Publications by authors named "Carolyn Ingram"

11 Publications

  • Page 1 of 1

Cumulative Impacts and COVID-19: Implications for Low-Income, Minoritized, and Health-Compromised Communities in King County, WA.

J Racial Ethn Health Disparities 2021 Jun 14. Epub 2021 Jun 14.

Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, USA.

Few studies have assessed how the intersection of social determinants of health and environmental hazards contributes to racial disparities in COVID-19. The aim of our study was to compare COVID-19 disparities in testing and positivity to cumulative environmental health impacts, and to assess how unique social and environmental determinants of health relate to COVID-19 positivity in Seattle, King County, WA, at the census tract level. Publicly available data (n = 397 census tracts) were obtained from Public Health-Seattle & King County, 2018 ACS 5-year estimates, and the Washington Tracking Network. COVID-19 testing and positive case rates as of July 12, 2020, were mapped and compared to Washington State Environmental Health Disparities (EHD) Map cumulative impact rankings. We calculated odds ratios from a series of univariable and multivariable logistic regression analyses using cumulative impact rankings, and community-level socioeconomic, health, and environmental factors as predictors and having ≥ 10% or < 10% census tract positivity as the binary outcome variable. We found a remarkable overlap between Washington EHD cumulative impact rankings and COVID-19 positivity in King County. Census tracts with ≥ 10 % COVID-19 positivity had significantly lower COVID-19 testing rates and higher proportions of people of color and faced a combination of low socioeconomic status-related outcomes, poor community health outcomes, and significantly higher concentrations of fine particulate matter (PM). King County communities experiencing high rates of COVID-19 face a disproportionate cumulative burden of environmental and social inequities. Cumulative environmental health impacts should therefore systematically be considered when assessing for risk of exposure to and health complications resulting from COVID-19.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s40615-021-01063-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202963PMC
June 2021

Community-Level Factors Associated with COVID-19 Cases and Testing Equity in King County, Washington.

Int J Environ Res Public Health 2020 12 18;17(24). Epub 2020 Dec 18.

Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA.

Individual-level Coronavirus Disease 2019 (COVID-19) case data suggest that certain populations may be more impacted by the pandemic. However, few studies have considered the communities from which positive cases are prevalent, and the variations in testing rates between communities. In this study, we assessed community factors that were associated with COVID-19 testing and test positivity at the census tract level for the Seattle, King County, Washington region at the summer peak of infection in July 2020. Multivariate Poisson regression was used to estimate confirmed case counts, adjusted for testing numbers, which were associated with socioeconomic status (SES) indicators such as poverty, educational attainment, transportation cost, as well as with communities with high proportions of people of color. Multivariate models were also used to examine factors associated with testing rates, and found disparities in testing for communities of color and communities with transportation cost barriers. These results demonstrate the ability to identify tract-level indicators of COVID-19 risk and specific communities that are most vulnerable to COVID-19 infection, as well as highlight the ongoing need to ensure access to disease control resources, including information and education, testing, and future vaccination programs in low-SES and highly diverse communities.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph17249516DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7767300PMC
December 2020

Evaluating the benefits of exercise for women receiving adjuvant therapy for breast cancer: research challenges.

Can Oncol Nurs J 2010 ;20(2):96-8

Faculty of Health Sciences, School of Nursing, McMaster University, 1200 Main Street West, HSC-2J32, Hamilton, ON L8N 3Z5.

View Article and Find Full Text PDF

Download full-text PDF

Source
July 2010

Women's perceptions of home-based exercise performed during adjuvant chemotherapy for breast cancer.

Eur J Oncol Nurs 2010 Jul 16;14(3):238-43. Epub 2010 Mar 16.

Faculty of Health Sciences, School of Nursing, McMaster University, 1200 Main Street West, HSC - 2J32, Hamilton, ON L8N3Z5, Canada.

Purpose: To describe women's perceptions of a home-based exercise intervention in which they participated while receiving adjuvant chemotherapy for breast cancer.

Methods And Sample: Participants were 8 women who were involved in a home-based exercise program while receiving 24 weeks of adjuvant chemotherapy for breast cancer. They were asked about their exercise program every 2 weeks by telephone, and completed a feasibility and acceptability questionnaire at the end of the study. The two principal investigators performed a content analysis on the resulting data.

Key Results: Participants highly valued the exercise program. The content analysis resulted in two major categories: exercise challenges and exercise facilitators and strategies. The most common exercise challenges were side effects of chemotherapy, particularly fatigue and pain. The women overcame challenges in many ways, most notably adapting the routine, internal motivation and external support. Their comprehension of breast cancer and its treatment, reinforced by expert advice and resources on exercise, helped them develop successful strategies to maintain the exercise program.

Conclusions: In spite of challenges, women in this study perceived that a customized, flexible, home-based exercise program was beneficial while they were undergoing adjuvant chemotherapy for breast cancer. Resource material and regular guidance helped them implement strategies to maintain the exercise program.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ejon.2010.01.027DOI Listing
July 2010

Exercise intervention to modify physiologic risk factors in cancer survivors.

Semin Oncol Nurs 2007 Nov;23(4):275-84

School of Nursing, Faculty of Health Sciences, McMaster University, 1200 Main St West, HSC - 2J32, Hamilton, Ontario L8N 3Z5, Canada.

Objective: To review the best current evidence regarding the effects of exercise on modifiable risk factors for adverse physiologic outcomes of cancer and its treatment.

Data Sources: Clinical practice guidelines, systematic reviews, meta-analyses, and single studies.

Conclusion: There is mounting evidence that exercise improves fatigue, physical functioning, and cardio-respiratory fitness. Preliminary evidence suggests that exercise also contributes to improvements in body weight and composition, metabolic risk factors, and immune function. It may also influence disease-free and overall survival in selected populations.

Implications For Nursing Practice: Exercise appears to be a safe and well-tolerated intervention that may minimize or prevent adverse physiologic outcomes of cancer and cancer treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.soncn.2007.08.005DOI Listing
November 2007

The effects of exercise on body weight and composition in breast cancer survivors: an integrative systematic review.

Oncol Nurs Forum 2006 Sep 1;33(5):937-47; quiz 948-50. Epub 2006 Sep 1.

School of Nursing, McMaster University, Hamilton, Canada.

Purpose/objectives: To examine the research literature regarding the effects of exercise on body weight and composition in breast cancer survivors.

Data Sources: Primary studies in English published from 1989-2004, located through electronic databases, hand searches, and personal contacts.

Data Synthesis: Of 1,314 studies screened, 14 met all inclusion criteria. Body weight and composition generally were secondary endpoints. Effects on weight were less common than reduction in percentage of body fat.

Conclusions: The evidence regarding exercise as a strategy for body weight and composition management in breast cancer is sparse. Research that considers these outcomes as primary endpoints is needed. Numerous measurement issues need to be addressed in future studies.

Implications For Nursing: Exercise may help to control adverse body weight and composition changes among breast cancer survivors. Improved research that assigns these outcomes primary importance will greatly enhance clinicians' ability to assist women in body weight and composition management.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1188/06.ONF.937-950DOI Listing
September 2006

A home based, physical activity intervention increased physical activity, fitness, and vigour and reduced fatigue in sedentary women with early stage breast cancer.

Authors:
Carolyn Ingram

Evid Based Nurs 2006 Jan;9(1):19

McMaster University, School of Nursing, Hamilton, Ontario, Canada.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/ebn.9.1.19DOI Listing
January 2006

Patterns of weight and body composition change in premenopausal women with early stage breast cancer: has weight gain been overestimated?

Cancer Nurs 2004 Nov-Dec;27(6):483-90

Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, Ontario, Canada.

The widely documented problem of weight gain during adjuvant breast cancer chemotherapy has decreased in frequency and magnitude. However, adverse changes in body composition remain a problem. This study identified the frequency, magnitude, and patterns of weight and body composition change in a sample of premenopausal breast cancer survivors who were receiving 3 common chemotherapy regimens. The longitudinal study followed 76 women at 2 centers in Ontario, Canada. Measures were obtained at baseline, the start of every other treatment cycle and treatment completion. Participants' mean age was 44.1 years (SD = 5.9). Their mean baseline weight and body mass index were 69.3 kg (SD = 17.0) and 26 kg/m2 (SD = 6.6), respectively. Fifty-five percent maintained stable weights, while 34% gained and 10.5% lost weight. Their mean weight change during treatment was a 1.4-kg gain. Weight gainers and losers gained or lost 3 to 4 times as much fat as fat-free mass, respectively. A researcher's definition of "weight change" will influence the amount of weight gain reported, and the results of this study suggest that previous research may have overestimated the frequency and magnitude of weight gain in this population. Further research is needed to design interventions that match survivors' needs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/00002820-200411000-00008DOI Listing
March 2005

A short term education intervention but not peer discussion improved vitality and pain in women with breast cancer.

Authors:
Carolyn Ingram

Evid Based Nurs 2002 Apr;5(2):47

School of Nursing, McMaster University, Hamilton, Ontario, Canada.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/ebn.5.2.47DOI Listing
April 2002

A comparison of problem-based and conventional curricula in nursing education.

Adv Health Sci Educ Theory Pract 2002 ;7(1):3-17

McMaster University.

The purpose of this study was to compare graduating baccalaureate students in a problem-based curriculum with those in a conventional nursing program with regard to perceived preparation for clinical practice, clinical functioning, knowledge and satisfaction with their education. Prior to graduation, students completed a self-report questionnaire that consisted of five sections and took about 45 minutes to complete. Following graduation, their pass rates on the National Nursing Registration Examination (RN Exam) were also compared. The findings indicated no significant differences in their perceived preparation for nursing practice, although the conventional students scored higher in all areas. There were also no significant differences between the two groups in their perceived clinical functioning, although there was a trend toward higher function in the areas of communication and self-directed learning in the PBL group. There were no statistically significant differences in RN scores. The PBL students scored significantly higher on perceptions of their nursing knowledge, particularly in the areas of individual, family and community health assessment, communication, teaching/learning, and the health care system. The students undertaking the PBL program were more satisfied with their educational experience than their counterparts in the conventional program, indicating higher satisfaction with tutors, level of independence, assessment and program outcomes, but no difference in relation to workload or clarity of expectations. This study contributes to our understanding of the relationship between different educational approaches and student outcomes. It suggests that PBL is an effective approach for educating nurses. Furthermore, it indicates that nursing students in the PBL program, like their counterparts in PBL medical programs, report higher levels of satisfaction. Future studies that are longitudinal in design and rely less on self-report measures would contribute further to our understanding of the benefits and limitations of PBL in nursing education.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1023/a:1014534712178DOI Listing
May 2002