Pamela Hull | Vanderbilt University Medical Center (original) (raw)

Papers by Pamela Hull

BACKGROUND Goal setting and tracking are well-established behavior change strategies that have be... more BACKGROUND Goal setting and tracking are well-established behavior change strategies that have been used with parents to modify child behaviors. Little is known about the extent to which commercially available mobile applications (apps) are designed to guide parents in using these strategies, their evidence base, and their quality. OBJECTIVE The purpose of this study was to review commercially available apps related to setting and tracking behavioral goals that target parents and children. The objectives were to: 1) classify the general characteristics, features, evidence base and target behaviors of the apps, 2) assess the quality of the identified apps, and 3) compare the apps that target health-related behaviors (HRB) versus apps without a health-related behavior (WHRB) included. METHODS Apps were identified using keyword searches in the Apple App Store and Google Play. Apps were included if the main purpose was to assist with setting goals, tracking goals, tracking behaviors, an...

BMC Cancer, 2021

Background Despite lower cancer incidence rates, cancer mortality is higher among rural compared ... more Background Despite lower cancer incidence rates, cancer mortality is higher among rural compared to urban dwellers. Patient, provider, and institutional level factors contribute to these disparities. The overarching objective of this study is to leverage the multidisciplinary, multispecialty oncology team from an academic cancer center in order to provide comprehensive cancer care at both the patient and provider levels in rural healthcare centers. Our specific aims are to: 1) evaluate the clinical effectiveness of a multi-level telehealth-based intervention consisting of provider access to molecular tumor board expertise along with patient access to a supportive care intervention to improve cancer care delivery; and 2) identify the facilitators and barriers to future larger scale dissemination and implementation of the multi-level intervention. Methods Coordinated by a National Cancer Institute-designated comprehensive cancer center, this study will include providers and patients a...

ID# P35 A Tailored Educational Program to improve Cancer Clinical Trial Participation among Afric... more ID# P35 A Tailored Educational Program to improve Cancer Clinical Trial Participation among African Americans and Latinos Authors: Jennifer Cunningham-Erves, PhDa, Claudia Barajasb, Tilicia Mayo-Gamble, PhDc, Caree R. McAfee, MSd, Pamela Hull, PhDe, Maureen Sanderson, PhDf, Juan Canedo, PhDg, Katina Beard, MSPHh, Consuelo H. Wilkins, MD, MSCIi a Assistant Professor, Department of Internal Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd, Nashville, Tennessee, 37208-3599, United States b Community Health Educator, Office of Patient and Community Education, VanderbiltIngram Cancer Center, Nashville, Tennessee, 37232, United States c Post-Doctoral Fellow, Department Family and Community Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd, Nashville, Tennessee 37208-3599, United States d Program Manager/CHE, Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, 2525 West End, Suite 800, Nashville, Tennessee, 372031738, United St...

Journal of health disparities research and practice, 2019

Community Advisory Boards (CABs) are used in efforts to reduce health disparities; however, there... more Community Advisory Boards (CABs) are used in efforts to reduce health disparities; however, there is little documentation in the literature regarding their use in precision medicine research. In this case study, an academic-CAB partnership developed a questionnaire and patient educational materials for two precision smoking cessation interventions that involved use of genetic or genetically-informed information. The community-engaged research (CEnR) literature provided a framework for enhancing benefits to CAB members involved in developing research documents for use with a low-income, ethnically diverse population of smokers.The academic partners integrated three CEnR strategies: 1) in-meeting statements acknowledging their desire to learn from community partners, 2) in-meeting written feedback to and from community partners, and 3) a survey to obtain CAB member feedback post-meetings. Strategies 1 and 2 yielded modifications to pertinent study materials, as well as suggestions for...

BMC Public Health, 2020

Background Addressing knowledge deficiencies about cancer clinical trials and biospecimen donatio... more Background Addressing knowledge deficiencies about cancer clinical trials and biospecimen donation can potentially improve participation among racial and ethnic minorities. This paper describes the formative research process used to design a culturally-appropriate cancer clinical trials education program for African American and Latino communities. We characterized community member feedback and its integration into the program. Methods We incorporated three engagement approaches into the formative research process to iteratively develop the program: including community-based organization (CBO) leaders as research team members, conducting focus groups and cognitive interviews with community members as reviewers/consultants, and interacting with two community advisory groups. An iterative-deductive approach was used to analyze focus group data. Qualitative data from advisory groups and community members were compiled and used to finalize the program. Results Focus group themes were: 1...

Public Health, 2018

Objectives: When examining vaccination coverage, researchers must make decisions about how to def... more Objectives: When examining vaccination coverage, researchers must make decisions about how to define outcome measures based on many factors, including the timing of doses. Different operationalizations of the same outcome can often lead to different findings and can affect the ability to make comparisons across studies. This methodological paper aimed to illustrate the implications of two options for operationalizing HPV vaccination based on timing: initiation of the first dose at any age versus prior to the 13th birthday (on-time). Study Design: Cross-sectional observational design Methods: The 2014 National Immunization Survey for Teens (NIS-Teen, N=16,439 adolescents ages 13-17) was analyzed using multivariate logistic regression for each outcome measure and effect modification by gender. Results: Age was positively associated with initiation at any age, but negatively associated with on-time initiation. Gender modified the effect of race/ethnicity for both measures of initiation, but the pattern across groups was different for the two outcomes. Gender modified the effect of provider recommendation for initiation at any age, while gender modified the effects of age and region for on-time initiation. Conclusion: Decisions of how to operationalize outcomes of HPV vaccine initiation among adolescents can lead to different conclusions about the role of age and gender differences for several predictive variables. In order to inform the development of public health efforts that promote on-time HPV vaccination among male and female adolescents, researchers should consider the importance of dose timing when operationalizing outcome measures. We recommend including on-time receipt of the HPV vaccine as an outcome measure.

Preventing chronic disease, Aug 24, 2017

The 2007 Interim Rule mandated changes to food packages in the Special Supplemental Nutrition Pro... more The 2007 Interim Rule mandated changes to food packages in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) for implementation by 2009. The 2014 Final Rule required additional changes, including increasing the cash value voucher for fruits and vegetables from 6to6 to 6to8 for children by June 2014, and allowing only low-fat (1%) or nonfat milk for mothers and children aged 2 to 4 years by October 2014. This study evaluated the effect of the 2014 Final Rule changes on the food environment of small and mid-sized WIC-authorized grocery stores. We analyzed secondary data using a natural experimental design to compare the percentage of shelf space for low-fat and nonfat milk and the number of fresh fruit and vegetable varieties in stock before and after the changes. We collected observational data on 18 small and mid-sized WIC-authorized grocery stores in Nashville, Tennessee, using the Nutrition Environment Measures in Store tool in March 2014 and February 2...

Cancer Epidemiology, Biomarkers & Prevention, 2015

There are more than 13.7 million cancer survivors in the United States and this number is expecte... more There are more than 13.7 million cancer survivors in the United States and this number is expected to grow to 18 million by 2020 because of improved outcomes from care and the aging of the population. Although cancer health disparities are well-described for incidence, diagnosis, and treatment, little is known about qualitative disparities among long-term survivors. At Vanderbilt-Ingram Cancer Center (VICC), an NCI-designated comprehensive cancer center, and Meharry Medical College, a minority serving institutional partner, we conducted focus groups with cancer survivors as part of formative research for reducing disparities in cancer survivorship. Methods: Adult cancer survivors were recruited from the institutional tumor registry lists at VICC (n=21) and MMC (n=20). Eligibility for participation included a primary breast (female), colorectal, lung or prostate cancer (male) diagnosed during 1995-2010 with survival for a least one year since diagnosis; age >35 years at the time o...

Using publically available mortality data from the CDC Wonder internet site, we observed national... more Using publically available mortality data from the CDC Wonder internet site, we observed national age-race-specific (35-44, 45-54, 55-64, 65-74, 75-84, 85+) black mortality rates for malignant neoplasm of the esophagus among women. From 1979 to 2005, there were net changes of 1.5 (per 100,000) to 0.4, 8.4 to 2.2, 15.0 to 5.7 (all p<0.0001) 11.1 to 9.6 (p=0.334), 12.2 to 13.5 (p=0.600) and 11.5 to 13.5 (p=0.654) respectively. Declines among 35 to 64 year olds occurred throughout the observation period, while increases in the older age groups were greatest from 1979 to 1987 (ages 85+) and 1979 to 1989 (ages 65-74 and 75-84). Corresponding (1979-2005) net changes in black:white mortality rate ratios were 13.0 to 2.0, 8.4 to 2.8, 3.9 to 2.0, 1.7 to 1.4, 1.4 to 1.2 and 0.8 to 0.9. On an age-adjusted basis (25-85+ years), US mortality declined from 6.5 per 100,000 in 1979 to 3.6 per 100,000 in 2005 among black women, while increasing slightly (from 2.4 to 2.5 per 100,000) among white w...

Problem/Objectives Since its creation in 2007, the Meharry-Vanderbilt Community Engaged Research ... more Problem/Objectives Since its creation in 2007, the Meharry-Vanderbilt Community Engaged Research Core (CERC) has been developing training resources for students, faculty and research staff at Vanderbilt University (VU) and Meharry Medical College (MMC) to grow the number of and support for researchers who understand the principles of community engagement and conduct community engaged research. Building and maintaining effective, mutually beneficial academic-community research partnerships is challenging. Rigorous research training programs generally do not prepare researchers to engage the community in their work. Without appropriate training or experience, their attempts to facilitate community and patient engagement are often ineffective, burdensome and leave community partners feeling disenfranchised. Methods A survey conducted by CERC in 2009 queried 391 academic researchers and 68 community partners about their experience with and desire to learn more about community engaged re...

Conclusions: The findings suggest that the delayed-intervention group did not function as a pure ... more Conclusions: The findings suggest that the delayed-intervention group did not function as a pure control and may have unintentionally received a partial intervention. This finding demonstrated that a low-cost prostate cancer awareness campaign within a church may be enough to affect prostate cancer knowledge, attitudes, and behaviors among African Amer- ican men. Further research should examine the church-specific intervention elements, cultural appropriateness of the messages, and whether group sessions provide additional effect. (Ethn Dis. 2008;18(Suppl 2):S2-179-S2-184)

JCO Precision Oncology, 2021

PURPOSE We conducted this systematic review to evaluate the clinical outcomes associated with mol... more PURPOSE We conducted this systematic review to evaluate the clinical outcomes associated with molecular tumor board (MTB) review in patients with cancer. METHODS A systematic search of PubMed was performed to identify studies reporting clinical outcomes in patients with cancer who were reviewed by an MTB. To be included, studies had to report clinical outcomes, including clinical benefit, response, progression-free survival, or overall survival. Two reviewers independently selected studies and assessed quality with the Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group or the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies depending on the type of study being reviewed. RESULTS Fourteen studies were included with a total of 3,328 patients with cancer. All studies included patients without standard-of-care treatment options and usually with multiple prior lines of therapy. In studies reporting response rates, patients receivi...

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HPV vaccination is recommended for all children ages 11-12, with catch up for females to age 26 a... more HPV vaccination is recommended for all children ages 11-12, with catch up for females to age 26 and males to age 21, for prevention of HPV-associated cancers, which disproportionately affect African Americans. However, uptake of HPV vaccine has lagged far behind that of other adolescent vaccines recommended for the same ages (meningococcal and Tdap), and completion was lower among African Americans than whites until 2013. The purpose of this study was to pilot test a culturally-appropriate social marketing intervention targeting parents of African American pre-adolescents to increase initiation and completion of the 3-dose HPV vaccine series, using a community-engaged approach. A Community Advisory Board (CAB) and Teen and Parent Committee participated in the development of the intervention. While the messages were developed to be culturally-appropriate for African American parents based on formative research, the CAB wanted to ensure that the intervention was designed to be appropr...

JMIR mHealth and uHealth

Background: Since 1972, the Special Supplemental Nutrition Program for Women, Infants, and Childr... more Background: Since 1972, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has been proven to improve the health of participating low-income women and children in the United States. Despite positive nutritional outcomes associated with WIC, the program needs updated tools to help future generations. Improving technology in federal nutrition programs is crucial for keeping nutrition resources accessible and easy for low-income families to use. Objective: This review aimed to analyze the main features of publicly available mobile phone apps for WIC participants. Methods: Keyword searches were performed in the app stores for the 2 most commonly used mobile phone operating systems between December 2017 and June 2018. Apps were included if they were relevant to WIC and excluded if the target users were not WIC participants. App features were reviewed and classified according to type and function. User reviews from the app stores were examined, including ratings and categorization of user review comments. Results: A total of 17 apps met selection criteria. Most apps (n=12) contained features that required verified access available only to WIC participants. Apps features were classified into categories: (1) shopping management (eg, finding and redeeming food benefits), (2) clinic appointment management (eg, appointment reminders and scheduling), (3) informational resources (eg, recipes, general food list, tips about how to use WIC, links to other resources), (4) WIC-required nutrition education modules, and (5) other user input. Positive user reviews indicated that apps with shopping management features were very useful. Conclusions: WIC apps are becoming increasingly prevalent, especially in states that have implemented electronic benefits transfer for WIC. This review offers new contributions to the literature and practice, as practitioners, software developers, and health researchers seek to improve and expand technology in the program.

JMIR Formative Research

Background The Special Supplemental Nutrition Assistance Program for Women, Infants, and Children... more Background The Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) is a federal nutrition program that provides nutritious food, education, and health care referrals to low-income women, infants, and children up to the age of 5 years. Although WIC is associated with positive health outcomes for each participant category, modernization and efficiency are needed at the clinic and shopping levels to increase program satisfaction and participation rates. New technologies, such as electronic benefits transfer (EBT), online nutrition education, and mobile apps, can provide opportunities to improve the WIC experience for participants. Objective This formative study applies user-centered design principles to inform the layout and prioritization of features in mobile apps for low-income families participating in the WIC program. Methods To identify and prioritize desirable app features, caregivers (N=22) of the children enrolled in WIC participated in ind...

Journal of Clinical Oncology

e20523 Background: Cancer health disparities are well described for incidence, diagnosis and trea... more e20523 Background: Cancer health disparities are well described for incidence, diagnosis and treatment. Little is known about disparities among long-term survivors. Methods: At Vanderbilt-Ingram Cancer Center (VICC), an NCI-designated comprehensive cancer center and Meharry Medical College (MMC), minority serving institutional partner, we evaluated quality of life (QOL) using the FACT-G, FACT-B, FACT-L, and FACT-P; posttraumatic stress disorder (PTSD) using the PTSD Checklist (PCL); and posttraumatic growth (PTG) using the PTG Inventory (PTGI) among breast, lung or prostate cancer survivors. We used linear regression to compare the scale mean values by institution while adjusting for confounding variables. Results: Among 111 breast, 53 lung and 68 prostate cancer survivors, mean age was 62 years, 61% were female, 33% were black, 65% were married, 22% and 67% respectively had a high school degree or some college/higher education, 36% were employed and 94% were insured. MMC survivors ...