This report describes the results of a randomized controlled feasibility study of the Mindfulness Intervention for Rehabilitation and Recovery in Schizophrenia (MIRRORS). MIRRORS is an adaptation of Mindfulness-Based Stress Reduction designed to help persons with schizophrenia to persist and perform better at work. Thirty-four participants with schizophrenia or schizoaffective disorder who were engaged in outpatient services were enrolled in a vocational rehabilitation program that included a job placement and then were randomized to receive MIRRORS (n ϭ 18) or Intensive Support (n ϭ 16) over a period of 16 weeks. The number of hours worked was recorded weekly and job performance was assessed monthly using the Work Behavior Inventory. Results of t-tests revealed that participants in the MIRRORS group worked a significantly greater number of hours and performed significantly better at the end of the 4-month intervention than those in the Intensive Support condition. Repeated-measures analysis of variance revealed that the MIRRORS group worked more hours each week on average and that this difference increased over time as well as having generally better work performance compared with the Intensive Support group. Results suggest a link between MIRRORS and higher levels of work performance and persistence in people with schizophrenia. Further research is indicated to evaluate MIRRORS in a fully powered randomized controlled trial.
Introduction Breast cancer is the most common cancer diagnosed among women and the second most common cause of cancer death among women. There are ways to reduce a woman’s risk of breast cancer; however, most eligible women in the United States are neither offered personalized screening nor chemoprevention. Surveys have found that primary care providers are largely unaware of breast cancer risk assessment models or chemoprevention. This survey aims to investigate Veterans Health Administration primary care providers’ comfort level, practice patterns, and knowledge of breast cancer risk assessment and chemoprevention. Materials and Methods An online, Research Electronic Data Capture-generated survey was distributed to VHA providers in internal medicine, family medicine, and obstetrics/gynecology. Survey domains were provider demographics, women’s health experience, comfort level, practice patterns, barriers to using risk models and chemoprevention, and knowledge of chemoprevention. Results Of the 167 respondents, 33.1% used the Gail model monthly or more often and only 2.4% prescribed chemoprevention in the past 2 years. Most VHA primary care providers did not answer chemoprevention knowledge questions correctly. Designated women’s health providers were more comfortable with risk assessment (P < 0.018) and chemoprevention (P < 0.011) and used both breast cancer risk models (P < 0.0045) and chemoprevention more often (P < 0.153). Reported barriers to chemoprevention were lack of education and provider time. Conclusions VHA providers and women Veterans would benefit from a system to ensure that women at increased risk of breast cancer are identified with risk modeling and that risk reduction options, such as chemoprevention, are offered when appropriate. VHA providers requested risk reduction education, which could improve primary care provider comfort level with chemoprevention.
1543 Background: Despite recommended guidelines and available medicationsto reduce breast cancer risk by up to 50-65%, <5% of the 10 million eligible women are offered chemoprevention in the U.S. The comfort level, practice patterns, and barriers to breast cancer risk assessment and chemoprevention use within the VA have not been reported. Methods: We assessed VA primary care providers using a REDcap survey. We obtained provider demographics, use and comfort level with breast cancer risk models and chemoprevention and knowledge about chemoprevention. Data was analyzed with Fishers exact or chi-square tests. Results: Of the 200 survey respondents, 167 were included for analysis. Overall, 30% used the Gail model monthly or more often, and 1.5 % prescribed chemoprevention in the last 2 years. Fewer than 30% correctly answered chemoprevention knowledge questions. Designated women's health providers were more comfortable with risk assessment and chemoprevention (p<.046, p<.004) and used risk models more often (p<.045). 63% expressed interest in education about breast cancer prevention. Conclusions: Breast cancer risk assessment and chemoprevention use by VA primary care is limited by lack of comfort and familiarity. Women's health providers are more comfortable and knowledgeable about breast cancer risk models and chemoprevention, offering an opportunity for partnership with high-risk oncologists to improve breast cancer risk assessment and chemoprevention use among female Veterans.[Table: see text]
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