Rollins Research Review: COVID-19 and Breast Cancer Therapy, Participatory Design Satisfaction, and Communication in Breastfeeding Care

Last month, Rollins researchers authored papers on a wealth of public health topics. Find summaries of a few highlights here.

COVID-19-Related Financial Hardship and Adherence to Adjuvant Endocrine Therapy Among Women with Early-Stage Breast Cancer

Journal: Health Services Research

Rollins Authors: Sara Arshad; Xin Hu, PhD; Joseph Lipscomb, PhD; Ilana Graetz, PhD

Important Takeaways:

• High cost and lack of health insurance can make women with breast cancer less likely to take adjuvant endocrine therapy (AET), an effective breast cancer treatment, as prescribed (known as adherence). This study explored how financial challenges during the COVID-19 pandemic affected adherence to AET.
• Researchers looked at information about 217 women with breast cancer who were enrolled in a larger trial studying AET adherence from April 2019 to June 2021.
• Over one-third of participants had financial challenges during the pandemic, including loss of income, changes or gaps in health insurance, and difficulty accessing basic needs. These challenges were more common in women living below the poverty line and those who had previously had chemotherapy or radiation.
• Women who faced financial challenges during the pandemic were less likely to take their AET as directed. Interventions that support women through financial instability during their five to 10 years taking AET could help improve adherence and improve health outcomes.

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Who Participates in ‘Participatory Design’ of WASH Infrastructure: A Mixed-Methods Process Evaluation

Journal: PLOS Global Public Health

Rollins Authors: Thea Mink; Allison Salinger; Sheela Sinharoy, PhD

Important Takeaways:

• A recent randomized controlled trial (RCT) used community participation to improve water, sanitation, and hygiene conditions in two communities: Makassar, Indonesia; and Suva, Fiji. The RCT researchers led design workshops and conducted home visits in the communities to involve residents in the process, a technique known as participatory design.
• Using surveys and interviews, another group of researchers learned who in the two communities participated in the study activities, who felt included in decision-making, and who was left out.
• In Makassar, 89% of people participated in study activities; in Suva, 75% participated. Responsibilities like work, housework, and schoolwork kept people from participating. While most participants in both communities were satisfied with how much they participated in the study and the level of influence they had on decisions, there were some inequities based on gender, religion, and marital status.
• Future participatory design studies should build connections and engage with communities throughout the process to understand the dynamics of the community and be sure that all voices are heard.

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What is Effective Communication in Breastfeeding Care? Perspectives from Latina Women

Journal: PLOS One

Rollins Author: Elizabeth Rhodes, PhD

Important Takeaways:

• Communication is key in person-centered care—health care that considers the needs, values, and preferences of the patient. Effective communication about breastfeeding could help more Hispanic and Latina women (who typically have lower breastfeeding rates in the U.S.) breastfeed exclusively for longer.
• Researchers interviewed low-income Hispanic and Latina women who had breastfed about their experiences receiving breastfeeding information from providers during pregnancy, delivery, and postpartum.
• Effective communication led women to have more trust in their health care providers and feel more positive about their care. To participants, this meant having open, back-and-forth conversations that let them share their knowledge and goals and allowed providers to give tailored information.

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