Requests For Help Research Articles

Accelerating Women-centered Local Action and Increasing Impact to Stop Preventable Maternal & Newborn Deaths in Low- and Middle -Income Countries: Case-study in Senegal

There is an urgent need for improvements in maternal and newborn health despite the efforts of numerous stakeholders and the adoption of specific targets as in the Sustainable Development Goals. In 2018, using an evidence-based and design-thinking approach involving communities, three stakeholders (a foundation, an NGO, and a startup) decided to combine their expertise to better understand and potentially revisit the drivers for improving maternal and newborn health. The AIM – Accelerated Impact Model - has been designed as a systemic, needs-led innovation framework for improving maternal and newborn health in low and middle-income countries. The AIM is currently being tested to assess its real-world impact in the Saint-Louis region of Senegal. This paper aims to explain the rationale and methodology for designing this innovative model, as well as presenting hypotheses concerning its impact. This novel, integrated approach is associated with community empowerment and accompanied by “glocal” experts and organizations. It represents the backbone of the AIM method. The first step of the AIM application was the pre-pilot phase, as the population itself identified the health and medical-social barriers contributing to maternal and newborn mortality together with the corresponding corrective measures. The second step integrated co-created projects into a three-pillar program centered on awareness of community engagement, optimizing the attractiveness of the health pyramid base, and the empowerment of women. To test the sustainability of the model, the third step of the AIM approach resulted in the creation of a local pilot team to accelerate the implementation of new co-created projects and optimize existing initiatives supported by local and global sponsors. Over the course of one month, the newly formed “Rawal ak Diam” platform transformed the COVID-19 epidemic into an opportunity to mobilize the community and connect with the authorities. This step was crucial for gaining legitimation for the platform and helped design and implement a three-pillar program. The community program focus here is on the two first deadlines (the decision to request help and access care) in maternal health while remaining aligned with the Sustainable Development Goal of reducing maternal and neonatal mortality in low- and middle-income countries.

Mental Health Conditions Among Struggling GME Learners: Results From a Single Center Remediation Program

Graduate medical education (GME) learners may struggle with clinical performance during training. A subset of these trainees has mental health conditions (MHCs). To characterize the MHCs that underlie poor trainee performance and their relationship to specific clinical performance deficit (CPD). At the University of Virginia (UVA), GME learners not meeting appropriate milestones, or who request help, have the option to self-refer or be referred to COACH (Committee on Achieving Competence Through Help). A physician remediation expert assesses the learner and identifies a primary CPD. If there is concern for an MHC, referral is made to a psychologist with expertise in working with trainees. All learners are offered remediation for the CPD. Using descriptive statistics, we tracked the prevalence of MHC and their correlation with specific CPDs. Between 2016 and 2019, COACH assessed 7% (61 of 820) of GME learners at UVA. Thirty-eight percent (23 of 61) had an MHC associated with the CPD. Anxiety was the most common MHC (48%), followed by depression (17%), cognitive dysfunction (17%), adjustment disorder (13%), and other (4%). Professionalism was the most identified CPD among learners with MHCs (52%). Of remediated learners, 47% have successfully finished remediation, 21% were terminated or voluntarily left their program, and 32% are still being remediated (83% of whom are in good standing). MHCs were identified in nearly 40% of struggling learners referred to a centralized remediation program. Professionalism is the most identified CPD among learners with MHCs.

Need-based transfer systems are more vulnerable to cheating when resources are hidden

Abstract Need-based transfer systems pool risk among interdependent individuals. Such arrangements are bound by two simple rules: Ask for help only when in need and, if you are able, give help to others who ask. But there may be a temptation for individuals to break these rules for short-term personal profit. Here, we study one factor that may enforce honesty in need-based transfer relationships: the visibility of resources. Across three experiments employing a novel experimental economic game, breaking of both need-based transfer rules increased when resources were hidden rather than visible (Experiment 1: n = 82, online convenience sample from the US; Experiment 2: n = 80, student sample from the US; Experiment 3: n = 42, online convenience sample from the US). Participants with hidden resources were (1) more likely to request help when not actually in need (greediness), and (2) more likely to not fulfill requests from others for help, even when they had sufficient resources available to help (stinginess). These findings highlight the visibility of resources as one potential limitation of cooperative risk pooling systems.

How Do You Feel About Interactions with Coworkers? The Role of Positive Relational Affect

This paper examines the role of affect in dyadic interactions between coworkers. Because task performance is becoming more team-driven, organizations are taking an increasing interest in the relationships among socially embedded team members. Emerging literature indicates that effect in relationships among coworkers has a critical role in organizational life; interpersonal affect is thus of central importance in the workplace. Drawing from the affect theory of social exchange and conservation of resources theory, we argue that when individuals experience positive affect in their interaction with a partner, they are more likely to request help from that partner. Additionally, experiencing positive affect during interaction with dyadic partners increases individuals’ resources and facilitates work engagement. We used experience sampling strategy to examine the workplace interactions and work engagement of 173 individuals (634 dyadic relations) for a period of 5 days, and analyzed the cross-classified multilevel model using round-robin design. The results supported the study’s hypotheses. We also discuss the theoretical and practical implications of our findings.

The Promise of Patient Portals for Individuals Living With Chronic Illness: Qualitative Study Identifying Pathways of Patient Engagement.

BackgroundPatients play a critical role in managing their health, especially in the context of chronic conditions like diabetes. Electronic patient portals have been identified as a potential means to improve patient engagement; that is, patients’ involvement in their care. However, little is known about the pathways through which portals may help patients engage in their care.ObjectiveOur objective is to understand how an electronic patient portal facilitates patient engagement among individuals with diabetes.MethodsThis qualitative study employed semistructured telephone interviews of 40 patients living with diabetes since at least 2011, who had experienced uncontrolled diabetes, and had used secure messaging through a portal at least 4 times over 18 months. The interviews were recorded, transcribed, coded, and analyzed using primarily an inductive approach to identify how patients living with diabetes use an online health portal to support diabetes self-management.ResultsOverall, patients who used the portal reported feeling engaged in their health care. We identified four pathways by which the portal facilitates patient engagement and some challenges. The portal provides a platform that patients use to (1) better understand their health by asking questions about new symptoms, notes, or labs, (2) prepare for medical appointments by reviewing labs and notes, (3) coordinate care between VA (Veterans Affairs) and non-VA health care teams, and (4) reach out to providers to request help between visits. Several patients reported that the portal helped improve the patient-provider relationship; however, aspects of the portal design may hinder engagement for others. Patients reported challenges with both secure messaging and access to medical records that had negative impacts on their engagement. Benefits for patient engagement were described by many types of portal users with varying degrees of diabetes control.ConclusionsPatient portals support engagement by facilitating patient access to their health information and by facilitating patient-provider communication. Portals can help a wide range of users engage with their care.

Families Requesting Advocates for Children With Disabilities: The Who, What, When, Where, Why, and How of Special Education Advocacy.

Because parents face barriers in advocating for their children within the special education system, some families request help from a special education advocate. In this study, we evaluated the perceptions of caregivers who requested advocacy support to understand why, for whom, when, and where the advocacy services were needed; how the advocate helped; and what the outcomes of the advocacy process were and which variables related to better outcomes. We conducted structured interviews with 36 families who had requested help and connected with an advocate over a 3-year period. Compared to national norms, families were more likely to request an advocate if their child had ASD, was in elementary school, and lived in non-rural areas. Family requests were most often for advocate attendance at IEP meetings; help to resolve disagreements with the school concerning supports and services; and information about school services and parental rights. Most advocate assistance was for a short duration, although a longer duration process, advocate attendance at meetings, and more intensive advocate assistance were all related to better outcomes. Most participants were satisfied with the advocate and with the end-result of the advocacy process. Findings are discussed in terms of implications for future research and practice.

Experiences and intentions of Ugandan household tuberculosis contacts receiving test results via text message: an exploratory study

BackgroundThe World Health Organization (WHO) recommends household contact investigation for tuberculosis (TB) in high-burden countries. However, household contacts who complete evaluation for TB during contact investigation may have difficulty accessing their test results. Use of automated short-messaging services (SMS) to deliver test results could improve TB status awareness and linkage to care. We sought to explore how household contacts experience test results delivered via SMS, and how these experiences influence follow-up intentions.MethodsWe conducted semi-structured interviews with household contacts who participated in a randomized controlled trial evaluating home sputum collection and delivery of TB results via SMS (Pan-African Clinical Trials Registry #201509000877140). We asked about feelings, beliefs, decisions, and behaviors in response to the SMS results. We analyzed the content and emerging themes in relation to the Theory of Planned Behavior.ResultsWe interviewed and achieved thematic saturation with ten household contacts. Nine received TB-negative results and one a TB-positive result. Household contacts reported relief upon receiving SMS confirming their TB status, but also said they lacked confidence in the results delivered by SMS. Some worried that negative results were incorrect until they spoke to a lay health worker (LHW). Household contacts said their long-term intentions to request help or seek care were influenced by perceived consequences of not observing the LHW’s instructions related to the SMS and follow-up procedures; beliefs about the curability of TB; anticipated support from LHWs; and perceived barriers to responding to an SMS request for further evaluation.ConclusionHousehold contacts experienced relief when they received results. However, they were less confident about results delivered via SMS than results delivered by LHWs. Delivery of results by SMS should complement continued interaction with LHWs, not replace them.

Инклюзивная образовательная среда: пилотное исследование взаимодействия педагогов и специалистов образовательной организации

The article is devoted to the pilot study of the problem of professional interaction in inclusive educational environment. The components of the development of an inclusive environment in education are highlighted. The purpose of the study is defined as studying the characteristics of the interaction between teachers of various levels of education in the work with students with disabilities in an inclusive educational environment. The results of an empirical study of online sample of volunteers (N=64) are presented. Respondents answered to the questionnaire about their attitude to the idea of inclusion, difficulties in interaction, the forms of interaction used and their willingness to request help. The results of the study based on a conventional content analysis, showed that interaction in an inclusive educational environment is built mainly through consultations (75%), workshops (59,4%) and other forms, while complicating professional interaction among more than half of respondents, mainly, the uncertainty of the responsibility of specialists in psychological and pedagogical support and various difficulties in building relationships. The data obtained show rather a different attitude towards the idea of inclusion in education in the light of the development of the inclusive educational environment of the educational organization, which determines the choice of the forms of interaction used.

Design and Development of an Incident Reporting Mobile Application

Reporting actual incidents through short messaging systems and telephone calls are tedious,prone to errors and misinterpretations. Developing a mobile application that can be utilized totransmit incident type, location, and images among other details can provide assistance inemergency situations. The software development method followed in this study was theprototyping model, where initial versions of the software were shown to the end users for it tobe refined to their needs. The target users of the mobile application are a group of 38Adventist motorcycle riders from Silang, Cavite, Philippines who are trained to be firstresponders. Interviews with end users and benchmarking on related systems were conductedto meet results. The end users’ feedback on the developed application can be summarized ashaving high accuracy, less prone to errors, and ease-of-use. Through Global PositioningSystems available on modern smart phones, reporting a specific incident location can be asaccurate as within five meters. The report receiver can view the location in a map.Minimizing text entry and utilizing control elements not only improve reporting time but alsoreduce chances of committing errors. Further, the application can provide map location andcontact information of the emergency facilities near the incident site. Reported information isalso centrally stored for references to improve response processes. Once substantial data isgathered from this system, it can be data-mined to predict possible hotspots, peak times andother information on the occurrences of incidents. To implement the system to a largergeographical territory, the proponents suggest employing artificial intelligence which canautomatically identify and request help from the nearest possible medical facilities.

Association between ambulatory status and call bell use in hospitalized patients-A retrospective cohort study.

Characterize the relationship between patient ambulatory status and in-hospital call bell use. Although call bells are frequently used by patients to request help, the relationship between physical functioning and call bell use has not been evaluated. Retrospective cohort study of 944 neuroscience patients hospitalized in a large academic urban medical centre between April 1, 2014 and August 1, 2014. We conducted multiple linear regression analyses with number of daily call bells from each patient as the primary outcome and patients' average ambulation status as the primary exposure variable. The mean number of daily call bell requests for all patients was 6.9 (6.1), for ambulatory patients 5.6 (4.8), and for non-ambulatory patients, it was 7.7 (6.6). Compared with non-ambulatory patients, ambulatory patients had a mean reduction in call bell use by 1.7 (95% CI 2.5 to -0.93, p<.001) calls per day. In a post hoc analysis, patients who could walk >250 feet had 5 fewer daily call bells than patients who were able to perform in-bed mobility. Ambulatory patients use their call bells less frequently than non-ambulatory patients. Frequent use of call bells by non-ambulatory patients can place additional demands on nursing staff; patient mobility status should be considered in nurse workload/patient assignment.

Codeine Addiction and Internet Forum Use and Support: Qualitative Netnographic Study.

BackgroundThe use of codeine as an analgesic is well-recognized, but there are increasing concerns that for some individuals continued use may lead to misuse, dependence, and fatalities. Research suggests that those affected may represent a hard-to-reach group who do not engage with formal treatment services.ObjectiveThis study sought to explore the experiences of people with self-reported addiction to codeine and, specifically, how a social media forum is used to communicate with others about this issue.MethodsUsing a qualitative netnographic methodology, the social media forum Mumsnet was used, with permission, and searches were undertaken in 2016 of any posts that related to codeine and addiction. A total of 95 relevant posts were identified; a purposive sample of 25 posts was selected to undertake subsequent six-stage thematic analysis and development of emerging themes. These 25 posts were posted between 2003 and 2016 and comprised 757 individual posts.ResultsIndividuals created posts to actively request help in relation to usually their own, but occasionally their partner’s or relative’s, problems relating to codeine use and self-reported “addiction.” Varying levels of detail were provided in narratives of problematic codeine use. There were both positive and negative descriptions of side effects emerging, problems experiencing withdrawal, and failed attempts to discontinue codeine use. Mainly positive and supportive responses to posts were identified from those with either self-reported health profession experience or lay respondents, who often drew on their own experiences of similar problems. Treatment advice emerged in two main ways, either as signposting to formal health services or to informal approaches and often anecdotal advice about how to taper or use cold turkey techniques. Some posts were more critical of the original poster, and arguments and challenges to advice were not uncommon. Shame and stigma were often associated with users’ posts and, while there was a desire to receive support and treatment advice in this forum, users often wanted to keep their codeine use hidden in other aspects of their lives. Distinctly different views emerged as to whether responsibility lay with prescribers or patients. Some users expressed anger toward doctors and their prescribing practices.ConclusionsThis study provides a unique insight into how a public internet forum is used by individuals to confirm and seek support about problematic codeine use and of the ways others respond. The pseudonymous use of internet forums for such information and variation in treatment options suggested by often lay respondents suggest that increased formal support and awareness about codeine addiction are needed. There may be opportunities for providing further support directly on such online forums. Improvements in prescribing codeine and in the over-the-counter supply of codeine are required to prevent problematic use from occurring.

Patients with benzodiazepine dependence in substance dependence treatment: baseline characteristics and comorbidities

Benzodiazepines (BZD) are frequently prescribed drugs, especially among substance use disorder (SUD) patients. BZD use disorder (BUD) is frequent among SUD patients. However, the number of patients who request help for their BUD is low. Little is known about the characteristics of these patients, as well as comorbidity, compared with those having other SUD. An explorative study with a cross-sectional design was performed. Data were collected in two addiction treatment centres in the Netherlands. The database used included 8122 admissions of patients, and provided data based on the Measurement of the Addictions for Triage and Evaluation (MATE). Baseline characteristic were obtained from registration data systems of the two centres. Baseline characteristics and comorbidity of patients with primary or secondary BUD (n = 207) were compared with those of patients who wanted help for their SUD, BZD excluded (n = 5948), and with patients who used BZD but did not indicate this as a problem (n = 1967). BUD patients proved to be more often female, older, married or widowed/divorced, and slightly higher educated than patients in the comparison category. The severity of dependence and/or misuse was higher. Furthermore, BUD patients more often suffered from symptoms of withdrawal, and from symptoms of depression, anxiety, and stress, as well as from somatic and psychiatric comorbidity. Although the use of benzodiazepines is common in patients with SUD, the number of patients who seek help because of BUD is limited. These patients experience more symptoms in all the above mentioned domains compared to those with other SUD.

Programa de Primeiros Socorros em Saúde Mental: Estudo piloto

Objetivo: O presente estudo piloto teve como objetivo apreciar comparativamente a qualidade do Programa de Primeiros Socorros em Saúde Mental na Literacia em saúde mental de recém-licenciados em Enfermagem. Método: Utilizou-se um desenho pré-experimental, designado estudo de caso com pós-teste de grupo único. O Programa teve a duração de dois dias (14 horas). A amostra do estudo foi constituída por 16 recém-licenciados em Enfermagem, com uma média de idades de 21,86 anos (DP = 0,54). Como instrumento de colheita de dados foi utilizado o Questionário de Avaliação da Literacia em Saúde Mental, aplicado à depressão, esquizofrenia e abuso de álcool. Em termos de análise de dados, recorreu-se às estatísticas resumo, ao teste Q de Cochran e teste de Friedman e como medidas de tamanho de efeito o ℜ e W, associadas ao teste adequado. Resultados: Observou-se, no final da intervenção, níveis elevados e diferenciados de literacia em saúde mental em todas as suas componentes, ao nível da depressão, esquizofrenia e uso/abuso de álcool, especificamente em termos de reconhecimento dos problemas. Comparativamente, a intenção de pedido de ajuda diferenciou-se consoante o problema descrito nas vinhetas (p &lt; 0,05), sendo mais elevada na depressão (81,30%) comparativamente ao abuso de álcool (56,30%) e à esquizofrenia (37,50%). Resultado idêntico foi obtido para a confiança em prestar primeiros socorros (p &lt; 0,05) e em que os participantes se sentiram mais confiantes nos casos da depressão e do abuso de álcool. Conclusões: Apesar das limitações decorrentes do tipo de desenho utilizado, nomeadamente a ausência de grupo de controlo e não existência de observação prévia à intervenção, os resultados mostram que no fim do programa os participantes apresentam elevada confiança para agir em prol da sua saúde mental e daqueles que lhe estão próximos.

Implementing On-Call-Tutor System for Facilitating Peer-Help Activities

In this study, we developedan on-call-tutor system to facilitate peer-help activities. The system was implemented in a face-to-face heterogeneous classroom with 119 students from different departments who were not familiar with each other. Students learned Geographic Information System (GIS) in a computer classroom in two groups: students, who learned without our on-call-tutor system, were in a control group whereas those, who learned with our on-call-tutor system, were in an experimental group. When students had any difficulties during the learning process (e.g., to use GIS), they could request help face-to-face (the control group) or through the system (the experimental group). When students requested help via the system, it selected one student from a pool of those who perceived himself/herself to have excellent learning progress and then assigned him/her as a tutor to a student in need (tutee). We carried out this study to explore whether our on-call-tutor system is useful to facilitate peer-help activities and to enhance student learning performance. To this end, based on the theoretical framework of this study, we designed an experiment in which learning performance and behavior of students in the two groups were explored and compared. We also analyzed student social network and investigated whether it can be extended with the support of the on-call-tutor system. Finally, factors that influence making a friend with an unfamiliar classmate and relationship among these factors were explored. For the data analysis, we gathered student logs to send messages, to help peers, and their practice time. We also collected students’ responses to a questionnaire survey about their attitudes towards using our on-call-tutor system. In addition, student learning performance was measured and interviews with students were carried out. Our results showed that, compared to students in the control group, those in the experimental group had more peer-help activities and better learning performance. Results also showed that students built their social network in which they interacted with each other and obtained/provided social support and useful knowledge for learning purpose. In addition, we found that usefulness of our system for learning was the main factor that influenced students’ willingness to build friendship in the social network with familiar/unfamiliar classmates and then communicate with them. Based on our results, we suggest employing the on-call-tutor system in a heterogeneously grouped classroom in order to facilitate peer-help activities, especially when students learn difficult subjects like computer software and are not acquainted with one another. Our system is useful for students in requesting help and finding a tutor in case when they need assistance or some further learning information. With the assistance of our system, students can build the social network among classmates and communicate with each other in order to find/provide learning assistance and social support. As a result, student peer-help activities can be facilitated and learning performance enhanced.

Facilitating Time Critical Information Seeking in Social Media

Social media plays a major role in helping people affected by natural calamities. These people use social media to request information and help in situations where time is a critical commodity. However, generic social media platforms like Twitter and Facebook are not conducive for obtaining answers promptly. Algorithms to ensure prompt responders for questions in social media have to understand and model the factors affecting their response time. In this paper, we draw from sociological studies on information seeking and organizational behavior to identify users who can provide timely and relevant responses to questions posted on social media. We first draw from these theories to model the future availability and past response behavior of the candidate responders and integrate these criteria with user relevance. We propose a learning algorithm from these criteria to derive optimal rankings of responders for a given question. We present questions posted on Twitter as a form of information seeking activity in social media and use them to evaluate our framework. Our experiments demonstrate that the proposed framework is useful in identifying timely and relevant responders for questions in social media.

Do spouse caregivers of persons with early- and late-onset dementia cope differently? A comparative study

ObjectivesTo explore spouse caregivers’ means of coping with the disease and compare them based on the age of onset of the disease in order to adapt support programs. MethodsInterviews were conducted with 38 spouse caregivers of persons with late-onset dementia (PLOD) and 40 spouse caregivers of persons with early onset dementia (PEOD). The first step in the analysis was qualitative, using QSR N’Vivo 10 to identify the coping strategies. The second step was quantitative, comparing the coping strategies based on the age of onset of the disease with a χ2 test. ResultsAn inventory of 26 strategies used by all caregivers was established and consolidated into two groups: acceptance strategies and avoidance strategies. The statistical results show that some strategies were used by the two groups of caregivers. However, when differences emerged, the “Planning” strategy was used by spouse caregivers of PEOD, whereas the “Re-arranging”, “Humor” and “Getting away from the entourage” strategies were used by spouse caregivers of PLOD. ConclusionIt would be interesting to develop a support program with a common framework and specific modules depending on the age of onset of the disease. Common modules would permit developing and strengthening acceptance strategies. Specific modules for caregivers of PEOD would guide them in the acquisition of more adaptability and flexibility in the assistance provided to the PWD, which can sometimes be too rigid and controlled. Specific modules for caregivers of PLOD would help them to develop the ability to request help and identify the intervention limits of the entourage.

استراتيجيات التكيف مع الضغوط النفسية وعلاقتها ببعض المتغيرات: دراسة ميدانية على عينة من طالبات السنة التحضيرية في جامعة حائل - المملكة العربية السعودية

Abstract The main objective of this study was to investigate the most Adaptation Strategies with Psychological Stress for the female students of preparatory Year at Hail University, and its relation with, scientific specialization and academic average. To fulfill the aim of the research, a scale of 35 items distributed among six fields has been prepared. The scale has been applied to a sample of (300) female student chosen randomly from faculty of education, the data is analyzed by using Mean, T test and ANNOVA. The results indicated that the order of female student strategies priorities according to the student's point of view in the six fields of the study are as follows: Religious field, problem solving, relaxation, request help from others, avoiding and escaping, and doing enjoys activities. The results also indicated that there is significant difference between the Mean scores of the student concerning their Adaptation Strategies with Psychological Stress according to the scientific specialization variable, and academic average. The study recommended that there should be more concern given to the University students, and the necessity of counseling and psychological services for the female students of property Year at Hail University.

Adaptation Strategies with Psychological Stress and Their Relative of Some Variables: A Field Study on A Sample of Female Student of Preparatory Year at Hail University

Abstract The main objective of this study was to investigate the most Adaptation Strategies with Psychological Stress for the female students of preparatory Year at Hail University, and its relation with, scientific specialization and academic average.To fulfill the aim of the research, a scale of 35 items distributed among six fields has been prepared. The scale has been applied to a sample of (300) female student chosen randomly from faculty of education, the data is analyzed by using Mean, T test and ANNOVA.The results indicated that the order of female student strategies priorities according to the student's point of view in the six fields of the study are as follows: Religious field, problem solving, relaxation, request help from others, avoiding and escaping, and doing enjoys activities.The results also indicated that there is significant difference between the Mean scores of the student concerning their Adaptation Strategies with Psychological Stress according to the scientific specialization variable, and academic average. The study recommended that there should be more concern given to the University students, and the necessity of counseling and psychological services for the female students of property Year at Hail University.

Abstract LB-146: Compassionate use navigator addresses challenges and facilitates access to investigational drugs for pediatric oncologists

Abstract Background: Targeted cancer treatments are almost always studied first in adults, and even when there is a biologically plausible potential for efficacy in children, studies very rarely include pediatric patients. Through compassionate use (expanded access) programs, children who are not eligible for clinical trials and for whom there are no satisfactory therapies available may have access to experimental therapies, including drugs under development for adults. Even when potential benefits of a promising experimental treatment may outweigh the potential risks of a relatively untested drug, the process to obtain the drug is complex. A physician must obtain a patient's consent, agreement from a pharmaceutical company to provide an investigational drug, and approvals from the FDA and an IRB. These time-consuming and poorly understood steps often present barriers to obtaining access to investigational drugs. Some physicians and patients do not know that applying for investigational drugs is an option. Objectives: 1) To design a web portal to assist families and physicians with submission of compassionate use applications for promising, investigational drugs for children with cancer, and 2) To study pediatric oncologists’ awareness and utilization of the compassionate use program, and identify barriers to its use. Methods: The Compassionate Use Navigator is a new program of Kids v Cancer (www.kidsvcancer.org/compassionate-use) that provides: a) An option for physicians to request help from Compassionate Use Navigator staff in completing a compassionate use application; b) Information on rules and procedures for obtaining expanded access for physicians and patients, including FDA and pharmaceutical company contacts; c) Instructions on how to apply for compassionate use; and d) Develops a registry of outcomes of compassionate use applications for children. A questionnaire has been developed to assess pediatric oncologists’ experiences with and barriers affecting use of compassionate use programs to be distributed before and after go-live of the Navigator in February 2016. Results: The Compassionate Use Navigator was created as a web-based tool and concierge service for pediatric oncologists and families who want to gain access to investigational drugs outside of clinical trials when no satisfactory FDA-approved treatment options are available. Conclusion: The complex process to obtain compassionate use of an investigational drug may be a barrier to utilization of the program, particularly in childhood cancer. Studies are needed to explore the effects of the Compassionate Use Navigator on the number of applications over time, and evaluate pediatric oncologists’ perceptions about the compassionate use program before and after implementation of the Compassionate Use Navigator. Citation Format: Elena Gerasimov, Lindy Zhang, Scott Moerdler, Michael Roth, Nancy Goodman, Daniel Weiser. Compassionate use navigator addresses challenges and facilitates access to investigational drugs for pediatric oncologists. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr LB-146.

Influences on uptake of cancer screening in mental health service users: a qualitative study.

BackgroundCancers are a leading cause of death worldwide. People with mental illness are 30 % more likely to die from cancer than the general population. One reason for this may be low uptake of nationally offered cancer screening tests by people with mental illness. We aimed to identify barriers and facilitators for breast, cervical and bowel cancer screening uptake by people with mental illness in order to inform interventions to promote equal access.MethodsThe interview study was conducted in both urban and rural settings. The study was informed by the Theoretical Domains Framework, using framework analysis and triangulation across participant groups. Participants included 45 mental health service users (service users) eligible for cancer screening, 29 mental health professionals and 11 professionals involved in cancer screening.ResultsThemes emerging from the data that affected uptake included knowledge of screening programmes by both service users and healthcare providers; knowledge of, and attitudes towards, mental illness; health service-delivery factors; service users’ beliefs and concerns about cancer screening, and practical issues. These are relevant to different stages of the screening process. Service users do not receive invitations to screening or cancer testing kits if they are admitted to hospital. They are not routinely invited for screening if they are not registered with a general practitioner (GP). Lack of integrated care means that mental health staff do not know if someone is overdue for a test and cancer screening is often not considered during health promotion. Barriers including information processing problems, the extent to which the screening process aggravates symptoms, poor staff client relationships and travel difficulties vary between individuals. Screening professionals are motivated to help, but may lack time or training to manage mental health needs. Reactive measures are available, but service users must request help which they may find difficult.ConclusionsThere are specific barriers to cancer screening uptake for mental health service users that prevent equality of care. Interventions that can be personalised are needed at individual, policy and service-delivery levels. Primary and secondary care staff and policy-makers should work together to develop an integrated approach to cancer screening in this population.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1505-4) contains supplementary material, which is available to authorized users.