I M Lipkus

Duke University, Durham, North Carolina, United States

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Publications (40)146.68 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Support from close others predicts smoking abstinence, yet little research has investigated what factors promote support. This study investigates predictors of support for a quit attempt. Partners of smokers (N = 131) reported their relationship quality, concern for partner's health, own smoking status, and intended support for a quit attempt. Smokers were less supportive than were nonsmokers. Relationship quality, concern for partners' health, and motivation to quit were positively associated, and nicotine dependence was negatively associated, with intended support. The findings suggest that support for smoking cessation depends on one's own smoking behaviors as well as characteristics of the relationship. © The Author(s) 2015.
    Journal of Health Psychology 01/2015; DOI:10.1177/1359105314567209 · 1.22 Impact Factor
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    ABSTRACT: With the emergence of electronic medical records and patient portals, patients are increasingly able to access their health records, including laboratory reports. However, laboratory reports are usually written for clinicians rather than patients, who may not understand much of the information in the report. While several professional guidelines define the content of test reports, there are no guidelines to inform the development of a patient-friendly laboratory report. In this Opinion, we consider patient barriers to comprehension of lab results and suggest several options to reformat the lab report to promote understanding of test results and their significance to patient care, and to reduce patient anxiety and confusion. In particular, patients' health literacy, genetic literacy, e-health literacy and risk perception may influence their overall understanding of lab results and affect patient care. We propose four options to reformat lab reports: 1) inclusion of an interpretive summary section, 2) a summary letter to accompany the lab report, 3) development of a patient user guide to be provided with the report, and 4) a completely revised patient-friendly report. The complexity of genetic and genomic test reports poses a major challenge to patient understanding that warrants the development of a report more appropriate for patients.
    Genome Medicine 07/2014; 6(7):58. DOI:10.1186/s13073-014-0058-6 · 4.94 Impact Factor
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    ABSTRACT: Providing smokers feedback using epigenetic markers of lung cancer risk has yet to be tested as a strategy to motivate smoking cessation. Epigenetic modification of Rb-p16 (p16) due to tobacco exposure is associated with increased risk of developing lung cancer. This study examined the acceptance of testing for methylated p16 and the understanding of test results in smokers at risk for development of lung cancer. Thirty-five current smokers with airways obstruction viewed an educational presentation regarding p16 function followed by testing for the presence of methylated p16 in sputum. Participants were offered smoking cessation assistance and asked to complete surveys at the time of enrolment regarding their understanding of the educational material, perception of risk associated with smoking and desire to quit. Participants were notified of their test result and follow-up surveys were administered 2 and 10 weeks after notification of their test result. Twenty per cent of participants had methylated p16. Participants showed high degree of understanding of educational materials regarding the function and risk associated with p16 methylation. Sixty-seven per cent and 57% of participants with low-risk and high-risk test results, respectively, reported that the information was more likely to motivate them to quit smoking. Smoking cessation rates were similar between methylated and non-methylated participants. Testing for an epigenetic marker of lung cancer risk is accepted and understood by active smokers. A low-risk test result does not decrease motivation to stop smoking. NCT01038492.
    05/2014; 1(1):e000032. DOI:10.1136/bmjresp-2014-000032
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    ABSTRACT: Making evidence-based decisions often requires comparison of two or more options. Research-based evidence may exist which quantifies how likely the outcomes are for each option. Understanding these numeric estimates improves patients' risk perception and leads to better informed decision making. This paper summarises current "best practices" in communication of evidence-based numeric outcomes for developers of patient decision aids (PtDAs) and other health communication tools. An expert consensus group of fourteen researchers from North America, Europe, and Australasia identified eleven main issues in risk communication. Two experts for each issue wrote a "state of the art" summary of best evidence, drawing on the PtDA, health, psychological, and broader scientific literature. In addition, commonly used terms were defined and a set of guiding principles and key messages derived from the results. The eleven key components of risk communication were: 1) Presenting the chance an event will occur; 2) Presenting changes in numeric outcomes; 3) Outcome estimates for test and screening decisions; 4) Numeric estimates in context and with evaluative labels; 5) Conveying uncertainty; 6) Visual formats; 7) Tailoring estimates; 8) Formats for understanding outcomes over time; 9) Narrative methods for conveying the chance of an event; 10) Important skills for understanding numerical estimates; and 11) Interactive web-based formats. Guiding principles from the evidence summaries advise that risk communication formats should reflect the task required of the user, should always define a relevant reference class (i.e., denominator) over time, should aim to use a consistent format throughout documents, should avoid "1 in x" formats and variable denominators, consider the magnitude of numbers used and the possibility of format bias, and should take into account the numeracy and graph literacy of the audience. A substantial and rapidly expanding evidence base exists for risk communication. Developers of tools to facilitate evidence-based decision making should apply these principles to improve the quality of risk communication in practice.
    BMC Medical Informatics and Decision Making 11/2013; 13 Suppl 2(Suppl 2):S7. DOI:10.1186/1472-6947-13-S2-S7 · 1.50 Impact Factor
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    ABSTRACT: Using regulatory focus theory, an intervention of daily weight loss-sustaining messages was developed and tested for acceptability, feasibility, and efficacy on helping people sustain weight loss. Participants (n = 120) were randomized to a promotion, prevention, or an attention-control text message group after completion of a weight loss program. Participants completed baseline assessments, and reported their weight at 1 and 3 months postbaseline. Participants found the message content and intervention acceptable and valuable. A minimum of one message per day delivered at approximately 8:00 am was deemed the optimal delivery time and frequency. The sustained weight loss rate at month 3 for the control, promotion, and prevention groups was 90%, 95%, and 100%, respectively. Medium-to-large effects were observed for the promotion and prevention groups at month 1 and for prevention at month 3 relative to controls. The mean weight loss for promotion and prevention was 15 pounds, compared with 10 in the controls at month 3. A clinically significant decrease in mean weight, higher rate of sustained weight loss, and medium-to-large effects on sustained weight loss occurred in the promotion and prevention interventions. Tools such as this text message-based intervention that are constructed and guided by evidence-based content and theoretical constructs show promise in helping people sustain healthy behaviors that can lead to improved health outcomes.
    The American journal of medicine 09/2013; 126(11). DOI:10.1016/j.amjmed.2013.07.001 · 5.30 Impact Factor
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    ABSTRACT: Couples in which both members smoke (dual-smoker couples) have not been the explicit target of cessation interventions. Quit rates are lower and relapse rates are higher among individuals in dual-smoker couples. A potentially effective strategy to motivate dual-smoker couples to quit is to convey messages that highlight how the positive outcomes of quitting (gain frame) or the negative outcomes of continued smoking (loss frame) affect the couple rather than the individual smoker. We explored whether dual-smoker couples' smoking behaviors (e.g., amount smoked) and desire to quit would differ as a function of message frame (gain vs. loss) or outcome focus (individual vs. couple). Dual-smoker couples (N = 40) completed a baseline survey and were then randomized to review gain- or loss-framed messages that varied whether the outcomes influenced the individual or the couple. Main outcomes were desire to quit after reading messages and smoking behaviors at a 1-month follow-up. Couple-focused messages produced the strongest desire to quit and decreased amount of cigarettes smoked at follow-up. The latter effect was mediated by desire to quit. Loss-framed messages produced inconsistent effects on desire to quit. There were no significant interactions between outcome focus and message framing. Findings suggest that messages emphasizing how smoking affects both partners can motivate cessation among dual-smoker couples. Contrary to findings showing that gain-framed messages motivate cessation targeting individual smokers, results suggest that loss-framed messages may be more persuasive than gain-framed messages when the target of the outcome involves significant others.
    Nicotine & Tobacco Research 08/2013; DOI:10.1093/ntr/ntt091 · 2.81 Impact Factor
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    ABSTRACT: Background: Mobile phone short message service (SMS) text messaging, has the potential to serve as an intervention medium to promote sustainability of weight loss that can be easily and affordably used by clinicians and consumers.
    01/2013; 1(1):e5. DOI:10.2196/mhealth.2343
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    ABSTRACT: INTRODUCTION: Quit rates are lower and relapse rates are higher for people in close relationships with a partner who smokes. Although desire to quit is often related to health concerns for one's self, much less is known about psychosocial factors associated with quitting in dual-smoker couples. This study investigated relations among beliefs about smoking and desire to quit from both partners' perspectives. METHODS: We recruited 63 couples in which both partners smoke daily. Participants were aged 21-67 (M = 43.0, SD = 11.3) and had been smoking for 4-51 years (M = 22.9, SD = 11.3). RESULTS: Individuals' desire to quit related to worry about partner's health (r = .29, p < .01), perceived risk of partner getting a disease if the partner continues to smoke (r = .39, p < .001), and belief that own smoking has caused partner physical harm (r = .38, p < .001). Within couples, partners were modestly concordant with regard to worry about harm of smoking for oneself (r = .30, p < .05) and partner (r = .30, p < .05), perceived risk of disease for oneself (r = .26, p < .05) and partner (r = .24, p < .05), and desire that partner quit (r = .34, p < .01). Participants had an extremely strong desire (78% = 7 on 1-7 scale) for their partner's help if they attempt to quit.Conclusions:Dual-smoker couples are at heightened health risks due to exposure to passive smoke and their own smoking. Partners' perceived risk and worry about the harms of smoking could be important leverage points for smoking cessation efforts. Interventions can be informed by considering both partners' beliefs and by helping partners develop plans for quitting and supporting each other.
    Nicotine & Tobacco Research 09/2012; 15(3). DOI:10.1093/ntr/nts210 · 2.81 Impact Factor
  • Clinical Genetics 04/2012; 82(2):203. DOI:10.1111/j.1399-0004.2012.01874.x · 3.65 Impact Factor
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    ABSTRACT: Pharmacogenetic (PGx) testing aims to improve therapeutic outcomes through tailoring treatment based on a patient's genetic risk for non-response and/or an adverse event. Given their expertise, geneticists could facilitate the use of PGx testing; however, the preparedness and perceived role of the clinical genetics community is unclear. To assess the attitudes, preparedness, and perceived roles of geneticists in the delivery of PGx testing, we conducted a survey of 1500 randomly selected board-certified genetic counselors and clinical geneticists in the United States [response rate: 37.8% (n = 516)]. Twelve percent of genetic counselors and 41% of clinical geneticists indicated that they had ordered or coordinated patient care for PGx testing, a seemingly high proportion at this early stage of adoption. Almost all respondents had some education on pharmacogenetics, although only 28% of counselors and 58% of clinical geneticists indicated they felt well-informed about PGx testing. About half of counselors (52%) and clinical geneticists (46%) felt they would play 'some' role in the delivery of PGx testing; 17 and 19%, respectively, felt that they would play 'no' or 'a little' role. At this early stage of PGx testing, the role of geneticists and genetic counselors is unclear. However, their experience may aid in readying PGx testing and informing delivery strategies into clinical practice.
    Clinical Genetics 01/2012; 82(2):115-20. DOI:10.1111/j.1399-0004.2012.01848.x · 3.65 Impact Factor
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    ABSTRACT: Guidelines suggest that patients with nondysplastic Barrett's esophagus (BE) undergo endoscopic surveillance every 3 to 5 years, but actual use of surveillance endoscopy and the determinants of variation in surveillance intervals are not known. To measure use of surveillance endoscopy and its variation in patients with nondysplastic BE. Multicenter, cross-sectional study. Three sites in Arizona, Minnesota, and North Carolina. This study involved patients who had prevalent BE without a history of high-grade dysplasia or esophageal adenocarcinoma. Participants were given validated measures of quality of life, numeracy, and cancer risk perception, and the total number of prior endoscopic surveillance examinations was measured. Oversurveillance was defined as >1 surveillance examination per 3-year period. Among 235 patients with nondysplastic BE, 76% were male and 94% were white. The average (± standard deviation [SD]) duration of BE was 6.5 ± 5.9 years. The mean (± SD) number of endoscopies per 3-year period was 2.7 ± 2.6. Oversurveillance was present in 65% of participants, resulting in a mean of 2.3 excess endoscopies per patient. Neither numeracy skills nor patient perception of cancer risk were associated with oversurveillance. Endoscopies were measured by patient report, which is subject to error. Results may be generalizable only to patients seen in academic centers. Most patients with nondysplastic BE had more surveillance endoscopic examinations than is recommended by published guidelines. Patient factors did not predict oversurveillance, indicating that other factors may influence decisions about the interval and frequency of surveillance examinations.
    Gastrointestinal endoscopy 11/2011; 75(1):23-31.e2. DOI:10.1016/j.gie.2011.08.042 · 4.90 Impact Factor
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    ABSTRACT: Genomic research is transforming our understanding of the role of genes in health and disease. These advances, and their application to common diseases that affect large segments of the general population, suggest that researchers and practitioners in public health genomics will increasingly be called upon to translate genomic information to individuals with varying levels of health literacy and numeracy. This paper discusses the current state of research regarding public understanding of genetics and genomics, the influence of health literacy and numeracy on genetic communication, and behavioral responses to genetic and genomic information. The existing research suggests that members of the general public have some familiarity with genetic and genomic terms but have gaps in understanding of underlying concepts. Findings from the limited research base to date indicate that health literacy affects understanding of print and oral communications about genetic and genomic information. Numeracy is also likely to be an important predictor of being able to understand and apply this information, although little research has been conducted in this area to date. In addition, although some research has examined behavior change in response to the receipt of information about genetic risk for familial disorders and genomic susceptibility to common, complex diseases, the effects of health literacy and numeracy on these responses have not been examined. Potential areas in which additional research is needed are identified and practical suggestions for presenting numeric risk information are outlined. Public health genomics researchers and practitioners are uniquely positioned to engage in research that explores how different audiences react to and use genomic risk information.
    Public Health Genomics 01/2011; 14(4-5):279-89. DOI:10.1159/000294191 · 2.46 Impact Factor
  • Gastroenterology 05/2010; 138(5). DOI:10.1016/S0016-5085(10)61525-9 · 13.93 Impact Factor
  • Isaac M. Lipkus
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    ABSTRACT: With the mapping of the human genome and the rapid discovery and application of new technologies, recent years have brought about unprecedented advances in genetics and genomics, the latter being defined as “the study not just of single genes, but of the functions and interactions of all the genes in the genome” (Guttmacher & Collins, 2002, p. 1512). In the foreseeable future, it is expected that predictive genetic tests will be available for as many as a dozen common conditions (Collins & McKusick, 2001). For example, strides have been made in the discovery of genetic and genomic markers for such diseases as asthma, diabetes, certain cancers, and heart disease (Altshuler et al., 2000; Bell, 2004; Bottini, Musumeci, Alonso, Rahmouni, Nika et al., 2004; Malerba & Pignatti, 2005; Ober & Hoffjan, 2006; Palma, Ristori, Ricevuto, Giannini, & Gulino, 2006; Sogaard, Kjaer, & Gayther, 2006; Wooster et al., 1994). Results of genetic testing for these common disorders will be used to inform, often in individuals with family histories of the disorder, their chance of developing the disease and as a consequence what steps can be taken, if any, to minimize or eliminate future harm.
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    Cancer Epidemiology Biomarkers & Prevention 11/2009; 18(11):3133-7. DOI:10.1158/1055-9965.EPI-18-11-ASPO · 4.32 Impact Factor
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    C M McBride, K M Emmons, I M Lipkus
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    ABSTRACT: The label 'teachable moment' (TM) has been used to describe naturally occurring health events thought to motivate individuals to spontaneously adopt risk-reducing health behaviors. This manuscript summarizes the evidence of TMs for smoking cessation, and makes recommendations for conceptual and methodological refinements to improve the next generation of related research. TM studies were identified for the following event categories: office visits, notification of abnormal test results, pregnancy, hospitalization and disease diagnosis. Cessation rates associated with pregnancy, hospitalization and disease diagnosis were high (10-60 and 15-78%, respectively), whereas rates for clinic visits and abnormal test results were consistently lower (2-10 and 7-21%, respectively). Drawing from accepted conceptual models, a TM heuristic is outlined that suggests three domains underlie whether a cueing event is significant enough to be a TM for smoking cessation: the extent to which the event (1) increases perceptions of personal risk and outcome expectancies, (2) prompts strong affective or emotional responses, and (3) redefines self-concept or social role. Research in TMs could be improved by giving greater attention to assessment of conceptually grounded cognitive and emotional variables, appropriately timed assessment and intervention, and inclusion of appropriate target and comparison samples.
    Health Education Research 05/2003; 18(2):156-70. DOI:10.1093/her/18.2.156 · 1.66 Impact Factor
  • Journal of Marketing Research 02/2003; 40(1):54-64. DOI:10.1509/jmkr.40.1.54.19133 · 2.52 Impact Factor
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    ABSTRACT: To update an evidence-based technology assessment of chemoprevention strategies for breast cancer risk reduction. POTENTIAL INTERVENTIONS: Tamoxifen, raloxifene, aromatase inhibition, and fenretinide. Outcomes of interest include breast cancer incidence, breast cancer-specific survival, overall survival, and net health benefit. A comprehensive, formal literature review was conducted for relevant topics. Testimony was collected from invited experts and interested parties. The American Society of Clinical Oncology (ASCO) prescribed technology assessment procedure was followed. More weight was given to published randomized trials. BENEFITS/HARMS: A woman's decision regarding breast cancer risk reduction strategies is complex and will depend on the importance and weight attributed to information regarding both cancer- and noncancer-related risks and benefits. For women with a defined 5-year projected breast cancer risk of > or= 1.66%, tamoxifen (at 20 mg/d for 5 years) may be offered to reduce their risk. Risk/benefit models suggest that greatest clinical benefit with least side effects is derived from use of tamoxifen in younger (premenopausal) women (who are less likely to have thromboembolic sequelae and uterine cancer), women without a uterus, and women at higher breast cancer risk. Data do not as yet suggest that tamoxifen provides an overall health benefit or increases survival. In all circumstances, tamoxifen use should be discussed as part of an informed decision-making process with careful consideration of individually calculated risks and benefits. Use of tamoxifen combined with hormone replacement therapy or use of raloxifene, any aromatase inhibitor or inactivator, or fenretinide to lower the risk of developing breast cancer is not recommended outside of a clinical trial setting. This technology assessment represents an ongoing process and recommendations will be updated in a timely matter. The conclusions were endorsed by the ASCO Health Services Research Committee and the ASCO Board of Directors.
    Journal of Clinical Oncology 08/2002; 20(15):3328-43. DOI:10.1200/JCO.2002.06.029 · 17.88 Impact Factor
  • RA Keller, IM Lipkus, BK Rimer
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    ABSTRACT: We examine the role of level of depression on updating of health-related risk estimates. Participants provided their risk of getting breast cancer before (baseline) and after (follow-up) receiving personalized (experiment 1) or standard (experiment 2) medical risk feedback. Although there were no significant differences in risk estimates at baseline, the follow-up risk estimates indicate that compared to nondepressives, depressives lowered their risk estimates such that they were more accurate or closer to the medical estimates provided in the risk feedback. In contrast to depressives, nondepressives with higher baseline risk estimates did not revise their follow-up risk estimates because they were in a positive mood after receiving the risk feedback.
    Journal of Consumer Research 06/2002; 29(1):57-69. · 3.10 Impact Factor
  • I M Lipkus, W M Klein, B K Rimer
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    ABSTRACT: Using a pre-post test design with a baseline, laboratory, and a 6-month follow-up, we communicated women's objective breast cancer risks, based on the Gail Model, using two formats: (a) range of risks (e.g., risk of breast cancer can be as low as 1% and as high as 5%); and (b) as a point estimate (e.g., your risk of breast cancer is 3%). We examined how these presentations individually and jointly affected women's perceived lifetime breast cancer risks. Overall, providing risk estimates either as a range of risks or as a point estimate lowered women's perceived lifetime risks compared with women who did not get information presented this way shortly after receipt of this information relative to baseline. At the 6-month follow-up, perceptions of lifetime risks generally returned to their baseline values. Overall, women viewed their risk feedback, whether presented as a point estimate or as a range of risks, as equally credible, trustworthy, accurate, and personally relevant. These results suggest that women evaluate risk feedback containing either point estimates or range of risks as equally acceptable. Both formats lead to short-term reductions in perceived risk (i.e., greater accuracy).
    Cancer Epidemiology Biomarkers & Prevention 09/2001; 10(8):895-8. · 4.32 Impact Factor

Publication Stats

2k Citations
146.68 Total Impact Points

Institutions

  • 2001–2015
    • Duke University
      • Department of Surgery
      Durham, North Carolina, United States
  • 1997–2009
    • Duke University Medical Center
      • • Department of Psychiatry and Behavioral Science
      • • Department of Psychiatry
      • • Duke Comprehensive Cancer Center
      Durham, North Carolina, United States
  • 1999
    • National Cancer Institute (USA)
      • Division of Cancer Control and Population Sciences
      Bethesda, MD, United States