Browsing by Author "Zarghami, Fatemeh"
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- Analysis of the Stakeholder Derived Conceptual Models and Exploration of Lung Cancer Screening Barriers in a Medically Underserved AreaZarghami, Fatemeh (Virginia Tech, 2018-06-13)The number of new cases of lung and bronchus cancer was 55.8 per 100,000 men and women per year. The number of deaths was 44.7 per 100,000 men and women per year. These rates are age-adjusted and based on 2010-2014 cases and deaths. Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined. The knowledge that lung cancer can be successfully treated if caught early has driven a decades-long search to find an accurate and reliable screening test. National Cancer Institute's National Lung Screening Trial (NLST) found that annual screening with Low-Dose CT (LDCT) for asymptomatic patients aged 55 to 74, with a smoking history of at least 30 pack-years, and smokers who quit less than 15 years ago, had a 20% reduction in risk of death from lung cancer. Findings of this trial resulted in that LDCT becoming the gold standard of screening for lung cancer. The SEED method is a community-engaged research approach to develop conceptual models and generate patient-centered research questions. This method has been used to engage community stakeholders of Martinsville, Virginia to develop conceptual models of the factors contributing to lung cancer outcomes. In the first manuscript of this dissertation, these models which were produced by 3 different groups of stakeholders have been examined closely to explore the complexity, similarities, and differences. The models were used to produce a research agenda on the topic of factors impacting lung cancer outcomes for future researchers. A literature review was conducted by the study team on the final research agenda. The goal of this literature review was to avoid duplication of research and to focus future research on the identified gaps. The knowledge and attitudes of the health care providers and patients about lung cancer screening and the barriers in the uptake of LDCT were identified as a research gap. The design of the Martinsville lung cancer study described in the second manuscript of this dissertation responds to this identified research gap. These studies and their results shed light on the factors that impact lung cancer outcomes using a community based participatory approach.
- Extended parallel process model (EPPM) in evaluating lung Cancer risk perception among older smokersZarghami, Fatemeh; Allahverdipour, Hamid; Jafarabadi, Mohammad Asghari (2021-10-17)Background There is a lack of scientific literature on the application of fear appeals theories to evaluate lung cancer risk perception among smokers. The aim of the present study is to apply the Extended Parallel Process Model (EPPM) to discover the perception of the smokers about their lifetime risk of developing lung cancer (perceived susceptibility), their perception of lung cancer survival (perceived severity), response efficacy, self-efficacy, and readiness to quit. Methods In this cross-sectional study, 215 eligible smokers (aged 45 years and over who have smoked at least 1 pack per day in the last 5 years) were recruited. The data collection tool was designed using validate self-report questionnaires and it was contained items on the perceived risk of a smoker contracting lung cancer and perceived lung cancer survival rate. It also had questions to measure the main constructs of the EPPM and Readiness to quit (“Low_Readiness”, and “High_Readiness”). To test how the data support conceptual EPPM to data, Generalized Structural Equation Modeling (GSEM) was used. Results Findings showed a significant relationship between Perceived_Susceptibility and Perceived_Response Efficacy; (B = 1.16, P < 0.001); between Perceived_Susceptibility and Perceived_Self Efficacy, (B = -0.93, P < 0.001), Perceived_Severity, and Perceived_Response Efficacy (B = 1.07, P < 0.001). There was also a significant relationship between Perceived_Threat and Perceived_Response Efficacy; between Perceived_Threat and Perceived_Self Efficacy. The relationship between High_Readiness and Perceived_Self Efficacy, and between High_Readiness and Perceived_Severity also were significant. However, the relationships between High_Readiness and Perceived_Threat were not significant (P > 0.05). Conclusion Perceived_threat and Perceived_efficacy were important for smokers with low readiness to quit, while Perceived_efficacy was most important for smokers with high readiness to quit. These findings could be used in promoting lung cancer awareness and designing smoking cessation programs based on smokers’ stages of change.
- A lung cancer research agenda that reflects the diverse perspectives of community stakeholders: process and outcomes of the SEED methodRafie, Carlin; Zimmerman, Emily B.; Moser, Dawn E.; Cook, Sarah; Zarghami, Fatemeh (2019-01-11)Plain English summary There is a need for methods that engage lay people and other stakeholders, such as patients and healthcare providers, in developing research questions about health issues important to them and their communities. Involving stakeholders helps ensure that funding goes to research that addresses their concerns. The SEED Method engages stakeholders in a systematic process to explore health issues and develop research questions. Diverse groups of stakeholders participate at three levels: as collaborators that lead the process throughout, as participants who use their expertise to develop the questions, and as consultants who provide additional perspectives about the health topic. We used the SEED Method to engage 61 stakeholders from different socioeconomic and professional backgrounds to create research questions on lung cancer outcomes. Participants included cancer patients and caregivers, healthcare providers and administrators, and policymakers from a rural Virginia community. They developed causal models that diagrammed factors that influence lung cancer outcomes and the relationships between them. They used these models to develop priority research questions. The questions reflect the participants' diverse perspectives and address different areas of inquiry related to lung cancer outcomes, including access to care, support systems, social determinants of health, and quality of care. Participants felt well prepared to perform the project tasks because they had the opportunity to review lung cancer information, receive causal model and research question development training, and participate in facilitated group activities. The SEED Method can be used in a variety of settings and applied to any health topic of interest to stakeholders. Abstract Background Engagement of stakeholders in prioritization of health research can help ensure that funding is directed to research that reflects their concerns and needs. The Stakeholder Engagement in quEstion Development and Prioritization (SEED) Method is a multi-stakeholder methodology that uses principles of community engagement and causal modeling to develop health research questions that reflect the priorities of patients, clinicians, and other community stakeholders. We conducted a demonstration of the SEED Method to generate research questions on lung cancer outcomes, and to evaluate the process, outcomes, and effectiveness of the method for generating a research agenda that reflects diverse stakeholder perspectives. Methods The SEED Method engages community members at three levels: collaboration, participation, and consultation. We conducted a demonstration project from November, 2015 to July, 2016, in a rural Virginia community that was experiencing a significant disparity in lung cancer outcomes. A community research team led the project and selected three distinct stakeholder groups (Topic groups, TG) for participatory engagement in analysis of the health issue, causal modeling, and research question development. We evaluated the quality of stakeholder engagement and compared TG causal models and research questions to evaluate the diversity of stakeholder perspectives resulting from the methodology. Results The resulting research agenda poses questions on how a broad range of topics including access to care, support systems and coping mechanisms, social determinants of health, and quality of care impacts lung cancer outcomes. Participants felt well prepared for the tasks they were asked to perform due to the technical trainings and facilitated modeling and question development activities that are part of the SEED Method. The causal models and research questions developed by the Topic Groups reflected the diverse perspectives of the stakeholders. Conclusions The SEED Method has the potential to generate relevant stakeholder-centered research agendas on a variety of health-related topics, and to create community capacity for sustained research engagement.
- Lung Cancer Risk Perception Among Older Smokers: a Cross-sectional StudyZarghami, Fatemeh; Allahverdipour, Hamid; Jafarabadi, Mohammad Asghari (2021-01-11)Background: Lung cancer is one of the deadliest cancers around the world. Also, scientific evidence proves the considerably lower lung cancer risk perceptions of smokers compared to non-smokers. Objectives: This study aimed at assessing the risk perception of smokers about their risk to contract lung cancer and their perceptions about lung cancer survival. Methods: In this cross-sectional study, the data were collected from 215 smokers in Tabriz, Iran, between April 2019 and July 2019. The data collection tool was designed, using validated questionnaires and contained questions on the perceived risk of smokers to develop lung cancer and their perception of lung cancer survival. A general linear model was conducted to model the relationship of risk perception with underlying predictors considering a significance level of 0.1. Results: The results of modeling indicated that perceived susceptibility (P-Sus) was negatively related to "years smoked" in simple regression (B = -0.035, P = 0.069) and multiple regression (B = -0.069, P = 0.007). P-Sus was also negatively related to the variable "age" in the age category of 45 to 50 years (B = -1.981, P = 0.046). Moreover, perceived severity (P-Sev) was negatively related to the variable "sex" (B = -1.037, P = 0.068). The results of the Spearman correlation indicated significant and direct correlations between "quitting intention" and P-Sus (r = 0.296, P < 0.001), P-Sev (r = 0.162, P = 0.009). Conclusions: Lung cancer risk perception of participants was moderately above the average and significant correlations were observed between "quitting intention" and "P-Sus" and "P-Sev" and "Risk Perception score". This could be utilized in developing educational programs to promote awareness about lung cancer, especially for smokers.
- Understanding Cancer: What we know about breast cancerRafie, Carlin; Zarghami, Fatemeh; Ju, Young H. (Virginia Cooperative Extension, 2017-01-04)Provides basic facts about breast cancer, including statistics, survival rate, types, symptoms, risks, treatment strategies, and prevention.
- Understanding Cancer: What We Know About Colorectal CancerRafie, Carlin; Anderson, Cody; Zarghami, Fatemeh; Ju, Young H. (Virginia Cooperative Extension, 2016-05-19)Offers basic facts about colorectal cancer, including statistics on number of cases, number of deaths, chances of survival, symptoms, early detection, risk factors, high risk populations, and treatment strategies.
- Understanding Cancer: What We Know About Lung CancerRafie, Carlin; Zarghami, Fatemeh; Ju, Young H. (Virginia Cooperative Extension, 2015-12-14)Provides information about lung cancer, including statistics, survival rate, types, symptoms, treatment, risks, and prevention.