Person: Moye, Jennifer
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Moye
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Jennifer
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Moye, Jennifer
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Publication A controlled trial of Partners in Dementia Care: veteran outcomes after six and twelve months(BioMed Central, 2014) Bass, David M; Judge, Katherine S; Snow, A Lynn; Wilson, Nancy L; Morgan, Robert O; Maslow, Katie; Randazzo, Ronda; Moye, Jennifer; Odenheimer, Germaine L; Archambault, Elizabeth; Elbein, Richard; Pirraglia, Paul; Teasdale, Thomas A; McCarthy, Catherine A; Looman, Wendy J; Kunik, Mark EIntroduction: “Partners in Dementia Care” (PDC) tested the effectiveness of a care-coordination program integrating healthcare and community services and supporting veterans with dementia and their caregivers. Delivered via partnerships between Veterans Affairs medical centers and Alzheimer’s Association chapters, PDC targeted both patients and caregivers, distinguishing it from many non-pharmacological interventions. Hypotheses posited PDC would improve five veteran self-reported outcomes: 1) unmet need, 2) embarrassment about memory problems, 3) isolation, 4) relationship strain and 5) depression. Greater impact was expected for more impaired veterans. A unique feature was self-reported research data collected from veterans with dementia. Methods and Findings: Five matched communities were study sites. Two randomly selected sites received PDC for 12 months; comparison sites received usual care. Three structured telephone interviews were completed every 6 months with veterans who could participate. Results: Of 508 consenting veterans, 333 (65.6%) completed baseline interviews. Among those who completed baseline interviews, 263 (79.0%) completed 6-month follow-ups and 194 (58.3%) completed 12-month follow-ups. Regression analyses showed PDC veterans had significantly less adverse outcomes than those receiving usual care, particularly for more impaired veterans after 6 months, including reduced relationship strain (B = −0.09; p = 0.05), depression (B = −0.10; p = 0.03), and unmet need (B = −0.28; p = 0.02; and B = −0.52; p = 0.08). PDC veterans also had less embarrassment about memory problems (B = −0.24; p = 0.08). At 12 months, more impaired veterans had further reductions in unmet need (B = −0.96; p < 0.01) and embarrassment (B = −0.05; p = 0.02). Limitations included use of matched comparison sites rather than within-site randomization and lack of consideration for variation within the PDC group in amounts and types of assistance provided. Conclusions: Partnerships between community and health organizations have the potential to meet the dementia-related needs and improve the psychosocial functioning of persons with dementia. Trial Registry NCT00291161Publication Preserving Rights for Individuals Facing Guardianship(American Medical Association (AMA), 2011) Moye, Jennifer; Naik, Aanand D.Publication Assessing multidimensional worry in cancer survivors(Wiley-Blackwell, 2013) Moye, Jennifer; Wachen, Jennifer Schuster; Mulligan, Elizabeth Anne; Doherty, Kelly; Naik, Aanand D.Anxiety in cancer survivors has been characterized in numerous ways. One way is posttraumatic stress disorder (PTSD) symptoms [1]. This approach usefully captures intrusive thoughts, avoidance, and hyperarousal – focusing on cancer as a past trauma creating current symptoms. Another characterization of anxiety focuses on the fear of recurrence (FOR) [2]. FOR appears common in survivors, potentially lasting for many years post-treatment. Still, others have characterized anxiety with multidimensional scales, such as for prostate cancer [3] and breast cancer [4]. Worry differs from these in that it is future oriented; therefore, it is unlike PTSD symptoms, which are past-focused. Worry shares with FOR that both are cognitive behaviors aimed at reducing anxious arousal. FOR is a contextually specific and important worry, but survivors may also worry about other issues. At least two worry scales have been developed for women with breast cancer. The 8-item Cancer Worries Scale includes worries about recurrence, future surgery, and family [5], yielding a one factor solution. The 15-item Brief Cancer-Related Worry Inventory includes worries about cancer getting worse, effects of current treatment, work, and economics [6], yielding a three factor solution for (i) future prospects; (ii) physical and somatic problems; and (iii) social and interpersonal problems. Building on important work with breast cancer survivors, we aimed to develop a multidimensional measure of worry, which (i) creates items based on the words of survivors; (ii) describes a range of concerns; and (iii) is brief, and therefore, practical in clinical and research applications.Publication Cancer survivor rehabilitation and recovery: Protocol for the Veterans Cancer Rehabilitation Study (Vet-CaRes)(BioMed Central, 2013) Naik, Aanand D; Martin, Lindsey A; Karel, Michele J.; Wachen, Jennifer Schuster; Mulligan, Elizabeth Anne; Gosian, Jeffrey S; Herman, Levi Ian; Moye, JenniferBackground: Cancer survivors are a rapidly growing and aging population in the U.S., but there are many challenges associated with the survivorship experience such as functional disabilities and psychosocial distress. When viewed next to the general population, Veterans are especially at risk for these challenges as they are older and have a high incidence of co-morbid conditions. While the Institute of Medicine (IOM) has called for further cancer survivorship research to address these challenges, we still know little about this experience from the perspective of aging Veterans. Methods/design We conducted a longitudinal, mixed-methods study over the course of three and a half years at the Boston and Houston VA Medical Centers. We recruited 170 Veterans diagnosed with head and neck, colorectal and esophageal/gastric cancers that were identified from the VA tumor registry. Veterans completed three in-depth interviews, conducted at 6, 12 and 18 months after pathology confirmation, measuring the physical, social and psychological factors related to cancer survivorship. The longitudinal design allowed us to assess any changes in cancer related disability and distress over time. Discussion Weekly teleconference study team meetings were a key aspect to the research process. Issues related to recruitment, data management and analysis, and the dissemination of research results was discussed. Interviewers presented detailed case reports of completed interviews that allowed us to refine our interview protocols. We also discussed issues relevant to the Veteran population of which we were previously unaware and some of the challenges of the research process itself. This novel study produced a robust data set that documents the functional and psychosocial cancer survivorship experiences of aging Veterans. The longitudinal design will help us more fully understand the recovery patterns for this specific population, and identify the unique needs and gaps in health services.