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Biomedical subjects

M Chris Gibbons

Publications and source records attributed to M Chris Gibbons.

7 recordsLinked to original sources

Provider roles in the recruitment of underrepresented populations to cancer clinical trials.

BACKGROUND: Providers play a vital role in the successful recruitment of underrepresented patients to cancer clinical trials because they often introduce the opportunity of clinical trials. The purpose of the current systematic review was to describe provider-related factors influencing recruitment of underrepresented populations to cancer clinical trials. METHODS: To find original studies on the recruitment of underrepresented populations to cancer clinical trials, electronic databases from January 1966 to December 2005 were searched; hand-searched titles in 34 journals from January 2003 to January 2006; and reference lists were examined of eligible articles. Title and abstract reviews were conducted to identify relevant studies. Potential articles were then abstracted using a structured instrument and a serial review process by 2 investigators. RESULTS: Eighteen studies were eligible for review: 13 targeted healthcare providers, 3 targeted patients/participants, and 2 targeted both providers and patients. The study designs included randomized controlled trial, concurrent controlled trial, case-control, descriptive, and qualitative. A lack of available protocols and/or a lack of provider awareness about clinical trials prevented providers from discussing the opportunity of clinical trials in 2 studies. In 14 studies, patient accrual was affected by provider attitudinal barriers relating to patient adherence to the study protocol, patient mistrust of research, patient costs, data collection costs, and/or patient eligibility. Providers' communication methods were barriers in 5 studies and promoters in 1 study. CONCLUSIONS: A heterogeneous body of evidence suggests that several provider-related factors influence recruitment of underrepresented groups to clinical trials. Future recruitment efforts should address these factors.

Clinical Trials as Topic↗

The sociobiologic integrative model (SBIM): enhancing the integration of sociobehavioral, environmental, and biomolecular knowledge in urban health and disparities research.

Disentangling the myriad determinants of disease, within the context of urban health or health disparities, requires a transdisciplinary approach. Transdisciplinary approaches draw on concepts from multiple scientific disciplines to develop a novel, integrated perspective from which to conduct scientific investigation. Most historic and contemporary conceptual models of health were derived either from the sociobehavioral sciences or the biomolecular sciences. Those models deriving from the sociobehavioral sciences generally lack detail on involved biological mechanisms whereas those derived from the biomolecular sciences largely do not consider socioenvironmental determinants. As such, advances in transdisciplinary characterizations of health in complex systems like the urban environment or health disparities may be impeded. This paper suggests a sociobiologic organizing model that encourages a multilevel, integrative perspective in the study of urban health and health disparities.

Causality↗

Effectiveness of strategies to recruit underrepresented populations into cancer clinical trials.

BACKGROUND: Certain populations, including racial and ethnic minorities and older persons, have had a history of low participation in cancer-related trials, yet there has been little information reported on recruitment strategies tailored to improve their enrollment. METHODS: We conducted a systematic literature review to examine the methods used to study recruitment of underrepresented populations into cancer prevention and treatment trials and examined the studies that compared the efficacy and/or effectiveness of different recruitment strategies. We performed an electronic search through multiple databases including PubMed and a hand search of 34 journals. Potential studies were pulled and underwent title, abstract, and article review by at least two investigators. RESULTS: Fourteen articles examined recruitment of underrepresented populations into cancer trials and, of these, five compared efficacy or effectiveness of different strategies for recruitment of underrepresented populations into randomized or concurrent controlled trials. These five studies used various strategies but only three reported that specific recruitment strategies, such as media campaigns and church-based project sessions, resulted in improvement in accrual to cancer trials. CONCLUSION: There is limited evidence for efficacious or effective strategies to recruit underrepresented populations in cancer-related trials. The available evidence cannot be generalized to these heterogeneous groups. Further study is needed on efficacious strategies for recruitment of underrepresented populations into cancer-related trials.

Clinical Trials as Topic↗

Health inequalities and emerging themes in compunetics.

Inequalities in health have been documented for hundreds of years. The causes of these inequalities are complex and related to social, medical, environmental, class, healthcare system and behavioral determinants. Currently governments and healthcare systems are struggling to effectively reduce these differences. In addition, the number of individuals with chronic diseases is rapidly growing, particularly in developed nations. Most of the care needed for effective management of these chronic diseases is performed outside of the hospital setting by non-physicians. However the world's healthcare systems are primarily oriented toward acute, hospital based emergency care and therefore currently largely unable to effectively and consistently provide high quality care to every person. Recent developments in the computer industry have led to major advances in scientific research capabilities and in like manner will, in the future, likely enable significant advances in the field of compunetics. By enabling the instantaneous capture and utilization of large amounts of diverse data, IT will facilitate a population level orientation in compunetics in addition to the current focus on individual patient applications. Similarly the development of behavioral compunetics or a focus innovative uses of technology to influence health behaviors of patients and physicians are on the verge of occurring. In so doing, these and other advances in compunetincs may significantly increase our ability to provide high quality community oriented care, improve the health of individuals and populations and thereby help reduce health inequalities.

Chronic Disease↗

The Johns Hopkins Urban Health Institute: A collaborative response to urban health issues.

The authors provide background on the poor health and economic status of the residents of East Baltimore, Maryland--the neighborhood surrounding a significant part of Johns Hopkins University, including the School of Medicine, the School of Nursing, the Bloomberg School of Public Health, and the Johns Hopkins Hospital. The president of the Johns Hopkins University established a council on urban health, consisting of a broad array of individuals from across the university and the community to develop a recommended course of action to help deal with these conditions. Based on the recommendations of the council, the Johns Hopkins Urban Health Institute was established with the mission to marshall the resources of the university and external groups to improve the health and well-being of the residents of East Baltimore and to promote evidence-based interventions to solve urban health problems nationwide. After becoming fully operational in 2001, the institute established three major goals: (1) strengthen research and learning, (2) reduce disparities in health and health care for East Baltimore residents, and (3) promote economic growth in East Baltimore. The article describes the institute's major activities, including community-based participatory research projects, the Journal of Community-Based Participatory Research, and programs for research fellows to promote research and learning; HIV/AIDS counseling and testing centers and a primary care clinic for the uninsured to reduce health disparities; and a technology resource center providing training and job opportunities to promote economic growth. The authors conclude by outlining the next steps planned for the institute.

Academic Medical Centers↗