Smith, R; Bolton, J; Strauss, JL
MLA Citation
Voils, CI, Gierisch, JM, Yancy, WS, Sandelowski, M, Smith, R, Bolton, J, and Strauss, JL. "Differentiating Behavior Initiation and Maintenance: Theoretical Framework and Proof of Concept." Health Educ Behav 41.3 (June 2014): 325-336.
PMID
24347145
Source
pubmed
Published In
Health Education & Behavior
Volume
41
Issue
3
Publish Date
2014
Start Page
325
End Page
336
DOI
10.1177/1090198113515242

Prioritization of patient-centered comparative effectiveness research for osteoarthritis.

Osteoarthritis is a leading cause of disability in the United States. This article describes a prioritized research agenda about osteoarthritis management developed for the Patient-Centered Outcomes Research Institute. Evidence gaps were identified by reviewing existing literature and engaging diverse stakeholders to expand and refine gaps. Stakeholders ranked evidence gaps by importance from their perspectives.Prioritized evidence gaps included the need to determine or evaluate key patient-centered outcomes; optimal duration, intensity, and frequency of nonsurgical interventions; whether the comparative effectiveness of nonsurgical interventions varies by socioeconomic factors; when and how to transition from nonsurgical to surgical interventions; effective ways to engage patients in self-management and promote long-term behavior change; standardized screening tools that improve early diagnosis; biomechanical strategies that improve symptoms; mechanisms for promoting and delivering coordinated, longitudinal care; and comparative effectiveness of nonsurgical therapies. Searches of PubMed and ClinicalTrials.gov showed many recent and ongoing studies addressing comparative effectiveness of nonsurgical interventions; relatively few of these evaluated treatments across categories (for example, drug therapy vs. weight management) or combined categories of treatment. Few studies addressed other high-priority evidence gaps.

Authors
Gierisch, JM; Myers, ER; Schmit, KM; McCrory, DC; Coeytaux, RR; Crowley, MJ; Chatterjee, R; Kendrick, AS; Sanders, GD
MLA Citation
Gierisch, JM, Myers, ER, Schmit, KM, McCrory, DC, Coeytaux, RR, Crowley, MJ, Chatterjee, R, Kendrick, AS, and Sanders, GD. "Prioritization of patient-centered comparative effectiveness research for osteoarthritis." Annals of internal medicine 160.12 (June 2014): 836-841.
PMID
24821227
Source
epmc
Published In
Annals of internal medicine
Volume
160
Issue
12
Publish Date
2014
Start Page
836
End Page
841
DOI
10.7326/m14-0318

Pharmacologic and behavioral interventions to improve cardiovascular risk factors in adults with serious mental illness: a systematic review and meta-analysis.

OBJECTIVE: Individuals with serious mental illness have high rates of cardiovascular disease (CVD) risk factors and mortality. This systematic review was conducted to evaluate pharmacologic and behavioral interventions to reduce CVD risk in adults with serious mental illness. DATA SOURCES: MEDLINE, EMBASE, PsycINFO, ClinicalTrials.gov, and Cochrane Database of Systematic Reviews were searched from January 1980 to July 2012 for English language studies. Examples of search terms used include schizophrenia, bipolar disorder, antipsychotics, weight, glucose, lipid, and cardiovascular disease. STUDY SELECTION: Two reviewers independently screened citations and identified 33 randomized controlled trials of at least 2 months' duration that enrolled adults with serious mental illness and evaluated pharmacologic or behavioral interventions targeting weight, glucose, or lipid control. DATA EXTRACTION: Reviewers extracted data, assessed applicability, and evaluated study quality; the team jointly graded overall strength of evidence. RESULTS: We included 33 studies. Most studies targeted weight control (28 studies). Compared with control groups, weight control was improved with behavioral interventions (mean difference = -3.13 kg; 95% CI, -4.21 to -2.05), metformin (mean difference = -4.13 kg; 95% CI, -6.58 to -1.68), anticonvulsive medications topiramate and zonisamide (mean difference = -5.11 kg; 95% CI, -9.48 to -0.74), and adjunctive or antipsychotic switching to aripiprazole (meta-analysis not possible). Evidence was insufficient for all other interventions and for effects on glucose and lipid control. The small number of studies precluded analyses of variability in treatment effects by patient characteristics. CONCLUSIONS: Few studies have evaluated interventions addressing 1 or more CVD risk factors in people with serious mental illness. Glucose- and lipid-related results were mainly reported as secondary outcome assessments in studies of weight-management interventions. Comparative effectiveness studies are needed to test multimodal strategies, agents known to be effective in nonserious mental illness populations, and antipsychotic-management strategies.

Authors
Gierisch, JM; Nieuwsma, JA; Bradford, DW; Wilder, CM; Mann-Wrobel, MC; McBroom, AJ; Hasselblad, V; Williams, JW
MLA Citation
Gierisch, JM, Nieuwsma, JA, Bradford, DW, Wilder, CM, Mann-Wrobel, MC, McBroom, AJ, Hasselblad, V, and Williams, JW. "Pharmacologic and behavioral interventions to improve cardiovascular risk factors in adults with serious mental illness: a systematic review and meta-analysis." The Journal of clinical psychiatry 75.5 (May 2014): e424-e440.
PMID
24922495
Source
epmc
Published In
Journal of Clinical Psychiatry
Volume
75
Issue
5
Publish Date
2014
Start Page
e424
End Page
e440
DOI
10.4088/jcp.13r08558

Prioritization of research addressing management strategies for ductal carcinoma in situ.

Ductal carcinoma in situ is a common finding in women having mammography screening, and there is considerable uncertainty about the balance of harms and benefits of different management options. This article outlines the process for developing a prioritized research agenda for the Patient-Centered Outcomes Research Institute as informed by a diverse group of stakeholders on the management of ductal carcinoma in situ. Evidence gaps were identified by reviewing existing literature and engaging diverse stakeholders to refine these gaps. Stakeholders ranked evidence gaps by importance from their perspectives using a forced-ranking prioritization method. PubMed was searched for relevant recent studies, and ClinicalTrials.gov was searched for relevant ongoing trials for the 10 highest-ranked evidence gaps. Strengths and limitations of different study designs were assessed to address gaps. Stakeholders prioritized evidence gaps related to incorporation of patient-centered outcomes into future research, development of better methods to predict risk for invasive cancer, evaluation of a strategy of active surveillance, and testing of decision-making tools. The degree to which prioritized evidence gaps may have already been addressed is uncertain because a comprehensive systematic review has not been done.

Authors
Gierisch, JM; Myers, ER; Schmit, KM; Crowley, MJ; McCrory, DC; Chatterjee, R; Coeytaux, RR; Kendrick, A; Sanders, GD
MLA Citation
Gierisch, JM, Myers, ER, Schmit, KM, Crowley, MJ, McCrory, DC, Chatterjee, R, Coeytaux, RR, Kendrick, A, and Sanders, GD. "Prioritization of research addressing management strategies for ductal carcinoma in situ." Annals of internal medicine 160.7 (April 2014): 484-491.
PMID
24567146
Source
epmc
Published In
Annals of internal medicine
Volume
160
Issue
7
Publish Date
2014
Start Page
484
End Page
491
DOI
10.7326/m13-2548

Prioritization of research addressing antipsychotics for adolescents and young adults with bipolar disorder.

Despite a paucity of high-quality evidence about benefits and harms, antipsychotic medication use among adolescents and young adults with bipolar disorder is increasing. The Patient-Centered Outcomes Research Institute tasked the Duke Evidence Synthesis Group with creating a prioritized agenda for research in this area that would incorporate the perspectives of relevant stakeholders. We identified a list of potential evidence gaps by reviewing existing literature and engaged a diverse group of 9 stakeholders to expand and refine this list. Using a forced-ranking prioritization method, stakeholders prioritized 10 of 23 potential evidence gaps as the most pressing for future research. These evidence gaps relate to 3 areas: the comparative effectiveness of intervention strategies, the effect of antipsychotics on patient-centered outcomes, and the influence of various patient characteristics on antipsychotic effectiveness. In addition to presenting these findings, we suggest appropriate study designs for addressing the stakeholder-prioritized research questions.

Authors
Crowley, MJ; McCrory, DC; Chatterjee, R; Gierisch, JM; Myers, ER; Schmit, KM; Coeytaux, RR; Correll, CU; Kendrick, AS; Sanders, GD
MLA Citation
Crowley, MJ, McCrory, DC, Chatterjee, R, Gierisch, JM, Myers, ER, Schmit, KM, Coeytaux, RR, Correll, CU, Kendrick, AS, and Sanders, GD. "Prioritization of research addressing antipsychotics for adolescents and young adults with bipolar disorder." Annals of internal medicine 160.7 (April 2014): 492-498.
PMID
24567115
Source
epmc
Published In
Annals of internal medicine
Volume
160
Issue
7
Publish Date
2014
Start Page
492
End Page
498
DOI
10.7326/m13-2549

Oral contraceptive use and risk of cancer--response.

Authors
Gierisch, JM; Myers, ER
MLA Citation
Gierisch, JM, and Myers, ER. "Oral contraceptive use and risk of cancer--response." Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 23.4 (April 2014): 677-678.
PMID
24636973
Source
epmc
Published In
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Volume
23
Issue
4
Publish Date
2014
Start Page
677
End Page
678
DOI
10.1158/1055-9965.epi-14-0082

Oral contraceptives and risk of ovarian cancer and breast cancer among high-risk women: a systematic review and meta-analysis.

PURPOSE: To estimate the risks of ovarian cancer and breast cancer associated with oral contraceptive (OC) use among women at elevated risk owing to mutations in BRCA1/2 or a strong family history. METHODS: We searched PubMed, Embase, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov for studies published 2000 to 2012 that evaluated associations between OC use and breast or ovarian cancer among women who are carriers of a BRCA1/2 mutation or have a family history of breast or ovarian cancer. RESULTS: From 6,476 unique citations, we identified six studies examining ovarian cancer risk in BRCA1/2 mutation carriers and eight studies examining breast cancer risk in BRCA1/2 mutation carriers. For BRCA1/2 mutation carriers combined, meta-analysis showed an inverse association between OC use and ovarian cancer (odds ratio [OR], 0.58; 95% CI, 0.46 to 0.73) and a nonstatistically significant association with breast cancer (OR, 1.21; 95% CI, 0.93 to 1.58). Findings were similar when examining BRCA1 and BRCA2 mutation carriers separately. Data were inadequate to perform meta-analyses examining duration or timing of use. For women with a family history of ovarian or breast cancer, we identified four studies examining risk for ovarian cancer and three for breast cancer, but differences between studies precluded combining the data for meta-analyses, and no overall pattern could be discerned. CONCLUSION: Our analyses suggest that associations between ever use of OCs and ovarian and breast cancer among women who are BRCA1 or BRCA2 mutation carriers are similar to those reported for the general population.

Authors
Moorman, PG; Havrilesky, LJ; Gierisch, JM; Coeytaux, RR; Lowery, WJ; Peragallo Urrutia, R; Dinan, M; McBroom, AJ; Hasselblad, V; Sanders, GD; Myers, ER
MLA Citation
Moorman, PG, Havrilesky, LJ, Gierisch, JM, Coeytaux, RR, Lowery, WJ, Peragallo Urrutia, R, Dinan, M, McBroom, AJ, Hasselblad, V, Sanders, GD, and Myers, ER. "Oral contraceptives and risk of ovarian cancer and breast cancer among high-risk women: a systematic review and meta-analysis." J Clin Oncol 31.33 (November 20, 2013): 4188-4198. (Review)
PMID
24145348
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
31
Issue
33
Publish Date
2013
Start Page
4188
End Page
4198
DOI
10.1200/JCO.2013.48.9021

Capsule commentary on Katz et al., Implementing smoking cessation guidelines for hospitalized veterans: effects on nurse attitudes and performance.

Authors
Gierisch, JM; Fish, LJ
MLA Citation
Gierisch, JM, and Fish, LJ. "Capsule commentary on Katz et al., Implementing smoking cessation guidelines for hospitalized veterans: effects on nurse attitudes and performance." J Gen Intern Med 28.11 (November 2013): 1493-.
PMID
23739811
Source
pubmed
Published In
Journal of General Internal Medicine
Volume
28
Issue
11
Publish Date
2013
Start Page
1493
DOI
10.1007/s11606-013-2503-4

Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: a systematic review.

Oral contraceptives may influence the risk of certain cancers. As part of the AHRQ Evidence Report, Oral Contraceptive Use for the Primary Prevention of Ovarian Cancer, we conducted a systematic review to estimate associations between oral contraceptive use and breast, cervical, colorectal, and endometrial cancer incidence. We searched PubMed, Embase, and Cochrane Database of Systematic Reviews. Study inclusion criteria were women taking oral contraceptives for contraception or ovarian cancer prevention; includes comparison group with no oral contraceptive use; study reports quantitative associations between oral contraceptive exposure and relevant cancers; controlled study or pooled patient-level meta-analyses; sample size for nonrandomized studies ≥100; peer-reviewed, English-language; published from January 1, 2000 forward. Random-effects meta-analyses were conducted by estimating pooled ORs with 95% confidence intervals (CIs). We included 44 breast, 12 cervical, 11 colorectal, and 9 endometrial cancers studies. Breast cancer incidence was slightly but significantly increased in users (OR, 1.08; CI, 1.00-1.17); results show a higher risk associated with more recent use of oral contraceptives. Risk of cervical cancer was increased with duration of oral contraceptive use in women with human papillomavirus infection; heterogeneity prevented meta-analysis. Colorectal cancer (OR, 0.86; CI, 0.79-0.95) and endometrial cancer incidences (OR, 0.57; CI, 0.43-0.77) were significantly reduced by oral contraceptive use. Compared with never use, ever use of oral contraceptives is significantly associated with decreases in colorectal and endometrial cancers and increases in breast cancers. Although elevated breast cancer risk was small, relatively high incidence of breast cancers means that oral contraceptives may contribute to a substantial number of cases.

Authors
Gierisch, JM; Coeytaux, RR; Urrutia, RP; Havrilesky, LJ; Moorman, PG; Lowery, WJ; Dinan, M; McBroom, AJ; Hasselblad, V; Sanders, GD; Myers, ER
MLA Citation
Gierisch, JM, Coeytaux, RR, Urrutia, RP, Havrilesky, LJ, Moorman, PG, Lowery, WJ, Dinan, M, McBroom, AJ, Hasselblad, V, Sanders, GD, and Myers, ER. "Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: a systematic review." Cancer Epidemiol Biomarkers Prev 22.11 (November 2013): 1931-1943. (Review)
PMID
24014598
Source
pubmed
Published In
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Volume
22
Issue
11
Publish Date
2013
Start Page
1931
End Page
1943
DOI
10.1158/1055-9965.EPI-13-0298

Risk of acute thromboembolic events with oral contraceptive use: a systematic review and meta-analysis.

To estimate the risk of venous thromboembolism, stroke, or myocardial infarction (MI) associated with the use of oral contraceptive pills (OCPs) and to describe how these risks vary by dose or formulation. We searched PubMed, Embase, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov for studies published from January 1995 through June 2012 that evaluated the association between OCP use and risk of venous thromboembolism, stroke, or MI. We reviewed 6,476 citations. We included English-language, controlled studies with human participants reporting a quantitative association between exposure to OCPs and outcomes of venous thromboembolism, stroke, or MI. Two investigators independently reviewed articles for inclusion or exclusion; discordant decisions were resolved by team review and consensus. Random-effects meta-analysis was used to generate summary odds ratios (ORs). Fifty studies met inclusion criteria. There were no randomized clinical trials. We found threefold increased odds of venous thromboembolism among current compared with noncurrent OCP users (14 studies; OR 2.97, 95% confidence interval [CI] 2.46-3.59). We found twofold increased odds of ischemic stroke (seven studies; OR 1.90, 95% CI 1.24-2.91). There was no evidence of increased risk of hemorrhagic stroke (four studies; OR 1.03, 95% CI 0.71-1.49) or MI (eight studies; OR 1.34, 95% CI 0.87-2.08). Current use of combined OCPs is associated with increased odds of venous thromboembolism and ischemic stroke but not hemorrhagic stroke or MI.

Authors
Peragallo Urrutia, R; Coeytaux, RR; McBroom, AJ; Gierisch, JM; Havrilesky, LJ; Moorman, PG; Lowery, WJ; Dinan, M; Hasselblad, V; Sanders, GD; Myers, ER
MLA Citation
Peragallo Urrutia, R, Coeytaux, RR, McBroom, AJ, Gierisch, JM, Havrilesky, LJ, Moorman, PG, Lowery, WJ, Dinan, M, Hasselblad, V, Sanders, GD, and Myers, ER. "Risk of acute thromboembolic events with oral contraceptive use: a systematic review and meta-analysis." Obstetrics and gynecology 122.2 Pt 1 (August 1, 2013): 380-389. (Review)
Source
scopus
Published In
Obstetrics and Gynecology
Volume
122
Issue
2 Pt 1
Publish Date
2013
Start Page
380
End Page
389

Risk of acute thromboembolic events with oral contraceptive use: a systematic review and meta-analysis.

OBJECTIVE: To estimate the risk of venous thromboembolism, stroke, or myocardial infarction (MI) associated with the use of oral contraceptive pills (OCPs) and to describe how these risks vary by dose or formulation. DATA SOURCES: We searched PubMed, Embase, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov for studies published from January 1995 through June 2012 that evaluated the association between OCP use and risk of venous thromboembolism, stroke, or MI. METHODS OF STUDY SELECTION: We reviewed 6,476 citations. We included English-language, controlled studies with human participants reporting a quantitative association between exposure to OCPs and outcomes of venous thromboembolism, stroke, or MI. Two investigators independently reviewed articles for inclusion or exclusion; discordant decisions were resolved by team review and consensus. Random-effects meta-analysis was used to generate summary odds ratios (ORs). TABULATION, INTEGRATION, AND RESULTS: Fifty studies met inclusion criteria. There were no randomized clinical trials. We found threefold increased odds of venous thromboembolism among current compared with noncurrent OCP users (14 studies; OR 2.97, 95% confidence interval [CI] 2.46-3.59). We found twofold increased odds of ischemic stroke (seven studies; OR 1.90, 95% CI 1.24-2.91). There was no evidence of increased risk of hemorrhagic stroke (four studies; OR 1.03, 95% CI 0.71-1.49) or MI (eight studies; OR 1.34, 95% CI 0.87-2.08). CONCLUSION: Current use of combined OCPs is associated with increased odds of venous thromboembolism and ischemic stroke but not hemorrhagic stroke or MI.

Authors
Peragallo Urrutia, R; Coeytaux, RR; McBroom, AJ; Gierisch, JM; Havrilesky, LJ; Moorman, PG; Lowery, WJ; Dinan, M; Hasselblad, V; Sanders, GD; Myers, ER
MLA Citation
Peragallo Urrutia, R, Coeytaux, RR, McBroom, AJ, Gierisch, JM, Havrilesky, LJ, Moorman, PG, Lowery, WJ, Dinan, M, Hasselblad, V, Sanders, GD, and Myers, ER. "Risk of acute thromboembolic events with oral contraceptive use: a systematic review and meta-analysis." Obstet Gynecol 122.2 Pt 1 (August 2013): 380-389. (Review)
PMID
23969809
Source
pubmed
Published In
Obstetrics and Gynecology
Volume
122
Issue
2 Pt 1
Publish Date
2013
Start Page
380
End Page
389
DOI
10.1097/AOG.0b013e3182994c43

Oral contraceptive pills as primary prevention for ovarian cancer: a systematic review and meta-analysis.

OBJECTIVE: To estimate the overall reduction in ovarian cancer risk associated with the use of oral contraceptive pills (OCPs) and whether reduction in risk is affected by specifics of OCP use, such as formulation or duration of use. DATA SOURCES: We searched PubMed, Embase, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov for studies published from January 1990 to June 2012, with primary analysis of studies published since January 2000. METHODS OF STUDY SELECTION: We reviewed 6,476 citations. We included English-language controlled studies with human participants reporting a quantitative association between exposure to OCPs (in which the explicit or implicit indication for OCP use was prevention of pregnancy or ovarian cancer) compared with no use of OCPs. Two investigators independently reviewed the title and abstract and full-text of articles for inclusion or exclusion decision; discordant decisions were resolved by team review and consensus. TABULATION, INTEGRATION, AND RESULTS: Fifty-five studies met inclusion criteria. A random-effects meta-analysis of 24 case-control and cohort studies showed significant reduction in ovarian cancer incidence in ever-users compared with never-users (odds ratio 0.73, 95% confidence interval 0.66-0.81). There was a significant duration-response relationship, with reduction in incidence of more than 50% among women using OCPs for 10 or more years. The lifetime reduction in ovarian cancer attributable to the use of OCPs is approximately 0.54% for a number-needed-to-treat of approximately 185 for a use period of 5 years. CONCLUSION: Significant duration-dependent reductions in ovarian cancer incidence in the general population are associated with OCP use.

Authors
Havrilesky, LJ; Moorman, PG; Lowery, WJ; Gierisch, JM; Coeytaux, RR; Urrutia, RP; Dinan, M; McBroom, AJ; Hasselblad, V; Sanders, GD; Myers, ER
MLA Citation
Havrilesky, LJ, Moorman, PG, Lowery, WJ, Gierisch, JM, Coeytaux, RR, Urrutia, RP, Dinan, M, McBroom, AJ, Hasselblad, V, Sanders, GD, and Myers, ER. "Oral contraceptive pills as primary prevention for ovarian cancer: a systematic review and meta-analysis." Obstet Gynecol 122.1 (July 2013): 139-147. (Review)
PMID
23743450
Source
pubmed
Published In
Obstetrics and Gynecology
Volume
122
Issue
1
Publish Date
2013
Start Page
139
End Page
147
DOI
10.1097/AOG.0b013e318291c235

Oral contraceptive use for the primary prevention of ovarian cancer.

To estimate the overall balance of harms and benefits from the potential use of oral contraceptives (OCs) for the primary prevention of ovarian cancerWe searched PubMed®, Embase®, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov for English-language studies published from January 1990 to June 2012 that evaluated the potential benefits (reduction in ovarian, colorectal, and endometrial cancers) and harms (increase in breast and cervical cancer, and vascular complications) of OC use.Two investigators screened each abstract and full-text article for inclusion; the investigators abstracted data, and they performed quality ratings, applicability ratings, and evidence grading. Random-effects models were used to compute summary estimates of effects. A simulation model was used to estimate the effects of OC use on the overall balance of benefits and harms.We reviewed 55 studies relevant to ovarian cancer outcomes, 66 relevant to other cancers, and 50 relevant to vascular events. Ovarian cancer incidence was significantly reduced in OC users (OR [odds ratio], 0.73; 95% CI [confidence interval], 0.66 to 0.81), with greater reductions seen with longer duration of use. Breast cancer incidence was slightly but significantly increased in OC users (OR, 1.08; 95% CI, 1.00 to 1.17), with a significant reduction in risk as time since last use increased. The risk of cervical cancer was significantly increased in women with persistent human papillomavirus infection who used OCs, but heterogeneity prevented a formal meta-analysis. Incidences of both colorectal cancer (OR, 0.86; 95% CI, 0.79 to 0.95) and endometrial cancer (OR, 0.57; 95% CI, 0.43 to 0.76) were significantly reduced by OC use. The risk of vascular events was increased in current OC users compared with nonusers, although the increase in myocardial infarction was not statistically significant. The overall strength of evidence for ovarian cancer prevention was moderate to low, primarily because of the lack of randomized trials and inconsistent reporting of important characteristics of use, such as duration. The simulation model predicted that the combined increase in risk of breast and cervical cancers and vascular events was likely to be equivalent to or greater than the decreased risk in ovarian cancer, although the harm/benefit ratio was much more favorable when protection against endometrial and colorectal cancers was added, resulting in net gains in life expectancy of approximately 1 month.There is insufficient evidence to recommend for or against the use of OCs solely for the primary prevention of ovarian cancer. Although the net effects of the current patterns of OC use likely result in increased life expectancy when other noncontraceptive benefits are included, the harm/benefit ratio for ovarian cancer prevention alone is uncertain, particularly when the potential quality-of-life impact of breast cancer and vascular events are considered.

Authors
Havrilesky, LJ; Gierisch, JM; Moorman, PG; Coeytaux, RR; Urrutia, RP; Lowery, WJ; Dinan, M; McBroom, AJ; Wing, L; Musty, MD; Lallinger, KR; Hasselblad, V; Sanders, GD; Myers, ER
MLA Citation
Havrilesky, LJ, Gierisch, JM, Moorman, PG, Coeytaux, RR, Urrutia, RP, Lowery, WJ, Dinan, M, McBroom, AJ, Wing, L, Musty, MD, Lallinger, KR, Hasselblad, V, Sanders, GD, and Myers, ER. "Oral contraceptive use for the primary prevention of ovarian cancer." Evidence report/technology assessment 212 (June 2013): 1-514.
PMID
24423062
Source
epmc
Published In
Evidence report/technology assessment
Issue
212
Publish Date
2013
Start Page
1
End Page
514

Multifamily group treatment for veterans with traumatic brain injury: what is the value to participants?

OBJECTIVE: This study evaluated the feasibility, acceptability, and helpfulness of implementation of multifamily group treatment for traumatic brain injury (TBI) among veterans who sustained a TBI during the wars in Iraq and Afghanistan and their families or caregivers. METHODS: Veterans and their family members who participated in an open clinical trial (August 2010-March 2011) of multifamily psychoeducation for TBI at two Veterans Affairs medical centers were invited to one of three focus groups. Participants were asked about problems experienced before and during the intervention, aspects of treatment that were helpful, and improvements that would facilitate effective implementation of multifamily group treatment for TBI. Postintervention focus group transcripts were analyzed by utilizing qualitative content analysis. RESULTS: Participants included eight veterans with TBI and eight family members. Five themes emerged: exploring common struggles and reducing isolation, building skills to cope with TBI and related problems, restoring relationships through communication and understanding, increasing understanding of the interconnection between TBI and posttraumatic stress disorder, and improving the multifamily group experience and increasing treatment engagement of veterans and families. Veterans and family members found multifamily group treatment for TBI highly acceptable and offered recommendations to improve and increase access to the program. CONCLUSIONS: The results supported the feasibility and acceptability of multifamily group treatment for TBI. Specific recommendations to improve this psychoeducational intervention and its implementation are offered.

Authors
Straits-Troster, K; Gierisch, JM; Strauss, JL; Dyck, DG; Dixon, LB; Norell, D; Perlick, DA
MLA Citation
Straits-Troster, K, Gierisch, JM, Strauss, JL, Dyck, DG, Dixon, LB, Norell, D, and Perlick, DA. "Multifamily group treatment for veterans with traumatic brain injury: what is the value to participants?." Psychiatric services (Washington, D.C.) 64.6 (June 2013): 541-546.
PMID
23450326
Source
epmc
Published In
Psychiatric Services
Volume
64
Issue
6
Publish Date
2013
Start Page
541
End Page
546
DOI
10.1176/appi.ps.001632012

Capsule commentary on Katz et al., implementing smoking cessation guidelines for hospitalized veterans: Effects on nurse attitudes and performance

Authors
Gierisch, JM; Fish, LJ
MLA Citation
Gierisch, JM, and Fish, LJ. "Capsule commentary on Katz et al., implementing smoking cessation guidelines for hospitalized veterans: Effects on nurse attitudes and performance." Journal of General Internal Medicine 28.11 (2013): 1493--.
Source
scival
Published In
Journal of General Internal Medicine
Volume
28
Issue
11
Publish Date
2013
Start Page
1493-
DOI
10.1007/s11606-013-2503-4

Oral contraceptive pills as primary prevention for ovarian cancer: A systematic review and meta-analysis

OBJECTIVE:: To estimate the overall reduction in ovarian cancer risk associated with the use of oral contraceptive pills (OCPs) and whether reduction in risk is affected by specifics of OCP use, such as formulation or duration of use. DATA SOURCES:: We searched PubMed, Embase, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov for studies published from January 1990 to June 2012, with primary analysis of studies published since January 2000. METHODS OF STUDY SELECTION:: We reviewed 6,476 citations. We included English-language controlled studies with human participants reporting a quantitative association between exposure to OCPs (in which the explicit or implicit indication for OCP use was prevention of pregnancy or ovarian cancer) compared with no use of OCPs. Two investigators independently reviewed the title and abstract and full-text of articles for inclusion or exclusion decision; discordant decisions were resolved by team review and consensus. TABULATION, INTEGRATION, AND RESULTS:: Fifty-five studies met inclusion criteria. A random-effects meta-analysis of 24 case-control and cohort studies showed significant reduction in ovarian cancer incidence in ever-users compared with never-users (odds ratio 0.73, 95% confidence interval 0.66-0.81). There was a significant duration-response relationship, with reduction in incidence of more than 50% among women using OCPs for 10 or more years. The lifetime reduction in ovarian cancer attributable to the use of OCPs is approximately 0.54% for a number-needed-to-treat of approximately 185 for a use period of 5 years. CONCLUSION:: Significant duration-dependent reductions in ovarian cancer incidence in the general population are associated with OCP use. © 2013 by The American College of Obstetricians and Gynecologists. Published by Lippincott Williams & Wilkins.

Authors
Havrilesky, LJ; Moorman, PG; Lowery, WJ; Gierisch, JM; Coeytaux, RR; Urrutia, RP; Dinan, M; McBroom, AJ; Hasselblad, V; Sanders, GD; Myers, ER
MLA Citation
Havrilesky, LJ, Moorman, PG, Lowery, WJ, Gierisch, JM, Coeytaux, RR, Urrutia, RP, Dinan, M, McBroom, AJ, Hasselblad, V, Sanders, GD, and Myers, ER. "Oral contraceptive pills as primary prevention for ovarian cancer: A systematic review and meta-analysis." Obstetrics and Gynecology 122.1 (2013): 139-147.
Source
scival
Published In
Obstetrics & Gynecology (Elsevier)
Volume
122
Issue
1
Publish Date
2013
Start Page
139
End Page
147
DOI
10.1097/AOG.0b013e318291c235

It's the amount of thought that counts: when ambivalence contributes to mammography screening delay.

PURPOSE: This study examines whether ambivalence toward mammography screening, as moderated by total amount of thought given to the reasons for and against getting mammograms at recommended intervals, predicts greater delay in obtaining subsequent screening mammograms. METHODS: A sample of 3,430 insured women with recent (within the last 8-9 months) screening mammograms completed telephone interviews as part of a 5-year intervention study to achieve sustained adherence to annual-interval mammography. Delay was assessed by the number of days between mammograms. RESULTS: Controlling for demographic factors and perceived screening barriers, days between mammograms increased as ambivalence and thought increased. Thought moderated ambivalence: Among women who were most ambivalent, women obtained mammograms 1 month earlier for each unit increase in thought. CONCLUSION: Future studies should test innovative ways to resolve ambivalence and increase thought about consequences of getting mammograms as a strategy to promote mammography screening adherence.

Authors
O'Neill, SC; Lipkus, IM; Gierisch, JM; Rimer, BK; Bowling, JM
MLA Citation
O'Neill, SC, Lipkus, IM, Gierisch, JM, Rimer, BK, and Bowling, JM. "It's the amount of thought that counts: when ambivalence contributes to mammography screening delay." Womens Health Issues 22.2 (March 2012): e189-e194.
PMID
22055988
Source
pubmed
Published In
Women's Health Issues
Volume
22
Issue
2
Publish Date
2012
Start Page
e189
End Page
e194
DOI
10.1016/j.whi.2011.08.008

Smoking cessation interventions for patients with depression: a systematic review and meta-analysis.

OBJECTIVES: We conducted a systematic literature review of smoking cessation interventions for patients with histories of depressive disorders or current significant depressive symptoms. We examined the comparative effectiveness of smoking cessation strategies on abstinence rates, differential effects of cessation strategies by depression status (i.e., history positive vs. current depression), and differential effects by gender. DATA SOURCES: Peer-reviewed literature in MEDLINE, Embase, PsycINFO, and Cochrane Library. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: Randomized controlled trials or secondary analysis of RCT data comparing two or more smoking cessation interventions or intervention to control, and reporting cessation outcomes in adults with depression. STUDY APPRAISAL AND SYNTHESIS METHODS: Two trained researchers screened articles for inclusion. When possible, we estimated pooled risk ratios with 95% confidence intervals by using a random effects model with the Mantel-Haenszel method. We synthesized other studies qualitatively. We classified each intervention as antidepressants, nicotine replacement therapy (NRT), brief smoking cessation counseling, smoking cessation behavioral counseling, or behavioral mood management. RESULTS: We identified 16 unique RCTs, of which, only three trials recruited participants with current depression. Meta-analysis demonstrated a small, positive effect of adding behavioral mood management (RR = 1.41, 95% CI 1.01-1.96). All included antidepressant trials showed small, positive effects, but risk ratio summary was not significant (RR = 1.31, 95% CI 0.73-2.34). Three NRT trials demonstrated small, positive effects on smoking cessation rates. We found insufficient evidence to examine gender and depression status moderator effects. LIMITATIONS: Few RCTs exist that test smoking cessation interventions among adults with depression. To make meaningful comparisons, we created broad intervention categories that contained heterogeneity. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Few trials enrolled smokers with current depression. Most of data identified were from subgroup analyses of patients history-positive for depression. However, several promising interventions exist. Healthcare providers should consider encouraging their patients with significant depressive symptoms or depression histories to seek smoking cessation services that include NRT and behavioral mood management.

Authors
Gierisch, JM; Bastian, LA; Calhoun, PS; McDuffie, JR; Williams, JW
MLA Citation
Gierisch, JM, Bastian, LA, Calhoun, PS, McDuffie, JR, and Williams, JW. "Smoking cessation interventions for patients with depression: a systematic review and meta-analysis." J Gen Intern Med 27.3 (March 2012): 351-360. (Review)
PMID
22038468
Source
pubmed
Published In
Journal of General Internal Medicine
Volume
27
Issue
3
Publish Date
2012
Start Page
351
End Page
360
DOI
10.1007/s11606-011-1915-2

Correlates of expected positive and negative support for smoking cessation among a sample of chronically ill veterans.

OBJECTIVE: To examine demographic, relationship, and smoking history factors related to expected positive and negative support for quitting smoking among chronically ill veterans. METHODS: Data for this report comes from baseline data from a randomized controlled trial of a support-based smoking cessation intervention for veterans with chronic diseases (cancer, cardiovascular disease, hypertension, diabetes, and chronic obstructive pulmonary disease). We used separate multiple linear regression models to analyze relationships between positive and negative support and variables selected for model entry. RESULTS: Veterans in our sample expected high positive and negative support for quitting. Veterans who were married/living as married, had some college education, were female, or named a female support person expected higher levels of positive support. Veterans who named a female or a nonsmoker as a support person expected higher levels of negative support. Males and non-Caucasians also reported higher levels of expected negative support. CONCLUSIONS: Individual differences that influence perceptions of expected support are likely to influence intervention participation and engagement. Thus, understanding factors associated with expected positive and negative support is necessary to optimize future implementation of support-based cessation interventions through better treatment matching.

Authors
Fish, LJ; Gierisch, JM; Stechuchak, KM; Grambow, SC; Rohrer, LD; Bastian, LA
MLA Citation
Fish, LJ, Gierisch, JM, Stechuchak, KM, Grambow, SC, Rohrer, LD, and Bastian, LA. "Correlates of expected positive and negative support for smoking cessation among a sample of chronically ill veterans." Addict Behav 37.1 (January 2012): 135-138.
PMID
21978930
Source
pubmed
Published In
Addictive Behaviors
Volume
37
Issue
1
Publish Date
2012
Start Page
135
End Page
138
DOI
10.1016/j.addbeh.2011.08.013

Tobacco use among Iraq- and Afghanistan-era veterans: a qualitative study of barriers, facilitators, and treatment preferences.

INTRODUCTION: Military service and combat exposure are risk factors for smoking. Although evidence suggests that veterans are interested in tobacco use cessation, little is known about their reasons for quitting, treatment preferences, and perceived barriers to effective tobacco use cessation treatment. Our study objective was to elicit perspectives of Iraq- and Afghanistan-era veterans who had not yet quit smoking postdeployment to inform the development of smoking cessation services for this veteran cohort. METHODS: We conducted 3 focus groups among 20 participants in October 2006 at the Durham Veterans Affairs Medical Center to explore issues on tobacco use and smoking cessation for Iraq- and Afghanistan-era veterans who continued to smoke postdeployment. We used qualitative content analysis to identify major themes and organize data. RESULTS: Veterans expressed the belief that smoking was a normalized part of military life and described multiple perceived benefits of smoking. Although veterans expressed a high level of interest in quitting, they listed several behavioral, situational, and environmental triggers that derailed smoking cessation. They expressed interest in such cessation treatment features as flexible scheduling, free nicotine replacement therapy, peer support, and family inclusion in treatment. CONCLUSION: Our results indicate that the newest cohort of veterans perceives smoking as endemic in military service. However, they want to quit smoking and identified several personal and environmental obstacles that make smoking cessation difficult. Our findings may inform programmatic efforts to increase successful quit attempts in this unique veteran population.

Authors
Gierisch, JM; Straits-Tröster, K; Calhoun, PS; Beckham, JC; Acheson, S; Hamlett-Berry, K
MLA Citation
Gierisch, JM, Straits-Tröster, K, Calhoun, PS, Beckham, JC, Acheson, S, and Hamlett-Berry, K. "Tobacco use among Iraq- and Afghanistan-era veterans: a qualitative study of barriers, facilitators, and treatment preferences." Prev Chronic Dis 9 (2012): E58-.
PMID
22338598
Source
pubmed
Published In
Preventing Chronic Diseases: Public health research, practice, and policy
Volume
9
Publish Date
2012
Start Page
E58

A five-step guide for moving from observational studies to interventional research for women veterans.

Authors
Rohrer, LD; Gierisch, JM; Fish, LJ; Blakeney, JK; Bastian, LA
MLA Citation
Rohrer, LD, Gierisch, JM, Fish, LJ, Blakeney, JK, and Bastian, LA. "A five-step guide for moving from observational studies to interventional research for women veterans." Womens Health Issues 21.4 Suppl (July 2011): S98-102.
PMID
21724150
Source
pubmed
Published In
Women's Health Issues
Volume
21
Issue
4 Suppl
Publish Date
2011
Start Page
S98
End Page
102
DOI
10.1016/j.whi.2011.05.004

COMPARATIVE EFFECTIVENESS TRIAL OF FAMILY-SUPPORTED SMOKING CESSATION INTERVENTION VERSUS STANDARD TELEPHONE COUNSELING FOR CHRONICALLY ILL VETERANS

Authors
Bastian, LA; Fish, LJ; Gierisch, JM; Rohrer, L; Stechuchak, KM; Grambow, S
MLA Citation
Bastian, LA, Fish, LJ, Gierisch, JM, Rohrer, L, Stechuchak, KM, and Grambow, S. "COMPARATIVE EFFECTIVENESS TRIAL OF FAMILY-SUPPORTED SMOKING CESSATION INTERVENTION VERSUS STANDARD TELEPHONE COUNSELING FOR CHRONICALLY ILL VETERANS." JOURNAL OF GENERAL INTERNAL MEDICINE 26 (May 2011): S297-S297.
Source
wos-lite
Published In
Journal of General Internal Medicine
Volume
26
Publish Date
2011
Start Page
S297
End Page
S297

Cancer screening adherence

Cancer is a devastating and debilitating disease. Each year more than 1.4 million people are diagnosed with non-skin cancers and 565,650 lives are lost in the United States [1]. Primary prevention of cancer through behavioral modifications in risk factors such as tobacco use, sun exposure, obesity, physical inactivity, unhealthy diet, and alcohol consumption can reduce the burden of cancer tremendously [2, 3]. However, beyond the small proportion of cancers linked to genetic mutations, many cancers are sporadic. Early detection via evidence-based screening tests (i.e., secondary prevention) remains an effective option for controlling the burden of cancer [4]. © 2010 Springer Science+Business Media, LLC.

Authors
Gierisch, JM; Bastian, LA
MLA Citation
Gierisch, JM, and Bastian, LA. "Cancer screening adherence." (December 1, 2010): 123-150. (Chapter)
Source
scopus
Publish Date
2010
Start Page
123
End Page
150
DOI
10.1007/978-1-4419-5866-2_6

Standard definitions of adherence for infrequent yet repeated health behaviors.

OBJECTIVE: To present common language for defining adherence of infrequent yet repeated health behaviors. METHODS: We illustrate methodological and conceptual issues using human papillomavirus (HPV) vaccination and screening mammography study data as examples. RESULTS: Adherence rates of infrequent, repeated behaviors varied widely depending on how adherence was defined and measured. We advocate use of 3 standard definitions of adherence: initiation of behavior (initiation), adherence to most recent opportunity (on-schedule), and timely adherence across multiple opportunities (maintenance or completion). CONCLUSIONS: The proposed framework has cross-cutting implications for research and practice. Standardizing adherence metrics may facilitate comparisons across studies of health behaviors practiced at infrequent yet repeated intervals.

Authors
Gierisch, JM; Reiter, PL; Rimer, BK; Brewer, NT
MLA Citation
Gierisch, JM, Reiter, PL, Rimer, BK, and Brewer, NT. "Standard definitions of adherence for infrequent yet repeated health behaviors." Am J Health Behav 34.6 (November 2010): 669-679.
PMID
20604693
Source
pubmed
Published In
American Journal of Health Behavior
Volume
34
Issue
6
Publish Date
2010
Start Page
669
End Page
679

Finding the minimal intervention needed for sustained mammography adherence.

BACKGROUND: Regular adherence to mammography screening saves lives, yet few women receive regular mammograms. DESIGN: RCT. SETTING/PARTICIPANTS: Participants were recruited through a state employee health plan. All were women aged 40-75 years and had recent mammograms prior to enrollment (n=3547). Data were collected from 2004 to 2009. INTERVENTION: Trial tested efficacy of a two-step adaptively-designed intervention to increase mammography adherence over 4 years. The first intervention step consisted of three reminder types: enhanced usual care reminders (EUCR); enhanced letter reminders (ELR); both delivered by mail, and automated telephone reminders (ATR). After delivery of reminders, women who became off-schedule in any of the 4 years received a second step of supplemental interventions. Three supplemental intervention arms contained priming letters and telephone counseling: barriers only (BarriCall); barriers plus positive consequences of getting mammograms (BarriConCall+); and barriers plus negative consequences of not getting mammograms (BarriConCall-). MAIN OUTCOME MEASURES: Average cumulative number of days non-adherent to mammography over 4 years based on annual screening guidelines (analyses conducted in 2009). RESULTS: All reminders performed equally well in reducing number of days of non-adherence. Women randomized to receive supplemental interventions had significantly fewer days of non-adherence compared to women who received EUCR (p=0.0003). BarrConCall+ and BarrConCall- conditions did not significantly differ in days non-adherent compared to women in the barriers-only condition (BarriCon). CONCLUSIONS: The minimal intervention needed for sustained mammography use is a combination of a reminder followed by a priming letter and barrier-specific telephone counseling for women who become off-schedule. Additional costs associated with supplemental interventions should be considered by organizations deciding which interventions to use. TRIAL REGISTRATION NUMBER: NCT01148875.

Authors
Gierisch, JM; DeFrank, JT; Bowling, JM; Rimer, BK; Matuszewski, JM; Farrell, D; Skinner, CS
MLA Citation
Gierisch, JM, DeFrank, JT, Bowling, JM, Rimer, BK, Matuszewski, JM, Farrell, D, and Skinner, CS. "Finding the minimal intervention needed for sustained mammography adherence." Am J Prev Med 39.4 (October 2010): 334-344.
PMID
20837284
Source
pubmed
Published In
American Journal of Preventive Medicine
Volume
39
Issue
4
Publish Date
2010
Start Page
334
End Page
344
DOI
10.1016/j.amepre.2010.05.020

Longitudinal predictors of nonadherence to maintenance of mammography.

BACKGROUND: Regular adherence to screening mammography, also known as maintenance of mammography, reduces breast cancer morbidity and mortality. However, mammography maintenance is uncommon and little is known about why women do not maintain regular screening schedules. We investigated longitudinal predictors of women not maintaining adherence. METHODS: Participants were insured women enrolled in an intervention trial who had screening mammograms 8 to 9 months before study enrollment (n = 1,493). Data were collected from 2003 to 2008. We used discrete event history analysis to model nonadherence to mammography maintenance over three successive annual screening intervals (+ 2 months). RESULTS: Most (54%) women did not maintain screening adherence over 3 years. Women who did not maintain adherence were more likely to be ages 40 to 49 years, rate their health fair or poor, be less satisfied with their last mammography experiences, report one or more barriers to getting mammograms, be less than completely confident about getting their next mammograms (lower self-efficacy), or have weaker behavioral intentions. The odds of not maintaining adherence decreased over time. DISCUSSION: Although great strides have been achieved in increasing the proportion of women who have received mammograms, most women still are not maintaining regular mammography use over time. Our findings provide insights into targets for future mammography maintenance interventions.

Authors
Gierisch, JM; Earp, JA; Brewer, NT; Rimer, BK
MLA Citation
Gierisch, JM, Earp, JA, Brewer, NT, and Rimer, BK. "Longitudinal predictors of nonadherence to maintenance of mammography." Cancer Epidemiol Biomarkers Prev 19.4 (April 2010): 1103-1111.
PMID
20354125
Source
pubmed
Published In
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Volume
19
Issue
4
Publish Date
2010
Start Page
1103
End Page
1111
DOI
10.1158/1055-9965.EPI-09-1120

TOBACCO USE AND CESSATION AMONG RETURNING COMBAT VETERANS: A MIXED METHODS STUDY

Authors
Straits-Troster, K; Acheson, S; Beckham, J; Calhoun, P; Gierisch, JM; Hamlett-Berry, K
MLA Citation
Straits-Troster, K, Acheson, S, Beckham, J, Calhoun, P, Gierisch, JM, and Hamlett-Berry, K. "TOBACCO USE AND CESSATION AMONG RETURNING COMBAT VETERANS: A MIXED METHODS STUDY." ANNALS OF BEHAVIORAL MEDICINE 39 (April 2010): 158-158.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
39
Publish Date
2010
Start Page
158
End Page
158

Factors associated with annual-interval mammography for women in their 40s.

BACKGROUND: Evidence is mounting that annual mammography for women in their 40s may be the optimal schedule to reduce morbidity and mortality from breast cancer. Few studies have assessed predictors of repeat mammography on an annual interval among these women. METHODS: We assessed mammography screening status among 596 insured Black and Non-Hispanic white women ages 43-49. Adherence was defined as having a second mammogram 10-14 months after a previous mammogram. We examined socio-demographic, medical and healthcare-related variables on receipt of annual-interval repeat mammograms. We also assessed barriers associated with screening. RESULTS: 44.8% of the sample were adherent to annual-interval mammography. A history of self-reported abnormal mammograms, family history of breast cancer and never having smoked were associated with adherence. Saying they had not received mammography reminders and reporting barriers to mammography were associated with non-adherence. Four barrier categories were associated with women's non-adherence: lack of knowledge/not thinking mammograms are needed, cost, being too busy, and forgetting to make/keep appointments. CONCLUSIONS: Barriers we identified are similar to those found in other studies. Health professionals may need to take extra care in discussing mammography screening risk and benefits due to ambiguity about screening guidelines for women in their 40s, especially for women without family histories of breast cancer or histories of abnormal mammograms. Reminders are important in promoting mammography and should be coupled with other strategies to help women maintain adherence to regular mammography.

Authors
Gierisch, JM; O'Neill, SC; Rimer, BK; DeFrank, JT; Bowling, JM; Skinner, CS
MLA Citation
Gierisch, JM, O'Neill, SC, Rimer, BK, DeFrank, JT, Bowling, JM, and Skinner, CS. "Factors associated with annual-interval mammography for women in their 40s." Cancer Epidemiol 33.1 (July 2009): 72-78.
PMID
19481879
Source
pubmed
Published In
Cancer Epidemiology
Volume
33
Issue
1
Publish Date
2009
Start Page
72
End Page
78
DOI
10.1016/j.cdp.2009.03.001

Impact of mailed and automated telephone reminders on receipt of repeat mammograms: a randomized controlled trial.

BACKGROUND: This study compares the efficacy of three types of reminders in promoting annual repeat mammography screening. DESIGN: RCT. SETTING AND PARTICIPANTS: Study recruitment occurred in 2004-2005. Participants were recruited through the North Carolina State Health Plan for Teachers and State Employees. All were aged 40-75 years and had a screening mammogram prior to study enrollment. A total of 3547 women completed baseline telephone interviews. INTERVENTION: Prior to study recruitment, women were assigned randomly to one of three reminder groups: (1) printed enhanced usual care reminders (EUCRs); (2) automated telephone reminders (ATRs) identical in content to EUCRs; or (3) enhanced letter reminders that included additional information guided by behavioral theory. Interventions were delivered 2-3 months prior to women's mammography due dates. MAIN OUTCOME MEASURES: Repeat mammography adherence, defined as having a mammogram no sooner than 10 months and no later than 14 months after the enrollment mammogram. RESULTS: Each intervention produced adherence proportions that ranged from 72% to 76%. Post-intervention adherence rates increased by an absolute 17.8% from baseline. Women assigned to ATRs were significantly more likely to have had mammograms than women assigned to EUCRs (p=0.014). Comparisons of reminder efficacy did not vary across key subgroups. CONCLUSIONS: Although all reminders were effective in promoting repeat mammography adherence, ATRs were the most effective and lowest in cost. Health organizations should consider using ATRs to maximize proportions of members who receive mammograms at annual intervals.

Authors
DeFrank, JT; Rimer, BK; Gierisch, JM; Bowling, JM; Farrell, D; Skinner, CS
MLA Citation
DeFrank, JT, Rimer, BK, Gierisch, JM, Bowling, JM, Farrell, D, and Skinner, CS. "Impact of mailed and automated telephone reminders on receipt of repeat mammograms: a randomized controlled trial." Am J Prev Med 36.6 (June 2009): 459-467.
PMID
19362800
Source
pubmed
Published In
American Journal of Preventive Medicine
Volume
36
Issue
6
Publish Date
2009
Start Page
459
End Page
467
DOI
10.1016/j.amepre.2009.01.032

When ambivalence predicts repeat mammography screening: It's the amount of thought that counts

Authors
Lipkus, IM; Bollen, MJ; Gierisch, JM; O'Neill, SC; Rimer, BK
MLA Citation
Lipkus, IM, Bollen, MJ, Gierisch, JM, O'Neill, SC, and Rimer, BK. "When ambivalence predicts repeat mammography screening: It's the amount of thought that counts." ANNALS OF BEHAVIORAL MEDICINE 35 (March 2008): S162-S162.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
35
Publish Date
2008
Start Page
S162
End Page
S162

Triangulating differential nonresponse by race in a telephone survey.

INTRODUCTION: In 1994, the U.S. Department of Health and Human Services mandated sufficient inclusion of racial and ethnic minorities in all federally funded research. This mandate requires researchers to monitor study samples for research participation and differential survey nonresponse. This study illustrates methods to assess differential survey nonresponse when population race data are incomplete, which is often the case when studies are conducted among members of health plans. METHODS: We collected data as part of the PRISM (Personally Relevant Information about Screening Mammography) study, a trial funded by the National Institutes of Health to increase rates of annual mammography adherence. We used two methods to estimate racial distribution of the PRISM study population. The first method, called E-Tech, estimated race of the sample frame by using individuals' names and zip codes. In the second method, we conducted interviews with a subsample of PRISM study refusals. We validated both estimation methods through comparisons with self-reported race. We used race information generated by E-Tech, interviewer estimates, and self-report to assess differential nonresponse in the PRISM study. RESULTS: The E-Tech method had moderate sensitivity (48%) in estimating race of black participants but higher specificity (97%) and positive predictive value (71%). The interviewer-estimation method had high sensitivity (100%), high specificity (95%), and moderate positive predictive value (80%). Black women were less likely than white women to be reached for study participation. CONCLUSION: There was slight differential nonresponse by race in the PRISM study. Techniques described here may be useful for assessing differential nonresponse in samples with incomplete data on race.

Authors
DeFrank, JT; Bowling, JM; Rimer, BK; Gierisch, JM; Skinner, CS
MLA Citation
DeFrank, JT, Bowling, JM, Rimer, BK, Gierisch, JM, and Skinner, CS. "Triangulating differential nonresponse by race in a telephone survey." Prev Chronic Dis 4.3 (July 2007): A60-.
PMID
17572964
Source
pubmed
Published In
Preventing Chronic Diseases: Public health research, practice, and policy
Volume
4
Issue
3
Publish Date
2007
Start Page
A60

Public education and cancer control.

OBJECTIVES: To provide an overview of public education efforts in tobacco, obesity, environmental health, and cancer screening. DATA SOURCES: Cochrane, AHRQ, the CDC's Guide to Community Preventive Services, and other reviews. CONCLUSION: Major changes in rates of smoking and cancer screening attest to the effectiveness of public education efforts. Diet and physical activity have more resistant behaviors. Communication technologies offer possibilities for connecting people with the education they need. IMPLICATIONS FOR NURSING PRACTICE: Nurses can play important roles in public education by helping to overcome people's misperceptions and biases related to cancer. There also may be an important role for nurses as information brokers.

Authors
Rimer, BK; Gierisch, JM
MLA Citation
Rimer, BK, and Gierisch, JM. "Public education and cancer control." Semin Oncol Nurs 21.4 (November 2005): 286-295. (Review)
PMID
16293517
Source
pubmed
Published In
Seminars in Oncology Nursing
Volume
21
Issue
4
Publish Date
2005
Start Page
286
End Page
295
DOI
10.1016/j.soncn.2005.06.003

'What do they know about it?' How the North Carolina public views cancer clinical trials: implications for primary care doctors.

Authors
Randall-David, B; Stark, N; Gierisch, J; Torti, F
MLA Citation
Randall-David, B, Stark, N, Gierisch, J, and Torti, F. "'What do they know about it?' How the North Carolina public views cancer clinical trials: implications for primary care doctors." N C Med J 62.5 (September 2001): 281-285.
PMID
11570327
Source
pubmed
Published In
North Carolina Medical Journal
Volume
62
Issue
5
Publish Date
2001
Start Page
281
End Page
285
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Research Areas:

  • Adult
  • Attitude to Health
  • Behavior Therapy
  • Body Weights and Measures
  • Breast Neoplasms
  • Cardiovascular Diseases
  • Caregivers
  • Chronic Disease
  • Comparative Effectiveness Research
  • Counseling
  • Depression
  • Diet
  • Early Detection of Cancer
  • Evidence-Based Medicine
  • Exercise
  • Family
  • Female
  • Focus Groups
  • Forecasting
  • Health Behavior
  • Health Education
  • Health Knowledge, Attitudes, Practice
  • Health Priorities
  • Health Promotion
  • Intervention Studies
  • Iraq
  • Iraq War, 2003-2011
  • Life Style
  • Maintenance
  • Mammography
  • Mass Screening
  • Mental Disorders
  • Neoplasms
  • North Carolina
  • Nutrition Therapy
  • Outcome Assessment (Health Care)
  • Patient Compliance
  • Patient Education as Topic
  • Patient Participation
  • Patient-Centered Care
  • Primary Health Care
  • Primary Prevention
  • Public Health
  • Qualitative Research
  • Questionnaires
  • Reminder Systems
  • Research
  • Research Design
  • Risk Management
  • Smoking
  • Smoking Cessation
  • Social Support
  • Telephone
  • Tobacco Use Cessation
  • Tobacco, Smokeless
  • United States
  • Veterans
  • Weight Reduction Programs
  • Women's Health