Results Of Survey Research Articles

Strategic Approaches to Reducing the Burden of Atopic Dermatitis in the Middle East and Africa Region

ObjectivesAtopic dermatitis (AD) creates a significant burden on patients and society. This study proposes a set of health policy interventions that can reduce the burden of AD in the Middle East and Africa. MethodsWe conducted a scoping review to find relevant actions that have been implemented or recommended to decrease AD burden globally. An expert panel was conducted to discuss the review findings, then experts were surveyed to suggest the most efficient actions. Finally, survey results and recommendations were formulated into key actions to reduce the burden in the Middle East and Africa region. ResultsRecommended actions were related to 5 domains; capacity building, guidelines, research, public awareness, and patient support and education. Several actions related to each domain can help reduce the burden. One of the most advocated recommendations was investing in patient education through trained healthcare professionals. Understanding the disease and learning how to control it is a key cornerstone to treatment optimization and reducing the burden. Multidisciplinary care, publishing defined therapeutic guidelines, and investing in research were the most recommended actions based on the experts’ discussion and survey results. ConclusionsAlthough the burden of AD is the highest among dermatological diseases, a well-grounded action plan has the potential to reduce the disease burden. Decision makers may develop a national AD action plan by selecting the most relevant items of this study based on their potential impact, feasibility, timeliness, and affordability.

Evolution of micro and SME's innovating senior management supply chains

Post-pandemic technology guides individuals to evolve strategic thinking by creating logistics solutions. The digital paradigm of MSMEs must innovate by linking administrative thinking with technology. Objectivity analyzes impacts on management 4.0 in supply chains, driving the individual to disrupt the logistics environment.The methodology is qualitative, descriptive. Using statistical samples. The design of the instrument consists of questionnaires that represent the main basis of impacts as an object of study, describing and analyzing survey results. The results represent 52% of MSMEs that sell online in Mexico and 48% sell through other channels, in addition productivity losses are explored with the impact of COVID-19. It is concluded that business evolution 4.0 generates adaptability to human evolution in the design of new visions of creating supply chains with a digital focus in the state of Mexico, resulting in an increase in operations by electronic commerce.Human evolution and its adaptation to a technological cognitive level is decisive to positively impact challenges in industry 4.0 and create strategies to balance occupational human wear to improve the quality of work and productive life in business entities.

РАННЯЯ ДИАГНОСТИКА МИОДИСТРОФИИ ДЮШЕННА: АКТУАЛЬНОСТЬ, ПРОБЛЕМЫ, ВОЗМОЖНОСТИ И ПЕРСПЕКТИВЫ

Duchenne muscular dystrophy (DMD) is an orphan neuromuscular progressive genetic disease that causes muscle breakdown and subsequent loss. Provided early diagnosis, complex standard and pathogenetic therapy significantly changes the trajectory of the disease, making it more benign. Diagnosis of DMD is a two-pillar system with creatine kinase (CK) level measured at the first stage followed by molecular genetic study in case the enzyme threshold values. The quality of genetic diagnostics in Russia has reached the best worldwide standards recently though identifying children with elevated CK levels is yet difficult. The number of diagnosed DMD patients in Russia is significantly lower than the statistically estimated global amount. The average age for diagnosis is not decreasing either. Thus, the median age for DMD and Becker muscular dystrophy (BMD) molecular diagnosis is 7 years and 8 months old. The number of identified children below the age of 2 y/o in Russia has remained consistently low over the past three years. According to the results of a familial cases survey, the correct primary diagnosis of DMD was established in less than half of all cases, 47.1%. The most common incorrect diagnoses were as follows: asymptotic hepatitis (25.1%), perinatal damage to the central nervous system (6.4%), cerebral palsy (2.7%), autism spectrum disorder (ASD) (2.7%) and flat feet, hallux valgus etc. (16% in total). The median duration between the initial DMD manifestation and molecular diagnosis is 3 years and 8 months as yet whilst the age-specific guidelines suggest prescribing standard and pathogenetic therapy during the 2 to 5 y/o period of life. Therefore, the Russia’s average age of DMD diagnosis above 7 y/o lies far beyond the optimal age for initiating of the DMD therapy with the purpose of gaining its maximum possible clinical benefit. The accumulated international and Russian experience demonstrates the possibility for improving of the primary DMD and BMD diagnosis in early preschool age and therefore requires its nationwide introduction.

Drug Testing Interpretation in the Peripartum Setting: Results of Clinician Survey.

The objectives of this study were to (1) survey obstetrical and pediatric clinicians' experience, confidence, and training in maternal and neonatal drug testing interpretation; (2) determine their proficiency in drug test interpretation; and (3) assess predictors of correct interpretation. We conducted a cross-sectional survey of clinicians caring for pregnant people or newborns at an urban academic center. We assessed clinicians' demographic characteristics, experience, confidence, and prior training in interpretation of maternal and newborn drug tests. We assessed proficiency in interpreting drug tests using 11 clinical vignettes and categorized scores as poor (0-2), fair (3-5), and good (≥6) performance to facilitate data interpretation. We used descriptive statistics to summarize responses. Multinomial logistic regression was used to determine associations of clinician characteristics and score category (reference category: poor performance). In total, 103 respondents completed the survey including 60 obstetrical clinicians (58.3%), 19 family medicine physicians (18.5%), 21 pediatric clinicians (20.4%), and 3 social workers (2.9%) (response rate, ~40%). The mean correct response was 4.1 (SD, 2.17; range, 0-11). Most respondent scores were fair (n = 47.6%), followed by good (n = 28.2%) and poor (n = 24.3%). Increased frequency, confidence, and training in interpreting maternal screening and confirmatory tests were associated with higher proficiency. Increased confidence and training in interpreting neonatal screening and confirmatory tests, but not frequency, were associated with higher proficiency. Most clinicians demonstrated fair proficiency in interpreting drug tests. Predictors of proficiency were confidence and prior training for drug test interpretation, suggesting that educational interventions could improve proficiency.

Supporting the Nurse Preceptor Role: Implementing the R2C2 Feedback Model.

Nurse preceptors are key to the successful transition of graduate nurses to practice and experienced nurses to a new organization. Providing ongoing preceptor development is essential to support nurses in this vital role. The evidence-based R2C2 (relationship, reaction, content, coach) feedback and coaching model was implemented to facilitate the delivery of constructive feedback from nurse preceptors to their orientees. Post-intervention survey results suggest an overall positive response to the use of the feedback model in practice.

Climate protection, health and other motives for active transport – results of a cross-sectional survey in Germany

BackgroundActive transport– for example walking and bicycling to travel from place to place– may improve physical fitness and health and mitigate climate change if it replaces motorised transport. The aim of this study is to analyse the active transport behaviour of adults living in Germany, to investigate differences among population groups and to determine whether climate protection is a frequent motive for this behaviour.MethodsThis study uses self-reported data of 4,971 adults who participated in a national health survey (German Health Update 2021), which was conducted as a telephone survey from July to December 2021. Associations between active transport behaviour and corresponding motives with sociodemographic and health-related variables were analysed using logistic regression models.ResultsOf the adult population, 83% use active transport at least once a week. The frequency and duration of walking per week are significantly higher than those for bicycling (walking 214 min/week; bicycling 57 min/week). Those with a lower education level are less likely to practise active transport than those with a higher education level. Furthermore, women are less likely to use a bicycle for transport than men. Among those practising active transport, the most frequently mentioned motive is “is good for health” (84%) followed by “to be physically active” (74%) and “is good for the climate/environment” (68%). Women and frequent bicyclists (at least 4 days/week) mention climate protection as a motive more often than men and those bicycling occasionally.ConclusionsThe improvement of active transport, especially among people with lower education and women (for bicycling), may benefit from better insights into motives and barriers. Climate protection is an important motivator for practising active transport within the adult population living in Germany and should therefore have greater emphasis in behavioural change programmes.

Which factors influence health services utilization in Bulgaria? Results of a cross-sectional survey.

Research on the factors influencing health care services utilization in Bulgaria does not apply a particular model to analyze these determinants. To fill this gap, we apply the Andersen's Behavioural Model, a commonly used framework, to determine the factors that impact the utilization of health care services in our country. Data are collected in an online survey conducted in Bulgaria in 2023 among consumers. The standardized questionnaire includes questions on the utilization of health care services used by the respondent during the preceding 12 months. We apply binary logistic regressions to analyze predictors of visits to general practitioners and medical specialists, as well as hospitalizations. The results of the regression analysis show that the factors of self-reported health status and the presence of a chronic disease influence the utilization of health care services except for general practitioner visits. Greater trust in general practitioners and hospitals is associated with an increased probability of undergoing examinations and hospitalizations. Predisposing and enabling characteristics appear as significant determinants of health care utilization. The study confirms the relevance of the Behavioural Model for the use of health care services in the Bulgarian context. Further research on health outcomes and their impact on utilization can help determine the most efficient level and appropriateness of the use of health care services.

Student experiences with an interprofessional hope-based healthy aging research project

ABSTRACT Interprofessional education (IPE) and research enhances learning, team-based communication, and cross-disciplinary collaborations, which can result in higher quality care for older adults. Despite the importance of IPE, it remains underutilized in higher education, demonstrating the need for extracurricular IPE opportunities. This study describes an interprofessional research project that brought together faculty, undergraduate, and graduate students from several health and social science disciplines to design and deliver a 15-week healthy aging program for older adults living in the urban Circumpolar North. Five faculty and one graduate research assistant led the project while eight students team-taught weekly, 1-hour sessions in the community focusing on healthy lifestyles within a framework of Persuasive Hope Theory. This paper describes the project, the student training procedures, and reports the results of the student satisfaction survey regarding their involvement with the research. Using a student self-assessment survey, students report gains in thinking like a scientist, increased confidence conducting research tasks, benefits from teamwork, and greater consideration of the needs of older adults in their field of study. Despite a small sample size, this study also suggests that students may be more likely to consider a career working with older adults if given hands-on experiences.

The Study of the Cognitive Tendency of Chinese Y and Z Generations towards the Design Element Shan-Shui in Architectural Environments

The future of architectural environments in China will serve the needs of, and thus be shaped/re-shaped by, the Chinese Y and Z generations. Although Shan-Shui designs have long been a classic style of architectural environment in China, there is a lack of comprehensive studies on how the Chinese Y and Z generations perceive Shan-Shui designs as an architectural style. Quantitatively analyzing and understanding Chinese YZ generations’ perceived relationships between Shan-Shui designs and architectural environments will have many implications for both the economy and education. In this paper, we present a large-scale study by conducting a questionnaire survey of 441 human subjects representative of both the Y and Z generations. The questionnaires were carefully designed with a focus on understanding the perceptions and cognitions of Shan-Shui designs in the survey group. The survey results were analyzed using the widely adopted SPSS25 method. Our overall analyses show that the Chinese Y and Z generations have a tendency to subconsciously perceive Shan-Shui as a relatively independent form/style from architectural environments. Between the Y and Z generations, our comparative analyses show that the latter has a more positive perception with respect to different aspects of Shan-Shui designs in architectural environments.

Application of Liposuction and Superior Pedicle Vertical Mammoplasty for Severe Breast Hypertrophy.

Vertical mammoplasty techniques have been widely used for breast reduction. The authors present the combination of superior pedicle vertical mammoplasty with liposuction in different regions in the treatment of severe breast hypertrophy in obese patients. We also propose some innovative methods in terms of surgical approach, breast parenchymal anatomy pattern and liposuction. A retrospective study of 50 female patients with severe hypertrophic breasts and obesity who underwent breast reduction in our department from February 2019 to February 2022 was performed. Pre- and postoperative photographs, breast parenchyma distribution and postoperative patient satisfaction were recorded. Fifty patients underwent breast reduction. Through clinical examination, patient photo evaluation and satisfaction survey results. Good breast shape and projection, full upper pole of the breast, and high satisfaction results were obtained. There were no serious complications. This technique is acceptable and reproducible. It is suitable for patients with varying degrees of breast hypertrophy, especially those with severe hypertrophic breasts and obesity. There are fewer associated complications and a lower rate of re-repair. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Risk assessment industry driven approach in occupational health and safety.

Risk assessment and management in companies plays a significant role in the prevention section of any field. In the field of Occupational Health and Safety (OHS), its inconsistent or incorrect application has a direct impact on the life and health of employees. In some companies, even today, it is not properly implemented and adequate procedures and methods are not used. The article discusses the development of a step-by-step procedure for risk assessment in industrial environments in the area of OHS. Main parts of the model and its steps present the partial results of a survey conducted on a sample of 500 small and micro enterprises in the field of risk assessment and the systematic procedure developed following the main survey results. The survey covered only enterprises located in the construction, manufacturing, transport and storage and agriculture, forestry and fishing sectors, which is also a significant statistical feature. Within the structure of respondents, statistical features such as: size of enterprise, sector, region by work are identified. Only enterprises with size by number of employees - micro enterprises from 1 to 9 employees and small enterprises from 10 to 49 employees - were included for the survey. New elements of the methods were integrated into the developed systematic procedure, which was subsequently validated in 7 plants of the one company on the same position. The application of the developed model was verified by an expert group consisting of 7 members, an odd number, and the developed checklists and risk register were applied. On the basis of the verification, the model, checklist and risk register were corrected. In addition, the scoring method and the risk matrix were also used, but they did not contain new elements. The procedure is still in use today and employees have been trained to use it. On the basis of the developed methodology and the Checklist, the procedure has been transposed into the European OiRA tool and can be used by companies throughout the European Union.

Assessing Approaches to Strengthen Monitoring and Evaluation in Development Projects: Evidence from Donor-Funded Projects in Machakos County, Kenya

Monitoring and Evaluation improves the quality of programme or project management since it provides information on how results namely outcomes, outputs and impact are achieved and assesses the effectiveness, relevance, coherence, efficiency, impact and sustainability of specific development interventions. The objectives of the study were to examine the influence of participatory monitoring and evaluation among development project teams in Machakos County and to assess the influence of M & E as a learning tool on implementation of development projects in Machakos County, Kenya. The study was guided by the Theory of Change which describes how particular interventions or sets of interventions lead to specific changes. The target population of this study was 102 programme staff implementing donor-funded projects. A census was done and therefore the target group formed the sample for the study. Primary data sources used were key informant interviews and a survey questionnaire. Quantitative data was analyzed in SPSS Version 28 and qualitative data was thematically analyzed. According to the survey results, 58.2% agreed that the involvement of all relevant project stakeholders during the preliminary stages of project design strengthens M&E. The survey results showed that 49.45% of the respondents agreed that project planning reflected the various community needs and supported decision-making processes during project implementation. A majority (58.23%) agreed that feedback from various stakeholders was often incorporated and used to strengthen the delivery of various project activities informant interviews. Majority of the survey respondents (72%) indicated that learning is integral to ensuring M&E is effective and project teams can learn immensely from M & E. A majority (71%) agreed that project teams feared participating in M&E activities due to fear that it could be used against them. The findings show that the involvement of stakeholders in project design and implementation directly influenced successful project M & E. The study recommended involving relevant parties and stakeholders in a project since this influences its implementation and M & E among donor-funded development projects. Project managers need to put in place incentives for project teams to learn not just for reporting to funding agencies but for the benefit of internal learning among project teams.

Prevalence of Gastrointestinal Parasites in Small Ruminant Farms in Southern Spain.

The primary population of small ruminants in Spain is concentrated in the southern region, a critical area for the country's livestock production. Indirect economic losses can occur when this livestock is affected by gastrointestinal parasites. This study aimed to determine the prevalence of these parasites in small ruminant herds (159 sheep and 39 goats) through coprological analyses and conducted a survey on farmers' management practices related to gastrointestinal parasite control. The survey results revealed some important aspects: monitoring through coprological analyses is not a common practice; veterinarians are not typically involved in deworming plans; anthelmintic treatment in adults is often applied twice a year in sheep and once a year in goats; and finally, drug rotation was higher in sheep farms. Coprological analyses showed Eimeria spp. as the most common parasitic infection, followed by Strongyles infection. Other parasites like Moniezia spp., Trichuris spp., and D. dendriticum were less important, although their prevalence was higher in sheep than goats. This constitutes the first report on the epidemiological status of gastrointestinal parasites in small ruminants in southern Spain. Based on the survey findings, the introduction of certain management measures on farms could potentially mitigate parasite infections.

Paramedical staffs' perception of their role during the continuum of care from detection to treatment in nursing homes: Results of the ONCOPAD-Pre survey.

e13768 Background: Prevalence of cancer in nursing homes (NH) increases. ONCOPAD is a 4-step program dedicated to identifying and acting on educational needs, cultural and ethical barriers associated with cancer treatment in NH. The program included a scoping review (step 1), semi-directive interviews with care providers (step 2) designed to identify the major topics to be included in a tailored intervention and evaluated before and after it. Here we report the results of the survey before the intervention. Methods: Questions were mainly presented as 7-point Likert scales and classified into 6 sections: interviewee’s description, detection phase, treatment phase, relations and communication at work, ethical questioning, continuing education. Statistical analyses included descriptive statistics, exploratory factorial analyses, testing of model sphericity and sampling adequation. Results: From 06/2022 to 03/2023, 65 participants (median age 41 years; females: 84.6%) completed the questionnaire; 40.0% were nurses, 35.4% nurse assistants; 87.7% were full-time employees, and 73.8% were post holder. Interviewees considered their role as important at the detection stage (mean 4.82), to inform the physician (5.58) and their colleagues (5.45), their role during the decisional process (4.40) and to inform the patient on his diagnosis (4.05) were perceived as less important; organizational problems (lack of staff, time, facilities) could impede this stage. Factors perceived important for treatment decision were related to the patient (physical performance, cognition, age), his opinion (4.49), the opinion of his family (4.38), of his physician (5.17) and less to the paramedical team (4.02). The decision to pursue was mainly focused on care: pain relief (5.48), detection of clinical and psychological signs (5.18); the organizational barriers were perceived as major as well. Relations and communication at work, both internal and external to the institutions, were perceived as poor quality; 8 (12.3%) of the interviewees even skipped this section. The ethical questioning was permanent and homogeneous. Considering education, the interviewees felt insufficiently trained and the preferred model for training was short sequences integrated into daily work schedules; coordinating physicians appear as good mediators for such training courses. Conclusions: In this survey, paramedical staffs perceived their role as important during both detection and treatment of cancers, focusing more on care than cure; however, organizational constraints and poor quality of internal and external relations, and communication appear as major barriers in the completion of their role. Educational intervention should be tailored, favoring short sequences integrated into daily work schedules, coordinating physicians appear as good mediators for improvement in the future.

Utility of a Neuromuscular Activation Exercise Protocol on Surgeon Posture.

Surgeons are at risk for musculoskeletal disorders from ergonomic strain in the operating room. These deficits may stem from neuromuscular control deficits. Neuromuscular activation exercises (NMEs) may strengthen the brain-muscle connection. This study aimed to assess the utility of a surgeon-oriented NME protocol on posture. Surgeons, operating room staff, and medical students completed a professionally established NME routine. An electronic application, PostureScreen®, assessed participants' posture. A long-term cohort was assessed before and after a 2 to 6-week routine. A short-term cohort was assessed immediately before and after completion. All participants additionally completed a postintervention survey. After intervention, the short-term cohort (n = 47) had significantly reduced frontal and sagittal postural deviation (P < 0.05). A significant decrease in effective head weight was additionally demonstrated with decreased neck flexion and increased cerebral-cervical symmetry (P < 0.05).The long-term cohort (n = 6) showed a significant postintervention decrease in lateral and anterior shoulder translation (P < 0.05). Total anterior translational deviations demonstrated trend-level decrease (P = 0.078). This demonstrates that after intervention, participants' shoulders were more centered with the spine as opposed to shifted right or left. Survey results showed participants favored exercises that immediately brought relief of tension. A decrease in postural deviations associated with NME in both cohorts demonstrates NME as a potential mechanism to protect surgeon musculoskeletal health and improve well-being. Survey results demonstrate areas of refinement for NME protocol design.

Conditions for approaching shared value creation management in the Japanese rice flour-related business: application of mixed methods research

This is the second paper on creating shared value (CSV) management in Japanese rice flour-related businesses conducted by the same authors. In the first study, the relationships among business philosophies, business strategies and business outcomes of rice flour-related corporates in Japan were clarified using structural equation modeling (SEM) and cognitive mapping of questionnaire survey results. The management philosophy, effective altruism, influences business strategies (potential head market, tail market, organizational learning, and proposals from stakeholders) of rice flour-related corporates, inducing innovation and determining current business performance and future prospects for shared value creation. The business performance reflects their expectations for the rice flour market, and influences the direction of market development. In addition, we showed a need for policy innovations that strengthen effective altruism and create shared value through organizational learning of the stakeholders in rice flour-related businesses. Therefore, the purpose of this study was to clarify conditions for approaching CSV management in domestic rice flour-related businesses by applying mixed methods research (MMR). Specifically, a latent class analysis (LCA) was introduced to classify the management characteristics of rice flour-related businesses with survey results, and a qualitative comparative analysis (QCA) conducted on the CSV management entities extracted from the LCA to clarify the necessary and sufficient conditions for achieving CSV management. The results revealed that there are very few rice flour-related businesses in Japan that have approached CSV management, and sufficient conditions for approaching CSV management in rice flour-related businesses are a combination of effective altruism and various management strategies (long tail/organizational learning/innovation/stakeholder proposals). Therefore, we conclude that to achieve a sustainable regional development of rice flour-related businesses, policy innovations that integrate pull-type and push-type strategies are important.

The effects of oral nutritional supplements on functional outcomes and body composition in patients with solid cancer undergoing systemic chemotherapy: A pilot study.

10074 Background: Cancer cachexia is a complex syndrome characterized by significant weight loss and depletion of skeletal muscle mass. Despite its profound impact on the well-being of cancer patients, the effective management of cancer cachexia remains a challenging and underexplored aspect of oncology. This study aims to investigate the potential benefits of oral nutritional supplements (ONS) to cancer patients undergoing chemotherapy. Methods: This is single-arm, prospective pilot study. Patients with cancer cachexia undergoing chemotherapy were included. Patients received ONS twice a day for 8 weeks. The ONS contained 200 kcal, 22.5 gram of carbohydrates, 7.5 gram of fat, and 12.5 gram of protein per 200 mL. Primary endpoints were improvements of lean body mass and physical performance. The secondary endpoints were changes of health-care related quality-of-life (HRQoL), nutritional status, and gut microbiomes profiles. EORTC-QLQ-C30 questionnaire, body composition analysis, 4-meter-walk test, hand grip strength test, and fecal microbiome analysis were conducted at baseline and after 8 weeks. The bacterial 16S rRNA gene (V3 and V4 region) was amplified using PCR and sequenced on the Illumina MiSeq platform. The QIIME 2 pipelines were used to analyze the raw data. Results: From January 2023 to October 2023, total of 10 patients were included. There were no significant differences of the mean daily energy intake (p=0.62) and calf-circumferences (p=0.2) between baseline and after 8 weeks. However, participants exhibited a statistically significant improvement in hand-grip strength (p=0.002) and 4-meter walk test (p=0.021) after 8 weeks. In the body composition analysis using dual-energy X-ray absorptiometry, no differences were observed in body weight (p=0.43), fat mass (p=0.62), fat-free mass (p=0.27), and fat-free mass index (p=0.38). Also, no significant differences were detected in the results of HRQoL survey (p=0.85). In the microbiome analysis, no differences of microbiome composition at phylum and genus levels, α-diversity, and β-diversity were observed between baseline and after 8 weeks. Conclusions: While ONS have shown potential in enhancing physical functions of patients with cancer cachexia undergoing chemotherapy, this did not correlate with the anticipated microbiome changes or improvements in body composition. The absence of expected microbiome alterations, despite enriched protein and dietary fiber, underscores the complexity of cachexia and indicates that its management may extend beyond nutritional supplementation alone. Further research should explore the broader context of cachexia, including nutrition, metabolic processes, and the impact of chemotherapy.

Improving recycling of medical nutrition packaging in primary and secondary care: follow-up survey results and next steps

Improving recycling of medical nutrition packaging in primary and secondary care: follow-up survey results and next steps

The Association Between Food Security and Mammography Screening: Cross-Sectional Survey Results From the National Health Interview Survey

ObjectiveThere are limited data about food insecurity within the cancer screening setting. To inform the potential need for food insecurity interventions, our study evaluated the association between food security and mammographic screening among eligible participants. MethodsFemale respondents aged 40 to 74 years in the 2019 National Health Interview Survey without history of breast cancer were included. Food insecurity was assessed using the Six-Item Food Security Scale developed by the National Center for Health Statistics. The proportion of patients who reported mammographic screening within the last year was estimated, stratified by food security. Multiple variable logistic regression analyses evaluated the association between food security and mammography screening, adjusted for potential confounders. All analyses were performed accounting for complex survey design features. ResultsIn all, 8,956 weighted survey respondents met inclusion criteria; 90.1% were classified as having high or marginal food security, of whom 56.6% reported screening; 6.1% were classified with low food security, of whom 42.1% reported screening; and 3.8% were classified with very low food security, of whom 43.1% reported screening. In our unadjusted analyses, participants with low food security (P < .001) and very low food security (P < .001) were less likely to report screening within the last year. In our adjusted analyses, participants with food insecurity (P = .009) were less likely to report screening. DiscussionIn a nationally representative cross-sectional survey, participants with food insecurity were less likely to report mammography screening. Radiology practices should consider screening patients for food insecurity and social determinants of health. Evidence-based food insecurity interventions may increase adherence to mammography screening.

Evolution of germline BRCA1/2 testing practices: A five-year comparative analysis among oncology providers and patients.

e13172 Background: The Association of Cancer Care Centers (ACCC) launched a quality improvement initiative in 2018 to address suboptimal germline BRCA1/2 testing rates and identify barriers impeding testing for patients with early-stage or metastatic breast cancer. Between 2018 and 2023, changes in clinical guidelines led to expanded testing criteria and increased referrals for genetic testing. A follow-up survey in 2023 aimed to assess changes in testing practices and challenges faced by cancer care teams, considering the evolving landscape of genetic testing and the impact of the COVID-19 pandemic. Methods: In 2018, a survey of 95 oncology providers was conducted to explore provider characteristics, testing characteristics, and challenges/barriers to germline BRCA 1/2 testing. The survey was conducted again in 2023 for comparative analysis with a response of 115 oncology providers. The surveys explored provider characteristics, testing practices, and challenges/barriers to germline BRCA1/2 testing. To comprehensively understand the patient's perspective, an additional survey was conducted in October 2023, involving 61 individuals recently diagnosed with breast cancer to evaluate the patient experience with germline BRCA 1/2 testing and subsequent follow-up. Results: The adoption of expanded testing criteria, which influenced changes in clinical guidelines, has led to a substantial increase in referrals for genetic testing. The utilization of genetic testing by medical oncologists experienced a notable surge with 64% of survey respondents in 2023 reporting that medical oncologists most often initiated tests for germline BRCA1/2 mutations, compared to 29% in 2018. Patients’ awareness and engagement were high, with 82% undergoing germline BRCA1/2 testing, 48% undergoing testing at diagnosis, 33% before treatment, and 13% during treatment. In 2023, 23% of providers reported routinely ordering germline BRCA1/2 testing for patients with early-stage breast cancer, marking a threefold increase from the 2018 survey results. For patients with metastatic breast cancer, 41% of providers routinely ordered BRCA mutation testing, a threefold increase from 14% in 2018. While testing rates improved, challenges and barriers persist such as patient concerns (47%), access to genetic counselors (42%), turnaround time for test results (36%), and reimbursement issues (28%). Conclusions: The comparative analysis revealed a moderate improvement in germline BRCA1/2 testing practices, with increased provider engagement and patient awareness. Despite progress, challenges persist, needing multi-pronged efforts to enhance testing uptake and distribute critical information on testing to patients. The results indicate positive trends but underscore the importance of addressing barriers for comprehensive patient care.