Psychometric Characteristics of the Parsimonious Chinese Version of the Smoking Self-Efficacy Survey (CSSES-20)*

BACKGROUND: Cigarette smoking is a health-risk behavior of global proportions. Self-efficacy plays an important role in both smoking acquisition and smoking resistance. Reliability and validity of an instrument is fundamental to research results, particularly in its simplified form on a different population. The purpose of this study was to conduct psychometric testing on the parsimonious Chinese version of the Smoking Self-efficacy Survey (CSSES-20). METHODS: The randomized cluster sample was drawn from 61 middle schools in Taipei City, Taiwan. Following a pilot test of the CSSES-20, the CSSES was administered to 571 adolescents. Construct validity was tested by the exploratory factor procedures and the contrasted group approach. Pearson correlation coefficients were used to examine the criterion validity and test-retest reliability for the stability of the scale. Cronbach's alpha coefficients were used to determine the internal consistency of the scale. RESULTS: The exploratory factor analysis yields three components, “opportunity to smoke,”“emotional stress,” and “influence of friends,” accounting for 80.4% of the total variances. The criterion validity was also supported by the study results. The contrasted group approaches affirmed the construct validity of the CSSES-20. Stability of scales was supported by test-retest reliability. Cronbach's alphas for 3 subscales ranged from .90 to .93. CONCLUSIONS: A concise instrument can alleviate response burden for adolescent study participants and increase their recruitment and retention rates. The CSSES-20 demonstrated satisfactory construct validity, criterion validity, stability, and internal consistency reliability. These findings can be used to provide school teachers and nurses with information about the relationship between self-efficacy to resist smoking and adolescent smoking behavior.     

Evaluation of the Centers for Disease Control and Prevention's Concussion Initiative for High School Coaches: “Heads Up: Concussion in High School Sports”

BACKGROUND: To reduce the number of sports-related concussions, the Centers for Disease Control and Prevention (CDC), with the support of partners and experts in the field, has developed a tool kit for high school coaches with practical, easy-to-use concussion-related information. This study explores the success of the tool kit in changing knowledge, attitudes, and practices related to the prevention and management of concussions. METHODS: A mail questionnaire was administered to all eligible high school coaches who received the tool kit. Follow-up focus groups were conducted for additional information. Both quantitative data from the surveys and qualitative data from the focus groups were analyzed to support the objectives of the study. RESULTS: Respondents self-reported favorable changes in knowledge, attitudes, and practices toward the prevention and management of concussions. Qualitative responses augmented the quantitative data. CONCLUSION: Barriers to concussion prevention and management are complex; however, these results highlight the role that coaches can play in school settings in establishing a safe environment for their athletes.     

Hospital Readmission Among Medicaid Patients with an Index Hospitalization for Mental and/or Substance Use Disorder

Hospital readmission rates are increasingly used as a performance indicator. Whether they are a valid, reliable, and actionable measure for behavioral health is unknown. Using the MarketScan Multistate Medicaid Claims Database, this study examined hospital- and patient-level predictors of behavioral health readmission rates. Among hospitals with at least 25 annual admissions, the median behavioral health readmission rate was 11% (10th percentile, 3%; 90th percentile, 18%). Increased follow-up at community mental health centers was associated with lower probabilities of readmission, although follow-up with other types of providers was not significantly associated with hospital readmissions. Hospital average length of stay was positively associated with lower readmission rates; however, the effect size was small. Patients with a prior inpatient stay, a substance use disorder, psychotic illness, and medical comorbidities were more likely to be readmitted. Additional research is needed to further understand how the provision of inpatient services and post-discharge follow-up influence readmissions.     

Oncology Social Workers' Perceptions of Barriers to Discussing Fertility Preservation with Cancer Patients

ABSTRACT

Infertility is a common result of cancer treatment; however, opportunities exist that allow patients to preserve their fertility prior to treatment. Evidence suggests health care providers, including social workers, do not consistently discuss this topic with patients. This study used a qualitative, cross-sectional design using a focus group and in-depth interviews to explore knowledge, attitudes, barriers, and behaviors related to social workers' discussion of fertility preservation with cancer patients. Factors that influence the discussion of fertility preservation among social workers include: (1) Knowledge (e.g., Fertility Preservation Resources); (2) Attitudes (e.g., Cost, Perceived Role, Comfort Level, Fertility Preservation Discussion Difficulty/Priority); (3) Barriers (e.g., Cost, Urgency to start Treatment/Time, Patient Factors, Physician Attitudes/Beliefs); (4) Behaviors; and (5) Suggestions. Results show social workers are not typically discussing fertility preservation methods with patients; however, they may be in an ideal position to facilitate the conversation between the physician and the patient. There is a strong need to develop educational interventions aimed at oncology social workers, to help facilitate discussions with patients.     

Implementing a Screening Tool for Identifying Patients at Risk for Hereditary Breast and Ovarian Cancer: A Statewide Initiative

Background

The Georgia Breast Cancer Genomic Health Consortium is a partnership created with funding from the Centers for Disease Control and Prevention (CDC) to the Georgia Department of Public Health to reduce cancer disparities among high-risk minority women. The project addresses young women at increased risk for hereditary breast and ovarian cancer (HBOC) syndrome through outreach efforts.

Methods

The consortium provides education and collects surveillance data using the breast cancer genetics referral screening tool (B-RST) available at www.BreastCancerGeneScreen.org. The HBOC educational protocol was presented to 73 staff in 6 public health centers. Staff used the tool during the collection of medical history. Further family history assessments and testing for mutations in the BRCA1/2 genes were facilitated if appropriate.

Results

Data was collected from November 2012 through December 2013, including 2,159 screened women. The majority of patients identified as black/African American and were 18–49 years old. Also, 6.0 % (n = 130) had positive screens, and 60.9 % (n = 67) of the 110 patients who agreed to be contacted provided a detailed family history. A total of 47 patients (42.7 %) met National Comprehensive Cancer Network guidelines when family history was clarified. Fourteen (12.7 %) underwent genetic testing; 1 patient was positive for a BRCA2 mutation, and 1 patient was found to carry a variant of uncertain significance.

Conclusions

The introduction of genomics practice within public health departments has provided access to comprehensive cancer care for uninsured individuals. The successful implementation of the B-RST into public health centers demonstrates the opportunity for integration of HBOC screening into primary care practices.     

Prostate Cancer Education in African American Churches

Abstract The use of churches as recruitment sites of African Americans into health promotion activities is a popular theme in the 1990s literature. This research measured the impact of previous exposure to cancer on participation in an educational program and a free prostate cancer screening. Cues to action from the Health Belief Model provided the conceptual framework. Over 500 men attended a prostate cancer educational program at their church. Men who participated in the educational program and completed the questionnaire were given a voucher that they could take to their doctor of choice for a free prostate cancer examination. Having a member of the congregation who was previously diagnosed with cancer was a significant cue to attendance at the educational program ( P = 0.03). Recommendations for future cancer screening in churches are given.