Marvella Ford | Medical University of South Carolina (original) (raw)

Papers by Marvella Ford

Advances in Cancer Research, 2020

Human papillomavirus (HPV) infection is the primary risk factor for cervical cancer. While the HP... more Human papillomavirus (HPV) infection is the primary risk factor for cervical cancer. While the HPV vaccine significantly reduces the risk of HPV infection and subsequent cervical cancer diagnosis, underuse is linked to lack of knowledge of its effectiveness in preventing cervical cancer. The purpose of this study was to evaluate a cancer educational intervention (titled "MOVENUP") to improve knowledge of cervical cancer, HPV, and the HPV vaccine among predominantly African American communities in South Carolina. The MOVENUP cancer educational intervention was conducted among participants residing in nine South Carolina counties who were recruited by community partners. The 4.5-h MOVENUP cancer educational intervention included a 30-min module on cervical cancer, HPV, and HPV vaccination. A sixitem investigator-developed instrument was used to evaluate pre-and post-intervention changes in knowledge related to these content areas. Ninety-three percent of the 276 participants were *

Journal of Cancer Education, 2015

The US is experiencing a severe shortage of underrepresented biomedical researchers. The purpose ... more The US is experiencing a severe shortage of underrepresented biomedical researchers. The purpose of this paper is to present two case examples of cancer research mentoring programs for underrepresented biomedical sciences students. The first case example is a National Institutes of Health/ National Cancer Institute (NIH/NCI) P20 grant titled BSouth Carolina Cancer Disparities Research Center (SC CaDRe)T raining Program, contributing to an increase in the number of underrepresented students applying to graduate school by employing a triple-level mentoring strategy. Since 2011, three undergraduate and four graduate students have participated in the P20 SC CaDRe program. One graduate student published * Marvella E.

Journal of Cancer Education, 2014

Colon cancer is one of the most commonly diagnosed cancers in the United States and an increasing... more Colon cancer is one of the most commonly diagnosed cancers in the United States and an increasing number of survivors has underscored the need for improved colon cancer surveillance care quality. Post-treatment surveillance includes follow-up care visits and tests as well as psychosocial support and lifestyle counseling. This formative study explored the individual, interpersonal and organizational-level factors related to adherence to surveillance care guidelines to identify modifiable factors for potential educational intervention strategies. A convenience sample of 22 survivors (12 women and 10 men) from two cancer centers were recruited to participate in focus groups or key informant telephone interviews to explore their experiences with care after completing treatment and complete a brief survey. Content analysis was used to identify themes. Results confirmed that survivors navigated a complex surveillance care schedule and described a strong trust in their health care providers that guided their follow-up care experiences. Participants defined the terms "survivorship" and "follow up" in a variety of different ways. Individual-level themes critical to survivors' experiences included having a positive attitude, relying on one's faith and coping with fears. Interpersonal-level themes centered around interactions and communication with family and health care providers in follow-up care. While organizational-level factors were highlighted infrequently, participants rated office reminder systems and communication among their multiple providers as valuable. Educational interventions capitalizing on survivors' connections with their physicians and focusing on preparing survivors for what to expect in the

Cancer Epidemiology, Biomarkers & Prevention, 2010

Introduction: Patient navigation interventions are an emerging approach to reducing cancer dispar... more Introduction: Patient navigation interventions are an emerging approach to reducing cancer disparities but few formal evaluations have been published. The purpose of this study was to evaluate perceptions of a breast cancer patient navigation program among patients, patient navigators (PNs), and breast cancer clinic staff members. Methods: Post-program interviews were conducted with 218 navigated patients. Individual semi-structured interviews were conducted with 5 PNs. Surveys were administered to 19 clinic staff. Results: Perceptions among Navigated Patients (n=218). Fifty-three percent of the surveyed patients were African American (n=116), 15.1% were Hispanic (n=33), 33.9% were married (n=74), 65.1% had ≤ a high school degree (n=142), and 75.2% had an annual income <$20,000 (n=164). The mean age was 44 years. Eighty-nine percent of the surveyed patients rated their overall satisfaction with the navigation services they received as excellent (n=194), 98.2% stated that they rec...

Cancer Epidemiology, Biomarkers & Prevention

Background: Enrollment of early-stage lung cancer patients to randomized trials has historically ... more Background: Enrollment of early-stage lung cancer patients to randomized trials has historically been challenging. The STARS Trial enrolled 36 of 1,030 intended patients from 28 sites, while the ROSEL Trial recruited 22 of 960 intended patients from 10 sites. Unfortunately, evidence shows African Americans with early-stage NSCLC are significantly less likely than their European American counterparts to undergo resection and may also be less likely to participate in lung cancer trials as well. Purpose: The purpose of this research is to describe interim recruitment results from an NIMHD-funded, NCI NCORP-based patient navigation trial conducted with African Americans with early-stage, probable/proven non-small cell lung cancer (NSCLC). Design: The protocol-driven, barriers-focused patient navigation intervention is being conducted in the context of a two-arm cluster-randomized trial testing the effectiveness of the intervention in increasing rates of lung-directed curative-intent the...

Supplemental material, sj-docx-1-cpc-10.1177_10556656211069828 for Racial and Ethnic Disparities ... more Supplemental material, sj-docx-1-cpc-10.1177_10556656211069828 for Racial and Ethnic Disparities in Primary Cleft Lip and Cleft Palate Repair by Mary Carter Mullen, Flora Yan, Marvella E. Ford, Krishna G. Patel and Phayvanh P. Pecha in The Cleft Palate-Craniofacial Journal

Cancer Epidemiology, Biomarkers & Prevention, 2020

Advanced glycation end-products (AGEs), are reactive metabolites produced endogenously as a conse... more Advanced glycation end-products (AGEs), are reactive metabolites produced endogenously as a consequence of glucose metabolism. AGEs accumulate in tissues and organs as we grow older to promote multiple chronic disease phenotypes. AGE pathogenic effects are mediated through modification of protein function, genetic fidelity, stress responses and cellular signaling pathways. Critically, cancer disparity factors such as a sedentary lifestyle, obesity and an unhealthy diet are external influences that have been shown to contribute to the accumulation of AGEs. This research group examined circulating and tumor AGE levels in clinical specimens of prostate cancer and identified a race specific, tumor-dependent pattern of accumulation. AGE levels were highest in aggressive tumors, especially those from men with African ancestry. As our understanding of tumor biology advances, it is becoming increasingly clear that these lifestyle factors have distinct molecular consequences on the biologic ...

Journal of cancer education : the official journal of the American Association for Cancer Education, Jan 2, 2018

The number of colorectal cancer (CRC) survivors in the USA is increasing and factors associated w... more The number of colorectal cancer (CRC) survivors in the USA is increasing and factors associated with CRC surveillance require attention. This study examined the role of personal, provider, and practice-level factors on CRC survivor care surveillance experiences and outcomes. A telephone survey, informed by the Chronic Care Model, was conducted over a 1-year period with 150 CRC survivors identified via the South Carolina Central Cancer Registry. Participants were ages ≥ 21 years and diagnosed with stages I-III CRC within 1.5 years of study enrollment. Data were analyzed using descriptive statistics and logistic regression. Adherence was defined as receipt of surveillance colonoscopy at 13 months post-CRC surgery, as recommended by evidence-based guidelines. The majority of participants were male (55%) and white (86%), with a median age of 65 years (range 25-89). Almost half (43%) had attained a high school degree or less. Cancer stage was fairly evenly distributed, and 58% had receiv...

Clinical trials (London, England), 2017

Racial/ethnic minority groups remain underrepresented in clinical trials. Many strategies to incr... more Racial/ethnic minority groups remain underrepresented in clinical trials. Many strategies to increase minority recruitment focus on minority communities and emphasize common diseases such as hypertension. Scant literature focuses on minority recruitment to trials of less common conditions, often conducted in specialty clinics and dependent on physician referrals. We identified trust/mistrust of specialist physician investigators and institutions conducting medical research and consequent participant reluctance to participate in clinical trials as key-shared barriers across racial/ethnic groups. We developed a trust-based continuous quality improvement intervention to build trust between specialist physician investigators and community minority-serving physicians and ultimately potential trial participants. To avoid the inherent biases of non-randomized studies, we evaluated the intervention in the national Randomized Recruitment Intervention Trial (RECRUIT). This report presents the...

Journal of the National Medical Association, 2008

Background: Minority populations in the United States, especially blacks and Hispanics, are gener... more Background: Minority populations in the United States, especially blacks and Hispanics, are generally underrepresented among participants in clinical trials. Here, we report the experience of enrolling ethnic minorities in a large cancer screening trial. Methods: The Prostate, Colorectal, Lung and Ovarian (PLCO) Cancer Screening Trial is a multicenter randomized trial designed to evaluate the effectiveness of screening for the PLCO cancers. Subjects were recruited at 10 U.S. centers between 1993 and 2001. One screening center had a major special recruitment effort for blacks and another center had a major special recruitment effort for Hispanics. Results: Among almost 155,000 subjects enrolled in PLCO, minority enrollment was as follows: black (5.0%), Hispanic (1.8%) and Asian (3.6%). This compares to an age-eligible population in the combined catchment areas of the PLCO centers that was 14.0% black, 2.9% Hispanic and 5.4% Asian, and an age-eligible population across the U.S. that was 9.5% black, 6.5% Hispanic and 3.0% Asian. About half (45%) of Hispanics were recruited at the center with the special Hispanic recruitment effort. Seventy percent of blacks were recruited at two centers; the one with the major special recruitment effort and a center in Detroit whose catchment area was 20% black among age-eligibles. Blacks, Hispanics and (non-Hispanic) whites were all more highly educated, less likely to currently smoke and more likely to get regular exercise than their counterparts in the general population. Conclusion: Significant efforts were made to recruit racial/ ethnic minorities into PLCO, and these efforts resulted in enrollment levels that were comparable to those seen in many recent cancer screening or prevention trials. Blacks and Hispanics were nonetheless underrepresented in PLCO compared to their levels among age-eligibles in the overall U.S. population or in the aggregate PLCO catchment areas.

Purpose/Goals of Project: South Carolina ranks high in the nation in cancer death, particularly a... more Purpose/Goals of Project: South Carolina ranks high in the nation in cancer death, particularly among African Americans. While financial barriers to care are considerable, lack of knowledge about cancer is an additional barrier. In 2007, we formed statewide partnerships to develop a series of faith based cancer education programs to overcome this barrier and reduce cancer disparities. Methodology: Three hundred African American women participated in the first program, which took place as part of a regional faith-based women's conference. Information pertaining to cancer prevention and early detection was disseminated, including information on the HPV vaccine. A 36-item survey was administered pre- and post-program. Change in knowledge was measured using the observed mean change and a 95% confidence interval. Results: The mean age of the participants was 61 years, 93% were African American, nearly 85% had completed high school, and 29% reported an annual household income of $40,0...

Cancer Epidemiology, Biomarkers & Prevention, 2014

Background: African Americans (AA) are disproportionately impacted by cancer mortality compared t... more Background: African Americans (AA) are disproportionately impacted by cancer mortality compared to their European American (EA) counterparts. Greater participation in cancer clinical trials among AA could help to reduce this disparity. However, negative perceptions of trials appear to negatively impact trial participation among AA. The Attitudes towards Randomized Trials Questionnaire (ARTQ) has been found to be a reliable measure of trial perceptions among EA. However, the utility of this instrument has never before been tested among AA. Objective: To evaluate the reliability of the ARTQ in assessing perceptions of cancer clinical trials in a predominantly AA sample. Methods: Principal component analysis (PCA) and Cronbach's alpha estimates were used to assess the reliability of the ARTQ. The sample consisted of residents from South Carolina counties with high racial disparities in cancer mortality rates (N=315, 81.4% AA) who participated in the study between 2008 and 2013. Res...

Qualitative health research, Jan 15, 2015

The purpose of this formative qualitatively driven mixed-methods study was to refine a measuremen... more The purpose of this formative qualitatively driven mixed-methods study was to refine a measurement tool for use in interventions to improve colorectal cancer (CRC) surveillance care. We employed key informant interviews to explore the attitudes, practices, and preferences of four physician specialties. A national survey, literature review, and expert consultation also informed survey development. Cognitive pretesting obtained participant feedback to improve the survey's face and content validity and reliability. Results showed that additional domains were needed to reflect contemporary interdisciplinary trends in survivorship care, evolving practice changes and current health policy. Observed dissonance in specialists' perspectives poses challenges for the development of interventions and psychometrically sound measurement. Implications for future research include need for a flexible care model with enhanced communication and role definitions among clinical specialists, impr...

ABSTRACT Purpose/Goals of Project: We examined the effect of baseline comorbidities on screening ... more ABSTRACT Purpose/Goals of Project: We examined the effect of baseline comorbidities on screening adherence in a sample of 703 older (ages 55+ years) African American (AA) men enrolled in a case management intervention in a longitudinal cancer screening trial. Methodology: The 703 men were randomly assigned to a case management retention trial intervention group (IG, n=352) or a case management control group (CG, n=351). The case managers referred intervention group participants to community agencies that provided services requested by participants. Results: Regardless of group assignment, participants with comorbidities were not less likely to adhere to trial screening than participants without comorbidities. Exceptions were current smokers, participants with bronchitis, and those with arthritis. IG participants who were current smokers were marginally less likely (56.0%) than others to adhere to the prostate specific antigen (PSA) test for prostate cancer screening (p=0.052). IG participants who reported having chronic bronchitis had a much lower chest x-ray screening (for lung cancer) adherence rate (28.6%) than participants in the other three groups (p=0.045). CG participants who reported having arthritis had the lowest adherence rate to flexible sigmoidoscopy for colorectal cancer screening, 40.5%, compared to the other three groups (p=0.022). Implications: In general, older African American men with comorbidities appear to be excellent candidates for participation in longitudinal cancer screening trials, although smokers have lower adherence rates. Sustainability: Future studies could examine the relationship between baseline health history and adherence to other types of cancer screening among older African American men and among other population groups.

Quality of Life Research

The purpose of this study was to examine the structure and reliability of the EORTC QLQ-C30. This... more The purpose of this study was to examine the structure and reliability of the EORTC QLQ-C30. This 30-item instrument has five functional scales (physical, role, cognitive, emotional, and social), three symptom scales (fatigue, pain, and nausea and vomiting) and a global health and quality of life scale. Confirmatory factor analysis and Cronbach's α estimates were used to assess the functioning of the EORTC QLQ-C30 in a sample of 489 African American (n = 255) and Caucasian (n = 234) adults aged 50 + years. Seven of the nine EORTC QLQ-C30 scales showed good reliability for both the African Americans and the Caucasians in the sample (Cronbach's > 0.75). In contrast, the cognitive functioning scale had a reliability coefficient of only 0.69 for the African Americans and 0.40 for the Caucasians, and the nausea and vomiting scale had a reliability coefficient of only 0.49 for the African Americans and 0.51 for the Caucasians. In summary, although the overall reliabilities of s...

Journal of Psychosocial Oncology, 2013

Promoting patient-centered care from diagnosis to end of life requires a better understanding of ... more Promoting patient-centered care from diagnosis to end of life requires a better understanding of physical, psychological, social, and spiritual coping factors in advanced cancer. Using qualitative methods, the authors explored diagnosis, care planning, and treatment experiences of individuals with metastatic colorectal cancer (N=26). The main physical factors salient to patients during all care phases included symptoms and physical functioning. Key psychological factors included persistent uncertainty and a range of emotions that varied by care phase. Participants also relied heavily on social and spiritual factors for guidance. Results highlight the complex nature of coping with advanced cancer and the resources needed to facilitate high-quality care.

Journal of Gerontological Social Work, 2002

... interventions are two-fold, in that they include both disabil-ity limitations and rehabilitat... more ... interventions are two-fold, in that they include both disabil-ity limitations and rehabilitation activities, with the goal of minimizing effects of disability and providing rehabilitation to the ... Powell, IJ, Banerjee, M., Novallo, M., Sakr, W., Grignon, D., Wood, DP, and Pontes, JE (2000). ...

Ethnicity & Health, 1997

Re-analysis of a randomized trial of an asthma education program designed to assess the effects o... more Re-analysis of a randomized trial of an asthma education program designed to assess the effects of the intervention on emergency department visits, limited days of activity and asthma knowledge and beliefs separately for African American and Caucasian adults with asthma. Two hundred and forty-one respondents between the ages of 18 and 70 were evaluated in two emergency departments (one inner city and one suburban location) of a large, midwestern health care system and were randomized to an intervention or control group. Regardless of race, members of the intervention group showed a decrease in the number of post-intervention emergency department visits (ANOVA interaction between race and group effect p value = 0.93). The greatest decrease occurred during the first four post-intervention months. No differential effect of the asthma education intervention by race was found on the change in asthma knowledge and beliefs over the study period (ANCOVA interaction between race and group effect p value = 0.60). This study demonstrates that post-intervention, both African American and Caucasian study participants showed a decrease in emergency department visits and an increase in asthma self-management. This finding is especially important for African Americans, who face increasing asthma mortality and morbidity.

Cancer Epidemiology, Biomarkers & Prevention, 2011

African Americans (AA) have worse survival from colorectal cancer (CRC) compared to European Amer... more African Americans (AA) have worse survival from colorectal cancer (CRC) compared to European Americans (EA), but the reasons for the racial differences in stage-specific survival are poorly understood. To address this gap, we analyzed population-based data from the South Carolina Central Cancer Registry (SCCCR) to examine racial differences in advanced stage survival before and after the introduction of the new chemotherapeutic regimens in 2004 and to integrate information on race, age, and pathologic prognostic tumor characteristics and survival. The study focused on metastatic disease because of similar recommended standard therapy, the large racial difference in the relative survival, and a documented change in chemotherapy usage in 2004. The study population was comprised of data from patients with newly diagnosed advanced stage CRC (SEER staging distant) from 1/1/96 through 12/31/06 with follow-up data until 12/31/07. Analyses were designed to compare AA to EA by computing medi...

Journal of Clinical Medicine

Human papillomavirus (HPV) infections are linked to at least six different types of cancer. The M... more Human papillomavirus (HPV) infections are linked to at least six different types of cancer. The Medical University of South Carolina (MUSC) Hollings Cancer Center (HCC) and Department of Pediatrics leaders identified suboptimal rates of HPV vaccinations in rural and medically underserved communities in South Carolina (SC). To address this major public health problem in SC, they received funding from the HealthyMe/HealthySC (HMHSC) program and HCC to create a statewide community engagement-focused HPV Vaccination Van Program in October 2021. The Program provides HPV vaccinations and other childhood immunizations in school districts and HMHSC health clinics throughout SC, focusing on children aged 9–18 who are eligible for the U.S. Centers for Disease Control and Prevention’s Vaccines for Children Program. As of 14 December 2022, the Program administered vaccinations in 16 counties of SC to 552 participants, 243 of whom received HPV vaccinations and were predominantly female (57.2%), ...