Access to and use of parks is associated with physical activity participation. Our Voice is a systematic method blending community-based participatory research (CBPR) and citizen science. As part of a comprehensive, mixed-methods study in St. Louis, Missouri (PARCS), we tested the feasibility of the Our Voice method for gathering community input on the barriers to and facilitators of accessibility and use of large metropolitan parks, by describing the implementation of the Our Voice method among recreational and commuter users of a large metropolitan park in St. Louis, MO. Due to challenges posed by COVID-19, the Our Voice methodology was adapted for remote participation. Twenty-three citizen scientists (14 recreational park users and 9 commuters) collected and analyzed geolocated route, photo, and audio or text data on facilitators and barriers to park use and access. They identified 6 priority themes and 12 solution ideas, and presented them to stakeholders. In contrast to previous Our Voice studies, separate user groups (recreation and commuter users) independently prioritized many of the same themes. Adaptation of the Our Voice protocol to virtual practices during COVID-19 revealed positive implications for cost, reach, and scale of studies grounded in CBPR and citizen science. We provide a set of recommended practices for using Our Voice as a method to evaluate and promote equity of access and use of metropolitan parks.
Between January 1990 and April 2001, 115 patients received high-dose chemotherapy (HDT) followed by autologous stem cell transplantation (ASCT) for relapsed or refractory Hodgkin lymphoma (HL). With a median follow-up of 58 months (range, 1 - 175 months), 5-year progression-free survival (PFS) and overall survival (OS) were 46% and 58%, respectively. Twelve patients with primary refractory disease had a 5-year PFS of 41% and OS of 58%, not significantly different from those of the remaining cohort. Early and overall regimen related mortality were 7% and 16%, respectively. Male gender (P = 0.04) and a time to relapse (TTR) < 12 months (P = 0.03) were associated with decreased OS by univariate analysis. In multivariate analysis, TTR < 12 months remained statistically significant (P = 0.04). We have confirmed that HDT and ASCT result in long-term survival for a proportion of patients with relapsed or refractory HL. All patients, including those with primary refractory disease, benefited from HDT and ASCT.
7552 Background: High dose chemotherapy (HDT) followed by autologous stem cell transplantation (ASCT) can produce long-term durable remissions in patients (PTS) with relapsed or refractory Hodgkin’s lymphoma (HL). We investigated whether previously reported prognostic factors could predict overall survival (OS) and progression free survival (PFS) in a modern cohort of PTS, and attempted to identify any subgroup with a particularly inferior survival. Methods: A retrospective chart review was performed on all PTS with relapsed or refractory HL who received HDT and ASCT at a single institution. Results: From 1990 to 2001, 115 PTS received HDT followed by ASCT for relapsed or refractory HL. 76/109 PTS (70%) had achieved a complete response to initial therapy. Median time from initial therapy to relapse (TTR) was 18 months (range, 0–220 months). 105 PTS (91%) received HDT with cyclophosphamide, BCNU, and VP-16. The source of stem cells was bone marrow in 68 PTS (59%) and peripheral blood in 47 PTS (41%). Five year PFS and OS were 46% and 58%, respectively, with a median follow-up of 58 months (range, 1–175 months). The five year PFS and OS of the 13 PTS (11%) with primary refractory disease was 39% and 54%, respectively, not significantly different. 59 PTS (51%) died after HDT and ASCT. The most common cause of death was relapsed HL. Regimen related mortality accounted for 8 deaths (7%). Male gender and TTR <12 months were associated with decreased OS by univariate analysis (P = 0.04 and P = 0.03, respectively). Similar, but non-significant trends were noted in PFS. In multivariate analysis, only TTR <12 months was associated with a statistically significant decrease in OS (P = 0.04). Five year OS for patients with TTR <12 and ≥12 months was 44% and 63%, respectively. Second malignancies occurred in 9 PTS (8%). The most common diagnosis was myelodysplastic syndrome/acute myelogenous leukemia [n = 6 (67%)]. Conclusions: We have confirmed that HDT and ASCT produces long-term PFS and OS in a proportion of PTS with relapsed or refractory HL. TTR <12 months was associated with a statistically significant decrease in OS by multivariate analysis; however, no group of PTS, including those with primary refractory disease, could be identified who did not benefit from HDT and ASCT. No significant financial relationships to disclose.
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