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Integrating stages of change models to cast new vision on interventions to improve global retinoblastoma and childhood cancer outcomes
BACKGROUND: Retinoblastoma, the most common intraocular tumor globally, represents a curable cancer when diagnosed early and treated promptly. Delay to diagnosis, lag time prior to treatment initiation, and abandonment of treatment including upfront treatment refusal, represent stark causes of high...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165911/ https://www.ncbi.nlm.nih.gov/pubmed/25213666 http://dx.doi.org/10.1186/1471-2458-14-944 |
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author | Weaver, Meaghann S Heminger, Christina L Lam, Catherine G |
author_facet | Weaver, Meaghann S Heminger, Christina L Lam, Catherine G |
author_sort | Weaver, Meaghann S |
collection | PubMed |
description | BACKGROUND: Retinoblastoma, the most common intraocular tumor globally, represents a curable cancer when diagnosed early and treated promptly. Delay to diagnosis, lag time prior to treatment initiation, and abandonment of treatment including upfront treatment refusal, represent stark causes of high retinoblastoma mortality rates in low- and middle- income settings, particularly regions in Africa. While a health delivery-based approach has been a historic focus of retinoblastoma treatments globally and is essential to quality care, this is necessary but not adequate. Retinoblastoma is a compelling disease model to illustrate the potential insights afforded in theory-informed approaches to improve outcomes that integrate public health and oncology perspectives, prioritizing both health service delivery and social efficacy for cure. DISCUSSION: Given that barriers to appropriate and timely diagnosis and treatment represent main contributors to mortality in children with retinoblastoma in resource-limited settings such as certain areas in Africa, an important priority is to overcome barriers to cure that may be predominantly socially influenced, alongside health delivery-based improvements. While Stages of Change models have been effectively utilized in cancer screening programs within settings of economic and cultural barriers, this application of health behavior theory has been limited to cancer screening rather than a comprehensive framework for treatment completion. Using retinoblastoma as a case example, we propose applying stage-based intervention models in critical stages of care, such as the Precaution Adoption Process Model to decrease delay to diagnosis and a Transtheoretical Model to increase treatment completion rates in resource-limited settings. SUMMARY: Stage-based theories recognize that improved cure and survival outcomes will require supportive strategies to progress households, communities, and social and economic institutions from being unaware and unengaged to committed and sustained in their respective roles. Applying a stage-based model lens to programmatic interventions in resource-limited settings has potential for visible improvement in outcomes for children with retinoblastoma and other cancers. |
format | Online Article Text |
id | pubmed-4165911 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-41659112014-09-18 Integrating stages of change models to cast new vision on interventions to improve global retinoblastoma and childhood cancer outcomes Weaver, Meaghann S Heminger, Christina L Lam, Catherine G BMC Public Health Debate BACKGROUND: Retinoblastoma, the most common intraocular tumor globally, represents a curable cancer when diagnosed early and treated promptly. Delay to diagnosis, lag time prior to treatment initiation, and abandonment of treatment including upfront treatment refusal, represent stark causes of high retinoblastoma mortality rates in low- and middle- income settings, particularly regions in Africa. While a health delivery-based approach has been a historic focus of retinoblastoma treatments globally and is essential to quality care, this is necessary but not adequate. Retinoblastoma is a compelling disease model to illustrate the potential insights afforded in theory-informed approaches to improve outcomes that integrate public health and oncology perspectives, prioritizing both health service delivery and social efficacy for cure. DISCUSSION: Given that barriers to appropriate and timely diagnosis and treatment represent main contributors to mortality in children with retinoblastoma in resource-limited settings such as certain areas in Africa, an important priority is to overcome barriers to cure that may be predominantly socially influenced, alongside health delivery-based improvements. While Stages of Change models have been effectively utilized in cancer screening programs within settings of economic and cultural barriers, this application of health behavior theory has been limited to cancer screening rather than a comprehensive framework for treatment completion. Using retinoblastoma as a case example, we propose applying stage-based intervention models in critical stages of care, such as the Precaution Adoption Process Model to decrease delay to diagnosis and a Transtheoretical Model to increase treatment completion rates in resource-limited settings. SUMMARY: Stage-based theories recognize that improved cure and survival outcomes will require supportive strategies to progress households, communities, and social and economic institutions from being unaware and unengaged to committed and sustained in their respective roles. Applying a stage-based model lens to programmatic interventions in resource-limited settings has potential for visible improvement in outcomes for children with retinoblastoma and other cancers. BioMed Central 2014-09-11 /pmc/articles/PMC4165911/ /pubmed/25213666 http://dx.doi.org/10.1186/1471-2458-14-944 Text en © Weaver et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Debate Weaver, Meaghann S Heminger, Christina L Lam, Catherine G Integrating stages of change models to cast new vision on interventions to improve global retinoblastoma and childhood cancer outcomes |
title | Integrating stages of change models to cast new vision on interventions to improve global retinoblastoma and childhood cancer outcomes |
title_full | Integrating stages of change models to cast new vision on interventions to improve global retinoblastoma and childhood cancer outcomes |
title_fullStr | Integrating stages of change models to cast new vision on interventions to improve global retinoblastoma and childhood cancer outcomes |
title_full_unstemmed | Integrating stages of change models to cast new vision on interventions to improve global retinoblastoma and childhood cancer outcomes |
title_short | Integrating stages of change models to cast new vision on interventions to improve global retinoblastoma and childhood cancer outcomes |
title_sort | integrating stages of change models to cast new vision on interventions to improve global retinoblastoma and childhood cancer outcomes |
topic | Debate |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165911/ https://www.ncbi.nlm.nih.gov/pubmed/25213666 http://dx.doi.org/10.1186/1471-2458-14-944 |
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