Jason Purnell

• PhD, MPH
• Professor (Associate) at Washington University in St. Louis

Civic education translates research evidence about topics of social importance for broad public audiences, with increased understanding and meaningful action of the desired outcomes. For the Sake of All is an example of civic education on the social determinants of health and health disparities situated in the local context of St. Louis, Missouri....

Life expectancy is lower and disease morbidity is higher in the United States than in other high-income countries.¹ This situation, decades old, is not for lack of skilled medical care; the United States has among the world’s best hospitals and technology. Nor is spending on health care inadequate; per capita health expenditures in the United State...

Among the challenges facing research translation-the effort to move evidence into policy and practice-is that key questions chosen by investigators and funders may not always align with the information priorities of decision makers, nor are the findings always presented in a form that is useful for or relevant to the decisions at hand. This disconn...

In light of the obesity epidemic, there is growing interest in the use of financial incentives for dietary behavior change. Previous reviews of the literature have focused on randomized controlled trials and found mixed results. The purpose of this systematic review is to update and expand on previous reviews by considering a broader range of study...

Persistent disparities in cancer screening by race/ethnicity and socioeconomic status require innovative prevention tools and techniques. Behavioral economics provides tools to potentially reduce disparities by informing strategies and systems to increase prevention of breast, cervical, and colorectal cancers. With an emphasis on the predictable, b...

Child Development Accounts (CDAs) aim to increase college completion rates among disadvantaged youth by helping youth see themselves as “college bound.” This article summarizes findings about the implementation and impacts of universal, progressive CDAs, with emphasis on outcomes for disadvantaged children. Data come from a large randomized experim...

The research community faces a growing need to deliver useful data and actionable evidence to support health systems and policymakers on ways to optimize the health of populations. Translating science into policy has not been the traditional strong suit of investigators, who typically view a journal publication as the endpoint of their work. They a...

Factors such as education, poverty, housing, and employment help shape the contexts in which individuals live their lives, with significant consequences for health. Policies related to these social determinants are one way to address disparities and can have substantial impact on preventing illness, injury, and premature death. This chapter include...

Objective: This article summarizes the design, implementation, and early findings of a statewide randomized experiment of Child Development Accounts (CDAs). The SEED for Oklahoma Kids experiment (SEED OK) is testing a concept for a universal, progressive asset-building policy with potential for national application. CDAs can start as early as birth...

The objective of this study was to examine workplace determinants of obesity and participation in employer-sponsored wellness programs among low-wage workers. We conducted key informant interviews and focus groups with 2 partner organizations: a health care employer and a union representing retail workers. Interviews and focus groups discussed work...

The public health burden and racial/ethnic, sex, and socioeconomic disparities in obesity and in diabetes require a population-level approach that goes beyond provision of high-quality clinical care. The Robert Wood Johnson Foundation's Commission to Build a Healthier America recommended 3 strategies for improving the nation's health: 1) invest in...

Background: African Americans bear disproportionate burdens of disease, disability, and death in St. Louis, Missouri. Health disparities are closely linked to social determinants of health (SDH) like education and income, but public understanding of these relationships remains limited. For the Sake of All is an ongoing community education project d...

Cancer treatment, including radiation therapy, can cause immediate side effects as well as persistent disruptions across several domains of functioning. Symptoms, and side effects related to radiation therapy should be conceptualized, assessed, and addressed as co-occurring rather than in isolation. Cancer-related fatigue and sleep problems associa...

The importance of sociocultural constructs as influences on cancer attitudes and screening has been established in the literature. This paper reports on the efforts to explore alternatives to sociocultural constructs previously associated with African-American cancer screening, but with low acceptance among community members or incomplete measureme...

Studies have consistently indicated that blacks report lower rates of depression than whites. This study examined the association between religion and depression and whether religion explained lower rates of depression among blacks compared to whites. Data were drawn from the National Survey of American Life, a multi-ethnic sample of African Americ...

Reviews the book, The Other Side of the Coin: The Psychological Implications of Microcredit edited by Luisa Brunori and Malcolm Pines (see record 2013-28862-000 ). An intervention that gives small business start-up loans to small groups of women in the developing world as a way to alleviate global poverty would certainly seem to have any number of...

Purpose Characterize mobile technology ownership, use, and relationship to self-reported cancer prevention behaviors and health status in a diverse, low-income sample of callers to 2-1-1. Design Secondary analyses of cross-sectional survey data from a larger trial collected from June 2010 to December 2012. Setting United Way Missouri 2-1-1 serves...

Breast cancer treatments (chemotherapy and hormone therapy) can cause a rapid loss in bone mineral density, leading to osteoporosis and fractures later in life. Fortunately, preventative measures (vitamin D, exercise, etc.) can delay bone loss if employed early enough. This study compares the prevalence of osteoporosis and osteoporosis-related disc...

Background: Connecting vulnerable populations to healthcare and health-related services remains a challenge. In San Diego County, California, many individuals are unaware that they are eligible for assistance, and community-based healthcare providers often do not have a single, reliable point of access for information on available programs. Purpose...

Background: Callers to 2-1-1 have greater need for and lesser use of cancer control services than other Americans. Integrating cancer risk assessment and referrals to preventive services into 2-1-1 systems is both feasible and acceptable to callers. Purpose: To determine whether callers will act on these referrals. Methods: In a randomized trial, 2...

The 2-1-1 system is a Federal Communications Commission nationally designated 3-digit telephone information and referral (IR track utilization of health services; and provide evidence-based information, referral, and behavioral interventions to vulnerable segments of the population. The papers in this supplement to the American Journal of Preventi...

Findings from community psychiatric epidemiologic studies have consistently indicated that blacks report lower rates of depression than whites. This paper considers whether these differences could, in part, be explained by subjective religiosity and church attendance. Data for this study were drawn from the National Survey of American Life, which i...

Innovative interventions are needed to connect underserved populations to cancer control services. With data from Missouri, North Carolina, Texas, and Washington this study a) estimated the cancer control needs of callers to 2-1-1, an information and referral system used by underserved populations, b) compared rates of need with state and national...

We examined the association between perceived discrimination and smoking status and whether psychological distress mediated this relationship in a large, multiethnic sample. We used 2004 through 2008 data from the Behavioral Risk Factor Surveillance System Reactions to Race module to conduct multivariate logistic regression analyses and tests of me...

OBJECTIVES: To evaluate the relationship of age with symptoms and interference with daily function and QOL during RT. DESIGN: A prospective observational study. SETTING: A university-based radiation oncology department. PARTICIPANTS: 903 cancer patients who received radiation therapy (RT). The mean age was 61 yrs (18-92) and 41% were ≥ 65 yrs. MEAS...

To characterize dyadic and general friendships of youth with spina bifida (SB). Families of youth with SB recruited a peer to participate; 106 dyads participated. Youth with SB and peers completed questionnaires and interviews regarding characteristics of the dyadic friendship and each individual's general friendships. Youth with SB and their peers...

The purposes of this review are to (1) describe recruitment and retention strategies for physical activity interventions focusing on underserved populations and (2) identify successful strategies which show the most promise for "best practices" recommendations to guide future research. The method used was systematic review. Data on recruitment and...

Patient navigation requires that patient load be equitably distributed. We examined whether navigators could predict the relative amount of time needed by different patients for navigation. Analysis of 139 breast and colorectal cancer patients randomized to the navigation arm of a trial evaluating the effectiveness of navigation. Navigators complet...

Vitamin D deficiency in the patients treated for breast cancer is associated with numerous adverse effects (bone loss, arthralgia, and falls). The first aim of this study was to assess vitamin D status, determined by 25-OH vitamin D levels, among women diagnosed with breast cancer according to demographic/clinical variables and bone mineral density...

Treatments for breast cancer, specifically hormonal therapy, accelerate bone loss (BL) among breast cancer survivors, leading to osteoporosis and an increase in fracture risk. Tai Chi Chuan (TCC) is a moderate form of weight-bearing exercise, equivalent to walking, and it has been shown to improve aerobic capacity and strength among breast cancer s...

9148 Background: Anxiety is prevalent among 18%-77% of cancer patients and is associated with increased insomnia, depression, fatigue and reduced quality of life. In a previous study, we found that gabapentin is effective in reducing hot flashes among cancer patients. Gabapentin is used for treatment of anxiety disorders but there is little scienti...

African American men have the highest rates of prostate cancer of any racial group, but very little is known about the psychological functioning of African American men in response to prostate cancer diagnosis and treatment. In this secondary analysis of a national trial testing a psychological intervention for prostate cancer patients, we report o...

Race/ethnicity and culture influence illness perceptions, health beliefs and behaviors, and communication with health care providers. However, information about the impact of race/ethnicity on the understanding of cancer diagnosis and treatment plan is limited. Nine hundred seventy-three cancer patients completed an information needs-assessment que...

Osteoporosis, a skeletal disorder characterized by a reduction in bone strength, increases fracture risk. Primary osteoporosis is usually a result of reduced bone mineral density as a consequence of natural aging. Secondary osteoporosis is usually a result of a disease, such as cystic fibrosis, or medical treatment, such as corticosteroids or cance...

The complexity of screening behavior and the numerous influences on adherence with recommendations raise a number of issues for understanding screening decisions and using that knowledge to inform interventions and public policy. Research to advance such understanding, such as that recommended in this commentary, is critical if we are to advance th...

Sleep disruption is prevalent in patients with cancer and survivors, but the prevalence of insomnia, a distressing sleep disorder, in these populations has yet to be determined in large-scale studies. A total of 823 patients with cancer receiving chemotherapy (mean age, 58 years; 597 female patients) reported on sleep difficulties in a prospective...

Background: The majority of recent, well-designed studies have shown that long-term cigarette smoking increases colorectal cancer risk, but older studies with shorter durations of exposure often found no association. This study aimed to examine colorectal cancer risk by smoking exposure using data collected in the late-1950s and early-1960s. Meth...

Models that explain preventive behaviors, such as colorectal cancer (CRC) screening, do not account for social and cultural factors relevant to African Americans. This exploratory study examined the relationship between socio-cultural factors (e.g., traditional acculturative strategy, group-based medical mistrust, physician ethnicity, and group-lev...

The type and quantity of information needed varies between patients who actively seek information and those who tend to avoid information.We analyzed data from a longitudinal study of adult cancer patients from outpatient clinics for whom information needs and behaviors were assessed by survey before and after treatment. We evaluated the relationsh...

5067 Background: African American (AA) men are nearly twice as likely as white (W) men to be diagnosed with prostate cancer. Cancer-related self-efficacy (i.e., confidence in one's ability to manage cancer) has been associated with better physical and psychosocial functioning, but little is known about self-efficacy in African American prostate can...

9610 Background: Weight-bearing exercise may slow the rate of bone loss associated with breast cancer treatment. The purpose of this study is to determine the effect of tai chi chuan (TCC) on bone health, as measured by the changes in the levels of bone resorption and bone formation. This study also aimed to investigate whether changes in bone heal...

9637 Background: Cancer patients suffer from significant psychological distress, including mood and anxiety disorders. Psychiatric disorders are common in cancer and affect 22 to 43% of cancer patients. We previously showed that Supportive Expressive Group Therapy (SET) was effective in reducing distress in women with metastatic breast cancer. The...

1550 Background: Low minority participation in clinical research is concerning for both research and for the public health. Objective: The aim of this project was to investigate barriers and successes in minority participation in cancer medical research and cancer clinical trials. More specifically to: (1) determine major environmental, cultural, a...

Previous studies have shown that acupressure bands can reduce chemotherapy-related nausea. Patients' expectations of efficacy account for part of this outcome. We conducted a three-arm randomized clinical trial to investigate the effectiveness of acupressure bands in controlling radiation therapy-induced nausea and to test whether an informational...

Religion and spirituality are resources regularly used by patients with cancer coping with diagnosis and treatment, yet there is little research that examines these factors separately. This study investigated the relationships between religious practice and spirituality and quality of life (QoL) and stress in survivors of breast cancer. The sample...

Cancer-related fatigue is the most common side effect reported by cancer patients during and after treatment. Cancer-related fatigue significantly interferes with a patient's ability to perform activities of daily living and maintain functional independence and quality of life. Cancer-related fatigue can also interfere with a patient's ability to c...

5163 Background: African American (AA) men continue to bear a disproportionate burden of prostate cancer relative to White (W) men, making it important to monitor their response to disease and subsequent treatment. This study compared AA and W ratings of the extent to which prostate cancer and its treatment interfered with several domains of daily...

Meaning in life is a multi-faceted construct that has been conceptualized in diverse ways. It refers broadly to the value and purpose of life, important life goals, and for some, spirituality. We developed a measure of meaning in life derived from this conceptualization and designed to be a synthesis of relevant theoretical and empirical traditions...

The purpose of this chapter is to present a strategy and model for implementing the Multicultural Guidelines as they relate to appreciating the role of indigenous healing practices. Specifically, we are proposing an interrogation of core beliefs (ICB) strategy, which can help ensure that the pitfalls of culturally incongruent and insensitive care a...

Abstract Meaning in life is a multi-faceted construct that has been conceptualized in diverse ways. It refers broadly to the value and purpose of life, important life goals, and for some, spirituality.

Abstract: Colorectal cancer is the third leading cause of cancer death for African Americans, but screening consistent with American Cancer Society guidelines remains underutilized. Many of the theoretical models currently used to explain preventive health behavior do not include social and cultural factors relevant to this population, such as adop...

Thesis (M.S.)--University of Rochester. School of Medicine and Dentistry. Dept. of Community & Preventive Medicine, 2009. Prostate cancer is the most commonly diagnosed cancer among men in the United States, and African American men have the highest prostate cancer rates in the world. Several studies have reported poorer health-related quality of l...