Rachel B. Issaka's research while affiliated with Fred Hutch Cancer Center and other places

... The study revealed that both age groups had a comparable occurrence of colon adenomas: 14% in the 40-49 age range and 16% in the 50-59 age range [33]. Recently published guidelines by the American Gastroenterological Association (AGA) recommend that individuals carrying mid-risk CRC probability should commence screening protocols at age 45, while individuals having exacerbated CRC risk due to first-degree relative/s developing CRC should commence screening protocols at least 10 years prior to age of CRC development within said relative, or commence screening at age 40 [34]. ...

... First, the response rate of 7.7% is low but is consistent with other studies distributed through large email contact lists without incentives for participation. [41,42] In addition, the representativeness of our sample size is limited by a lack of gender diversity, with no respondents reporting that they are nonbinary, as well as an overrepresentation of female and White respondents. Furthermore, several of our findings may be reflective of medical training more broadly and may not be unique to hepatology. ...

... A diverse medical and research workforce has been shown to drive innovation and improve access to high-quality, culturally competent patient-centered care for racial and ethnic minorities. 1,2 Further, diversity in academic medicine and clinical and translational science (CTS) may broaden the medical research agenda 3 , allow for more diverse clinical trial recruitment 4 , support institutional excellence 5,6 , and enhance education. 4 As such, diversity, equity, and inclusion (DEI) in CTS are paramount to driving science forward and increasing health equity. ...

... Presently, the quantity and quality of interventional studies addressing upstream social determinants of health in gastroenterology and hepatology are described as "grim." [4] There are many barriers to conducting research in this area: (1) the causal relationship between social determinants of health and liver disease is convoluted and complex, (2) in the short term, intervention leads to "soft" nonclinical outcomes (eg, reduced alcohol intake), (3) interventions are often multimorbidity focused, and (4) potential research participants are predominantly in the community rather than hospital settings-limiting the accessibility of the research population to predominantly hospital-based hepatologists. [3] An important additional contributory factor to this lack of evidence is our collective professional insistence on using clinical research methods to solve what are essentially public health problems. ...

... In this mixed-methods study we identified barriers to follow-up colonoscopy at the patient-level (e.g., declined colonoscopy and fear of colonoscopy), provider-level (e.g., not alerting patients of abnormal FIT results and attributing result to another cause), and system-level (e.g., colonoscopy scheduling challenges and COVID-19 procedures) for which there are practical solutions. For example, addressing logistical barriers to colonoscopy including transportation assistance at the patient-level (Bell-Brown et al., 2022), education about abnormal FIT follow-up in patients with a recent colonoscopy at the provider-level, and population health management tools that streamline FIT-based CRC screening at the health system-level, could lead to improvements in follow-up colonoscopy in safety-net systems. Determining which combination of interventions will most effectively improve colonoscopy completion after an abnormal FIT result and testing these interventions is an important next step. ...

... Following their training, many IMGs join the U.S. workforce through private practice, academia, the federal government, or a research facility [2,4,5]. Currently, 25% of the U.S. physician workforce are IMGs [6]. It has been predicted that by 2020-2025, there will be a shortage of 200,000 physicians in the U.S., resulting in a 20% gap in required healthcare coverage [7] that could potentially be filled by IMGs. ...

... These results contrast with the finding from prior research that higher household wealth increases utilization of preventive services such as CRC screening (Morales et al., 2004;Solmi et al., 2015). However, our findings do align with published studies suggesting that money is not a key determinant of having completed a CRC screening exam (Issaka & Dominitz, 2021;Levin, 2017). For example, offering a financial incentive to adults who are eligible for CRC screening has not been consistently found to increase screening uptake (Facciorusso et al., 2021), although larger incentives (e.g., $100) that offset some of the costs associated with screening may help to some degree compared with smaller incentives (e.g., $5, $10; Mehta et al., 2017). ...

... For our qualitative analysis, we applied a hybrid approach combining inductive and deductive methods (Hsieh and Shannon, 2005). We have described our process in detail elsewhere (Issaka et al., 2021), but in brief, two authors (RBI & ABB), developed an initial list of codes and definitions in a deductive fashion informed by the social cognitive theory. Then in an inductive approach, the coders independently reviewed a subset of the same interviews, created additional subcodes to reflect participants' responses, and compared common themes and relevant quotes to ensure intercoder reliability. ...

... At present, there is a lack of representation of female physicians in senior and leadership roles in gastroenterology that can only be addressed by support and promotion of current female faculty. Though cultural change will take time, active steps can be taken now to improve visibility of female physicians through their inclusion as speakers at conferences, on panels, editorial boards, authorship lists, and in leadership positions [4][5][6][7]. If young female trainees are aware of more female physicians' successes, they may retain faith that they, too, have a path to successful career in gastroenterology. ...

... They reported no statistically significant differences in endoscopy completion by sociodemographic factors but reported significant delays in procedure for screening purposes. 12 Therefore, as we move forward with new COVID-19 surges and variants, it is important to mobilize efforts, especially in vulnerable populations to reduce follow-up loss. ...