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Biomedical subjects

Linda Fleisher

Publications and source records attributed to Linda Fleisher.

11 recordsLinked to original sources
PubMed2006

Increasing access to clinical and educational studies.

In 2001, the National Cancer Institute (NCI) provided funds to support the Increasing Access to Clinical and Educational Studies (ACES) Project of the Thomas Jefferson University, Kimmel Cancer Center in Philadelphia. The ACES Project enabled the Center to engage in the systematic development of approaches for reducing cancer health disparities among African Americans in Philadelphia. This project brought together community partners, clinical partners, cancer prevention and control experts, and staff from an NCI-designated cancer center to develop and implement a community-based outreach education program, a special populations investigator (SPI) training program, and SPI pilot studies in cancer screening and clinical trials participation. At the end of 5 years, the ACES Project had 1) organized a steering committee, expert panel, and a network of community collaborators and clinical partners; 2) implemented a clinical trials education program for community-based nurses, lay health advocates active in community organizations, and health ministries in community churches; 3) mentored 4 SPIs in cancer prevention and control research; 4) completed SPI pilot studies; and 5) leveraged these activities to gain support for cancer health disparities related research. The Project established a successful dialogue between an NCI-designated cancer center and the African American population related to cancer research, and enabled SPIs from the community to adapt evidence-informed interventions for application in cancer prevention and control research. Lessons learned from the Project can guide the implementation of such projects in the future. Cancer 2006. (c) 2006 American Cancer Society.

Black or African American↗
PubMed2006

Relationship of Internet health information use with patient behavior and self-efficacy: experiences of newly diagnosed cancer patients who contact the National Cancer Institute's Cancer Information Service.

This study examines the relationship of Internet health information use with patient behavior and self-efficacy among 498 newly diagnosed cancer patients. Subjects were classified by types of Internet use: direct use (used Internet health information themselves), indirect use (used information accessed by friends or family), and non-use (never accessing Internet information). Subjects were recruited from callers of the National Cancer Institute's (NCI's) Cancer Information Service, Atlantic Region. They were classified by type of Internet use at enrollment and interviewed by telephone after 8 weeks. There were significant relationships among Internet use and key study variables: subject characteristics, patient task behavior, and self-efficacy. Subjects' Internet use changed significantly from enrollment to 8 week follow-up; 19% of nonusers and indirect users moved to a higher level of Internet use. Significant relationships also were found among Internet use and perceived patient-provider relationship, question asking, and treatment compliance. Finally, Internet use was also significantly associated with self-efficacy variables (confidence in actively participating in treatment decisions, asking physicians questions, and sharing feelings of concern). The results of this study show that patients who are newly diagnosed with cancer perceive the Internet as a powerful tool, both for acquiring information and for enhancing confidence to make informed decisions.

Adolescent↗
PubMed2005

Facilitating informed decision making about breast cancer risk and genetic counseling among women calling the NCI's Cancer Information Service.

Despite increased interest among the public in breast cancer genetic risk and genetic testing, there are limited services to help women make informed decisions about genetic testing. This study, conducted with female callers (N = 279) to the National Cancer Institute's (NCI's) Atlantic Region Cancer Information Service (CIS), developed and evaluated a theory-based, educational intervention designed to increase callers' understanding of the following: (a) the kinds of information required to determine inherited risk; (b) their own personal family history of cancer; and (c) the benefits and limitations of genetic testing. Callers requesting information about breast/ovarian cancer risk, risk assessment services, and genetic testing were randomized to either: (1) standard care or (2) an educational intervention. Results show that the educational intervention reduced intention to obtain genetic testing among women at average risk and increased intention among high-risk women at 6 months. In addition, high monitors, who typically attend to and seek information, demonstrated greater increases in knowledge and perceived risk over the 6-month interval than low monitors, who typically are distracted from information. These findings suggest that theoretically designed interventions can be effective in helping women understand their cancer risk and appropriate risk assessment options and can be implemented successfully within a service program like the CIS.

Breast Neoplasms↗
PubMed2005

The CIS model for collaborative research in health communications: a brief retrospective from the current generation of research.

The Cancer Information Service (CIS) of the National Cancer Institute (NCI) is the premiere organization for providing cancer information to the nation. The CIS provides a stellar example of how a service organization dedicated to health communications also can serve as a laboratory for research. This journey by the CIS into health communication research is described briefly, along with the current generation of research summarized in this issue of the Journal of Health Communication (JHC). The CIS model for collaborative research is presented as an exemplar that other service organizations might embrace as a strategic tool for quality improvement in health communications.

Biomedical Research↗
PubMed2005

A randomized controlled trial of multiple tailored messages for smoking cessation among callers to the cancer information service.

Self-help materials computer-tailored to the specific needs of smokers have shown promise as a high-reach, low-cost intervention for smoking cessation. Adding tailored cessation materials to telephone-based cessation counseling may be a way of generating greater efficacy in promoting and maintaining cessation. The objective of this study is to assess the efficacy of adding different types of behavioral smoking cessation materials to brief telephone-based cessation counseling.A total of 1,978 smokers calling the National Cancer Institute's (NCI's) Cancer Information Service (CIS) for help in quitting smoking initially received brief cognitive-behavioral cessation counseling from a CIS information specialist. Following a baseline interview administered by the information specialist, subjects were randomly assigned to one of four conditions, each delivered by U.S. mail: a single, untailored smoking cessation guide (SU); a single, tailored smoking cessation guide (ST); a series of four (multiple) printed materials tailored only to baseline data (MT); and a series of four (multiple) printed materials tailored to baseline as well as retailored using 5-month interim progress data (MRT). The primary outcome measure was 7-day point prevalence abstinence rates assessed using a computer-assisted telephone interview (CATI) at 12-month follow-up.At 12-month follow-up, using intent-to-treat, imputed, and per-protocol analyses, no differences were found among the four experimental conditions (linear trend), or when the ST, MT, and MRT groups were compared with the control (SU) group. Participants in the two multiple message group conditions combined (MT + MRT), however, had significantly higher abstinence rates than participants in the two single message group conditions combined (SU + ST). Moreover, among subjects who reported quitting at the 5-month follow-up, participants receiving the MRT materials reported higher abstinence rates at 12 months than the other three groups combined (SU + ST + MT). The results of this study support the effectiveness, over and above a single telecounseling interaction, of multiple tailored print material contacts on cessation. These effects, however may be due to tailoring, or the longitudinal nature of the two multiple tailored conditions, or both. The strongest evidence for tailoring occurred in the MRT condition for relapse prevention, suggesting that print materials tailored to interim progress may be especially effective in this context. The qualities of specific psychosocial and communication elements in tailored materials should receive attention in future research.

Adult↗
PubMed2005

Exploring e-Health usage and interest among cancer information service users: the need for personalized interactions and multiple channels remains.

Since searching for health information is among the most popular uses of the Internet, we analyzed a survey of 6,019 callers to the National Cancer Institute's (NCI's) Cancer Information Service (CIS) to assess Internet usage and interest in technologies to access health and cancer information. Findings suggest that about 40% of CIS callers used the Internet to obtain cancer information and, of these, only about 20% found all the information they sought. Nearly 33% of Internet users called the CIS to discuss information found on the Internet; most (>90%) reported that the CIS was helpful. Those who sought cancer information on the Internet were more likely to call the CIS about this information if they found all or most of the information they were seeking, compared with those who found some or little of the information. New communication services endorsed by most CIS callers included e-mails from an information specialist and telephone support from the CIS while on the Internet. The survey results indicate the importance of multiple access points, both traditional and technology based, and that there is still a need for more traditional, personalized forms of health communication. A crucial question is how best to harness and integrate these new technologies within the current generation of mediated health information systems.

Adult↗
PubMed2005

What websites are patients using: results of a tracking study exploring patients use of websites at a multi-media patient education center.

Abstract: An exploratory study utilized computer tracking software at a hospital based patient education center was conducted to access use of the Web. During six months, 625 hits were tracked with 1/3 to www.cancer.gov one of the recommended websites, while over half of the sites were not on the recommended list. Here we report the challenges and results of this tracking study.

Adult↗
PubMed2004

The Appalachia Cancer Network: cancer control research among a rural, medically underserved population.

Residents of Appalachia, especially those in rural Appalachia, are generally considered to be medically underserved. In fact, cancer mortality in Appalachia, especially in rural Appalachia, is higher than it is in the remainder of the United States. Developing from the Appalachia Leadership Initiative on Cancer, the Appalachia Cancer Network (ACN) is a network of academic and community organizations that seek to conduct surveillance, intervention, and dissemination research to reduce this excess cancer burden in Appalachia. The purpose of this report is to (1) describe the approach to cancer control research in ACN, a Special Population Network, among the medically underserved of Appalachia, and (2) to put forward observations from this experience to enhance the research of other academic and community networks among underserved populations. ACN has instituted a conceptual model, organizational structure, and other methods to foster this research and to develop junior and community-based investigators. Important issues and questions related to the effectiveness of such research networks have also been articulated.

Appalachian Region↗
PubMed2003

Awareness of cancer information among Asian Americans.

The present study aimed to find the awareness level of cancer information among Asian Americans in the Delaware Valley region (Pennsylvania and South Jersey). A cross-sectional self-report survey was conducted with a sample of 1374 Asian Americans including Chinese, Korean, Vietnamese and Cambodians. The sample was collected by using a stratified-cluster proportional sampling technique. This paper assessed self-reported smoking behaviors, knowledge of smoking cessation methods, availability of health professional's advice in quitting smoking in the past 12 months, awareness of the National Cancer Institute's Cancer Information Service, knowledge of, and interest in participation in cancer clinical trials for identified Asian smokers. Overall, the level of awareness of cancer information services among the four subgroups was low. Among current and former smokers, only 31% had been advised by a health care professional to quit smoking. Forty-three percent used at least one smoking cessation method to quit in the past. The results also reveal an increased awareness level among those who had health insurance, higher education and were less likely to speak their native language. Significant differences on cancer awareness existed among the four ethnic groups as well. This study suggests urgent needs to educate Asian Americans about important cancer control issues and services and highlights the differences in baseline knowledge and attitudes among the various ethnic groups.

Asian↗
PubMed2002

Relationships among Internet health information use, patient behavior and self efficacy in newly diagnosed cancer patients who contact the National Cancer Institute's NCI Atlantic Region Cancer Information Service (CIS).

This NCI funded study examined the relationship between the use of Internet health information by people newly diagnosed with cancer (N=500), with patient task behavior and perceived self efficacy. Study variables were compared among Direct users of Internet health information (people using the Internet themselves), Indirect users of Internet health information (people receiving Internet health information from friends or family members), and Non-users of Internet health information (people not using the Internet or receiving health information from the Internet). The subjects were recruited from persons who called the Atlantic Region of the NCI's Cancer Information Service (CIS), located at Fox Chase Cancer Center in Philadelphia, PA. Follow up phone interviews were done with participants six weeks after initial contact to assess impact of the use of the Internet on perceived patient task behavior and self efficacy. Results show significant relationships between Internet use and all study variables.

Health Education↗