Celia Shmukler

Publications (7)32.92 Total impact

• Article: Intervention costs and cost-effectiveness of a successful telephonic intervention to promote diabetes control.

  Clyde B Schechter, Hillel W Cohen, Celia Shmukler, Elizabeth A Walker
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  ABSTRACT: OBJECTIVE To characterize the costs and cost-effectiveness of a telephonic behavioral intervention to promote glycemic control in the Improving Diabetes Outcomes study. RESEARCH DESIGN AND METHODS Using the provider perspective and a time horizon to the end of the 1-year intervention, we calculate the costs of a telephonic intervention by health educators compared with an active control (print) intervention to improve glycemic control in adults with type 2 diabetes. We calculate the cost-effectiveness ratios for a reduction of one percentage point in hemoglobin A(1c) (A1C), as well as for one participant to achieve an A1C <7%. Base-case and sensitivity analysis results are presented. RESULTS The intervention cost $176.61 per person randomized to the telephone group to achieve a mean 0.36 percentage point of A1C improvement. The incremental cost-effectiveness ratio was $490.58 per incremental percentage point of A1C improvement and $2,617.35 per person over a 1-year intervention in achieving the A1C goal. In probabilistic sensitivity analysis, the median (interquartile range) of per capita cost, cost per percentage point reduction in A1C, and cost per person achieving the A1C goal of <7% are $175.82 (147.32-203.56), $487.75 (356.50-718.32), and $2,312.88 (1,785.58-3,220.78), respectively. CONCLUSIONS The costs of a telephonic intervention for diabetes self-management support are moderate and commensurate to the modest associated improvement in glycemic control.
  Diabetes care 07/2012; 35(11):2156-60. · 8.09 Impact Factor
• Source

  Available from: Stephen Lepore

  Article: Informed Decision Making About Prostate Cancer Testing in Predominantly Immigrant Black Men: A Randomized Controlled Trial.

  Stephen J Lepore, Randi L Wolf, Charles E Basch, Melissa Godfrey, Emma McGinty, Celia Shmukler, Ralph Ullman, Nigel Thomas, Sally Weinrich
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  ABSTRACT: BACKGROUND: Decision support interventions have been developed to help men clarify their values and make informed decisions about prostate cancer testing, but they seldom target high-risk black and immigrant men. PURPOSE: This study evaluated the efficacy of a decision support intervention focused on prostate cancer testing in a sample of predominantly immigrant black men. METHODS: Black men (N = 490) were randomized to tailored telephone education about prostate cancer testing or a control condition. RESULTS: Post-intervention, the intervention group had significantly greater knowledge, lower decision conflict, and greater likelihood of talking with their physician about prostate cancer testing than the control group. There were no significant intervention effects on prostate specific antigen testing, congruence between testing intention and behavior, or anxiety. CONCLUSIONS: A tailored telephone decision support intervention can promote informed decision making about prostate cancer testing in black and predominantly immigrant men without increasing testing or anxiety.
  Annals of Behavioral Medicine 07/2012; · 4.20 Impact Factor
• Source

  Available from: Elizabeth A Walker

  Article: Results of a successful telephonic intervention to improve diabetes control in urban adults: a randomized trial.

  Elizabeth A Walker, Celia Shmukler, Ralph Ullman, Emelinda Blanco, Melissa Scollan-Koliopoulus, Hillel W Cohen
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  ABSTRACT: To compare the effectiveness of a telephonic and a print intervention over 1 year to improve diabetes control in low-income urban adults. A randomized trial in Spanish and English comparing a telephonic intervention implemented by health educators with a print intervention. Participants (N = 526) had an A1C ≥7.5% and were prescribed one or more oral agents. All were members of a union/employer jointly sponsored health benefit plan. Health coverage included medications. Primary outcomes were A1C and pharmacy claims data; secondary outcomes included self-report of two medication adherence measures and other self-care behaviors. Participants were 62% black and 23% Hispanic; 77% were foreign born, and 42% had annual family incomes <$30 thousand. Baseline median A1C was 8.6% (interquartile range 8.0-10.0). Insulin was also prescribed for 24% of participants. The telephone group had mean ± SE decline in A1C of 0.23 ± 0.11% over 1 year compared with a rise of 0.13 ± 0.13% for the print group (P = 0.04). After adjusting for baseline A1C, sex, age, and insulin use, the difference in A1C was 0.40% (95% CI 0.10-0.70, P = 0.009). Change in medication adherence measured by claims data, but not by self-report measures, was significantly associated with change in A1C (P = 0.01). Improvement in medication adherence was associated (P = 0.005) with the telephonic intervention, but only among those not taking insulin. No diabetes self-care activities were significantly correlated with the change in A1C. A 1-year tailored telephonic intervention implemented by health educators was successful in significantly, albeit modestly, improving diabetes control compared with a print intervention in a low-income, insured, minority population.
  Diabetes care 01/2011; 34(1):2-7. · 8.09 Impact Factor
• Article: Telephone outreach to increase colorectal cancer screening in an urban minority population.

  Charles E Basch, Randi L Wolf, Corey H Brouse, Celia Shmukler, Alfred Neugut, Lawrence T DeCarlo, Steven Shea
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  ABSTRACT: We compared the effectiveness of a telephone outreach approach versus a direct mail approach in improving rates of colorectal cancer (CRC) screening in a predominantly Black population. A randomized trial was conducted between 2000 and 2003 that followed 456 participants in the New York metropolitan area who had not had recent CRC screening. The intervention group received tailored telephone outreach, and the control group received mailed printed materials. The primary outcome was medically documented CRC screening 6 months or less after randomization. CRC screening was documented in 61 of 226 (27.0%) intervention participants and in 14 of 230 (6.1%) controls (prevalence rate difference=20.9%; 95% CI = 14.34, 27.46). Compared with the control group, the intervention group was 4.4 times more likely to receive CRC screening within 6 months of randomization. Tailored telephone outreach can increase CRC screening in an urban minority population.
  American Journal of Public Health 01/2007; 96(12):2246-53. · 3.93 Impact Factor
• Source

  Available from: aphapublications.org

  Article: Patient preferences and adherence to colorectal cancer screening in an urban population.

  Randi L Wolf, Charles E Basch, Corey H Brouse, Celia Shmukler, Steven Shea
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  ABSTRACT: We measured patient preferences for colorectal cancer (CRC) screening strategies and actual receipt of alternative CRC screening tests among an urban minority sample participating in an intervention study. The fecal occult blood test was the most preferred test, reportedly owing to its convenience and the noninvasive nature. For individuals who obtained a test that was other than their stated preference (41.1%), reasons for this discordance may be due to physician preferences that override patient preferences.
  American Journal of Public Health 06/2006; 96(5):809-11. · 3.93 Impact Factor
• Article: Barriers to colorectal cancer screening: an educational diagnosis.

  Corey H Brouse, Charles E Basch, Randi L Wolf, Celia Shmukler
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  ABSTRACT: Colorectal cancer (CRC) is a largely preventable disease through early detection and treatment, yet screening rates remain low and mortality rates remain high, particularly among low-income, minority populations. This study was conducted to identify barriers to CRC screening. Repeated telephone contacts were conducted with 226 individuals from 52 to 80 years of age, who had not recently received CRC screening. The contacts were intended to educate and encourage participants to obtain CRC screening. Within this context, CRC screening barriers were identified and categorized using an educational diagnosis as specified in the Precede-Proceed Framework. Findings showed that the most frequently observed barrier was lack of familiarity with CRC screening guidelines and tests. Availability and accessibility to screening tests was a barrier that was difficult to overcome for many participants. The majority of participants faced two or more barriers. This study suggests a need for public health education about CRC screening guidelines and tests and greater accessibility to CRC screening.
  Journal of Cancer Education 02/2004; 19(3):170-3. · 0.76 Impact Factor
• Source

  Available from: aphapublications.org

  Article: Barriers to colorectal cancer screening with fecal occult blood testing in a predominantly minority urban population: a qualitative study.

  Corey H Brouse, Charles E Basch, Randi L Wolf, Celia Shmukler, Alfred I Neugut, Steven Shea
  American Journal of Public Health 09/2003; 93(8):1268-71. · 3.93 Impact Factor