Isaac M. Lipkus

Duke University, Durham, North Carolina, United States

Are you Isaac M. Lipkus?

Claim your profile

Publications (52)184.82 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Cigarette smoking is a leading cause of preventable mortality. Mobile technologies, including text messaging, provide opportunities to promote quitting. Many text messaging-based cessation interventions contain content created by experts. However, smokers may be best persuaded by receipt of text messages they created based on their reasons for quitting, assisted or not by a motivational facilitator. This study assessed the feasibility and participants' evaluation of two ways to self-generate smoking cessation messages delivered via cell-phone. Methods: We enrolled smokers (N=24) and randomized them to: (1) behavioral counseling assistance plus self-generated messages, or (2) self-generated messages only. Both groups wrote: (1) their reasons for wanting to quit and then (2) text messages related to their reason(s) for quitting, Messages were delivered as text messages as well as with a link to verbatim self-recorded audio message for 10 days. At follow-up, participants evaluated the intervention. Results: Participants composed and recorded messages and evaluated them and the intervention favorably. The counseling+message group wrote an average of 7.66 [SD=4.86] text messages while the message-only wrote an average of 6.66 [SD=2.93] messages. Most participants felt that the messages were of appropriate length, including the frequency and timing of message delivery. Conclusion: It is feasible for smokers to self-generate motivational text and audio messages concerning reasons for quitting, even among smokers without an immediate desire to quit. Participants evaluated the messages and intervention favorably. Future research should test self-generated messages in larger trials of self- vs. expert-generated message.
    No preview · Article · Dec 2015 · Nicotine & Tobacco Research
  • Darren Mays · Kenneth P. Tercyak · Isaac M. Lipkus
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: This study investigated the immediate effects of brief education messages delivered online about harms and addictiveness of waterpipe tobacco use among young adult waterpipe users ages 18 to 30 years. Methods: Participants (n = 327, mean age 24.8 years, 62.1% male, 77.6% white, 67.8% used waterpipe monthly, 26.4% weekly, 5.8% daily) were recruited online and randomized to one of three experimental conditions: (1) Control condition viewing no messages; (2) Harms condition viewing messages about harms of waterpipe tobacco; (3) Harms and addiction condition viewing messages about harms and addictiveness of waterpipe tobacco. Outcomes included perceived harm and addictiveness of waterpipe, worry about harm and addiction, and desire to quit. Results: Compared to the control condition, participants in the harms condition reported significantly greater perceived harm and addictiveness of waterpipe relative to cigarettes, perceived risk of harm and addiction, worry about harm and addiction, and desire to quit. There were few significant differences in these outcomes between participants in the harms condition and the harms and addiction condition. Mediation analyses suggest waterpipe tobacco use harm messages may increase desire to quit by producing greater worry about harm and addiction. Conclusions: Brief education messages about waterpipe tobacco use harm increased young adult's perceptions of harm and addictiveness of waterpipe tobacco use and generated stronger desire to quit. The waterpipe tobacco use addiction messages tested had little added impact. Studies should prospectively examine the real-world impact of waterpipe tobacco use harm messages and investigate more effective strategies for designing addiction messages.
    No preview · Article · Oct 2015 · Nicotine & Tobacco Research
  • [Show abstract] [Hide abstract]
    ABSTRACT: Prostate cancer may affect quality of life in men diagnosed as well as their spouses. Changes in health may disrupt the couple's relationship functioning which disrupts recovery. This study examined how mental and physical health relates to relationship satisfaction for couples at diagnosis through the year following treatment. Patients with stage I-II prostate cancer and their spouses (N = 159 couples) were recruited from a urology clinic and completed questionnaires at diagnosis, 1 month, 6 months, and 12 months post prostatectomy on demographics, mental and physical health quality of life, and relationship satisfaction. The Actor-Partner Interdependence Model was employed to examine effects of each partners' mental and physical health on their own and their partner's relationship satisfaction. Patients and spouses had declined mental and physical health at 1 month post-surgery. Health improved at 6 and 12 months but did not fully return to pre-surgery levels. Actor effects showed that patient's physical health consistently predicted own relationship satisfaction. Both patient's and spouse's mental health consistently related to their own relationship satisfaction. Partner effects showed that patient's and spouse's physical health had an effect on each other's relationship satisfaction at 1 month. Spouse's mental health predicted patient's relationship satisfaction throughout the year following treatment. The effects of patient and spouse mental and physical health quality of life on their own as well as their partner's relationship satisfaction differed across time which will inform psychosocial interventions for couples with prostate cancer. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
    No preview · Article · Aug 2015 · Psycho-Oncology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this work is to advance knowledge of how to measure gist and verbatim understanding of risk magnitude information and to apply this knowledge to address whether graphics that focus on the number of people affected (the numerator of the risk ratio, i.e., the foreground) are effective displays for increasing (a) understanding of absolute and relative risk magnitudes and (b) risk avoidance. In 2 experiments, the authors examined the effects of a graphical display that used icons to represent the foreground information on measures of understanding (Experiments 1 and 2) and on perceived risk, affect, and risk aversion (Experiment 2). Consistent with prior findings, this foreground-only graphical display increased perceived risk and risk aversion; however, it also led to decreased understanding of absolute (although not relative) risk magnitudes. Methodologically, this work shows the importance of distinguishing understanding of absolute risk from understanding of relative risk magnitudes, and the need to assess gist knowledge of both types of risk. Substantively, this work shows that although using foreground-only graphical displays is an appealing risk communication strategy to increase risk aversion, doing so comes at the cost of decreased understanding of absolute risk magnitudes.
    Full-text · Article · Jun 2015 · Journal of Health Communication
  • Source
    [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.
    Full-text · Article · Jan 2015 · Journal of Health Psychology
  • Source
    [Show abstract] [Hide abstract]
    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.
    Full-text · Article · Jul 2014 · Genome Medicine
  • Source
    [Show abstract] [Hide abstract]
    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.
    Full-text · Article · May 2014
  • Source
    [Show abstract] [Hide abstract]
    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.
    Full-text · Article · Nov 2013 · BMC Medical Informatics and Decision Making
  • [Show abstract] [Hide abstract]
    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.
    No preview · Article · Sep 2013 · The American journal of medicine
  • Isaac M Lipkus · Krista W Ranby · Megan A Lewis · Benjamin Toll
    [Show abstract] [Hide abstract]
    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.
    No preview · Article · Aug 2013 · Nicotine & Tobacco Research
  • Source
    [Show abstract] [Hide abstract]
    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.
    Full-text · Article · May 2013
  • [Show abstract] [Hide abstract]
    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.
    No preview · Article · Sep 2012 · Nicotine & Tobacco Research
  • Sb Haga · Jm O'Daniel · Gm Tindall · R Mills · I Lipkus · R Agans

    No preview · Article · Apr 2012 · Clinical Genetics
  • S S Haga · J M O'Daniel · G M Tindall · R Mills · I M Lipkus · R Agans
    [Show abstract] [Hide abstract]
    ABSTRACT: Haga SB, O’Daniel JM, Tindall GM, Mills R, Lipkus IM, Agans R. Survey of genetic counselors and clinical geneticists' use and attitudes toward pharmacogenetic testing. 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.
    No preview · Article · Jan 2012 · Clinical Genetics
  • [Show abstract] [Hide abstract]
    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.
    No preview · Article · Nov 2011 · Gastrointestinal endoscopy
  • Source
    [Show abstract] [Hide abstract]
    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.
    Full-text · Article · Jul 2011 · Public Health Genomics

  • No preview · Article · May 2010 · Gastroenterology

  • No preview · Article · Jan 2010 · Cancer Prevention Research
  • Isaac M. Lipkus
    [Show abstract] [Hide abstract]
    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.
    No preview · Article · Jan 2010
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: 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 the public health goal of using screening to reduce cancer mortality.
    Full-text · Article · Nov 2009 · Cancer Epidemiology Biomarkers & Prevention

Publication Stats

3k Citations
184.82 Total Impact Points


  • 1999-2015
    • Duke University
      • • School of Nursing
      • • Department of Surgery
      • • Department of Medicine
      Durham, North Carolina, United States
  • 1993-2009
    • Duke University Medical Center
      • • Department of Psychiatry and Behavioral Science
      • • Duke Comprehensive Cancer Center
      • • Department of Psychiatry
      Durham, North Carolina, United States
  • 1995
    • University of Wisconsin - Whitewater
      • Department of Psychology
      Whitewater, WI, United States