The American Public Health Association’s 140th Annual Meeting
Faculty and students collaborated on poster presentations, oral presentations, and a roundtable. See below for a sample of accepted presentations.
“Predictors of Positive Colonoscopy Expectations among Patients in the Rural South – Pathway for Disparities?” (roundtable)
Curbow, B, Barnett, TE, Dailey, AB, George TJ, Jr., King-Marshall, EC, Martin, E, McGinley, J, Rodriguez, E, Schumacher, J, Sultan, S, Telford, B.
At-risk patients (African American, lower level of education, lower income) appear to have higher expectations for positive physician treatment pre- and post-colonoscopy. To the extent that expectations are not met, future screening behaviors may be affected negatively, thus presenting an avenue for health disparities.
“Development of a Measure of Discrimination within the Health Care System: Preliminary Findings of Pre-Colonoscopy Patient Surveys” (poster presentation)
King-Marshall, EC, Curbow, B, Rodriguez, EM, Barnett, TE, Dailey, AB, George TJ, Jr., Schumacher,J, Martin, E, Sultan, S, Telford, B.
Approximately 58.6% of adults are up-to-date with their colorectal screening, compared to the Healthy People 2020 target of 70.5%. Rates of colorectal screening are lower than they should be; one potential barrier is perceived discrimination resulting in lack of trust of doctors and the health care system. Utilizing a self selected pre-colonoscopy patient population we assessed the level of perceived discrimination and medical trust and its potential association with socio-demographic variables. Results of the factor analysis revealed that two underlying constructs explained 67% of the variance. Whites, and higher educated individuals were more likely to agree with statements describing discrimination towards at risk groups.
“Barriers to Cancer Screening for Individuals with Disabilities: A Literature Review” (oral presentation)
Moorhouse, M., Pomeranz, J., Merten, J., Hinson, W.P.
Routine preventive screenings for breast, cervical and colorectal cancer are recommended for adults to identify and treat cancer with detection offering the best chances for treatment and survival. Over 50 million Americans currently have some form of disability and most people will experience a disability during their life. Studies have shown that people with disabilities are underinsured, have less access to healthcare, and are more likely to engage in risky health behavior. Existing research on preventive cancer screenings among the disabled is scarce with current studies suggesting that those with intellectual and physical disabilities are not being screened for cancer as often as the able-bodied population. Barriers include cost, access, healthcare provider discomfort, and physical and cognitive restraints. Potential interventions to improve routine preventative cancer screenings should include specialized healthcare provider training, community interventions and emphasis on the value of health promotion specific to the healthcare needs of people with disabilities.
“Delivery of a Colorectal Cancer Diagnosis to Colonoscopy Patients in the Rural South” (oral presentation)
Schumacher, J, Curbow, B, King-Marshall, E, Barnett, TE, Dailey, A, George TJ, Jr., Martin, E, Rodriguez, E, Sultan, S.
Communication of colonoscopy results by gastroenterologists may play an important role in follow-up health decision making of the patient. Findings suggest most GI’s deliver a cancer diagnosis in two steps 1. Disclosing suspected cancer in recovery post colonoscopy and 2) confirming cancer following pathology. During step 1, most providers conveyed verbal seriousness of a suspected diagnosis by indicating they have “bad/unfortunate news,” using the word “cancer” or “malignancy”, describing the need for follow-up treatments/tests, and making referrals/appointments for surgery and/or oncology on the day of colonoscopy. 40% of GIs were unaware of their use of non-verbal cues to convey disease seriousness. Those who did described changing facial expression and voice tone. Other strategies included moving to a quiet environment, making sure a caregiver is present, sitting down, maintaining eye contact, talking with hands, pausing, and touch (e.g., hold hand). During step 2, providers report confirming the diagnosis by phone if cancer was initially suspected or by phone/in-person if not suspected. Providers indicated that telling patients they suspected cancer at colonoscopy was important preparation for the conversation confirming the diagnosis following pathology and communicating treatment options. These interactions were less difficult than conversations with patients with cancer not suspected at colonoscopy. Communication of suspected cancer by GIs at colonoscopy plays an important role in preparing patients for a cancer diagnosis and most importantly, lays the foundation for future treatment decision making. These findings underscore the importance of interactions following a procedure complicated by sedation.
“The Relationship Between Weight Loss Behaviors and Cigarette Use Among College Females” (oral presentation)
Soule, E., Barnett, T.
We examined the relationship between weight loss behaviors, self-body image, and cigarette use among college females by conducting a secondary data analysis of National College Health Assessment-II data. In our analysis, we predicted both ever and current (past 30 day) cigarette use among college females between the ages of 18 and 23. Multiple logistic regression analyses indicated that females who reported they were trying to lose weight, described themselves as overweight, engaged in unhealthy weight loss behaviors (vomited, took laxatives, and/or took diet pills to lose weight), and health weight loss behaviors (exercised and/or “went on a diet”) were more likely to report cigarette use. These findings indicate college females who have body dissatisfaction or are trying to lose weight may be at greater risk for cigarette use.