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The patient decision aid (PDA) is a promising patient engagement tool for use in shared decision making (SDM). Selecting a PDA is an essential precursor to successful SDM implementation. Little is known regarding the organizational stakeholder process for assessing and selecting a PDA. We conducted a qualitative, multicase study within the context of a maternal health decision to identify the criteria used by stakeholders to select a PDA. We further explored the perceived value of PDA certification on PDA selection. We reported the PDA selection criteria within the domains of (1) Design and Functionality, (2) User Fit, (3) Context and Climate, (4) Support, and (5) Strategic Vision and found that certification was perceived to be a valuable screening mechanism for smaller health organizations. Health organizations and researchers may use our PDA selection criteria and conceptual model to plan future deployments of PDAs and patient engagement tools.

<i>Objective:</i> The present study reports on the important issue of how family communication and support regarding breast cancer risk affects interest in genetic testing and mental health. <i>Methods:</i> Participants (n = 221) were women aged 18–74 who had at least one relative of Ashkenazi Jewish descent, no personal history of breast or ovarian cancer, and lived within 60 miles of Seattle, Wash. <i>Results:</i> Communication about breast cancer risk was reported with very low frequency across all types of relatives. Women talked with their mothers and sisters more often than their fathers, brothers, or children. The only significant predictor of interest in genetic testing was the individual level variable of seeking social support. <i>Conclusion:</i> Social support needs might be a part of the genetic testing process.

Background.Worksites are natural settings for health promotion. In many cases, the effectiveness of such interventions is appraised by surveying employees to assess worksite-wide changes in the targeted behavior. Little attention has been paid to increasing worksite survey response rates. One way is to utilize community organization strategies, which involve enlisting the individuals within a group to work together with researchers to affect the social environment.Methods.Community organization strategies and multiple contacts were used to obtain responses from employees in five worksites involved in a smoking cessation project. Employee Advisory Board members in each worksite reviewed, adapted, and revised the survey distribution method, the messages that accompanied the survey, and the survey content. Three major survey waves were undertaken: a worksite effort, a home mailing (in the pilot worksite only), and a telephone call to nonrespondents.Results.Response rates to a worksite-wide survey in one worksite the first year and four additional worksites the next year yielded 99.3% and 98.4% response rates, respectively. In the pilot worksite, 273 employees were eligible for the survey with 366 eligible employees in the four other worksites. Chi-square or analysis of variance computations were used, as appropriate, to test for differences in characteristics of respondents in the various data collection waves.Discussion.These results suggest that there may be merit in adapting such community organization intervention methods for research applications.

The Cancer Genetics Network (CGN) is one of a growing number of large-scale registries designed to facilitate investigation of genetic and environmental contributions to health and disease. Despite compelling scientific and social justice arguments that recommend diverse participation in biomedical research, members of ethnic minority groups continue to be chronically underrepresented in such projects. The CGN studies reported in this issue used strategies well documented to increase minority participation in research activities, including use of community-targeted materials, addressing community trust concerns, and the adoption of personalized and flexible research protocols. Here, we review the outcome of these efforts to increase minority recruitment to the CGN, and ask what lessons the findings suggest for future minority recruitment initiatives.

<b><i>Background:</i></b> The practice of biorepository-based genetics research raises questions related to what ethical obligations researchers have to their participants. It is important to explore and include the thoughts of current biorepository participants as we move forward with this type of research. <b><i>Methods:</i></b> Thirty participants (17 cancer patients, 7 cancer-free controls, and 6 relatives) were drawn from the Northwest Cancer Genetics Registry and participated in qualitative interviews lasting between 45 and 90 min. Topics explored in this study include which types of genetic test results participants of large biorepositories expect and would like to receive from research analyzing their samples, as well as thoughts on best practice for conducting this type of research. <b><i>Results:</i></b> Cancer cases, controls, and first-degree relatives have differing views on what results they would like to receive from biorepository-based research. Participants across all groups attempted to balance the costs and benefits of returning individual research results. <b><i>Discussion:</i></b> In the wake of precision medicine, it is important to describe the range of ways participants in large biorepositories both think and talk about the utilization of their specimens for genetics research.

Purpose. Conduct a process evaluation of a low-fat, high-fruit/vegetable dietary intervention in religious organizations (ROs). The purpose of this process evaluation was to explore differences in healthy eating activities between the intervention and delayed control ROs and among the intervention ROs to identify the intervention activities most associated with dietary change. Methods. Process data were collected via phone surveys and participation logs. A 12-month follow-up phone survey was conducted with an RO representative from intervention and delayed control ROs. The survey asked about healthy eating activities. Eating for a Healthy Life staff maintained participation logs of intervention RO participation in intervention activities: advisory board meetings, volunteer activities, healthy eating sessions, social events, dietary change mailings, print advertisements, and motivational messages. We used a stepwise regression model to determine which intervention activities were associated with changes in fat-and fiber-related dietary behaviors. Results. RO member participation in advisory board meetings, social activities, and healthy eating sessions were associated with healthier fat- and fiber-related dietary behaviors. Greater RO attendance at advisory board meetings and greater numbers of healthy eating sessions at the RO were associated with decreased fat-related dietary behaviors (p ≤ .05). Member participation in social activities was associated with more favorable fat, fruit, and vegetable intake. Conclusion. We successfully delivered an increased number of healthy activities at the intervention ROs and improved dietary-related behaviors.

Purpose.This study examined how to improve dietary habits of individuals from the general public.Design.The Eating for a Healthy Life project was a randomized trial.Setting.The study was conducted among members of religious organizations (ROs).Subjects.Participants were a sample of RO members.Intervention.The intervention was a multilevel package, based on our previous experience, designed to lower fat and increase fruit and vegetable consumption.Measures.The Eating Behaviors Questionnaire was administered preintervention and postintervention, together with 24-hour food recalls in a randomly selected subset.Analysis.Linear mixed models were used to evaluate the study's intervention, incorporating the design effects of blocking, intraclass correlation within RO, and correlation between the preintervention and postintervention points.Results.Participants (n = 2175) reported significantly healthier dietary behaviors in intervention ROs at the 12-month follow-up period, compared to participants in the comparison ROs, for a fat scale change of .08 summary scale points and an adjusted intervention effect of .06 overall.Conclusion.Dietary intervention through ROs is a positive and successful method of changing dietary habits.