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"Clifton, Shari"
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Using focus groups to evaluate a multiyear consumer health outreach collaboration
2021
Objectives: Academic health sciences librarians sought to evaluate the efficacy and future of the Health Information Specialists Program, a five-year consumer health information outreach collaboration with public libraries across the state.Methods: Five focus groups were held with participants from all five years of the program. Thirty-four participants from the program attended. Facilitators used structured interview guides consisting of eleven questions regarding the impact of the collaboration on participants’ abilities to connect themselves or others to health information; the usefulness of materials or knowledge gained and its applications; any consumer health outreach projects that arose from the program; and suggestions for future topics, formats, or modifications. Data was hand-coded and analyzed using the framework analysis methodology for qualitative research.Results: Participants reported feeling improved confidence and comfort in providing health information services to their patrons. Numerous instances of knowledge transfer—in their personal lives, with their colleagues, and for their patrons—were described. Participants reported improved abilities to both find and evaluate consumer health information, and many adapted class materials for their own programming or teaching. Suggestions were provided for future class topics as well as a program website.Conclusion: Based on data from the five focus groups, the Health Information Specialists Program has positively impacted participants in a number of ways. Primary among these were self-reported improvement in both health information retrieval skills and the ability to evaluate the reliability of health information online, as well as in the confidence to help patrons with their health information needs.
Journal Article
Systematic Review of Reflection Spectroscopy-Based Skin Carotenoid Assessment in Children
2023
Assessing children’s skin carotenoid score (SCS) using reflection spectroscopy (RS) is a non-invasive, widely used method to approximate fruit and vegetable consumption (FVC). The aims for the current review were to (1) identify distributions of SCS across demographic groups, (2) identify potential non-dietary correlates for RS-based SCS, (3) summarize the validity and reliability of RS-based SCS assessment, and (4) conduct meta-analyses of studies examining the correlation between RS-based SCS with FVC. A literature search in eight databases in June 2021 resulted in 4880 citations and peer-reviewed publications written in English that investigated children’s (2–10 years old) SCS using RS. We included 11 studies (intervention = 3, observational = 8). Potential covariates included weight status, ethnicity, seasonal variation, age, sex, and income. Studies reported criterion validity with children’s FVC but not with plasma carotenoid. Additionally, no studies reported the reliability of RS-based SCS in children. Among the 726 children included in the meta-analysis, the correlation between RS-based SCS and FVC was r = 0.2 (p < 0.0001). RS-based SCS is a valid method to quantify skin carotenoids for children’s FVC estimation with the potential for evaluating nutrition policies and interventions. However, future research should use standardized protocol for using RS and establish how RS-based SCS can translate to the amount of daily FVC in children.
Journal Article
Teaching trauma-informed care in undergraduate medical education: A scoping review
by
Meireles, Juliana
,
Clifton, Shari
,
Jelley, Martina
in
Collaboration
,
Competencies
,
Competency-based
2025
Background
Experiencing trauma can affect health and wellbeing throughout the lifespan. Trauma-informed care is a framework that addresses the impact of trauma and promotes treatment approaches sensitive to this lived experience. In response to emerging awareness about trauma-informed care, educators are beginning to adapt undergraduate medical education (UME) to include content about using a trauma-informed approach when caring for patients. In 2023, leaders in the field of trauma-informed care developed a core set of competencies that institutions can use to guide their curricula in this area. This scoping review aggregated and synthesized studies evaluating trauma-informed care curricula in medical schools to examine the efficacy of different pedagogical approaches. It also mapped how these approaches align with the recently developed trauma-informed competencies for UME.
Methods
A comprehensive search strategy was used to search seven databases for articles related to teaching trauma-informed care principles to undergraduate medical students. Articles were included only if the curricula had been implemented and evaluated. A total of 233 articles were retrieved. Independent coders used a two-tier process to determine which papers met inclusion criteria. The coders extracted key information from the studies focused on training facilitators, participants, curriculum content, teaching methods, learner outcomes, and competencies.
Results
Fifteen papers were included in this scoping review, and several common themes emerged among the studies. Most trainings were brief (median 3.5 h) and taught by a multidisciplinary team. All trainings incorporated didactic components. Most also gave the trainees opportunities to apply and practice their knowledge through role playing, simulations, or patient interviews. All studies included a qualitative evaluation component, with most also having a quantitative component. Most studies reported that students acquired more knowledge and confidence in implementing trauma-informed care following the trainings. However, only two included a longitudinal follow-up component in their evaluation.
Conclusions
Trauma-informed care is beginning to be implemented in undergraduate medical education. Brief trainings in this area can increase future providers’ abilities to understand how trauma affects patients and to work in appropriate ways with patients who have experienced trauma. The literature in this review can be used to guide educators seeking to incorporate trauma-informed care into undergraduate medical curricula.
Journal Article
Influence of Socio-Demographic Factors in Patients With Cutaneous Lupus Erythematosus
by
Clifton, Shari C.
,
Ogunsanya, Motolani E.
,
Walker, Amanda M.
in
autoimmunity
,
Cross-sectional studies
,
Cultural differences
2022
Cutaneous lupus erythematosus (CLE) is a chronic autoimmune skin disease with potential for systemic involvement, disfigurement, and significant disease burden. The relationships of demographics and socioeconomic status with patients with CLE are emerging topics with important clinical implications. The primary objective of our study is to perform a literature review of studies that have investigated demographic and socioeconomic factors amongst patients with CLE and determine whether these factors influence diagnosis frequency, disease severity and outcomes or health related quality of life. We searched multiple databases to identify literature addressing CLE and concepts such as race, ethnicity, gender, income, education level and geographic location. Information regarding primary research objective was extracted from all full text articles, and a summary of findings was prepared. We found that race and ethnicity can influence CLE diagnosis frequency and disease outcomes. Chronic cutaneous lupus (CCLE) occurs more frequently in Black patients, often with higher overall disease damage. Differences between genders exist in CLE in terms of health-related quality of life, as female gender was a risk factor for worse quality of life in several studies. Lower income, low educational attainment, and lack of health insurance all contribute to poorer overall outcomes in CLE patients. This review will help inform physicians about populations at risk for potentially worse outcomes to guide treatment decisions for patients with CLE and provide important information to design interventions that address modifiable social determinants of health in this population.
Journal Article
HPV vaccination and Native Americans: protocol for a systematic review of factors associated with HPV vaccine uptake among American Indians and Alaska Natives in the USA
by
Janitz, Amanda E
,
Campbell, Janis
,
Stoner, Julie
in
Adolescent
,
Alaska Natives
,
American Indian or Alaska Native
2020
IntroductionThe nine-valent human papillomavirus (HPV) vaccine could prevent an estimated 92% of the cancers attributable to HPV types targeted by the vaccine. However, uptake of the HPV vaccine among American Indian and Alaska Native (AI/AN) adolescents has been low. AI/ANs also bear a disproportionate burden of cervical and other HPV-associated cancers. Increasing HPV vaccination rates is a national priority, but reviews and national surveys on HPV vaccination factors are lacking for the AI/AN population. The objective of this systematic review is to assess factors associated with HPV vaccination among AI/ANs in the USA.Methods and analysisA systematic review is proposed to synthesise the current literature on HPV vaccination factors in AI/ANs from 1 July 2006 until 30 September 2019. As applicable, controlled vocabulary terms, keywords and special features (eg, limits, explode and focus) will be incorporated into database searches. To maximise the identification of relevant studies, citation indexes and databases that index dissertations, preprints and grey literature are included. Studies will be screened and selected independently in two stages. In stage 1, titles and abstracts will be screened. In stage 2, full-text articles will be screened and selected. A data extraction form and quality assessment tool will be piloted, revised and implemented. If available, measures of frequency and association will be presented. A narrative synthesis of the included studies will also be undertaken and reported.Ethics and disseminationAs our review will use publicly available data and publications, an Institutional Review Board review will not be required. We will disseminate the findings from this review through peer-reviewed publication(s) and conference presentation(s).Potential amendmentsIn the event of amendments to the protocol, we will provide the date, rationale, and description of the change for each amendment.PROSPERO registration numberCRD42020156865.
Journal Article
Cultivating a community of practice: the evolution of a health information specialists program for public librarians
2017
Background: To help improve the culture of health in Oklahoma—a state that frequently ranks poorly on multiple measures of health and wellness—faculty librarians from an academic health sciences library sought to create a collaborative network of health information professionals in Oklahoma’s public libraries through the implementation of the Health Information Specialists Program.Case Presentation: Health sciences librarians offered a variety of consumer health information courses for public library staff across the state of Oklahoma for three years. Courses were approved by the Medical Library Association for credit toward the Consumer Health Information Specialization. A total of seventy-two participants from public libraries attended the courses, sixty-five achieved a Level I Consumer Health Information Specialization, and nine went on to achieve Level II.Conclusions: Feedback from participants in the Health Information Specialists Program has indicated a positive impact on the health information expertise of participants, who in turn have used the knowledge that they gained to help their patrons.
Journal Article
Indirect Effects of the COVID-19 Pandemic on Routine Childhood Vaccination in Low-Income Countries: A Systematic Review to Set the Scope for Future Pandemics
2024
The COVID-19 pandemic halted progress in global vaccine coverage and disrupted routine childhood vaccination practices worldwide. While there is ample evidence of the vaccination decline experienced during the pandemic, it is less clear how low-income countries were affected. We executed a systematic review to synthesize the current literature on the impacts of routine childhood vaccinations in low-income countries from 1 January 2020 to 8 February 2023. We collected data using an extraction form on Covidence and assessed the quality of studies included in the review using the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool. Effect estimates for changes in vaccination during the pandemic were reported and summarized. Factors that influenced changes were grouped into descriptive themes. Thirteen studies, encompassing 18 low-income countries and evaluating 15 vaccines at varying doses, were included in the final review. We found that routine childhood vaccinations during the COVID-19 pandemic varied considerably by vaccine type, location, and phase of the pandemic. Nine different themes were identified as factors that influenced changes in vaccination. Documenting past experiences and lessons learned is crucial for informing preparedness efforts in anticipation of future public health emergencies. Failure to effectively address these things in the next public health emergency could result in a recurrence of declining routine childhood vaccinations.
Journal Article
Library As Safe Haven
by
Wilson, Daniel T
,
Clifton, Shari C
,
Halsted, Deborah D
in
Conservation and restoration
,
Emergency management
,
Handbooks, manuals, etc
2014
Libraries have always played a special role in times of disaster by continuing to provide crucial information and services.
Health Risks of Structural Firefighters from Exposure to Polycyclic Aromatic Hydrocarbons: A Systematic Review and Meta-Analysis
by
Clifton, Shari
,
Hwang, Jooyeon
,
Agnew, Robert J.
in
Air Pollutants, Occupational - analysis
,
Bladder
,
Cancer
2021
Firefighters have an elevated risk of cancer, which is suspected to be caused by occupational and environmental exposure to fire smoke. Among many substances from fire smoke contaminants, one potential source of toxic exposure is polycyclic aromatic hydrocarbons (PAH). The goal of this paper is to identify the association between PAH exposure levels and contributing risk factors to derive best estimates of the effects of exposure on structural firefighters’ working environment in fire. We surveyed four databases (Embase, Medline, Scopus, and Web of Science) for this systematic literature review. Generic inverse variance method for random effects meta-analysis was applied for two exposure routes—dermal and inhalation. In dermal, the neck showed the highest dermal exposure increased after the fire activity. In inhalation, the meta-regression confirmed statistically significant increases in PAH concentrations for longer durations. We also summarized the scientific knowledge on occupational exposures to PAH in fire suppression activities. More research into uncontrolled emergency fires is needed with regard to newer chemical classes of fire smoke retardant and occupational exposure pathways. Evidence-based PAH exposure assessments are critical for determining exposure–dose relationships in large epidemiological studies of occupational risk factors.
Journal Article
Meta-Analysis on the Impact of Ventricular Arrhythmias on Mortality in Patients With Continuous Flow Left Ventricular Assist Devices
by
Clifton, Shari
,
Ul Abideen Asad, Zain
,
Agarwal, Siddharth
in
Arrhythmia
,
Arrhythmias, Cardiac - etiology
,
Bias
2023
Patients with continuous flow left ventricular assist devices (CFLVADs) have an increased risk of ventricular arrhythmias (VA), but the impact of VA on survival is unclear. A systematic search of electronic databases was conducted to identify studies that reported the impact of VA on all-cause mortality and right ventricular failure (RVF) in patients with CFLVAD. The Mantel–Haenszel method was used to calculate the 95% confidence interval (CI) and pooled risk ratio (RR) with a random-effects model. A total of 19 observational studies with 4,544 patients and a median follow-up of 18.5 months (interquartile range 11.5 to 26.4) were included. There was statistically significantly higher mortality in patients with any VA than in those with no VA after CFLVAD implantation (RR 1.33, 95% CI 1.01 to 1.75, p = 0.04, I2 = 78%). On sensitivity analysis, after removing the largest study by Rehorn et al,10 the association between overall mortality and VA was lost, suggesting that these results should be interpreted with caution. Early VA developing within 30 days after implantation was associated with a higher risk of mortality (RR 1.37, 95% CI 1.15 to 1.63, p <0.01, I2 = 52%), whereas late VA developing after 30 days after CFLVAD implantation was not associated with any significant difference in mortality (RR: 1.00; 95% CI: 0.80 to 1.24; p = 0.98, I2 = 35%). In addition, there was a statistically significant higher risk of RVF in patients with VA than in those with no VA (RR 1.58, 95% CI 1.20 to 2.08, p <0.01, I2 = 0%). In conclusion, in patients with CFLVAD, the development of any VA was associated with a 33% higher risk of all-cause mortality. Early VA developing within 30 days after implantation was significantly associated with a higher risk of mortality, whereas late VA was not associated with mortality. VA after left ventricular assist device was significantly associated with a higher risk of developing RVF.
Journal Article