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Julia Griffith

Bio: Julia Griffith is an academic researcher from Washington University in St. Louis. The author has contributed to research in topics: Genogram & Public health. The author has an hindex of 4, co-authored 4 publications receiving 94 citations.

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Journal ArticleDOI
TL;DR: Given the extensive reach of 2-1-1s and the elevated risk profile of their callers, even modest response rates could have meaningful impact on population health if proactive health referrals were implemented nationally.

41 citations

Journal ArticleDOI
TL;DR: This qualitative study of 32 African American women analyzed participants’ definitions of family, family communication about health, and collection of family health history information to suggestFamily health history initiatives should address family tensions and communication patterns that affect discussion and collection.
Abstract: Public health initiatives encourage the public to discuss and record family health history information, which can inform prevention and screening for a variety of conditions. Most research on family health history discussion and collection, however, has predominantly involved White participants and has not considered lay definitions of family or family communication patterns about health. This qualitative study of 32 African American women-16 with a history of cancer-analyzed participants' definitions of family, family communication about health, and collection of family health history information. Family was defined by biological relatedness, social ties, interactions, and proximity. Several participants noted using different definitions of family for different purposes (e.g., biomedical vs. social). Health discussions took place between and within generations and were influenced by structural relationships (e.g., sister) and characteristics of family members (e.g., trustworthiness). Participants described managing tensions between sharing health information and protecting privacy, especially related to generational differences in sharing information, fear of familial conflict or gossip, and denial (sometimes described as refusal to "own" or "claim" a disease). Few participants reported that anyone in their family kept formal family health history records. Results suggest family health history initiatives should address family tensions and communication patterns that affect discussion and collection of family health history information.

37 citations

Journal ArticleDOI
TL;DR: Although participants thought collecting FHH information was important and had positive reactions to both tools, the majority did not use the tools to write down information and instead collected FHH informally, underline the importance of separating the components of FHH collection behaviors to analyze the steps used in FHH creation.
Abstract: Little is known about African American women’s collection of family health history (FHH) information and use of FHH tools. Most FHH research has investigated tools that use a biomedical paradigm, but other kinds of tools, such as those that include information about family social context, have been developed for use in diverse populations. Using mixed methods, we interviewed 32 African American women about behavioral steps to collecting FHH, family communication about health, and reactions to a biomedical FHH tool. Participants chose one of two FHH tools to take home. A follow-up call three weeks later assessed tool use. Many participants expressed support for writing down FHH information, but at baseline few had done so; most participants who had collected FHH information had done so verbally. Participants reacted positively to the biomedical FHH tool used during the interview, with many saying it allowed them to see patterns in their FHH. At follow-up, 67 % reported using their FHH tool, primarily to promote discussion among family members; only 32 % used the tool to write down FHH information. Although participants thought collecting FHH information was important and had positive reactions to both tools, the majority did not use the tools to write down information and instead collected FHH informally. These findings underline the importance of separating the components of FHH collection behaviors to analyze the steps used in FHH creation. Practitioners should consider additional methods of encouraging patients to create written FHHs in order to share the information with health care providers.

20 citations

Journal ArticleDOI
TL;DR: Cell phone ownership is growing and has potential to deliver health information to low-income populations, and the national 2-1-1 system may be a promising model and platform.
Abstract: Purpose. Characterize mobile technology ownership, use, and relationship to self-reported cancer prevention behaviors and health status in a diverse, low-income sample of callers to 2-1-1. Design. Secondary analyses of cross-sectional survey data from a larger trial collected from June 2010 to December 2012. Setting. United Way Missouri 2-1-1 serves 99 of 114 counties and received 166,000 calls in 2011. Subjects. The respondents (baseline, n = 1898; 4 month, n = 1242) were predominantly female, non-Hispanic Black, younger than 50 years, with high-school education or less and annual income <$20,000. Measures. Cell phone ownership and use and its relationship to cancer prevention services and health status were assessed via telephone-based survey, using items adapted from previous research and the Behavioral Risk Factor Surveillance System. Smartphone ownership and use were also assessed. Analysis. Descriptive statistics and bivariate and multivariate associations between cell phone ownership and p...

12 citations


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Journal ArticleDOI
TL;DR: The public is urged to take action to protect themselves and their loved ones from disease-causing substances.

781 citations

Journal ArticleDOI
TL;DR: The effectiveness of different forms of print-based self-help materials, compared with no treatment and with other minimal contact strategies; the effectiveness of adjuncts to print- based self help, such as computer-generated feedback, telephone hotlines and pharmacotherapy; and the effectivenessof approaches tailored to the individual compared with non-tailored materials were determined.
Abstract: © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Background: Many smokers give up smoking on their own, but materials giving advice and information may help them and increase the number who quit successfully. Objectives: The aims of this review were to determine: the effectiveness of different forms of print-based self-help materials, compared with no treatment and with other minimal contact strategies; the effectiveness of adjuncts to print-based self help, such as computer-generated feedback, telephone hotlines and pharmacotherapy; and the effectiveness of approaches tailored to the individual compared with non-tailored materials. Search methods: We searched the Cochrane Tobacco Addiction Group trials register. Date of the most recent search April 2014. Selection criteria: We included randomized trials of smoking cessation with follow-up of at least six months, where at least one arm tested a print-based self-help intervention. We defined self help as structured programming for smokers trying to quit without intensive contact with a therapist. Data collection and analysis: We extracted data in duplicate on the participants, the nature of the self-help materials, the amount of face-to-face contact given to intervention and to control conditions, outcome measures, method of randomization, and completeness of follow-up. The main outcome measure was abstinence from smoking after at least six months follow-up in people smoking at baseline. We used the most rigorous definition of abstinence in each trial, and biochemically validated rates when available. Where appropriate, we performed meta-analysis using a fixed-effect model. Main results: We identified 74 trials which met the inclusion criteria. Many study reports did not include sufficient detail to judge risk of bias for some domains. Twenty-eight studies (38%) were judged at high risk of bias for one or more domains but the overall risk of bias across all included studies was judged to be moderate, and unlikely to alter the conclusions. Thirty-four trials evaluated the effect of standard, non-tailored self-help materials. Pooling 11 of these trials in which there was no face-to-face contact and provision of structured self-help materials was compared to no intervention gave an estimate of benefit that just reached statistical significance (n = 13,241, risk ratio [RR] 1.19, 95% confidence interval [CI] 1.04 to 1.37). This analysis excluded two trials with strongly positive outcomes that introduced significant heterogeneity. Six further trials without face-to-face contact in which the control group received alternative written materials did not show evidence for an effect of the smoking self-help materials (n = 7023, RR 0.88, 95% CI 0.74 to 1.04). When these two subgroups were pooled, there was no longer evidence for a benefit of standard structured materials (n = 20,264, RR 1.06, 95% CI 0.95 to 1.18). We failed to find evidence of benefit from providing standard self-help materials when there was brief contact with all participants (5 trials, n = 3866, RR 1.17, 95% CI 0.96 to 1.42), or face-to-face advice for all participants (11 trials, n = 5365, RR 0.97, 95% CI 0.80 to 1.18). Thirty-one trials offered materials tailored for the characteristics of individual smokers, with controls receiving either no materials, or stage matched or non-tailored materials. Most of the trials used more than one mailing. Pooling these showed a benefit of tailored materials (n = 40,890, RR 1.28, 95% CI 1.18 to 1.37) with moderate heterogeneity (I2 = 32%). The evidence is strongest for the subgroup of nine trials in which tailored materials were compared to no intervention (n = 13,437, RR 1.35, 95% CI 1.19 to 1.53), but also supports tailored materials as more helpful than standard materials. Part of this effect could be due to the additional contact or assessment required to obtain individual data, since the subgroup of 10 trials where the number of contacts was matched did not detect an effect (n = 11,024, RR 1.06, 95% CI 0.94 to 1.20). In two trials including a direct comparison between tailored materials and brief advice from a health care provider, there was no evidence of a difference, but confidence intervals were wide (n = 2992, RR 1.13, 95% CI 0.86 to 1.49). Only four studies evaluated self-help materials as an adjunct to nicotine replacement therapy, with no evidence of additional benefit (n = 2291, RR 1.05, 95% CI 0.88 to 1.25). A small number of other trials failed to detect benefits from using additional materials or targeted materials, or to find differences between different self-help programmes. Authors' conclusions: Standard, print-based self-help materials increase quit rates compared to no intervention, but the effect is likely to be small. We did not find evidence that they have an additional benefit when used alongside other interventions such as advice from a healthcare professional, or nicotine replacement therapy. There is evidence that materials that are tailored for individual smokers are more effective than non-tailored materials, although the absolute size of effect is still small. Available evidence tested self-help interventions in high income countries; further research is needed to investigate their effect in contexts where more intensive support is not available.

104 citations

Journal ArticleDOI
TL;DR: Minimal intervention was effective in promoting smoke-free homes in low income households and offers a potentially scalable model for protecting children and adult nonsmokers from secondhand smoke exposure in their homes.
Abstract: Objectives. We tested the efficacy of a minimal intervention to create smoke-free homes in low-income households recruited through the United Way of Greater Atlanta 2-1-1, an information and referral system that connects callers to local social services.Methods. We conducted a randomized controlled trial (n = 498) from June 2012 through June 2013, with follow-up at 3 and 6 months. The intervention consisted of 3 mailings and 1 coaching call.Results. Participants were mostly smokers (79.7%), women (82.7%), African American (83.3%), and not employed (76.5%), with an annual household income of $10 000 or less (55.6%). At 6-months postbaseline, significantly more intervention participants reported a full ban on smoking in the home than did control participants (40.0% vs 25.4%; P = .002). The intervention worked for smokers and nonsmokers, as well as those with or without children.Conclusions. Minimal intervention was effective in promoting smoke-free homes in low income households and offers a potentially sca...

54 citations

Journal ArticleDOI
TL;DR: The ResearchKit framework is outlined and evaluated, identifying issues for ethics approval and indicating how this system fits into current practice, as well as outlining and evaluating the development platform with relatively little assumed knowledge.
Abstract: Alongside the Apple Watch, in March 2015 Apple released ResearchKit, an open source software framework for medical research. Available at www.researchkit.org, ResearchKit enables investigators to create mobile applications which use the iPhone’s capacity to collect data, track movement and take measurements. Intended to facilitate largescale, opt-in surveys and observational studies as well as providing a new way for researchers to collect adjuvant data on subjects recruited elsewhere, ResearchKit is now demonstrating its power. A recently opened study of cardiovascular health at Stanford University recruited over 10,000 participants within 24 h of their ResearchKit platform being launched. Engagement with novel electronic research methodologies varies; barriers related to healthcare systems, culture and investigator technological fluency are challenging. Encouragingly, surveys of junior doctors indicate high levels of enthusiasm for developing new smartphone applications (apps) for use in healthcare and research. ResearchKit offers a development platform with relatively little assumed knowledge. Here, we outline and evaluate the framework, identifying issues for ethics approval and indicating how this system fits into current practice.

52 citations

Journal ArticleDOI
TL;DR: It is found that cancer-specific patient-centered technologies seem to be effective, especially when tailored, in improving patient and care-related outcomes.
Abstract: Background: In the United States, more than 16 million new cases of cancer are estimated to be diagnosed each year However, the burden of cancer among the US population is not shared equally, with racial and ethnic minorities and lower-income populations having a higher cancer burden compared with their counterparts For example, African Americans have the highest mortality rates and shortest survival rates for most cancers compared with other racial or ethnic groups in the United States A wide range of technologies (eg, internet-based [electronic health, eHealth] technologies, mobile [mobile health, mHealth] apps, and telemedicine) available to patients are designed to improve their access to care and empower them to participate actively in their care, providing a means to reduce health care disparities; however, little is known of their use among underserved populations Objective: The aim of this study was to systematically review the current evidence on the use of cancer-specific patient-centered technologies among various underserved populations Methods: Computer-based search was conducted in the following academic databases: (1) PubMed (cancer subset), (2) MEDLINE, (3) PsycINFO, and (4) CINAHL We included studies that were peer-reviewed, published in the English language, and conducted in the United States Each study was individually assessed for relevance, with any disagreements being reconciled by consensus We used a 3-step inclusion process in which we examined study titles, abstracts, and full-text papers for assessment of inclusion criteria We systematically extracted information from each paper meeting our inclusion criteria Results: This review includes 71 papers that use patient-centered technologies that primarily targeted African Americans (n=31), rural populations (n=14), and Hispanics (n=12) A majority of studies used eHealth technologies (n=41) finding them to be leading sources of cancer-related health information and significantly improving outcomes such as screening among nonadherent individuals and increasing knowledge about cancer and cancer screening Studies on mHealth found that participants reported overall favorable responses to receiving health information via short message service (SMS) text message; however, challenges were experienced with respect to lack of knowledge of how to text among some participants More complex mobile technologies (eg, a tablet-based risk assessment tool) were also found favorable to use and acceptable among underserved populations; however, they also resulted in more significant barriers, for example, participants expressed concerns regarding security and unfamiliarity with the technology and preferred further instruction and assistance in its use Conclusions: There is a growing body of literature exploring patient-centered technology and its influence on care of underserved populations In this review, we find that these technologies seem to be effective, especially when tailored, in improving patient and care-related outcomes Despite the potential of patient-centered technologies and the receptivity of underserved populations, challenges still exist with respect to their effective use and usability

42 citations