Mandi Pratt-Chapman | The George Washington University (original) (raw)

Papers by Mandi Pratt-Chapman

Preventing chronic disease, Apr 4, 2024

Oxford University Press eBooks, Apr 11, 2024

JCO oncology practice, Mar 28, 2024

Cancer Causes & Control, Jul 17, 2022

Journal of Clinical Oncology, Jun 1, 2023

Journal of Cancer Education, Jan 17, 2022

Care coordination among primary care providers and oncologists continues to be a challenge in can... more Care coordination among primary care providers and oncologists continues to be a challenge in cancer survivorship care. The Advancing Patient-Centered Cancer Survivorship Care Toolkit ("Toolkit") was developed to provide a "workshop in a box" for comprehensive cancer control (CCC) stakeholders to advance patient-centered cancer survivorship care in their region. The Toolkit was disseminated through an e-learning module, established webpages, an online forum, and social media. Toolkit dissemination was evaluated using the RE-AIM framework. For effectiveness, e-learning module and workshop participants were surveyed to assess changes in confidence in learning objectives. The Toolkit Web page received over 10,000 impressions. E-learning module participants (n = 212) reported statistically significant improvement (p < 0.001) between the pre- (M = 3.42, SD = 0.85) and post-test (M = 4.18, SD = 0.60) mean scores on self-confidence to describe patient-reported priorities for cancer survivorship care. Among virtual workshop trainees (n = 121), 28 participants completed paired pre- and post-workshop surveys. Among those with matched responses, there were statistically significant improvements from pre- to post-workshop self-reported knowledge on what patients want in cancer survivorship care (M = 2.5, SD = 1.0, vs. M = 3.3, SD = 1.0; p = 0.001); confidence in describing critical components of patient-centered cancer survivorship care (M = 3.1, SD = 1.2, vs. M = 4.2, SD = 0.5; p < 0.001); and confidence in describing patient priorities for cancer survivorship care (M = 3.0, SD = 1.1, vs. M = 4.1, SD = 0.6; p < 0.001). Provision of technical assistance resources in a variety of formats can successfully build capacity of healthcare providers and comprehensive cancer coalition stakeholders to feel more prepared to deliver patient-centered, coordinated cancer survivorship care.

Journal of The National Comprehensive Cancer Network, May 1, 2023

Patients with cancer in the LGBTQ1 community experience worse health outcomes when compared with ... more Patients with cancer in the LGBTQ1 community experience worse health outcomes when compared with their non-LGBTQ1 peers because of a variety of factors, including stigma, underrepresentation in research, lack of support, and implicit bias on the part of clinicians. For generations, many LGBTQ1 people have feared disclosing their identity to providers, leading to gaps in care and even higher mortality. As more people are identifying as members of the LGBTQ1 community, it's crucial for providers to recognize them appropriately in healthcare, take steps such as acknowledging chosen names and pronouns, and provide care free from judgment. In today's political climate, members of this community are facing increasing scrutiny, challenges, and barriers to accessing safe and affirming care. Providers can do their part to improve health outcomes among LGBTQ1 people by making their practices known as safe and affirming spaces, working to increase inclusivity in oncology care and improving data collection.

Journal of Cancer Education, Sep 9, 2020

Racial, ethnic, sexual, and gender minorities are more likely to report challenges with oncology ... more Racial, ethnic, sexual, and gender minorities are more likely to report challenges with oncology provider communication and quality of care. The Together-Equitable-Accessible-Meaningful (TEAM) training was developed to improve health equity across cancer care organizations by guiding teams of interprofessional learners through planning and implementation of quality improvements to advance equitable, accessible, and patient-centered cancer care. This study compared changes to self-reported cultural competence as measured by the Cultural Competency Assessment (CCA); Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS); and Interprofessional Socialization and Valuing Scale (ISVS). The primary aim of the study was to assess changes to self-reported cultural competence; the secondary aim was to examine changes to interprofessional valuation from baseline to post-intervention. Results indicated statistically significant improvements in selfreported Cultural Competency Behaviors (p = .055), a subscale of the CCA, and Attitudinal Awareness toward sexual and gender minorities (p = .046), a subscale of the LGBT-DOCSS, using p < .10 as statistically significant. These subscale results drove statistically significant improvements for their respective composite scales. No other statistically significant results were found. This study suggests that cultural competency training among interprofessional oncology health care professionals can be effective. Given the growing diversity within the USA, additional opportunities for cultural competency training are needed.

PubMed, Sep 1, 2020

Background: There are limited training opportunities for healthcare professionals focused on the ... more Background: There are limited training opportunities for healthcare professionals focused on the supportive care needs of sexual and gender minority (SGM) patients. SGM prostate cancer survivors have unique physical, psychosocial, and sexual needs that often go unaddressed due to lack of provider understanding of those needs. Methods: To inform the development of a training and companion materials for healthcare professionals to fill this gap, the authors conducted formative research to assess the needs of target learners and SGM patients. Formative research included a survey and focus group of oncology social workers, and interviews with SGM prostate cancer survivors. Results: Survey respondents indicated SGM patients deserved the same quality care as heterosexual, cisgender patients; however, one-third indicated they were not well informed regarding health needs of SGM people. Focus group themes included differing social support structures for SGM people and the need for healthcare professional training. Patient interviews indicated a need for SGM-specific training of healthcare professionals. Conclusion: There is a need for ongoing education and training among healthcare professionals to meet the needs of SGM prostate cancer survivors.

Annals of LGBTQ public and population health, Mar 1, 2022

A growing body of research suggests lesbian, gay, bisexual, transgender, queer, and intersex (LGB... more A growing body of research suggests lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) people—referred collectively as sexual and/or gender minorities (SGM)—experience health disparities. While research is growing, limited evidence exists to inform patient-centered care for SGM people. The collection of demographic data is a cornerstone of quality assurance, yet collection of sexual orientation and gender identity (SOGI) data remains challenging and sparse. SGM people share with racial, ethnic, and other minoritized people stigma and suboptimal social determinants of health that may result in chronic stress and poorer health outcomes compared to cisgender, white, heterosexual people. Challenges are compounded for those who occupy multiple minoritized categories. The stigma and discrimination experienced by SGM are critically tied to behavioral risks related to maladaptive coping. Additionally, stigma impacts screening and other healthcare seeking behaviors. To advance SGM health equity, both clinicians and researchers need training on culturally appropriate collection of SOGI data and the relevance of these data to cancer prevention, screening, treatment, and survivorship.

Translational behavioral medicine, Sep 7, 2020

Tobacco-related health disparities (TRHDs) have a significant impact on population health in the ... more Tobacco-related health disparities (TRHDs) have a significant impact on population health in the USA. Effectively preventing and controlling TRHDs among young adult populations require multiple prevention and cessation points, including within college/university contexts. This commentary addresses current campus tobacco control policies and cessation interventions for U.S. college students, with an emphasis on TRHDs and opportunities for research and research translation to reduce these disparities. This commentary is informed by literature published between 2010 and 2020 regarding (a) prevalence and impact of campus tobacco control policies; and/or (b) behavioral outcomes from cessation interventions for young adults attending colleges. Despite a doubling of college campuses adopting tobacco-free policies from 2012 to 2017, roughly two-thirds continue to operate without such policies. Few policies address alternative tobacco products (e.g., e-cigarettes, cigars/cigarillos, and hookah), and communication about and enforcement of existing policies is extremely limited. A broad range of cessation intervention strategies have targeted individuals in this age group, but with little focus on TRHDs and limited intervention dissemination. Importantly, college students representing populations at risk for TRHDs (e.g., racial/ethnic/sexual/gender minorities, low socioeconomic status) are less likely to be exposed to strong tobacco control policies or supports for cessation. There are untapped opportunities for behavioral medicine approaches to reduce TRHDs in college settings. Research findings regarding multilevel (policy, community-level, and individual-level) interventions must be translated to policy/practice in order to address tobacco use, particularly among vulnerable college student populations.

Substance Abuse, Feb 7, 2022

Background:Despite literature documenting disparities in tobacco use among sexual minority young ... more Background:Despite literature documenting disparities in tobacco use among sexual minority young adults, research is just emerging regarding alternative tobacco product (ATP) use among specific sexual minority men versus women. The current study examined associations between sexual orientation and traditional and ATP use among young adult men and women.Methods:We analyzed survey data (September–December 2018) from 2,809 young adults (ages 18–34) recruited via social media. Multivariable regression models were used to examine the binary outcomes of any past 30-day use of cigarettes, e-cigarettes, cigars, hookah, and any tobacco product (logistic regression), and the continuous outcome of number of categories of tobacco products used (linear regression), in relation to sexual orientation (bisexual, gay/lesbian, heterosexual) among men versus women, controlling for age and race/ethnicity.Results:In this sample (Mage = 24.60, SD = 4.73; 56.0% women, 71.5% White, 5.4% Black, 12.6% Asian, 11.5% Hispanic), 9.3% of participants identified as gay/lesbian (13.1% of men, 6.2% of women) and 17.6% bisexual (8.3% of men, 25.0% of women). Gay men were less likely to use e-cigarettes, cigars, and any tobacco product, and used fewer products relative to heterosexual men. Bisexual women were more likely to use each tobacco product and any tobacco product, and used more categories of products relative to heterosexual women.Conclusions:Specific tobacco use disparities differ with respect to type of product, gender, and sexual orientation, underscoring the need to better understand the underlying mechanisms of these differences (e.g., marketing, social influences) and developing interventions to address them.

Survivorship care is a type of care that patients get during and after cancer treatments. This ca... more Survivorship care is a type of care that patients get during and after cancer treatments. This care includes checking to see if the cancer has returned, screening for new cancers, and treating health problems related to cancer and its treatment.

Journal of Oncology Practice, Nov 1, 2019

PURPOSE Patient navigation (PN) is an increasingly recognized element of high-quality, patient-ce... more PURPOSE Patient navigation (PN) is an increasingly recognized element of high-quality, patient-centered cancer care, yet PN in many cancer programs is absent or limited, often because of concerns of extra cost without tangible financial benefits. METHODS Five real-world examples of PN programs are used to demonstrate that in the pure fee-for-service and the alternative payment model worlds of reimbursement, strong cases can be made to support the benefits of PN. RESULTS In three large programs, PN resulted in increased patient retention and increased physician loyalty within the cancer programs, leading to increased revenue. In addition, in two programs, PN was associated with a reduction in unnecessary resource utilization, such as emergency department visits and hospitalizations. PN also reduces burdens on oncology providers, potentially reducing burnout, errors, and costly staff turnover. CONCLUSION PN has resulted in improved patient outcomes and patient satisfaction and has important financial benefits for cancer programs in the fee-for-service and the alternative payment model worlds, lending support for more robust staffing of PN programs.

Journal of Cancer Education, Nov 18, 2022

The purpose of this study is to describe the context, curriculum design, and pilot evaluation of ... more The purpose of this study is to describe the context, curriculum design, and pilot evaluation of the educational program "Sexual and Gender Minority Cancer Curricular Advances for Research and Education" (SGM Cancer CARE), a workshop for early-career researchers and healthcare providers interested in gaining knowledge and skills in sexual and gender minority (SGM) cancer research and healthcare advocacy. A needs assessment of a sample of clinicians and researchers (n = 104) and feedback from an Advisory Board informed the curriculum design of the SGM Cancer CARE workshop. Four SGMtailored modules, focusing on epidemiology, clinical research, behavioral science and interventions, and community-based participatory approaches, were developed and tested in a 2.5-day virtual format among 19 clinicians and researchers. A fifth module to provide feedback to participants on brief presentations about their SGM cancer research ideas or related efforts was added later. A mixed-methods evaluation comprised of pre-and post-modular online evaluation surveys and virtual focus groups was used to determine the degree to which the workshop curriculum met participant needs. Compared to pre-module evaluations, participants reported a marked increase in SGM cancer research knowledge in post-module scores. Quantitative results were supported by our qualitative findings. In open field response survey questions and post-workshop focus groups, participants reported being extremely pleased with the content and delivery format of the SGM Cancer CARE workshop. Participants did regret not having the opportunity to connect with instructors, mentors, and colleagues in person. The SGM Cancer CARE curriculum was shown to increase the knowledge, skills, and level of preparedness of early-career clinicians and scientists to conduct culturally relevant and appropriate research needed to improve care for SGM persons across the cancer care continuum from prevention to survivorship. Keywords Cancer health disparities • Sexual and gender minorities • SGM • LGBTQ • Education and training • Healthcare providers • Researchers Miria Kano and Irene Tamí-Maury are co-first authors.

Patient Education and Counseling, Jul 1, 2021

PURPOSE This study examined whether higher levels of self-reported cultural competency training w... more PURPOSE This study examined whether higher levels of self-reported cultural competency training were associated with less anti-gay bias among a cancer healthcare provider sample (n = 404) recruited in January 2017. METHODS A factorial analysis of variance (ANOVA) was performed to examine anti-gay bias across professional role, sex and level of cultural competency training using the Index of Attitudes on Homosexuality (IAH). RESULTS Females, F(1, 396) = 8.861, p = 0.003, ηp2 = 0.022, and those who reported higher levels of cultural training, F(1, 396) = 6.136, p = 0.014, ηp2 = 0.015 had lower mean IAH composite scores than men or those with lower levels of training, respectively. Females reported statistically significantly lower mean scores than males for Avoidance, F(1, 396) = 14.105, p < 0.001, ηp2 = 0.034. However, those with more cultural training, reported statistically significantly lower mean scores than those with less training for the Approach, F(1, 396) = 5.402, p = 0.021, ηp2 = 0.013, and Acceptance, F(1, 396) = 6.699, p = 0.010, ηp2 = 0.017 factors, regardless of sex assigned at birth. CONCLUSION Findings suggest that cultural competency training may moderate some aspects of anti-gay bias. PRACTICE IMPLICATIONS Cultural competency training may be one important strategy to improve care for sexual minority patients.

Current Sexual Health Reports, Nov 20, 2020

Purpose of review:Until recently, sexual and gender minority (SGM) people have been largely invis... more Purpose of review:Until recently, sexual and gender minority (SGM) people have been largely invisible in health care and health services research. However, understanding the needs and experiences of SGM cancer patients is critical to providing high-quality care, including needs and experiences related to sexual health. In this narrative review, we highlight that the literature on sexual health for SGM people with cancer is lacking, summarize existing literature on disparities affecting SGM patients with cancer, and discuss factors associated with these disparities. We conclude with recommendations and suggestions for future research in this area.Recent Findings:Emerging evidence suggests that SGM people are at a higher risk for breast, cervical, endometrial, HPV-related, and lung cancers, as well as poor cancer outcomes, due to behavioral risk factors and health care system factors (e.g. lower access to health care insurance, discrimination in non-affirming care settings, negative health care interactions with providers). Additional research suggests that lack of clear guidelines for cancer screening in SGM patients, particularly for transgender and gender diverse patients, negatively impacts cancer screening uptake among SGM people. A growing number of studies have suggested greater sexual challenges following cancer treatment for sexual minority men with prostate cancer, while other studies highlight positive outcomes for sexual minority women following cancer treatment, such as benefit finding and resilience. Research on transgender and gender diverse patients is lacking.Summary:Collection of sexual orientation and gender identity data across clinical enterprises and population-based surveys, mandatory health care provider training on cultural and clinical competency with SGM patients, and additional research inclusive of and focused on SGM cancer patients are key strategies to advance evidence-based clinical cancer care for diverse SGM populations.